,i  #aac? ,,congress  #b;d ,session  ,h4
 ,r4 #dcii  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,april #d1 #bjad ,mr4 
,mi*aud introduc$ ! foll[+ bill2 :i* 0  
ref]r$ to ! ,committee on ,vet]ans'     
,affairs  ,a ,,bill  ,to am5d title #ch1
 ,unit$ ,/ates ,code1 to improve !      
p]=mance appraisal sy/em = s5ior        
executives ( ! ,dep>tm5t ( ,vet]ans     
,affairs1 & = o!r purposes4  #a4 ,%ort  
title ,?is ,act may be cit$ z !         
,compreh5sive ,dep>tm5t ( ,vet]ans      
,affairs ,p]=mance ,managem5t &         
,acc\ntability ,re=m ,act ( #bjad4  #b4 
,improvem5t ( p]=mance appraisal ( s5ior
 executives ( ! ,dep>tm5t ( ,vet]ans    
,affairs  7a7 ,p]=mance appraisal sy/em 
7#a7 ,9 g5]al ,*apt] #g ( title #ch1    
,unit$ ,/ates ,code1 is am5d$ by add+ at
 ! end ! foll[+ new section3  #gac4     
,s5ior ,executive ,s]vice3 p]=mance     
appraisal  7a7 ,p]=mance appraisal sy/em
 ,! ,secret>y %all be responsible =     
c>ry+ out ! requirem5ts ( sub*apt] ,,ii 
( *apt] #dc ( title #e4  7b7            

,organizational p]=mance requirem5ts    
7#a7 ,9 implem5t+ ! p]=mance appraisal  
sy/em = s5ior executives ( ! ,dep>tm5t  
requir$ by section #dcab ( title #e1 !  
,secret>y %all issue1 by n lat] ?an     
,septemb] #a ( ea* ye>1 organizational  
p]=mance requirem5ts to be us$ to in=m !
 e/abli%m5t ( p]=mance requirem5ts = ea*
 s5ior executive ( ! ,dep>tm5t4 ,!      
p]=mance requirem5ts ( ea* s5ior        
executive %all be a*ievable by ea* s5ior
 executive & %all be consi/5t ) !       
organizational p]=mance requirem5ts     
issu$ by ! ,secret>y4  7#b7 ,n less ?an 
half ( ! annual summ>y rat+ ( a s5ior   
executive ( ! ,dep>tm5t "u section #dcad
 ( title #e %all be bas$ on !           
organizational p]=mance requirem5ts     
issu$ "u ?is subsection & applicable to 
su* s5ior executive4  7#c7 ,n lat] ?an  
,decemb] #ae ( ea* ye>1 ! ,secret>y %all
 submit to ! ,committees on ,vet]ans'   
,affairs ( ! ,s5ate & ,h\se (           
,repres5tatives c]tification t = !      
fiscal ye> dur+ :i* ! c]tification is   

submitt$ t--  7,a7 all individual &     
organizational p]=mance requirem5ts     
applicable to s5ior executives ( !      
,dep>tm5t pursuant to section #dcab (   
title #e accurately reflect$ !          
organizational p]=mance requirem5ts ( ! 
,dep>tm5t2 &  7,b7 ! p]=mance           
requirem5ts e/abli%$ = ea* s5ior        
executive are expect$ to lead to !      
ov]all success ( ! ,dep>tm5t 9 meet+ its
 organizational p]=mance requirem5ts4   
7c7 ,additional requirem5ts  7#a7 ,9    
implem5t+ ! p]=mance appraisal sy/em =  
s5ior executives ( ! ,dep>tm5t requir$  
by section #dcab ( title #e1 ! ,secret>y
 %all ensure t su* sy/em is design$ to--
  7,a7 evaluate ! contribution ( ea*    
s5ior executive to ! ov]all mission &   
objectives ( ! ,dep>tm5t2  7,b7 ensure t
 ea* s5ior executive is acc\ntable =    
ef=ts und]tak5 to fur!r ! objectives ( !
 ,dep>tm5ts2 &  7,c7 evaluate !         
contribution ( ea* s5ior executive 9    
ensur+ ! ,dep>tm5t meets ! ne$s (       
vet]ans & _! dep5dants4  7#b7  7,a7 ,!  

p]=mance review bo>d e/abli%$ pursuant  
to section #dcad ( title #e %all ensure 
t--  7i7 ! p]=mance requirem5ts = ea*   
s5ior executive ( ! ,dep>tm5t cle>ly &  
di/9ctly address bo? individual &       
organizational p]=mance2 &  7ii7 !      
p]=mance ( ea* s5ior executive is       
evaluat$ bas$ on su* p]=mance           
requirem5ts toge!r ) ! demon/rat$       
acc\ntability1 executive1 & lead]%ip    
capabilities ( ! s5ior executive4  7,b7 
,9 evaluat+ ! p]=mance ( a s5ior        
executive ( ! ,dep>tm5t1 ! p]=mance     
review bo>d %all take into consid]ation 
ea* ( ! foll[+3  7i7 ,any defici5cies   
id5tifi$ by ! ,inspector ,g5]al ( !     
,dep>tm5t or ! ,comptroll] ,g5]al ( !   
,unit$ ,/ates 9 ! p]=mance ( duties or  
areas manag$ by ! s5ior executive4  7ii7
 ,any f9al det]m9ation 9 response to a  
=mal compla9t submitt$ reg>d+ ! p]=mance
 ( ! s5ior executive or a defici5cy 9 a 
program "u ! direction ( ! s5ior        
executive4  7iii7 ,! f9d+s ( any f9al   
report relat+ to ! p]=mance ( ! s5ior   

