,,ii  #aaeth ,,congress  #b;d ,session  
,s4 #bceg  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,january #cj1  
#bjah ,mr4 ,tester 7for himself1 ,mrs4  
,murray1 ,mr4 ,blumenthal1 and ,mr4     
,manchin7 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 review the       
processes and requirements of the       
,department of ,veterans ,affairs for   
scheduling appointments for health care 
and conducting consultations under the  
laws administered by the ,secretary1 and
 for other purposes4  #a4 ,short title  
,this ,act may be cited as the          
,accountability in ,department of       
,veterans ,affairs ,scheduling and      
,consult ,management ,act4  #b4         
,processes and requirements for         
scheduling appointments for health care 
from ,department of ,veterans ,affairs  
7a7 ,processes and requirements ,not    
later than #fj days after the date of   

the enactment of this ,act1 the         
,secretary of ,veterans ,affairs shall  
submit to the ,committee on ,veterans'  
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a           
description of the processes and        
requirements for scheduling appointments
 for health care from the ,department of
 ,veterans ,affairs at the medical      
facility level to be used by the        
,department4  7b7 ,training on processes
 and requirements  7#a7 ,certification  
,not later than one year after the date 
of the enactment of this ,act1 the      
,secretary shall require individuals    
involved in the scheduling of           
appointments for health care from the   
,department to certify to the ,secretary
 that the individual understands the    
processes and requirements described in 
subsection 7a74  7#b7 ,new employees    
,the ,secretary shall require all       
employees hired by the ,department after
 the date of the enactment of this ,act 

who are to be involved in the scheduling
 of appointments for health care from   
the ,department to undergo training on  
the processes and requirements described
 in subsection 7a7 as part of the       
onboarding process4  7c7 ,method ,to    
monitor compliance  7#a7 ,in general    
,not later than #ahj days after the date
 of the enactment of this ,act1 the     
,secretary shall establish or maintain a
 method or tool to monitor and ensure   
that each medical facility of the       
,department complies with the processes 
and requirements described in subsection
 7a74  7#b7 ,use throughout ,department 
7,a7 ,in general ,the ,secretary shall  
require each medical facility of the    
,department to use the method or tool   
described in paragraph 7#a74  7,b7      
,certification ,not later than one year 
after the date of the enactment of this 
,act1 the ,secretary shall require the  
director of each medical facility of the
 ,department to certify to the          
,secretary that the director is using   

the method or tool described in         
paragraph 7#a74  7#c7 ,audits  7,a7 ,in 
general ,not less frequently than twice 
each year1 the ,secretary shall provide 
for the conduct of facility-level audits
 of the scheduling of appointments1     
which shall include recommendations for 
corrective action1 including additional 
training1 increased personnel1 and such 
other resources as the ,secretary       
considers necessary4  7,b7 ,transmittal 
to ,,vha ,any audits conducted under    
subparagraph 7,a7 shall be transmitted  
to the ,under ,secretary for ,health of 
the ,department so that the ,under      
,secretary can--  7i7 strengthen        
oversight of those audits2  7ii7 monitor
 national policy on the scheduling of   
appointments throughout the ,department2
  7iii7 determine if a mobile deployment
 team is warranted2 and  7iv7 develop a 
remediation plan to address issues      
uncovered by those audits4  7#d7        
,reporting of scheduling issues ,the    
,secretary shall require each director  

of a medical center of the ,department--
 7,a7 to submit to the ,under ,secretary
 for ,health1 not less frequently than  
quarterly1 a report containing any      
scheduling issues that are uncovered at 
that medical center2  7,b7 to identify  
any corrective actions to be taken with 
respect to such issues1 including       
increased training or hiring2 and  7,c7 
to certify to the ,secretary that the   
director is in compliance with          
requirements of subparagraphs 7,a7 and  
7,b74  #c4 ,administration of           
non-,department of ,veterans ,affairs   
health care  7a7 ,certification of      
proper administration  7#a7 ,review     
7,a7 ,in general ,the ,secretary of     
,veterans ,affairs shall conduct a      
review of the staffing1 training1 and   
other requirements necessary to         
administer section #aja of the ,veterans
 ,access1 ,choice1 and ,accountability  
,act of #bjad 7,public ,law #aac-adf2   
#ch ,u4,s4,c4 #agja note7 and any other 
community care program of the           

