I 116TH CONGRESS 1ST SESSION H. R. 1125 To direct the Secretary of Veterans Affairs to carry out a pilot program on physical security at Department of Veterans Affairs medical facilities, to direct the Secretary to make certain improvements relating to inspec- tions of Department of Veterans Affairs medical facilities and improving care for women, and for other purposes. IN THE HOUSE OF REPRESENTATIVES FEBRUARY 8, 2019 Mr. KILMER (for himself, Mr. WEBSTER of Florida, Mr. RUTHERFORD, Mr. PETERS, Mrs. MURPHY, Mr. KELLY of Pennsylvania, Mr. MOULTON, Mrs. BROOKS of Indiana, and Ms. KUSTER of New Hampshire) intro- duced the following bill; which was referred to the Committee on Vet- erans’ Affairs A BILL To direct the Secretary of Veterans Affairs to carry out a pilot program on physical security at Department of Veterans Affairs medical facilities, to direct the Secretary to make certain improvements relating to inspections of Department of Veterans Affairs medical facilities and improving care for women, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 19:25 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1125.IH H1125 pamtmann on DSKBFK8HB2PROD with BILLS 2 •HR 1125 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Accountability for 2 Quality VA Healthcare Act’’. 3 SEC. 2. PILOT PROGRAM ON PHYSICAL SECURITY AT DE- 4 PARTMENT OF VETERANS AFFAIRS MEDICAL 5 FACILITIES. 6 (a) IN GENERAL.—Beginning not later than 90 days 7 after the date of the enactment of this Act the Secretary 8 of Veterans Affairs shall carry out a pilot program to en- 9 hance the physical security of Department of Veterans Af- 10 fairs medical facilities. At the medical facilities selected 11 for the pilot program, the Secretary shall— 12 (1) ensure that alarm systems effectively notify 13 relevant staff in the police command and control 14 centers and the unit nursing stations of the facility; 15 and 16 (2) require relevant medical center stakeholders 17 to coordinate and consult on— 18 (A) plans for new and renovated units; and 19 (B) any changes to physical security fea- 20 tures, including closed-circuit television cam- 21 eras. 22 (b) LOCATIONS.—The Secretary shall select five med- 23 ical facilities of the Department to participate in the pilot 24 program. 25 VerDate Sep 11 2014 19:25 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1125.IH H1125 pamtmann on DSKBFK8HB2PROD with BILLS 3 •HR 1125 IH (c) TERMINATION.—The pilot program shall termi- 1 nate on the date that is two years after the date on which 2 the pilot program commences. 3 (d) REPORT.—Not later than 30 days after the termi- 4 nation of the pilot program under subsection (c), the Sec- 5 retary shall submit to Congress a report on the pilot pro- 6 gram. 7 SEC. 3. REPORT ON DEPARTMENT OF VETERANS AFFAIRS 8 IMPROVEMENT OF FACILITY ALIGNMENT. 9 (a) IN GENERAL.—Not later than 90 days after the 10 date of the enactment of this Act, the Secretary of Vet- 11 erans Affairs shall submit to Congress a report on the 12 findings and recommendations of the report of the Govern- 13 ment Accountability Office entitled ‘‘VA Real Property: 14 VA Should Improve Its Efforts to Align Facilities with 15 Veterans’ Needs’’. The report submitted by the Secretary 16 shall include the plan of the Secretary, including a time 17 frame for completion, to specifically address the following 18 recommendations: 19 (1) To address identified limitations to the stra- 20 tegic capital investment planning process, including 21 limitations to scoring and approval and access to in- 22 formation. 23 (2) To assess the value of the Department of 24 Veterans Affairs Integrated Planning facility master 25 VerDate Sep 11 2014 19:25 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1125.IH H1125 pamtmann on DSKBFK8HB2PROD with BILLS 4 •HR 1125 IH plans as a facility-planning tool, and based on con- 1 clusions contained in the Government Accountability 2 Office report, either discontinue the development of 3 such master plans or address the limitations of such 4 master plans. 5 (3) To develop and distribute guidance for Vet- 6 erans Integrated Service Networks and facilities 7 using best practices on how to effectively commu- 8 nicate with stakeholders about alignment change. 9 (4) To develop and implement a mechanism to 10 evaluate Veterans Integrated Service Network and 11 facility communication efforts with stakeholders to 12 ensure that such communication efforts are working 13 as intended and align with guidance and best prac- 14 tices. 