US Codex
Pub. L.
Notes

Title V — Other Matters

115th Congress · Approved Jun 6, 2018 · 132 Stat. 1393 · Lineage

TITLE V Other Matters

SEC. 501. Annual Report on Performance Awards and Bonuses Awarded to Certain High-Level Employees of the Department.

(a)
In General.— Chapter 7 of title 38, United States Code, is amended by adding at the end the following new section:

Ҥ 726. Annual report on performance awards and bonuses awarded to certain high-level employees

“(a) In General.—Not later than 100 days after the end of each fiscal year, the Secretary shall submit to the appropriate committees of Congress a report that contains, for the most recent fiscal year ending before the submittal of the report, a description of all performance awards or bonuses awarded to each of the following:

“(1) Regional Office Director of the Department.

“(2) Director of a Medical Center of the Department.

“(3) Director of a Veterans Integrated Service Network.

“(4) Senior executive of the Department.

“(b) Elements.—Each report submitted under subsection (a) shall include the following with respect to each performance award or bonus awarded to an individual described in such subsection:

“(1) The amount of each award or bonus.

“(2) The job title of the individual awarded the award or bonus.

“(3) The location where the individual awarded the award or bonus works.

“(c) Definitions.—In this section:

“(1) The term ‘appropriate committees of Congress’ means the Committees on Veterans’ Affairs and Appropriations of the Senate and House of Representatives.

“(2) The term ‘senior executive’ means—

“(A) a career appointee; or

“(B) an individual—

“(i) in an administrative or executive position; and

“(ii) appointed under section 7306(a) or section 7401(1) of this title.

“(3) The term ‘career appointee’ has the meaning given that term in section 3132(a) of title 5, United States Code.”

(b)
Clerical Amendment.— The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 725 the following new item:

“726. Annual report on performance awards and bonuses awarded to certain high-level employees.”.

SEC. 502. Role of Podiatrists in Department of Veterans Affairs.

(a)
Inclusion as Physician.—
(1)
In general.— Subchapter I of chapter 74 is amended by adding at the end the following new section:

Ҥ 7413. Treatment of podiatrists; clinical oversight standards

“(a) Podiatrists.—Except as provided by subsection (b), a doctor of podiatric medicine who is appointed as a podiatrist under section 7401(1) of this title is eligible for any supervisory position in the Veterans Health Administration to the same degree that a physician appointed under such section is eligible for the position.

“(b) Establishment of Clinical Oversight Standards.—The Secretary, in consultation with appropriate stakeholders, shall establish standards to ensure that specialists appointed in the Veterans Health Administration to supervisory positions do not provide direct clinical oversight for purposes of peer review or practice evaluation for providers of other clinical specialties.”

(2)
Clerical amendment.— The table of sections at the beginning of chapter 74 is amended by inserting after the item relating to section 7412 the following new item:

“7413. Treatment of podiatrists; clinical oversight standards.”.

(b)
Modification and Clarification of Pay Grade.—
(1)
Grade.— The list in section 7404(b) of such title is amended—
(A)
by striking “ PHYSICIAN AND DENTIST SCHEDULE” and inserting “ PHYSICIAN AND SURGEON (MD/DO), PODIATRIC SURGEON (DPM), AND DENTIST AND ORAL SURGEON (DDS, DMD) SCHEDULE”;
(B)
by striking “ Physician grade” and inserting “ Physician and surgeon grade”; and
(C)
by striking “ PODIATRIST, CHIROPRACTOR, AND” and inserting “ CHIROPRACTOR AND”.
(2)
Application.— The amendments made by paragraph (1) shall apply with respect to a pay period of the Department of Veterans Affairs beginning on or after the date that is 30 days after the date of the enactment of this Act.

SEC. 503. Definition of Major Medical Facility Project.

(a)
Modification of Definition of Medical Facility.— Section 8101(3) is amended by striking “ Secretary” and all that follows through “ nursing home,” and inserting “ Secretary, or as otherwise authorized by law, for the provision of health-care services (including hospital, outpatient clinic, nursing home,”.
(b)
Modification of Definition of Major Medical Facility Project.— Paragraph (3) of section 8104(a) is amended to read as follows:

“(3) For purposes of this subsection, the term ‘major medical facility project’ means a project for the construction, alteration, or acquisition of a medical facility involving a total expenditure of more than $20,000,000, but such term does not include an acquisition by exchange, nonrecurring maintenance projects of the Department, or the construction, alteration, or acquisition of a shared Federal medical facility for which the Department’s estimated share of the project costs does not exceed $20,000,000.”

SEC. 504. Authorization of Certain Major Medical Facility Projects of the Department of Veterans Affairs.

