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Title II — Training and Hiring of Health Care Staff

S. 2450 · 113th Congress · Jun 9, 2014 · Lineage

II Training and Hiring of Health Care Staff

Sec. 201 Treatment of staffing shortage and biannual report on staffing of medical facilities of the Department of Veterans Affairs

(a)
Staffing shortage—
(1)
In general— Not later than 180 days after the date of the enactment of this Act, and not later than September 30 each year thereafter, the Inspector General of the Department of Veterans Affairs shall determine, and the Secretary of Veterans Affairs shall publish in the Federal Register, the five occupations of health care providers of the Department of Veterans Affairs for which there is the largest staffing shortage throughout the Department.
(2)
Recruitment and appointment— Notwithstanding sections 3304 and 3309 through 3318 of title 5, United States Code, the Secretary may, upon a determination by the Inspector General under paragraph (1) that there is a staffing shortage throughout the Department with respect to a particular occupation of health care provider, recruit and directly appoint highly qualified health care providers to serve as health care providers in that particular occupation for the Department.
(3)
Priority in Health Professionals Educational Assistance Program to certain providers— Section 7612(b)(5) of title 38, United States Code, is amended—
(A)
in subparagraph (A), by striking “and” at the end;
(B)
by redesignating subparagraph (B) as subparagraph (C); and
(C)
by inserting after subparagraph (A) the following new subparagraph (B):

“(B) shall give priority to applicants pursuing a course of education or training towards a career in an occupation for which the Secretary has, in the most current determination published in the Federal Register pursuant to section 201(a)(1) of the Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014, determined that there is one of the largest staffing shortages throughout the Department with respect to such occupation; and”

(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 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 assessing 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 assessment 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 panels.
(iv)
Appropriate numbers of full-time staff, or full-time equivalents, dedicated to direct care of patients.
(v)
Appropriate physical plant space to meet the capacity needs of the Department in that area.
(vi)
Such other factors as the Secretary considers necessary.
(B)
A plan for addressing any issues identified in the assessment described in subparagraph (A), including a timeline for addressing such issues.
(C)
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)
Such other clinics as the Secretary considers appropriate.
(D)
A description of the results of the most current determination of the Inspector General under paragraph (1) of subsection (a) and a plan to use direct appointment authority under paragraph (2) of such subsection to fill staffing shortages, including recommendations for improving the speed at which the credentialing and privileging process can be conducted.
(E)
The current staffing models of the Department for the following clinics, including recommendations for changes to such models:
(i)
Mental health.
(ii)
Primary care.
(iii)
Gastroenterology.
(iv)
Women’s health.
(v)
Such other clinics as the Secretary considers appropriate.
(F)
A detailed analysis of succession planning at medical facilities of the Department, including the following:
(i)
The number of positions in medical facilities throughout the Department that are not filled by a permanent employee.
(ii)
The length of time each position described in clause (i) remained vacant or filled by a temporary or acting employee.
(iii)
A description of any barriers to filling the positions described in clause (i).
(iv)
A plan for filling any positions that are vacant or filled by a temporary or acting employee for more than 180 days.
(v)
A plan for handling emergency circumstances, such as administrative leave or sudden medical leave for senior officials.
(G)
The number of health care providers of the Department who have been removed from their positions, have retired, or have left their positions for another reason, disaggregated by provider type, during the two-year period preceding the submittal of the report.
(H)
Of the health care providers specified in subparagraph (G) who have been removed from their positions, the following:
(i)
The number of such health care providers who were reassigned to other positions in the Department.
(ii)
The number of such health care providers who left the Department.
(iii)
The number of such health care providers who left the Department and were subsequently rehired by the Department.

Sec. 202 Clinic management training for managers and health care providers of the Department of Veterans Affairs

(a)
Clinic management training program—
(1)
In general— Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall commence a clinic management training program to provide in-person, standardized education on health care management to all managers of, and health care providers at, medical facilities of the Department of Veterans Affairs.
(2)
Elements— The clinic management training program required by paragraph (1) shall include the following:
(A)
Training on how to manage the schedules of health care providers of the Department, including the following:
(i)
Maintaining such schedules in a manner that allows appointments to be booked at least eight weeks in advance.
(ii)
Proper planning procedures for vacation, leave, and graduate medical education training schedules.
(B)
Training on the appropriate number of appointments that a health care provider should conduct on a daily basis, based on specialty.
(C)
Training on how to determine whether there are enough available appointment slots to manage demand for different appointment types and mechanisms for alerting management of insufficient slots.
(D)
Training on how to properly use the appointment scheduling system of the Department, including any new scheduling system implemented by the Department.
(E)
Training on how to optimize the use of technology, including the following:
(i)
Telemedicine.
(ii)
Electronic mail.
(iii)
Text messaging.
(iv)
Such other technologies as specified by the Secretary.
(F)
Training on how to properly use physical plant space at medical facilities of the Department to ensure efficient flow and privacy for patients and staff.
(3)
Sunset— The clinic management training program required by paragraph (1) shall terminate on the date that is two years after the date on which the Secretary commences such program.
(b)
Training materials—
(1)
In general— After the termination of the clinic management training program required by subsection (a), the Secretary shall provide training materials on health care management to each of the following employees of the Department upon the commencement of employment of such employee:
(A)
Any manager of a medical facility of the Department.
(B)
Any health care provider at a medical facility of the Department.
(C)
Such other employees of the Department as the Secretary considers appropriate.
(2)
Update— The Secretary shall regularly update the training materials required under paragraph (1).

Sec. 203 Use of unobligated amounts to hire additional health care providers for the Veterans Health Administration

(a)
In general— At the end of each of fiscal years 2014 and 2015, all covered amounts shall be made available to the Secretary of Veterans Affairs to hire additional health care providers for the Veterans Health Administration of the Department of Veterans Affairs, or to carry out any provision of this Act or the amendments made by this Act, and shall remain available until expended.
(b)
Priority in hiring— The Secretary shall prioritize hiring additional health care providers under subsection (a) at medical facilities of the Department and in geographic areas in which the Secretary identifies the greatest shortage of health care providers.
(c)
Covered amounts defined— In this section, the term covered amounts means amounts—
(1)
that are made available to the Veterans Health Administration of the Department for an appropriations account—
(A)
under the heading “Medical Services”;
(B)
under the heading “Medical Support and Compliance”; or
(C)
under the heading “Medical Facilities”; and
(2)
that are unobligated at the end of the applicable fiscal year.