,,ii #aacth ,,congress #ast ,session ,s4 #edc ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #ac1 #bjac ,mr4 ,burr 7for himself and ,mr4 ,coburn7 introduced the following bill2 which was read twice and referred to the ,committee on ,veterans' ,affairs ,a ,,bill ,to require the ,secretary of ,veterans ,affairs to reorganize the ,veterans ,integrated ,service ,networks of the ,veterans ,health ,administration1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,,visn ,reorganization ,act of #bjac4 #b4 ,administration of ,veterans ,integrated ,service ,networks 7a7 ,veterans ,integrated ,service ,networks 7#a7 ,in general ,subchapter ,i of chapter #gc of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #gcaj4 ,veterans ,integrated ,service ,networks 7a7 ,organization ,the ,secretary shall organize the ,veterans ,health ,administration in #ab geographically defined ,veterans ,integrated ,service ,networks4 7b7 ,alignment with mission of ,department ,the ,secretary shall ensure that the staff1 services1 and programs of each ,veterans ,integrated ,service ,network are aligned with the mission of the ,department and the specific health care requirements of each population of veterans in each ,network4 7c7 ,implementation of ,national goals ,the ,secretary shall ensure that each ,veterans ,integrated ,service ,network takes appropriate measures to implement the national goals of the ,department within their networks and associated medical centers4 7d7 ,integrated health care system ,the ,secretary shall ensure that each ,veterans ,integrated ,service ,network maintains a regional integrated healthcare system by-- 7#a7 implementing alliances with such other governmental1 public1 and private health care organizations and practitioners as the ,secretary considers appropriate to meet the needs of veterans in the ,network2 7#b7 providing oversight and management of1 and taking responsibility for1 a regional budget for the activities of the ,veterans ,health ,administration in the geographic area of the ,network that-- 7,a7 is aligned with the budget guidelines of the ,department and the ,veterans ,health ,administration2 and 7,b7 is balanced at the end of each fiscal year2 7#c7 using national metrics to develop systems to provide effective1 efficient1 and safe delivery of health care that is rated as highly satisfactory by patients and families of patients2 and 7#d7 ensuring high quality clinical programs and services are rendered in and through-- 7,a7 the medical centers and outpatient clinics of the ,department that are located in the ,network2 and 7,b7 other non-,department clinical or health care delivery settings located in the ,network4 7e7 ,reduction in duplicate functions ,the ,secretary shall ensure that the ,veterans ,integrated ,service ,networks identify and reduce1 whenever practicable1 the duplication of functions in clinical1 administrative1 and operational processes and practices of the ,veterans ,health ,administration4 7f7 ,collaboration and cooperation ,the ,secretary shall ensure that each ,veteran ,integrated ,service ,network-- 7#a7 works to achieve maximum effectiveness in patient care and safety1 graduate medical education1 and research2 and 7#b7 assesses the consolidation or realignment of institutional functions1 including capital asset1 safety1 and operational support functions1 in collaboration and cooperation with other ,veterans ,integrated ,service ,networks and the following offices or entities within the geographical area of the ,network3 7,a7 ,the offices of the ,veterans ,benefits ,administration and the ,national ,cemetery ,administration4 7,b7 ,the offices1 installations1 and facilities of the ,department of ,defense1 including the offices1 installations1 and facilities of each branch of the ,armed ,forces and the reserve components of the ,armed ,forces4 7,c7 ,the offices1 installations1 and facilities of the ,coast ,guard4 7,d7 ,offices of ,state and local agencies that have a mission to provide assistance to veterans4 7,e7 ,medical schools and other affiliates4 7,f7 ,offices of ,congress1 offices of ,state and local elected officials1 and other government offices4 7,g7 ,federal1 ,state and local emergency preparedness organizations4 7,h7 ,community and faith-based organizations4 7,i7 ,such other offices of the ,federal ,government as the ,secretary considers appropriate4 7g7 ,development and sharing of innovations and practices ,the ,secretary shall ensure that the ,veterans ,integrated ,service ,networks develop and share innovations and best practices with each other at the local1 regional1 and national levels4 7h7 ,headquarters 7#a7 ,the ,secretary shall ensure that each ,veterans ,integrated ,service ,network has only one headquarters office4 7#b7 ,the location of a headquarters office for a ,veterans ,integrated ,service ,network shall be determined by the ,secretary and co-located with a ,department of ,veterans ,affairs medical center4 7#c7 7,a7 ,the ,secretary may employ or contract for the services of not more than #fe full time equivalent employees and contractors at the headquarters of each ,veterans ,integrated ,service ,network4 7,b7 ,not less frequently than once each year1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on employment at the headquarters of ,veterans ,integrated ,service ,networks during the most recently completed fiscal year4 7,c7 ,each report submitted under subparagraph 7,b7 shall include the following for the year covered by the report3 