,i  #aacth ,,congress  #b;d ,session    
,h4 ,r4 #dcii  ,,in ,,the ,,house ,,of  
,,representatives  ,april #d1 #bjad ,mr4
 ,michaud introduced the following bill2
 which was referred to the ,committee on
 ,veterans' ,affairs  ,a ,,bill  ,to    
amend title #ch1 ,united ,states ,code1 
to improve the performance appraisal    
system for senior executives of the     
,department of ,veterans ,affairs1 and  
for other purposes4  #a4 ,short title   
,this ,act may be cited as the          
,comprehensive ,department of ,veterans 
,affairs ,performance ,management and   
,accountability ,reform ,act of #bjad4  
#b4 ,improvement of performance         
appraisal of senior executives of the   
,department of ,veterans ,affairs  7a7  
,performance appraisal system  7#a7 ,in 
general ,chapter #g of title #ch1       
,united ,states ,code1 is amended by    
adding at the end the following new     
section3  #gac4 ,senior ,executive      
,service3 performance appraisal  7a7    
,performance appraisal system ,the      

,secretary shall be responsible for     
carrying out the requirements of        
subchapter ,,ii of chapter #dc of title 
#e4  7b7 ,organizational performance    
requirements  7#a7 ,in implementing the 
performance appraisal system for senior 
executives of the ,department required  
by section #dcab of title #e1 the       
,secretary shall issue1 by not later    
than ,september #a of each year1        
organizational performance requirements 
to be used to inform the establishment  
of performance requirements for each    
senior executive of the ,department4    
,the performance requirements of each   
senior executive shall be achievable by 
each senior executive and shall be      
consistent with the organizational      
performance requirements issued by the  
,secretary4  7#b7 ,not less than half of
 the annual summary rating of a senior  
executive of the ,department under      
section #dcad of title #e shall be based
 on the organizational performance      
requirements issued under this          

subsection and applicable to such senior
 executive4  7#c7 ,not later than       
,december #ae of each year1 the         
,secretary shall submit to the          
,committees on ,veterans' ,affairs of   
the ,senate and ,house of               
,representatives certification that for 
the fiscal year during which the        
certification is submitted that--  7,a7 
all individual and organizational       
performance requirements applicable to  
senior executives of the ,department    
pursuant to section #dcab of title #e   
accurately reflected the organizational 
performance requirements of the         
,department2 and  7,b7 the performance  
requirements established for each senior
 executive are expected to lead to the  
overall success of the ,department in   
meeting its organizational performance  
requirements4  7c7 ,additional          
requirements  7#a7 ,in implementing the 
performance appraisal system for senior 
executives of the ,department required  
by section #dcab of title #e1 the       

,secretary shall ensure that such system
 is designed to--  7,a7 evaluate the    
contribution of each senior executive to
 the overall mission and objectives of  
the ,department2  7,b7 ensure that each 
senior executive is accountable for     
efforts undertaken to further the       
objectives of the ,departments2 and     
7,c7 evaluate the contribution of each  
senior executive in ensuring the        
,department meets the needs of veterans 
and their dependants4  7#b7  7,a7 ,the  
performance review board established    
pursuant to section #dcad of title #e   
shall ensure that--  7i7 the performance
 requirements for each senior executive 
of the ,department clearly and          
distinctly address both individual and  
organizational performance2 and  7ii7   
the performance of each senior executive
 is evaluated based on such performance 
requirements together with the          
demonstrated accountability1 executive1 
and leadership capabilities of the      
senior executive4  7,b7 ,in evaluating  

the performance of a senior executive of
 the ,department1 the performance review
 board shall take into consideration    
each of the following3  7i7 ,any        
deficiencies identified by the          
,inspector ,general of the ,department  
or the ,comptroller ,general of the     
,united ,states in the performance of   
duties or areas managed by the senior   
executive4  7ii7 ,any final             
determination in response to a formal   
complaint submitted regarding the       
performance of the senior executive or a
 deficiency in a program under the      
direction of the senior executive4      
7iii7 ,the findings of any final report 
relating to the performance of the      
senior executive or to a deficiency in a
 program under the direction of the     
senior executive4  7d7 ,annual summary  
ratings  7#a7 ,the ,secretary shall     
provide in a timely manner to any senior
 executive who receives an annual       
summary rating under section #dcad7;a7  
of title #e of any level of performance 

lower than fully successful a detailed  
explanation of the performance          
deficiencies of the senior executive4   
7#b7 ,in the case of a senior executive 
for whom it is determined during a      
mid-year review that the senior         
executive is likely to receive an annual
 summary rating of less than fully      
successful1 the ,secretary shall ensure 
that senior executive is provided a plan
 to address performance deficiencies    
before the end of the evaluation period4
  7#c7 ,any senior executive of the     
,department who receives two annual     
summary ratings of any level of         
performance lower than fully successful 
shall be removed from the ,senior       
,executive ,service4  7#d7 ,any senior  
executive who receives three consecutive
 annual summary ratings of the highest  
level of performance shall be provided  
with an opportunity to obtain a         
different position within the           
,department with more responsibility1 if
 such a position is available4  7e7     