(a)
Authorization.— The Secretary of Veterans Affairs may carry out the following major medical facility project, to be carried out in an amount not to exceed the amount specified for that project: Construction of the new East Bay Community Based Outpatient Clinic and all associated site work, utilities, parking, and landscaping, construction of the Central Valley Engineering and Logistics support facility, and enhanced flood plain mitigation at the Central Valley and East Bay Community Based Outpatient Clinics as part of the realignment of medical facilities in Livermore, California, in an amount not to exceed $117,300,000.
(b)
Authorization of Appropriations for Construction.— There is authorized to be appropriated to the Secretary of Veterans Affairs for fiscal year 2018 or the year in which funds are appropriated for the Construction, Major Projects account, $117,300,000 for the project authorized in subsection (a).
(c)
Submittal of Information.— Not later than 90 days after the date of the enactment of this Act, for the project authorized in subsection (a), 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 the following information:
(1)
A line item accounting of expenditures relating to construction management carried out by the Department of Veterans Affairs for such project.
(2)
The future amounts that are budgeted to be obligated for construction management carried out by the Department for such project.
(3)
A justification for the expenditures described in paragraph (1) and the future amounts described in paragraph (2).
(4)
Any agreement entered into by the Secretary regarding a non-Department of Veterans Affairs Federal entity providing management services relating to such project, including reimbursement agreements and the costs to the Department for such services.

SEC. 505. Department of Veterans Affairs Personnel Transparency.

(a)
Publication of Staffing and Vacancies.—
(1)
Website required.— Subject to paragraph (2) and not later than 90 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall make publicly available on an Internet website of the Department of Veterans Affairs the following information, which shall, subject to subparagraph (D), be displayed by departmental component or, in the case of information relating to Veterans Health Administration positions, by medical facility:
(A)
The number of personnel encumbering positions.
(B)
The number of accessions and separation actions processed during the quarter preceding the date of the publication of the information.
(C)
The number of vacancies, by occupation.
(D)
The percentage of new hires for the Department who were hired within the time-to-hire target of the Office of Personnel Management, disaggregated by administration.
(2)
Exceptions.— The Secretary may withhold from publication under paragraph (1) information relating to law enforcement, information security, or such positions in the Department that the Secretary determines to be sensitive.
(3)
Update of information.— The Secretary shall update the information on the website required under paragraph (1) on a quarterly basis.
(4)
Treatment of contractor positions.— Any Department of Veterans Affairs position that is filled with a contractor may not be treated as a Department position for purposes of the information required to be published under paragraph (1).
(5)
Inspector general review.— On a semi-annual basis, the Inspector General of the Department shall review the administration of the website required under paragraph (1) and make recommendations relating to the improvement of such administration.
(b)
Report to Congress.— The Secretary of Veterans Affairs shall submit to Congress an annual report on the steps the Department is taking to achieve full staffing capacity. Each such report shall include the amount of additional funds necessary to enable the Department to reach full staffing capacity.

SEC. 506. Program on Establishment of Peer Specialists in Patient Aligned Care Team Settings Within Medical Centers of Department of Veterans Affairs.

(a)
Program Required.— The Secretary of Veterans Affairs shall carry out a program to establish not fewer than two peer specialists in patient aligned care teams at medical centers of the Department of Veterans Affairs to promote the use and integration of services for mental health, substance use disorder, and behavioral health in a primary care setting.
(b)
Timeframe for Establishment of Program.— The Secretary shall carry out the program at medical centers of the Department as follows:
(1)
Not later than May 31, 2019, at not fewer than 15 medical centers of the Department.
(2)
Not later than May 31, 2020, at not fewer than 30 medical centers of the Department.
(c)
Selection of Locations.—
(1)
In general.— The Secretary shall select medical centers for the program as follows:
(A)
Not fewer than five shall be medical centers of the Department that are designated by the Secretary as polytrauma centers.
(B)
Not fewer than 10 shall be medical centers of the Department that are not designated by the Secretary as polytrauma centers.
(2)
Considerations.— In selecting medical centers for the program under paragraph (1), the Secretary shall consider the feasibility and advisability of selecting medical centers in the following areas:
(A)
Rural areas and other areas that are underserved by the Department.
(B)
Areas that are not in close proximity to an active duty military installation.
(C)
Areas representing different geographic locations, such as census tracts established by the Bureau of the Census.
(d)
Gender-Specific Services.— In carrying out the program at each location selected under subsection (c), the Secretary shall ensure that—
(1)
the needs of female veterans are specifically considered and addressed; and
(2)
female peer specialists are made available to female veterans who are treated at each location.
(e)
Engagement With Community Providers.— At each location selected under subsection (c), the Secretary shall consider ways in which peer specialists can conduct outreach to health care providers in the community who are known to be serving veterans to engage with those providers and veterans served by those providers.
(f)
Reports.—
(1)
Periodic reports.—
(A)
In general.— Not later than 180 days after the date of the enactment of this Act, and not less frequently than once every 180 days thereafter until the Secretary determines that the program is being carried out at the last location to be selected under subsection (c), the Secretary shall submit to Congress a report on the program.
(B)
Elements.— Each report required by subparagraph (A) shall, with respect to the 180-day period preceding the submittal of the report, include the following:
(i)
The findings and conclusions of the Secretary with respect to the program.
(ii)
An assessment of the benefits of the program to veterans and family members of veterans.
(iii)
An assessment of the effectiveness of peer specialists in engaging under subsection (e) with health care providers in the community and veterans served by those providers.
(2)
Final report.— Not later than 180 days after the Secretary determines that the program is being carried out at the last location to be selected under subsection (c), the Secretary shall submit to Congress a report detailing the recommendations of the Secretary as to the feasibility and advisability of expanding the program to additional locations.