executive or to a defici5cy 9 a program 
"u ! direction ( ! s5ior executive4  7d7
 ,annual summ>y rat+s  7#a7 ,! ,secret>y
 %all provide 9 a timely mann] to any   
s5ior executive :o receives an annual   
summ>y rat+ "u section #dcad7;a7 ( title
 #e ( any level ( p]=mance l[] ?an fully
 successful a detail$ explanation ( !   
p]=mance defici5cies ( ! s5ior          
executive4  7#b7 ,9 ! case ( a s5ior    
executive = :om x is det]m9$ dur+ a     
mid-ye> review t ! s5ior executive is   
likely to receive an annual summ>y rat+ 
( less ?an fully successful1 ! ,secret>y
 %all ensure t s5ior executive is       
provid$ a plan to address p]=mance      
defici5cies be=e ! end ( ! evaluation   
p]iod4  7#c7 ,any s5ior executive ( !   
,dep>tm5t :o receives two annual summ>y 
rat+s ( any level ( p]=mance l[] ?an    
fully successful %all be remov$ f !     
,s5ior ,executive ,s]vice4  7#d7 ,any   
s5ior executive :o receives ?ree        
consecutive annual summ>y rat+s ( !     
highe/ level ( p]=mance %all be provid$ 

) an opportunity to obta9 a diff]5t     
position )9 ! ,dep>tm5t ) m             
responsibility1 if su* a position is    
available4  7e7 ,annual reports ,n lat] 
?an ,janu>y #a ( ea* ye>1 ! ,secret>y   
%all submit to ! ,committees on         
,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( 
,repres5tatives a report on ! s5ior     
executive p]=mance appraisal sy/em ( !  
,dep>tm5t = ! fiscal ye> prec$+ ! fiscal
 ye> dur+ :i* ! report is submitt$4 ,ea*
 su* report %all include1 = ! ye> cov]$ 
by ! report1 ea* ( ! foll[+3  7#a7 ,!   
numb] ( s5ior executives :o receiv$     
summ>y rat+s4  7#b7 ,! numb] ( s5ior    
executives :o receiv$ a summ>y rat+ at  
ea* level ( p]=mance4  7#c7 ,any actions
 tak5 ) respect to s5ior executives :o  
receiv$ rat+s at a level ( p]=mance l[] 
?an fully successful4  7#d7 ,! numb] (  
initial annual summ>y rat+s t 7 rais$ or
 l[]$ by ! p]=mance review bo>d4  4     
7#b7 ,cl]ical am5dm5t ,! table (        
sections at ! beg9n+ ( su* *apt] is     
am5d$ by add+ at ! end ! foll[+ new     

item3  #gac4 ,s5ior ,executive ,s]vice3 
p]=mance appraisal4  4  7b7 ,p]=mance   
pay = physicians & d5ti/s ,section #gdca
 ( title #ch1 ,unit$ ,/ates ,code1 is   
am5d$--  7#a7 9 subsection 7b77#c71 by  
ins]t+ aft] d5ti/ ! foll[+3 :o receiv$ a
 fully successful level ( p]=mance at ! 
physician or d5ti/'s mo/ rec5t p]=mance 
appraisal2  7#b7 9 subsection 7c7--     
7,a7 9 p>agraph 7#b7--  7i7 by ins]t+   
7,a7 be=e ,m>ket pay2 &  7ii7 by add+ at
 ! end ! foll[+ new subp>agraph3  7,b7  
,! ,secret>y %all submit to !           
,committees on ,vet]ans' ,affairs ( !   
,s5ate & ,h\se ( ,repres5tatives a      
semi-annual report on heal? c>e tr5ds1  
includ+ anticipat$ %ortages ( heal? c>e 
pr(essionals by specific specialty &    
location1 :i* %all be us$ 9 det]m9+ !   
recruitm5t & ret5tion ne$s ( ! ,dep>tm5t
 = purposes ( ?is subsection4 ,!        
,secret>y may n provide m>ket pay to a  
physician or d5ti/ "u ?is subsection    
unless ! paym5t ( m>ket pay to !        
physician or d5ti/ meets a specialty or 