15 (b) PUBLIC AVAILABILITY.—Upon submittal of the 16 report under subsection (a), the Secretary shall make the 17 report publicly available on an internet website of the De- 18 partment. 19 SEC. 4. UPDATE OF HANDBOOK TO IMPROVE LEASING 20 PROJECTS. 21 Not later than 180 days after the date of the enact- 22 ment of this Act, and not less than once every five-year 23 period thereafter, the Secretary of Veterans Affairs shall 24 update the handbook of the Department of Veterans Af- 25 VerDate Sep 11 2014 19:25 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1125.IH H1125 pamtmann on DSKBFK8HB2PROD with BILLS 5 •HR 1125 IH fairs titled ‘‘Planning and Activating Community Based 1 Outpatient Clinics’’, or a successor handbook, to reflect 2 current policies, best practices, and clarify the roles and 3 responsibilities of the personnel of the Department in- 4 volved in the leasing projects of the Department. 5 SEC. 5. IMPROVEMENT OF INSPECTIONS OF DEPARTMENT 6 OF VETERANS AFFAIRS MEDICAL FACILITIES 7 AND IMPROVEMENT OF CARE FOR WOMEN 8 PROVIDED BY DEPARTMENT OF VETERANS 9 AFFAIRS. 10 (a) FINDINGS.—Congress makes the following find- 11 ings: 12 (1) The Department of Veterans Affairs has 13 policies in place to help ensure the privacy, safety, 14 and dignity of women veterans when they receive 15 care at its medical facilities. 16 (2) A Government Accountability Office report 17 found many instances of noncompliance with such 18 policies. 19 (3) Women veterans are the fastest growing co- 20 hort within the veteran community. 21 (4) Women serve in every branch of the Armed 22 Forces and represent nearly 15 percent of the mem- 23 bers of the Armed Forces currently serving on active 24 VerDate Sep 11 2014 19:25 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1125.IH H1125 pamtmann on DSKBFK8HB2PROD with BILLS 6 •HR 1125 IH duty and 18 percent of members of the National 1 Guard and reserve components. 2 (5) The number of women veterans using the 3 medical care provided by the Department of Vet- 4 erans Affairs is expected to increase dramatically. 5 (b) SENSE OF CONGRESS.—It is the sense of Con- 6 gress that— 7 (1) female veterans are put at risk by a system 8 that is currently designed for men; and 9 (2) the Department of Veterans Affairs should 10 follow through with commitments to ensure female 11 veterans can access services tailored to their needs. 12 (c) IMPROVEMENT OF INSPECTIONS OF DEPART- 13 MENT OF VETERANS AFFAIRS MEDICAL FACILITIES AND 14 IMPROVEMENT OF CARE FOR WOMEN PROVIDED BY DE- 15 PARTMENT OF VETERANS AFFAIRS.— 16 (1) IMPROVEMENT OF INSPECTIONS PROC- 17 ESS.—The Secretary of Veterans Affairs shall 18 strengthen the environment of care inspections proc- 19 ess and oversight of such process by— 20 (A) expanding the list of requirements that 21 facility staff inspect for compliance to align 22 with the policy of the Veterans Health Adminis- 23 tration; 24 VerDate Sep 11 2014 19:25 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1125.IH H1125 pamtmann on DSKBFK8HB2PROD with BILLS 7 •HR 1125 IH (B) ensuring that all patient care areas of 1 Department medical facilities are inspected as 2 required; 3 (C) clarifying the roles and responsibilities 4 of Department medical facility staff responsible 5 for identifying and addressing compliance; and 6 (D) establishing a process to verify that 7 noncompliance information reported by facilities 8 to the Veterans Health Administration central 9 office is accurate and complete. 10 (2) IMPROVEMENT OF CARE FOR WOMEN.— 11 (A) MONITORING OF GENDER-SPECIFIC 12 CARE SERVICES.—To improve care for women 13 veterans, the Secretary of Veterans Affairs shall 14 monitor women veterans’ access to gender-spe- 15 cific care services under current and future 16 community care contracts or agreements. Such 17 monitoring shall include an examination of ap- 18 pointment scheduling and completion times, 19 driving times to appointments, and reasons ap- 20 pointments could not be scheduled with commu- 21 nity providers. 22 (B) DEFINITIONS.—In this subparagraph: 23 VerDate Sep 11 2014 19:25 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1125.IH H1125 pamtmann on DSKBFK8HB2PROD with BILLS 8 •HR 1125 IH (i) The term ‘‘gender-specific care 1 services’’ means mammography, maternity 2 care, and gynecology. 