SEC. 507. Department of Veterans Affairs Medical Scribe Pilot Program.

(a)
In General.— The Secretary of Veterans Affairs shall carry out a 2-year pilot program under which the Secretary shall increase the use of medical scribes at Department of Veterans Affairs medical centers.
(b)
Locations.— The Secretary shall carry out the pilot program at the 10 medical centers of the Department as follows:
(1)
At least four such medical centers located in rural areas.
(2)
At least four such medical centers located in urban areas.
(3)
Two such medical centers located in areas with need for increased access or increased efficiency, as determine by the Secretary.
(c)
Medical Scribes.—
(1)
Hiring.— Under the pilot program the Secretary shall—
(A)
hire 20 new Department of Veterans Affairs term employees as medical scribes; and
(B)
seek to enter into contracts with appropriate entities for the employment of 20 additional medical scribes.
(2)
Distribution.— The Secretary shall assign four medical scribes to each of the 10 medical centers of the Department where the Secretary carries out the pilot program as follows:
(A)
Two scribes shall be assigned to each of two physicians.
(B)
Thirty percent of the scribes shall be employed in the provision of emergency care.
(C)
Seventy percent of the scribes shall be employed in the provision of speciality care in specialties with the longest patient wait times or lowest efficiency ratings, as determined by the Secretary.
(d)
Reports.—
(1)
Reports to congress.— Not later than 180 days after the commencement of the pilot program required under this section, and every 180 days thereafter for the duration of the pilot program, the Secretary of Veterans Affairs shall submit to Congress a report on the pilot program. Each such report shall include each of the following:
(A)
A separate analysis of each the following with respect to medical scribes employed by the Department of Veterans Affairs and medical scribes performing Department of Veterans Affairs functions under a contract:
(i)
Provider efficiency.
(ii)
Patient satisfaction.
(iii)
Average wait time.
(iv)
The number of patients seen per day by each physician or practitioner.
(v)
The amount of time required to hire and train an employee to perform medical scribe functions under the pilot program.
(B)
Metrics and data for analyzing the effects of the pilot program, including an evaluation of the each of the elements under clauses (i) through (iv) of subparagraph (A) at medical centers who employed scribes under the pilot program for an appropriate period preceding the hiring of such scribes.
(2)
Comptroller general report.— Not later than 90 days after the termination of the pilot program under this section, the Comptroller General of the United States shall submit to Congress a report on the pilot program. Such report shall include a comparison of the pilot program with similar programs carried out in the private sector.
(e)
Definitions.— In this section:
(1)
The term “medical scribe” means an unlicensed individual hired to enter information into the electronic health record or chart at the direction of a physician or licensed independent practitioner whose responsibilities include the following:
(A)
Assisting the physician or practitioner in navigating the electronic health record.
(B)
Responding to various messages as directed by the physician or practitioner.
(C)
Entering information into the electronic health record, as directed by the physician or practitioner.
(2)
The terms “urban” and “rural” have the meanings given such terms under the rural-urban commuting codes developed by the Secretary of Agriculture and the Secretary of Health and Human Services.
(f)
Funding.— The pilot program under this section shall be carried out using amounts otherwise authorized to be appropriated for the Department of Veterans Affairs. No additional amounts are authorized to be appropriated to carry out such program.

SEC. 508. Extension of Requirement to Collect Fees for Housing Loans Guaranteed by Secretary of Veterans Affairs.

Section 3729(b)(2) of title 38, United States Code, is amended by striking “ 2027” each place it appears and inserting “ 2028”.

SEC. 509. Extension of Reduction in Amount of Pension Furnished by Department of Veterans Affairs for Certain Veterans Covered by Medicaid Plans for Services Furnished by Nursing Facilities.

Section 5503(d)(7) of title 38, United States Code, is amended by striking “ September 30, 2027” and inserting “ September 30, 2028”.

SEC. 510. Appropriation of Amounts.

(a)
Veterans Choice Program.— There is authorized to be appropriated, and is appropriated, to the Secretary of Veterans Affairs, out of any funds in the Treasury not otherwise appropriated, $5,200,000,000 to be deposited in the Veterans Choice Fund under section 802 of the Veterans Access, Choice, and Accountability Act of 2014 (Public Law 113–146; 38 U.S.C. 1701 note).
(b)
Availability of Amounts.— The amounts appropriated under subsection (a) shall be available for obligation or expenditure without fiscal year limitation.

SEC. 512. Budgetary Effects.

(a)
Statutory Pay-As-You-Go Scorecards.— The budgetary effects of this Act shall not be entered on either PAYGO scorecard maintained pursuant to section 4(d) of the Statutory Pay-As-You-Go Act of 2010.
(b)
Senate PAYGO Scorecards.— The budgetary effects of this Act shall not be entered on any PAYGO scorecard maintained for purposes of section 4106 of H. Con. Res. 71 (115th Congress).