,i #aaith ,,congress #ast ,session ,h4 ,r4 #fgcc ,,in ,,the ,,house ,,of ,,representatives ,december #af1 #bjbe,mr4 ,bost introduced the following bill2 which was referred to the ,committee on ,veterans' ,affairs ,a ,,bill ,to amend title #ch1 ,united ,states ,code1 to make certain improvements to the administration of ,veterans ,integrated ,service ,networks under laws administered by the ,secretary of ,veterans ,affairs1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,,visn ,reform ,act of #bjbe4 #b4 ,administration of ,veterans ,integrated ,service ,networks 7a7 ,veterans integrated service networks ,subchapter ,i of chapter #gc of title #ch1 ,united ,states ,code1 is amended by inserting after section #gcje following new section3 #gcje;,a4 ,veterans ,integrated ,service ,networks 7a7 ,organization ,the ,secretary shall organize the ,veterans ,health ,administration in eight geographically defined ,veterans ,integrated ,service ,networks 7hereinafter referred to as ,v,i,s,ns74 7b7 ,alignment with mission of department ,the ,secretary shall ensure that the employees1 services1 and programs of each ,,visn are aligned with the mission of the ,department and the specific health care requirements of each population of veterans in each ,network4 7c7 ,integrated health care system ,the ,secretary shall maintain a regional integrated health care system within the geographic area served by each ,,visn by-- 7#a7 entering into agreements with such other governmental1 public1 and private health care organizations and practitioners as the ,secretary considers appropriate to meet the needs of veterans who reside in the geographic area served by the ,,visn2 7#b7 providing oversight and management of1 and taking responsibility for1 a regional budget for the activities of each ,,visn 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 and 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 patients4 7d7 ,reduction in duplicate functions ,the ,secretary shall identify functions that are duplicated across the clinical1 administrative1 and operational processes and practices of the ,veterans ,health ,administration and operate the system of ,v,i,s,ns in a manner designed to reduce the duplication of such functions4 7e7 ,collaboration and cooperation 7#a7 ,the ,secretary shall operate the ,,visn system by working to achieve maximum effectiveness with respect to the provision hospital care1 medical services1 and nursing home care1 graduate medical education1 and research2 and 7#b7 ,the ,secretary shall assess1 on an ongoing basis1 the consolidation or realignment of institutional functions1 including capital asset1 safety1 and operational support functions1 in collaboration and cooperation with other ,v,i,s,ns and the following offices or entities within the geographic area served by the ,,visn3 7,a7 ,the offices of the ,veterans ,benefits ,administration and the ,national ,cemetery ,administration4 7,b7 ,offices of ,state and local agencies that have a mission to provide assistance to veterans4 7,c7 ,medical schools and other affiliates4 7,d7 ,federal1 ,state1 and local emergency preparedness organizations4 7,e7 ,such other offices of the ,federal ,government as the ,secretary considers appropriate4 7#c7 ,the ,director of each ,,visn shall be responsible for oversight and for the enforcement of ,department policies authorities applicable to medical facilities of the ,department with respect to such medical facilities located in the geographic area served by such ,,visn4 7f7 ,headquarters 7#a7 ,there shall be only one headquarters office for each ,,visn4 ,the ,secretary shall choose the location of each such office and shall ensure each such office is colocated with a medical center of the ,department4 7#b7 7,a7 ,each headquarters office established under paragraph 7#a7 shall have not more than #ej full-time employees4 ,of such #ej full-time employees1 not more than #aj shall be contractor employees4 7,b7 7i7 ,the ,secretary may waive the limitation under subparagraph 7,a7 with respect to a ,,visn headquarters if the ,secretary-- 7,i7 determines the waiver is necessary to maintain essential operations of the ,,visn headquarters during the implementation of the plan required under paragraph 7#c72 and 7,,ii7 before the date on which the waiver becomes effective1 submits to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a written certification of such determination4 7ii7 ,the term of any wavier issued pursuant to clause 7i7 may not exceed one year4 7,c7 ,not less frequently than once each fiscal year1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a report on employment at the ,,visn headquarters offices during the preceding fiscal year4 ,each such report shall include the following for the year covered by the report3 7i7 ,the number of individuals employed at each ,,visn headquarters office4 7ii7 ,the number of individuals employed by the ,veterans ,health ,administration in each ,,visn who are not employed at the same location as the headquarters office of that ,,visn4 7iii7 ,the title for each position of employment at a headquarters office4 7iv7 ,the title for each position of employment with the ,veterans ,health ,administration in each ,,visn whose duty station is not at the same location as