7i7 ,the number of individuals employed at each headquarters of a ,veterans ,integrated ,service ,network4 7ii7 ,the number of individuals employed by the ,veterans ,health ,administration in each ,veterans ,integrated ,service ,network who are not employed at the same location as the headquarters of the ,network4 7iii7 ,the title for each position of employment at a headquarters of a ,veterans ,integrated ,service ,network4 7iv7 ,the title for each position of employment with the ,veterans ,health ,administration in each ,veterans ,integrated ,service ,network that is not at the same location as the headquarters of the ,network4 7v7 ,an assessment of the impact on the budget of the ,department by the employment of individuals at the headquarters of the ,veterans ,integrated ,service ,networks4 7i7 ,triennial structure review1 reassessment1 and report 7#a7 ,beginning three years after the date of the enactment of this section and not less frequently than once every three years thereafter1 the ,secretary shall conduct a review and assessment of the structure and operations of the ,veterans ,integrated ,service ,networks4 7#b7 ,not later than #ahj days after conducting a review and assessment under paragraph 7#a71 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on such review and assessment1 which shall include such recommendations for legislative or regulatory action as the ,secretary considers appropriate to improve the ,veterans ,integrated ,service ,networks4 4 7#b7 ,clerical amendment ,the table of sections at the beginning of chapter #gc of such title is amended by inserting after the item relating to section #gcji the following new item3 #gcaj4 ,veterans ,integrated ,service ,networks4 4 7b7 ,consolidation of networks 7#a7 ,in general ,in order to comply with section #gcaj7;a7 of title #ch1 ,united ,states ,code1 as added by subsection 7a71 not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall geographically realign and combine the #ba ,veterans ,integrated ,service ,networks in effect on the day before the date of the enactment of this ,act into #ab geographically defined ,veterans ,integrated ,service ,networks as follows3 7,a7 ,veterans ,integrated ,service ,network #a1 ,veterans ,integrated ,service ,network #b1 and ,veterans ,integrated ,service ,network #c shall be combined into a single ,veterans ,integrated ,service ,network4 7,b7 ,veterans ,integrated ,service ,network #d and ,veterans ,integrated ,service ,network #e shall be combined into a single ,veterans ,integrated ,service ,network4 7,c7 ,veterans ,integrated ,service ,network #i and ,veterans ,integrated ,service ,network #aj shall be combined into a single ,veterans ,integrated ,service ,network4 7,d7 ,veterans ,integrated ,service ,network #aa and ,veterans ,integrated ,service ,network #ab shall be combined into a single ,veterans ,integrated ,service ,network4 7,e7 ,veterans ,integrated ,service ,network #ae and ,veterans ,integrated ,service ,network #bc shall be combined into a single ,veterans ,integrated ,service ,network4 7,f7 ,veterans ,integrated ,service ,network #ag and ,veterans ,integrated ,service ,network #ah shall be combined into a single ,veterans ,integrated ,service ,network4 7,g7 ,veterans ,integrated ,service ,network #ai and ,veterans ,integrated ,service ,network #bj shall be combined into a single ,veterans ,integrated ,service ,network4 7,h7 ,veterans ,integrated ,service ,network #ba and ,veterans ,integrated ,service ,network #bb shall be combined into a single ,veterans ,integrated ,service ,network4 7#b7 ,consolidation of headquarters 7,a7 ,in general ,except as provided in subsection 7c71 for each set of ,veterans ,integrated ,service ,networks consolidated under paragraph 7#a71 the ,secretary shall retain one of the headquarters of such set in effect on the day before the date of the enactment of this ,act in the same location as in effect on the day before such date and eliminate any other headquarters of such set to meet the requirements of section #gcaj7;h7 of such title1 as added by subsection 7a74 7,b7 ,reemployment assistance ,for each individual whose position of employment is eliminated as a result of eliminating a headquarters under subparagraph 7,a71 the ,secretary shall take such measures as the ,secretary considers practicable to find a new position of employment for such individual within the ,department of ,veterans ,affairs4 7#c7 ,implementation plan ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a plan to carry out this subsection4 7c7 ,relocation of headquarters 7#a7 ,in general ,in the case of a headquarters office of a ,veterans ,integrated ,service ,network that on the day before the date of the enactment of this ,act was in a location that was not co-located with a ,department of ,veterans ,affairs medical center and the ,secretary is engaged in a lease for such location1 the ,secretary may-- 7,a7 relocate such headquarters upon the expiration of such lease so that such headquarters is co-located as required by section #gcaj7;h77#b7 of such title1 as added by subsection 7a72 or 7,b7 notwithstanding section #gcaj7;h77#b7 of such title1 as so added1 renew such lease or enter into a new lease to keep such headquarters in such location4 7#b7 ,report ,if the ,secretary renews a lease or engages in a new lease under paragraph 7#a77;,b71 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives1 before renewing such lease or engaging in such lease1 a report describing the reasons