,department of ,veterans ,affairs4  7,b7
 ,elements ,the review conducted under  
paragraph 7#a7 shall include1 with      
respect to each medical facility of the 
,department1 an assessment of the type  
of positions required to be staffed1 the
 number of such positions at the medical
 facility1 and the number filled at the 
medical facility4  7#b7 ,certification  
,not later than #ahj days after the date
 of the enactment of this ,act1 and     
every #ahj days thereafter1 the         
,secretary of ,veterans ,affairs shall  
submit to the ,committee on ,veterans'  
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives the results 
of the review conducted under paragraph 
7#a71 including a certification that all
 staffing1 training1 and other          
requirements described in paragraph     
7#a77;,a7 are fulfilled4  7b7           
,scheduling of appointments  7#a7 ,in   
general ,the ,secretary shall be        
responsible for ensuring that           

appointments for health care from       
non-,department health care providers   
under the laws administered by the      
,secretary are scheduled4  7#b7         
,timeliness goals ,not later than #cj   
days after the date of the enactment of 
this ,act1 the ,secretary shall         
establish timeliness goals for each step
 in scheduling an appointment for health
 care from a non-,department health care
 provider4  7#c7 ,measurement of        
timeliness for each facility ,not later 
than #abj days after the date of the    
enactment of this ,act1 the ,secretary  
shall measure1 for each medical facility
 of the ,department1 the time it takes  
from the date that a clinician of the   
,department determines that a veteran   
requires care from a non-,department    
health care provider to each of the     
following3  7,a7 ,the date that the     
referral for care is sent to the        
non-,department health care provider4   
7,b7 ,the date that the non-,department 
health care provider accepts the        

referral4  7,c7 ,the date that the      
appointment with the non-,department    
health care provider is made4  7,d7 ,the
 date of the appointment with the       
non-,department health care provider4   
7,e7 ,any other step that the ,secretary
 determines necessary to measure4  7#d7 
,publication of data  7,a7 ,in general  
,not later than one year after the date 
of the enactment of this ,act1 the      
,secretary shall publish the data       
measured under paragraph 7#c71          
disaggregated by medical facility1 on a 
publicly available ,internet website of 
the ,department4  7,b7 ,update ,not less
 frequently than biweekly1 the          
,secretary shall update the data        
published under subparagraph 7,a74  7c7 
,comptroller ,general report  7#a7 ,in  
general ,beginning not later than one   
year after the date of the enactment of 
this ,act1 the ,comptroller ,general of 
the ,united ,states shall review        
compliance by the ,secretary with the   
requirements of this section1 including 

a review of the veracity of data        
published by the ,secretary under       
subsection 7b77#d74  7#b7 ,completion   
,not later than three years after the   
date of the enactment of this ,act1 the 
,comptroller ,general shall submit to   
the ,committee on ,veterans' ,affairs of
 the ,senate and the ,committee on      
,veterans' ,affairs of the ,house of    
,representatives the results of the     
review conducted under paragraph 7#a74  
#d4 ,administration of consultations for
 health care from ,department of        
,veterans ,affairs  7a7 ,administration 
of outpatient consultation requests     
7#a7 ,national process ,not later than  
#ahj days after the date of the         
enactment of this ,act1 the ,secretary  
of ,veterans ,affairs shall establish a 
national process to track and process   
outpatient clinical consultation        
requests4  7#b7 ,training ,not later    
than one year after the date of the     
enactment of this ,act1 the ,secretary  
shall ensure that all individuals       

involved in the process of scheduling   
outpatient clinical consultations are   
properly trained4  7#c7 ,certification  
7,a7 ,in general ,the ,secretary shall  
ensure that directors of medical centers
 and ,veterans ,integrated ,service     
,networks of the ,department of         
,veterans ,affairs certify compliance1  
on a quarterly basis1 with the national 
process established under paragraph     
7#a74  7,b7 ,elements ,the certification
 under subparagraph 7,a7 shall include  
the following3 7i7 ,an assessment of    
whether consultations were appropriately
 processed4  7ii7 ,data with respect to 
consultations as follows3 7,i7          
,consultations that were scheduled      
within the request window4  7,,ii7      
,duplicate consultation requests4       
7,,iii7 ,consultations that were        
discontinued4  7,,iv7 ,delays in        
consultations4  7,v7 ,consultations that
 were not properly closed4  7iii7 ,for  
consultations that were improperly      
discontinued1 a description of          

remediation attempts4  7#d7 ,requests   
for mobile deployment teams  7,a7 ,in   
general ,a director of a medical center 
of the ,department shall request from   
the ,secretary a mobile deployment team 
under the program established under     
section #f if the requirements of the   
national process established under      
paragraph 7#a7 have not been met with   
respect to a facility under the         
jurisdiction of the director4  7,b7     
,report ,not less frequently than once  
every #ahj days1 the ,secretary shall   
submit to the appropriate committees of 
,congress a report setting forth each   
request under subparagraph 7,a7 during  
the period covered by the report1       
including an explanation of why a mobile
 deployment team was or was not         
provided1 as the case may be4  7b7      
,initial review  7#a7 ,in general ,the  
,secretary shall review the processes   
and requirements of the ,department with
 respect to consultations for health    
care under the laws administered by the 