3 (ii) The term ‘‘community care con- 4 tract or agreement’’ means an agreement 5 described in section 101(d) of the Veterans 6 Access, Choice, and Accountability Act of 7 2014 (Public Law 113–146), or other con- 8 tract or agreement under which the Sec- 9 retary furnishes hospital care and medical 10 treatment to veterans at non-Department 11 of Veterans Affairs health care facilities. 12 SEC. 6. IMPROVEMENT OF DELIVERY OF CARE AT DEPART- 13 MENT OF VETERANS AFFAIRS MEDICAL FA- 14 CILITIES. 15 (a) WAIT TIMES.—The Secretary of Veterans Affairs 16 shall clearly identify measures for wait times for medical 17 appointments in Department of Veterans Affairs medical 18 facilities in a manner that reduces the likelihood of an in- 19 dividual misinterpreting such measures. 20 (b) SCHEDULING.—The Secretary shall ensure that 21 the term ‘‘patient indicated date’’ is clearly defined for 22 purposes of the scheduling policy of the Veterans Health 23 Administration and in related training documents. The 24 Secretary shall take such steps as may be necessary to 25 VerDate Sep 11 2014 19:25 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H1125.IH H1125 pamtmann on DSKBFK8HB2PROD with BILLS 9 •HR 1125 IH ensure such term is correctly implemented by employees 1 who perform scheduling functions. 2 (c) STAFF AVAILABILITY.— 3 (1) ALLOCATION; SCHEDULING.—The Secretary 4 shall develop a policy requiring Department of Vet- 5 erans Affairs medical facilities to routinely assess 6 the scheduling needs and resources required to en- 7 sure that employees of such facilities are allocated in 8 such a manner as to adequately respond to the de- 9 mand for scheduling medical appointments. 10 (2) RECRUITMENT AND RETENTION.—The Sec- 11 retary shall develop a strategy to improve recruit- 12 ment and retention of Department of Veterans Af- 13 fairs medical providers and employees who perform 14 scheduling functions for Department medical facili- 15 ties. Such strategy shall be designed to ensure ade- 16 quate staffing of Department medical facilities and 17 shall emphasize recruitment and retention in facili- 18 ties located in rural areas. 19 (d) TELEPHONE ACCESS.—The Secretary shall— 20 (1) ensure that all Department medical facili- 21 ties provide oversight of telephone access and imple- 22 ment the best practices outlined in the Department 23 2015 Telephone Access and Contact Management 24 Improvement Guide, or a successor guide; and 25 VerDate Sep 11 2014 19:25 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H1125.IH H1125 pamtmann on DSKBFK8HB2PROD with BILLS 10 •HR 1125 IH (2) identify medical facilities that are using out- 1 dated telephone technology and replace such tech- 2 nology with new systems designed to improve tele- 3 phone service and access to health care. 4 SEC. 7. ANNUAL REPORT REGARDING THE RECRUITMENT, 5 HIRING, AND RETENTION OF NURSES FOR 6 THE VETERANS HEALTH ADMINISTRATION. 7 (a) REPORT REQUIRED.—Not later than one year 8 after the date of the enactment of this Act and annually 9 thereafter, the Secretary of Veterans Affairs shall publish 10 and submit to the Committees on Veterans’ Affairs of the 11 Senate and the House of Representatives a report regard- 12 ing efforts to recruit, hire, and retain nurses for the Vet- 13 erans Health Administration. 14 (b) ELEMENTS.—The report under subsection (a) 15 shall include details relating to— 16 (1) efforts to recruit, hire, and retain nurses at 17 each medical facility of the Department; 18 (2) resources provided by the Secretary to re- 19 cruit, hire, and retain nurses for the Veterans 20 Health Administration; and 21 (3) recommendations for legislation the Sec- 22 retary considers appropriate. 23 VerDate Sep 11 2014 19:25 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H1125.IH H1125 pamtmann on DSKBFK8HB2PROD with BILLS 11 •HR 1125 IH SEC. 8. REINSTATEMENT OF REPORTING REQUIREMENT 1 REGARDING THE DEPARTMENT OF VET- 2 ERANS AFFAIRS HEALTH PROFESSIONALS 3 EDUCATIONAL ASSISTANCE PROGRAM. 4 Section 3003(a)(1) of the Federal Reports Elimi- 5 nation and Sunset Act of 1995 (Public Law 104–66; 31 6 U.S.C. 1113 note) shall not apply to the report required 7 under section 7632 of title 38, United States Code. 8 Æ VerDate Sep 11 2014 19:25 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\H1125.IH H1125 pamtmann on DSKBFK8HB2PROD with BILLS