the headquarters office of that ,,visn4 7v7 ,an assessment of the effect of the employment of individuals at ,,visn headquarters offices on the budget of the ,department4 7#c7 7,a7 ,not later than #ahj days after the date of the enactment of this section1 the ,secretary shall develop and submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a comprehensive plan for the reorganization and right-sizing of the workforce of each ,,visn headquarters to achieve compliance with the limitation under paragraph 7#b77;,a74 7,b7 ,the plan under subparagraph 7,a7 shall include1 for each ,,visn headquarters-- 7i7 an identification of all positions currently assigned to the headquarters1 including duty location1 occupational services1 pay grade1 and primary function2 7ii7 a determination of which positions-- 7,i7 are essential to execute the mission of the ,,visn2 and 7,,ii7 are duplicative or administrative in nature2 7iii7 a phased implementation schedule for such plan2 7iv7 a description of any workforce realignments1 reassignments1 or separations required to comply with the limitation under paragraph 7#b77;,a71 including voluntary separation incentive payments or retraining opportunities under title #e2 and 7v7 a certification that the implementation of such plan will not result in a reduction in access to care or services furnished to veterans under the laws administered by the ,secretary4 7,c7 ,in developing and implementing the plan required under this subsection1 the ,secretary shall-- 7i7 ensure that each ,,visn headquarters is in compliance with the limitation under paragraph 7#b77;,a7 not later than the date that is three years after the date of the enactment of this section2 and 7ii7 to the maximum extent practicable1 offer each employee of a ,,visn headquarters who is a licensed physician1 nurse1 psychologist1 or other healthcare professional such the opportunity to transfer1 without loss of pay or benefits1 to a position appointed under chapter #gd of this title to furnish direct patient care or clinical support at a ,department medical facility4 7g7 ,personnel 7#a7 ,the head of each ,,visn shall be the ,director1 who shall be appointed by the ,president1 by and with the advice and consent of the ,senate4 ,the position of ,director of a ,,visn shall be a noncareer appointee position4 ,the ,director of a ,,visn shall-- 7,a7 be responsible for the functions of the ,,visn2 and 7,b7 have the authority and responsibility to enforce the policies and standards of the ,department with respect to all ,department personnel employed within the ,,visn4 7#b7 ,each employee employed at a facility of the ,veterans ,health ,administration located in the geographic area served by a ,,visn shall-- 7,a7 report directly to the ,director of the ,,visn2 7,b7 in the case of an employee who is licensed to practice in a hospital1 work at least one day each week in a ,department medical center located in such geographic area2 and 7,c7 visit routinely with service line chiefs at ,department medical centers1 as directed by the ,secretary4 7h7 ,triennial structure review1 reassessment and report 7#a7 ,not later than three years after the date of the enactment of this section1 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 ,v,i,s,ns4 7#b7 ,not later than #ahj days after conducting a review and assessment under paragraph 7#a71 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and 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 ,v,i,s,ns4 4 7b7 ,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 #gcje the following new item3 #gcje;,a4 ,veterans ,integrated ,service ,networks 4 #c4 ,consolidation of ,veterans ,integrated ,service ,networks ,in order to comply with section #gcje;,a of title #ch1 ,united ,states ,code1 as added by section #b1 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 ,veterans ,integrated ,service ,networks in effect on the day before the date of enactment of this ,act into 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 #d shall be ,combined into a single ,veterans ,integrated ,service ,network4 7#b7 ,veterans ,integrated ,service ,network #e1 ,veterans ,integrated ,service ,network #f1 and ,veterans ,integrated ,service ,network #i shall be combined into a single ,veterans ,integrated ,service ,network4 7#c7 ,veterans ,integrated ,service ,network #aj1 ,veterans ,integrated ,service ,network #ab1 and ,veteran ,integrated ,service ,network #bc shall be combined into a single ,veterans ,integrated ,service ,network4 7#d7 ,veterans ,integrated ,service ,network #g1 ,veterans ,integrated ,service ,network #h1 and ,veteran ,integrated ,service ,network #af shall be combined into a single ,veterans ,integrated ,service ,network4 7#e7 ,veterans ,integrated ,service ,network #ae and ,veteran ,integrated ,service ,network #ai shall be combined into a single ,veterans ,integrated ,service ,network4 7#f7 ,veterans ,integrated ,service ,network #ag and ,veteran ,integrated ,service ,network #bb shall be combined into a single ,veterans ,integrated ,service ,network4 7#g7 ,veterans ,integrated ,service ,network #bj shall remain a single ,veterans ,integrated ,service ,network4 7#h7 ,veterans ,integrated ,service ,network #ba shall remain a single ,veterans ,integrated ,service ,network4