,annual reports ,not later than ,january
 #a of each year1 the ,secretary shall  
submit to the ,committees on ,veterans' 
,affairs of the ,senate and ,house of   
,representatives a report on the senior 
executive performance appraisal system  
of the ,department for the fiscal year  
preceding the fiscal year during which  
the report is submitted4 ,each such     
report shall include1 for the year      
covered by the report1 each of the      
following3  7#a7 ,the number of senior  
executives who received summary ratings4
  7#b7 ,the number of senior executives 
who received a summary rating at each   
level of performance4  7#c7 ,any actions
 taken with respect to senior executives
 who received ratings at a level of     
performance lower than fully successful4
  7#d7 ,the number of initial annual    
summary ratings that were raised or     
lowered by the performance review board4
  4  7#b7 ,clerical amendment ,the table
 of sections at the beginning of such   
chapter is amended by adding at the end 

the following new item3  #gac4 ,senior  
,executive ,service3 performance        
appraisal4  4  7b7 ,performance pay for 
physicians and dentists ,section #gdca  
of title #ch1 ,united ,states ,code1 is 
amended--  7#a7 in subsection 7b77#c71  
by inserting after dentist the          
following3 who received a fully         
successful level of performance at the  
physician or dentist's most recent      
performance appraisal2  7#b7 in         
subsection 7c7--  7,a7 in paragraph     
7#b7--  7i7 by inserting 7,a7 before    
,market pay2 and  7ii7 by adding at the 
end the following new subparagraph3     
7,b7 ,the ,secretary shall submit to the
 ,committees on ,veterans' ,affairs of  
the ,senate and ,house of               
,representatives a semi-annual report on
 health care trends1 including          
anticipated shortages of health care    
professionals by specific specialty and 
location1 which shall be used in        
determining the recruitment and         
retention needs of the ,department for  

purposes of this subsection4 ,the       
,secretary may not provide market pay to
 a physician or dentist under this      
subsection unless the payment of market 
pay to the physician or dentist meets a 
specialty or location need of the       
,department as articulated in a report  
submitted under this subparagraph4  4   
7,b7 in paragraph 7#d77;,b7--  7i7 in   
clause 7i71 by striking the last        
sentence2 and  7ii7 in clause 7iii71 by 
striking should1 to the extent          
practicable1 and inserting shall2 and   
7#c7 in subsection 7d7--  7,a7 in       
paragraph 7#a7--  7i7 by inserting 7,a7 
before ,one element2 and  7ii7 by adding
 at the end the following3 ,the         
,secretary shall establish a performance
 appraisal system for physicians and    
dentists4 ,the performance appraisal    
system shall provide for annual summary 
ratings of levels of performance as     
follows3  7,a7 one or more fully        
successful levels2  7,b7 a minimally    
satisfactory level2 and  7,c7 an        

unsatisfactory level4  2  7iii7 by      
inserting after subparagraph 7,a7 the   
following new subparagraph3  7,b7 ,under
 the performance appraisal system under 
subparagraph 7,a71 performance shall be 
evaluated based on both individual and  
organizational performance and specific 
goals or objectives shall be explicitly 
linked to improved health care outcomes 
and quality as well as the ,department's
 overall effectiveness in providing     
quality health care services4 ,the      
specific goals and objectives shall be  
consistent with the overarching         
objectives and goals of the ,department4
  7,c7 ,under such performance appraisal
 system1 each physician and dentist     
employed by the ,department shall       
receive an annual review by the ,under  
,secretary of ,health4 ,for each year1  
the ,under ,secretary shall submit to   
the ,secretary certification that such  
reviews are conducted4  2  7,b7 by      
striking paragraph 7#c7 and             
redesignating paragraph 7#b7 as         

paragraph 7#c72  7,c7 by inserting after
 paragraph 7#a7 the following new       
paragraph 7#b73  7#b7 ,under the        
performance appraisal system established
 under paragraph 7#a7--  7,a7 on or     
before the beginning of each rating     
period1 performance requirements for    
each physician or dentist shall be      
established in consultation with1 and   
communicated to1 each physician or      
dentist2  7,b7 written appraisals of    
performance shall be based on the       
individual and organizational           
performance requirements established for
 the rating period involved2 and  7,c7  
each physician or dentist shall be      
provided a copy of the appraisal and the
 physician or dentist's performance     
appraisal rating and shall be given an  
opportunity to respond in writing and   
have the rating reviewed by the ,under  
,secretary for ,health before the rating
 becomes final4  2  7,d7 in paragraph   
7#c71 as redesignated by subparagraph   
7,b7--  7i7 by inserting only after     

paid2 and  7ii7 by striking on the basis
 and inserting who receives a level of  
performance of fully successful under   
the performance appraisal system        
established under paragraph 7#a7 and    
whose performance exceeds the specific  
goals and performance objectives        
established under such system42  7,e7 in
 paragraph 7#d71 by striking paragraph  
7#b7 and inserting this subsection2     
7,f7 in paragraph 7#e77;,b71 by striking
 #g4e percent and inserting #e percent2 
and  7,g7 by striking paragraph 7#f72   
and  7#d7 by adding at the end the      
following new subsection3  7i7 ,failure 
,to maintain a license ,a physician or  
dentist who has not maintained an       
appropriate professional license may not
 be paid4  4  7c7 ,study ,not later than
 one year after the date of the         
enactment of this ,act1 the ,secretary  
shall submit to the ,committees on      
,veterans' ,affairs of the ,senate and  
,house of ,representatives a report on  
the training program of the ,department 

of ,veterans ,affairs for senior        
executives4 ,such report shall include--
  7#a7 an evaluation of succession      
planning and long-term career           
development plans for senior executives 
and efforts undertaken by the           
,department to improve cross-,department
 opportunities for senior executives2   
and  7#b7 the recommendations of the    
,secretary for improving the mobility   
and effectiveness of senior executives4