,i  #aac? ,,congress  #b;d ,session  ,h4
 ,r4 #ejjg  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,june #bf1 #bjad ,mr4 
,ruiz introduc$ ! foll[+ bill2 :i* 0    
ref]r$ to ! ,committee on ,vet]ans'     
,affairs  ,a ,,bill  ,to assess /aff+   
%ortages at m$ical facilities ( !       
,dep>tm5t ( ,vet]ans ,affairs1 & = o!r  
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,re/or+ ,acc\ntability 9   
,vet]ans ,access to ,heal? ,c>e ,act4   
#b4 ,treatm5t ( /aff+ %ortage & report  
on /aff+ ( m$ical facilities ( !        
,dep>tm5t ( ,vet]ans ,affairs  7a7      
,/aff+ %ortage  7#a7 ,9 g5]al ,n lat]   
?an #ahj days aft] ! date ( ! enactm5t (
 ?is ,act1 & annually !reaft]1 !        
,inspector ,g5]al ( ! ,dep>tm5t (       
,vet]ans ,affairs %all det]m9e1 & publi%
 9 ! ,f$]al ,regi/]1 ! five occupations 
( heal? c>e provid]s ( ! ,dep>tm5t (    
,vet]ans ,affairs = :i* !re is ! l>ge/  
/aff+ %ortage ?r\gh\t ! ,dep>tm5t4  7#b7
 ,recruitm5t & appo9tm5t ,not)/&+       
sections #ccjd & #ccji ?r\gh #ccah (    

title #e1 ,unit$ ,/ates ,code1 !        
,secret>y ( ,vet]ans ,affairs1 bas$ ^u a
 det]m9ation by ! ,inspector ,g5]al "u  
p>agraph 7#a7 t !re is a /aff+ %ortage  
?r\gh\t ! ,dep>tm5t ) respect to a      
p>ticul> occupation ( heal? c>e provid]1
 may recruit & directly appo9t highly   
qualifi$ heal? c>e provid]s to a        
position to s]ve z a heal? c>e provid] 9
 t p>ticul> occupation = ! ,dep>tm5t4   
7b7 ,reports  7#a7 ,9 g5]al ,n lat] ?an 
#ahj days aft] ! date ( ! enactm5t ( ?is
 ,act1 & n lat] ?an ,decemb] #ca ( ea*  
ev5 numb]$ ye> !reaft] until #bjbd1 !   
,secret>y ( ,vet]ans ,affairs %all      
submit to ! ,committee on ,vet]ans'     
,affairs ( ! ,s5ate & ! ,committee on   
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives a report assess+ ! /aff+
 ( ea* m$ical facility ( ! ,dep>tm5t (  
,vet]ans ,affairs4  7#b7 ,elem5ts ,ea*  
report submitt$ "u p>agraph 7#a7 %all   
include ! foll[+3  7,a7 ,! results ( a  
sy/em-wide assessm5t ( all m$ical       
facilities ( ! ,dep>tm5t to ensure !    

foll[+3  7i7 ,appropriate /aff+ levels =
 heal? c>e provid]s to meet ! goals ( ! 
,secret>y = timely access to c>e =      
vet]ans4  7ii7 ,appropriate /aff+ levels
 = support p]sonnel1 includ+ cl]ks4     
7iii7 ,appropriate sizes = cl9ical      
panels4  7iv7 ,appropriate numb]s (     
full-"t /aff1 or full-"t equival5t1     
d$icat$ to direct c>e ( pati5ts4  7v7 ,!
 appropriate physician to pati5t ratio  
7includ+ = bo? prim>y & specialty c>e71 
z comp>$ to su* ratio z x exi/s on !    
date ( ! report4  7vi7 ,appropriate     
physical plant space to meet ! capacity 
ne$s ( ! ,dep>tm5t 9 t area4  7vii7 ,su*
 o!r factors z ! ,secret>y consid]s     
necess>y4  7,b7 ,an explanation ( !     
measurable productivity /&>ds us$ to    
e/abli% ! levels 9 ! assessm5t describ$ 
9 subp>agraph 7,a74  7,c7 ,a plan =     
address+ any issues id5tifi$ 9 !        
assessm5t describ$ 9 subp>agraph 7,a71  
includ+ a timel9e = address+ su* issues4
  7,d7 ,a li/ ( ! curr5t wait times &   
workload levels = ! foll[+ cl9ics 9 ea* 

