,,ii  #aafth ,,congress  #ast ,session  
,s4 #fbi  ,,in ,,the ,,senate ,,of ,,the
 ,,united ,,states  ,february #bh1      
#bjai,mr4 ,tester 7for himself1 ,mrs4   
,murray1 ,mr4 ,blumenthal1 and ,mr4     
,brown7 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  7#a7   
,in general ,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 of the       
,department of ,veterans ,affairs for   
scheduling appointments for health care 
from the ,department at the medical     
facility level4  7#b7 ,periodic revision
  7,a7 ,in general ,the ,secretary may  
revise the processes and requirements   
required under paragraph 7#a7 as the    
,secretary considers necessary4  7,b7   
,submittal to ,congress ,not later than 
#cj days before revising the processes  
and requirements under subparagraph     
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    
,representative a description of those  
revised processes and requirements1     

including a description of any          
modifications to the certification and  
training under subsection 7b74  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    
7a71 including the maximum number of    
days allowed to complete each step of   
the scheduling process4  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 enable     
real-time monitoring of and ensure that 
each medical facility of the ,department
 complies with the scheduling processes 
and requirements described in subsection
 7a71 including compliance with policies
 of the ,department relating to the     
maximum number of days allowed to       
complete each step of the scheduling    
process4  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  7d7       
,comptroller ,general report ,not later 
than two years after the date of the    
enactment of this ,act1 the ,comptroller
 ,general of the ,united ,states 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 
the compliance of the ,secretary with   
the requirements of this section4  #c4  
,audits regarding scheduling of         
appointments and management of          
consultations for health care from      
,department of ,veterans ,affairs  7a7  
,in general ,not later than one year    
after the date of the enactment of this 
,act1 and not less frequently than      
annually thereafter1 the ,secretary of  
,veterans ,affairs shall provide for the
 conduct of facility-level audits of the
 scheduling of appointments and the     
management of consultations for health  
care under the laws administered by the 
,secretary4  7b7 ,elements ,each audit  

conducted under subsection 7a7 shall    
include the following3 7#a7 ,with       
respect to each medical center of the   
,department of ,veterans ,affairs1 an   
assessment of any scheduling or         
consultation management issues at that  
medical center1 including the following3
  7,a7 ,an assessment of non-compliance 
with policies of the ,veterans ,health  
,administration relating to scheduling  
appointments and managing consultations4
  7,b7 ,an assessment of the extent to  
which appointments or consultations are 
not timely processed4  7,c7 ,a          
description of any backlogs in          
appointments or consultations that are  
awaiting action4  7,d7 ,an assessment of
 whether consultations are appropriately
 processed4  7,e7 ,data with respect to 
consultations as follows3  7i7          
,consultations that were scheduled      
within the request window4  7ii7        
,duplicate consultation requests4  7iii7
 ,consultations that were discontinued4 
7iv7 ,delays in consultations4  7v7     

,consultations that were not properly   
closed or discontinued1 including a     
description of remediation attempts4    
7,f7 ,a review for accuracy with respect
 to consultation management as follows3 
7i7 ,a review of the accuracy of the    
type of service1 either administrative  
or clinical1 that is inputted in the    
electronic health record4  7ii7 ,a      
review of the accuracy of the type of   
consultation setting1 either impatient  
or outpatient1 that is inputted in the  
electronic health record4  7iii7 ,a     
review of the appropriateness of the    
level of urgency of the consultation    
that is inputted in the electronic      
health record4  7iv7 ,a review of any   
delayed or unresolved consultations4    
7#b7 ,an identification of such         
recommendations for corrective action as
 the ,secretary considers necessary1    
including additional training1 increased
 personnel1 and other resources4  7#c7  
,a certification that the director of   
each medical center of the ,department  

is in compliance with the processes and 
requirements described in section #b7;a7
 and such other requirements relating to
 the scheduling of appointments and     
management of consultations as the      
,secretary considers appropriate4  7#d7 
,with respect to referrals for health   
care between health care providers or   
facilities of the ,department1 a        
measurement of1 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  7c7 ,conduct of  
audit by third party ,each audit        
conducted under subsection 7a7 with     
respect to a medical facility of the    
,department shall be conducted by an    
individual or entity that is not        
affiliated with the facility4  7d7      
,transmittal to ,,vha ,each audit       
conducted under subsection 7a7 shall be 
transmitted to the ,under ,secretary for
 ,health of the ,department so that the 
,under ,secretary can--  7#a7 strengthen
 oversight of the scheduling of         
appointments and management of          
consultations throughout the            
,department2  7#b7 monitor national     
policy on such scheduling and           
management2  7#c7 determine if a mobile 
deployment team furnished under the     
pilot program established under section 
#djb of the ,,va ,,mission ,act of #bjah
 7,public ,law #aae-ahb7 is warranted2  
and  7#d7 develop a remediation plan to 

address issues uncovered by those       
audits4  7e7 ,annual report  7#a7 ,in   
general ,not later than ,december #ca of
 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 the audits 
conducted under subsection 7a7 during   
the year ending on that date4  7#b7     
,elements ,the ,secretary shall include 
in each report required by paragraph    
7#a7-- 7,a7 a description of the audits 
conducted under subsection 7a7 with     
respect to each facility of the         
,department2  7,b7 an assessment of how 
the ,department strengthened oversight  
of the scheduling of appointments and   
management of consultations at that     
facility as a result of those audits2   
7,c7 an assessment of how those audits  
informed the national policy of the     
,department with respect to the         
scheduling of appointments and          
management of consultations2 and  7,d7 a

 description of any remediation plans to
 address issues raised by those audits  
that were completed4  #d4               
,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      
note71 section #agjc of title #ch1      
,united ,states ,code 7as in effect on  
the date specified in section #aja7;b7  
of the ,caring for ,our ,veterans ,act  
of #bjah 7title ,i of ,public ,law      
#aae-ahb771 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 ,department--  7i7 an   

assessment of the type of positions     
required to be staffed at the medical   
facility2  7ii7 the number of such      
positions authorized2  7iii7 the number 
of such positions filled2 and  7iv7 the 
number of additional such positions     
required to be authorized4  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
 provider set forth under subparagraphs 
7,a7 through 7,f7 of paragraph 7#c74    
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 that the          
appointment with the non-,department    
health care provider occurs4  7,e7 ,the 
date that the referral to the           
non-,department health care provider is 
completed4  7,f7 ,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      
,review ,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 validity and reliability
 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  #e4 ,requests for mobile         
deployment teams by directors of medical
 centers of ,department of ,veterans    
,affairs  7a7 ,in general ,a director of
 a medical center of the ,department of 
,veterans ,affairs shall request from   
the ,secretary of ,veterans ,affairs a  
mobile deployment team under the pilot  
program established under section #djb  
of the ,,va ,,mission ,act of #bjah     
7,public ,law #aae-ahb7 if requirements 
of the ,department under sections #b and

 #d have not been met with respect to a 
facility under the jurisdiction of the  
director4  7b7 ,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 
subsection 7a7 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   
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  #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 ,consultation ,in         
conducting the examination under        
paragraph 7#a71 the ,secretary shall    
consult with health care staffing       
experts in the ,federal ,government and 
the private sector4  7#c7 ,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