for such renewal or engagement4 ,such report shall include the following3 7,a7 ,a list of ,department of ,veterans ,affairs medical centers in the ,veterans ,integrated ,service ,network of the headquarters with underutilized buildings1 the number of such buildings1 and the total underutilized square footage for each such medical center4 7,b7 ,the cost of the current lease 7the annual amount of rent1 the total cost over the life of the lease1 and the total cost per square foot7 and the current square footage being leased4 7,c7 ,the cost of the new lease 7the annual amount of rent1 the total cost over the life of the lease1 and the total cost per square foot7 and the square footage to be leased4 #c4 ,regional support centers for ,veterans ,integrated ,service ,networks 7a7 ,regional support centers 7#a7 ,in general ,subchapter ,i of chapter #gc of title #ch1 ,united ,states ,code1 as amended by section #b7;a71 is further amended by adding at the end the following new section3 #gcaj;,a4 ,regional support centers for ,veterans ,integrated ,service ,networks 7a7 ,establishment ,the ,secretary shall establish not more than four regional support centers within the ,veterans ,health ,administration to assess the effectiveness and efficiency of the ,veterans ,integrated ,service ,networks4 ,the head of each regional support center shall report to the ,under ,secretary of ,health4 7b7 ,functions ,the functions of the regional support centers established under subsection 7a7 are as follows3 7#a7 ,to assess the quality of work performed within finance operations and other compliance related activities of the ,veterans ,integrated ,service ,networks4 7#b7 ,to assess how effectively and efficiently each ,veterans ,integrated ,service ,network conducts outreach to veterans who served in ,operation ,enduring ,freedom1 ,operation ,iraqi ,freedom1 ,operation ,new ,dawn1 or another contingency operation 7as defined in section #aja of title #aj74 7#c7 ,to assess how effectively and efficiently each ,veterans ,integrated ,service ,network conducts programs for the benefit of women veterans4 7#d7 ,to assess how effectively and efficiently each ,veterans ,integrated ,service ,network conducts programs that address homelessness among veterans4 7#e7 ,to assess how effectively and efficiently each ,veterans ,integrated ,service ,network consumes energy4 7#f7 ,to assess such other matters concerning the operations and activities of the ,veterans ,integrated ,service ,networks as the ,secretary considers appropriate4 7c7 ,staff ,the ,secretary may hire such employees and contractors as the ,secretary considers appropriate to carry out the functions of the regional support centers4 7d7 ,location of regional support centers 7#a7 ,except as provided in paragraph 7#b71 the location of each regional support center established under subsection 7a7 shall be determined by the ,secretary and co-located with a ,department of ,veterans ,affairs medical center4 7#b7 ,the ,secretary may choose a location for a regional support center established under subsection 7a7 that is not co-located with a ,department of ,veterans ,affairs medical center if the ,secretary submits to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives1 before engaging in a lease for such location1 a report explaining the reasons for the choice of the ,secretary of a location for the regional support center that is not co-located with a ,department of ,veterans ,affairs medical center4 ,such report shall include the following3 7,a7 ,a list of ,department of ,veterans ,affairs medical centers in the ,veterans ,integrated ,service ,network of the regional support center with underutilized buildings1 the number of all ,veterans ,health ,administration buildings in such ,network1 and the total underutilized square footage for each medical center in such ,network4 7,b7 ,in the case that the ,secretary engages in a lease for the location of the regional support center1 the cost of such lease 7the annual amount of rent1 the total cost over the life of the lease1 and the total cost per square foot7 and the square footage to be leased4 4 7#b7 ,clerical amendment ,the table of sections at the beginning of chapter #gc of such title1 as amended by section #b7;a77#b71 is further amended by inserting after the item relating to section #gcaj the following new item3 #gcaj;,a4 ,regional support centers for ,veterans ,integrated ,service ,networks4 4 7b7 ,initial staffing ,in providing for the initial staff of each regional support center established under section #gcaj;,a7a7 of title #ch1 ,united ,states ,code1 as added by subsection 7a71 the ,secretary of ,veterans ,affairs shall1 to the extent practicable1 transfer employees who were employed in positions at headquarters of ,veterans ,integrated ,service ,networks that covered functions similar to those described in section #gcaj;,a7b7 of such title1 as so added1 from such headquarters to regional support centers4 #d4 ,construction ,nothing in this ,act shall be construed to require any change in the location or type of medical care or service provided by a ,department of ,veterans ,affairs medical center1 a ,department community-based outpatient clinic1 a center for readjustment counseling and related mental health services for veterans under section #agab;,a of title #ch1 ,united ,states ,code 7known as a vet center71 or another facility that provides direct care or services under a law administered by the ,secretary of ,veterans ,affairs4