m$ical facility3  7i7 ,m5tal heal?4     
7ii7 ,prim>y c>e4  7iii7 ,ga/ro5t]ology4
  7iv7 ,wom5's heal?4  7v7 ,specialty   
c>e4  7vi7 ,oph?almology4  7vii7 ,su*   
o!r cl9ics z ! ,secret>y consid]s       
appropriate4  7,e7 ,a description ( !   
results ( ! det]m9ation ( ! ,secret>y "u
 p>agraph 7#a7 ( subsection 7a7 & a plan
 to use direct appo9tm5t au?ority "u    
p>agraph 7#b7 ( su* subsection to fill  
/aff+ %ortages1 includ+ recomm5dations =
 improv+ ! spe$ at :i* ! cr$5tial+ &    
privileg+ process c be conduct$4  7,f7  
,! curr5t /aff+ models ( ! ,dep>tm5t = !
 foll[+ cl9ics1 includ+ recomm5dations =
 *anges to su* models3  7i7 ,m5tal      
heal?4  7ii7 ,prim>y c>e4  7iii7        
,ga/ro5t]ology4  7iv7 ,wom5's heal?4    
7v7 ,specialty c>e4  7vi7 ,oph?almology4
  7vii7 ,su* o!r cl9ics z ! ,secret>y   
consid]s appropriate4  7,g7 ,a detail$  
analysis ( succession plann+ at m$ical  
facilities ( ! ,dep>tm5t1 includ+ !     
foll[+3  7i7 ,! numb] ( positions 9     
m$ical facilities ?r\gh\t ! ,dep>tm5t t 

are n fill$ by a p]man5t employee4  7ii7
 ,! l5g? ( "t ea* su* position describ$ 
9 clause 7i7 rema9$ vacant or fill$ by a
 tempor>y or act+ employee4  7iii7 ,a   
description ( any b>ri]s to fill+ !     
positions describ$ 9 clause 7i74  7iv7  
,a plan = fill+ any positions t are     
vacant or fill$ by a tempor>y or act+   
employee = m ?an #ahj days4  7v7 ,a plan
 = h&l+ em]g5cy circum/ances1 su*       
adm9i/rative leave or sudd5 m$ical leave
 = s5ior (ficials4  7,h7 ,! numb] (     
heal? c>e provid]s :o h be5 remov$ f _! 
position or h retir$1 by provid] type1  
dur+ ! two-ye> p]iod prec$+ ! submittal 
( ! report4  7,i7 ,( ! heal? c>e        
provid]s specifi$ 9 subp>agraph 7,g7 t h
 be5 remov$ f _! position1 ! foll[+3    
7i7 ,! numb] ( su* heal? c>e provid]s :o
 7 reassign$ to ano!r position 9 !      
,dep>tm5t4  7ii7 ,! numb] ( su* heal?   
c>e provid]s :o left ! ,dep>tm5t4  #c4  
,cl9ic managem5t tra9+ program ( !      
,dep>tm5t ( ,vet]ans ,affairs  7a7 ,9   
g5]al ,n lat] ?an #ahj days aft] ! date 

( ! enactm5t ( ?is ,act1 ! ,secret>y (  
,vet]ans ,affairs %all implem5t a cl9ic 
managem5t tra9+ program to provide      
9-p]son1 /&>diz$ education on heal? c>e 
managem5t to all manag]s (1 & heal? c>e 
provid]s at1 m$ical facilities ( !      
,dep>tm5t ( ,vet]ans ,affairs4  7b7     
,elem5ts ,! cl9ic managem5t tra9+       
program requir$ by subsection 7a7 %all  
include ! foll[+3  7#a7 ,tra9+ on h[ to 
manage ! s*$ules ( heal? c>e provid]s ( 
! ,dep>tm5t & tra9+ on cu/om] s]vice &  
vet]an-c5t]$ c>e1 includ+ prop] plann+  
proc$ures = vacation1 leave1 & graduate 
m$ical education tra9+ s*$ules4  7#b7   
,tra9+ on ! appropriate numb] (         
appo9tm5ts t a heal? c>e provid] %\ld   
conduct on a daily basis1 bas$ on       
specialty4  7#c7 ,tra9+ on h[ to det]m9e
 :e!r !re are en\gh available appo9tm5t 
slots to manage dem& = diff]5t appo9tm5t
 types & me*anisms = al]t+ managem5t (  
insuffici5t slots4  7#d7 ,tra9+ on h[   
s*$ul+ sy/ems w be monitor$ & h[ s*$ul]s
 w be held acc\ntable = accurate data4  

7#e7 ,tra9+ on h[ to prop]ly use data to
 meet ! dem& = heal? c>e1 includ+ !     
foll[+3  7,a7 ,tra9+ on det]m9+ ! next  
available appo9tm5t = ea* heal? c>e     
provid] at ! m$ical facility4  7,b7     
,tra9+ on det]m9+ ! numb] ( heal? c>e   
provid]s ne$$ to meet dem& = heal? c>e  
at ! m$ical facility4  7,c7 ,tra9+ on   
det]m9+ ! numb] ( exam rooms ne$$ to    
meet dem& = su* heal? c>e 9 an effici5t 
mann]4  7#f7 ,tra9+ on h[ to prop]ly use
 ! appo9tm5t s*$ul+ sy/em ( ! ,dep>tm5t1
 includ+ any new s*$ul+ sy/em implem5t$ 
by ! ,dep>tm5t4  7#g7 ,tra9+ on h[ to   
optimize ! use ( te*nology1 includ+ !   
foll[+3  7,a7 ,telem$ic9e4  7,b7        
,electronic mail4  7,c7 ,text messag+4  
7,d7 ,su* o!r te*nologies z specifi$ by 
! ,secret>y4  7#h7 ,tra9+ on h[ to      
prop]ly use physical plant space at     
m$ical facilities ( ! ,dep>tm5t to      
ensure effici5t fl[ & privacy = pati5ts 
& /aff4