location ne$ ( ! ,dep>tm5t z articulat$ 
9 a report submitt$ "u ?is subp>agraph4 
4  7,b7 9 p>agraph 7#d77;,b7--  7i7 9   
clause 7i71 by /rik+ ! la/ s5t5ce2 &    
7ii7 9 clause 7iii71 by /rik+ %\ld1 to !
 ext5t practicable1 & ins]t+ %all2 &    
7#c7 9 subsection 7d7--  7,a7 9 p>agraph
 7#a7--  7i7 by ins]t+ 7,a7 be=e ,"o    
elem5t2 &  7ii7 by add+ at ! end !      
foll[+3 ,! ,secret>y %all e/abli% a     
p]=mance appraisal sy/em = physicians & 
d5ti/s4 ,! p]=mance appraisal sy/em %all
 provide = annual summ>y rat+s ( levels 
( p]=mance z foll[s3  7,a7 "o or m fully
 successful levels2  7,b7 a m9imally    
satisfactory level2 &  7,c7 an          
unsatisfactory level4  2  7iii7 by      
ins]t+ aft] subp>agraph 7,a7 ! foll[+   
new subp>agraph3  7,b7 ,"u ! p]=mance   
appraisal sy/em "u subp>agraph 7,a71    
p]=mance %all be evaluat$ bas$ on bo?   
individual & organizational p]=mance &  
specific goals or objectives %all be    
explicitly l9k$ to improv$ heal? c>e    
outcomes & quality z well z !           

,dep>tm5t's ov]all effectiv5ess 9       
provid+ quality heal? c>e s]vices4 ,!   
specific goals & objectives %all be     
consi/5t ) ! ov]>*+ objectives & goals (
 ! ,dep>tm5t4  7,c7 ,"u su* p]=mance    
appraisal sy/em1 ea* physician & d5ti/  
employ$ by ! ,dep>tm5t %all receive an  
annual review by ! ,"u ,secret>y (      
,heal?4 ,= ea* ye>1 ! ,"u ,secret>y %all
 submit to ! ,secret>y c]tification t   
su* reviews are conduct$4  2  7,b7 by   
/rik+ p>agraph 7#c7 & r$esignat+        
p>agraph 7#b7 z p>agraph 7#c72  7,c7 by 
ins]t+ aft] p>agraph 7#a7 ! foll[+ new  
p>agraph 7#b73  7#b7 ,"u ! p]=mance     
appraisal sy/em e/abli%$ "u p>agraph    
7#a7--  7,a7 on or be=e ! beg9n+ ( ea*  
rat+ p]iod1 p]=mance requirem5ts = ea*  
physician or d5ti/ %all be e/abli%$ 9   
consultation )1 & communicat$ to1 ea*   
physician or d5ti/2  7,b7 writt5        
appraisals ( p]=mance %all be bas$ on ! 
individual & organizational p]=mance    
requirem5ts e/abli%$ = ! rat+ p]iod     
involv$2 &  7,c7 ea* physician or d5ti/ 

%all be provid$ a copy ( ! appraisal & !
 physician or d5ti/'s p]=mance appraisal
 rat+ & %all be giv5 an opportunity to  
respond 9 writ+ & h ! rat+ review$ by ! 
,"u ,secret>y = ,heal? be=e ! rat+      
becomes f9al4  2  7,d7 9 p>agraph 7#c71 
z r$esignat$ by subp>agraph 7,b7--  7i7 
by ins]t+ only aft] paid2 &  7ii7 by    
/rik+ on ! basis & ins]t+ :o receives a 
level ( p]=mance ( fully successful "u !
 p]=mance appraisal sy/em e/abli%$ "u   
p>agraph 7#a7 & ^: p]=mance exce$s !    
specific goals & p]=mance objectives    
e/abli%$ "u su* sy/em42  7,e7 9 p>agraph
 7#d71 by /rik+ p>agraph 7#b7 & ins]t+  
?is subsection2  7,f7 9 p>agraph        
7#e77;,b71 by /rik+ #g4e p]c5t & ins]t+ 
#e p]c5t2 &  7,g7 by /rik+ p>agraph     
7#f72 &  7#d7 by add+ at ! end ! foll[+ 
new subsection3  7i7 ,failure ,to ma9ta9
 a lic5se ,a physician or d5ti/ :o has n
 ma9ta9$ an appropriate pr(essional     
lic5se may n be paid4  4  7c7 ,/udy ,n  
lat] ?an "o ye> aft] ! date ( ! enactm5t
 ( ?is ,act1 ! ,secret>y %all submit to 

! ,committees on ,vet]ans' ,affairs ( ! 
,s5ate & ,h\se ( ,repres5tatives a      
report on ! tra9+ program ( ! ,dep>tm5t 
( ,vet]ans ,affairs = s5ior executives4 
,su* report %all include--  7#a7 an     
evaluation ( succession plann+ &        
long-t]m c>e] developm5t plans = s5ior  
executives & ef=ts und]tak5 by !        
,dep>tm5t to improve cross-,dep>tm5t    
opportunities = s5ior executives2 &     
7#b7 ! recomm5dations ( ! ,secret>y =   
improv+ ! mobility & effectiv5ess (     
s5ior executives4