,secretary4  7#b7 ,report ,not later    
than #ahj days after the date of the    
enactment of this ,act1 the ,secretary  
shall submit to the appropriate         
committees of ,congress a report on the 
results of the review conducted under   
paragraph 7#a74  7c7 ,biannual review   
,not later than #ahj days after the date
 of the enactment of this ,act1 and     
every #ahj days thereafter1 the         
,secretary shall conduct a review of    
consultations conducted at each medical 
facility of the ,department that        
includes the following3  7#a7 ,a review 
of the accuracy of the type of service1 
either administrative or clinical1 that 
is inputted in the electronic health    
record4  7#b7 ,a review of the accuracy 
of the type of consultation setting1    
either inpatient or outpatient1 that is 
inputted in the electronic health       
record4  7#c7 ,a review of the          
appropriateness of the level of urgency 
of the consultation that is inputted in 
the electronic health record4  7#d7 ,a  

review of any delayed or unresolved     
consultations4  7#e7 ,a determination of
 the timeliness of consultations based  
on guidance set forth by the ,under     
,secretary for ,health of the           
,department4  7d7 ,appropriate          
committees of ,congress defined ,in this
 section1 the term appropriate          
committees of ,congress means-- 7#a7 the
 ,committee on ,veterans' ,affairs and  
the ,committee on ,appropriations of the
 ,senate2 and  7#b7 the ,committee on   
,veterans' ,affairs and the ,committee  
on ,appropriations of the ,house of     
,representatives4  #e4 ,measurement of  
timeliness for referrals for health care
 among health care providers or         
facilities of ,department of ,veterans  
,affairs  7a7 ,in general ,with respect 
to referrals for health care between    
health care providers or facilities of  
the ,department of ,veterans ,affairs1  
not later than #abj days after the date 
of the enactment of this ,act1 the      
,secretary of ,veterans ,affairs shall  

measure1 for each medical facility of   
the ,department1 the time it takes from 
the date that a clinician of the        
,department determines that a veteran   
requires care from another health care  
provider or facility to each of the     
following3  7#a7 ,the date that the     
referral for care is sent to the other  
health care provider or facility4  7#b7 
,the date that the other health care    
provider or facility accepts the        
referral4  7#c7 ,the date that the      
appointment with the other health care  
provider or at the other facility is    
made4  7#d7 ,the date of the appointment
 with the other health care provider or 
at the other facility4  7#e7 ,any other 
step that the ,secretary determines     
necessary to measure4  7b7 ,publication 
of data ,not later than one year after  
the date of the enactment of this ,act1 
the ,secretary shall publish the data   
measured under subsection 7a71          
disaggregated by medical facility1 on a 
publicly available ,internet website of 

the ,department4  #f4 ,examination of   
health care consultation and scheduling 
positions of ,department of ,veterans   
,affairs  7a7 ,proper grading of        
consultation and scheduling positions   
7#a7 ,in general ,the ,secretary of     
,veterans ,affairs shall conduct an     
examination of health care positions of 
the ,department of ,veterans ,affairs to
 determine whether health care positions
 involved in the consultation and       
scheduling processes are appropriately  
graded4  7#b7 ,submittal to ,congress   
,not later than #abj days after the date
 of the enactment of this ,act1 the     
,secretary shall submit to the          
appropriate committees of ,congress the 
results of the examination conducted    
under paragraph 7#a74  7b7 ,review of   
onboarding process ,not later than #ahj 
days after the date of the enactment of 
this ,act1 the ,secretary shall submit  
to the appropriate committees of        
,congress--  7#a7 a review of the       
onboarding process of individuals in    

health care positions described in      
subsection 7a71 including how long it   
takes to hire those individuals2 and    
7#b7 a description of any changes that  
the ,secretary has made or plans to make
 to improve that process4  7c7          
,appropriate committees of ,congress    
defined ,in this section1 the term      
appropriate committees of ,congress     
means--  7#a7 the ,committee on         
,veterans' ,affairs and the ,committee  
on ,appropriations of the ,senate2 and  
7#b7 the ,committee on ,veterans'       
,affairs and the ,committee on          
,appropriations of the ,house of        
,representatives4  #g4 ,program to      
furnish mobile deployment teams to      
medical facilities that require         
assistance  7a7 ,in general ,the        
,secretary of ,veterans ,affairs shall  
establish a program to furnish mobile   
deployment teams of scheduling and      
medical personnel to medical facilities 
of the ,department that require         
assistance4  7b7 ,elements ,in          

furnishing a mobile deployment team to a
 medical facility under subsection 7a71 
including the particular personnel to be
 included1 the ,secretary shall consider
 the following elements3  7#a7 ,the     
scheduling needs of the facility4  7#b7 
,the unfilled medical positions at the  
facility4  7#c7 ,the number of open     
consultations at the facility4  7#d7    
,the results of scheduler audits        
conducted under section #b7;d77#c74     
7#e7 ,requests under section #d7;a77#d7 
for mobile deployment teams due to a    
failure of the facility to meet         
consultation requirements4  7#f7 ,such  
other elements as the ,secretary        
considers necessary for effective       
oversight of the program established    
under subsection 7a74  7c7 ,completion  
of duty ,in carrying out the program    
under this section1 the ,secretary shall
 require each mobile deployment team    
furnished to a medical facility under   
subsection 7a7 to develop a remediation 
plan that1 upon completion1 terminates  

the deployment of the team to that      
facility4