[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1427 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                S. 1427

To amend title 38, United States Code, to establish a Hospital Quality 
 Report Card Initiative to report on health care quality in Department 
      of Veterans Affairs Medical Centers, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              July 9, 2009

Mr. Wyden (for himself and Mr. Johanns) introduced the following bill; 
which was read twice and referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
To amend title 38, United States Code, to establish a Hospital Quality 
 Report Card Initiative to report on health care quality in Department 
      of Veterans Affairs Medical Centers, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Department of Veterans Affairs 
Hospital Quality Report Card Act of 2009''.

SEC. 2. DEPARTMENT OF VETERANS AFFAIRS HOSPITAL QUALITY REPORT CARD 
              INITIATIVE.

    (a) Purpose.--The purpose of this section is to provide for the 
establishment within the Department of Veterans Affairs of an 
initiative to be known as the ``Hospital Quality Report Card 
Initiative'' to ensure that information on the quality and performance 
of hospitals administered by the Secretary of Veterans Affairs is 
readily available and accessible for purposes as follows:
            (1) To inform patients and consumers about health care 
        quality in such hospitals.
            (2) To assist health care providers of the Department of 
        Veterans Affairs in identifying opportunities for quality 
        improvement and cost containment.
            (3) To enhance the understanding of policy makers and 
        public officials of health care issues, raise public awareness 
        of hospital quality issues, and help constituents of such 
        policy makers and officials identify quality health care 
        options for the Department of Veterans Affairs.
    (b) Establishment.--Subchapter I of chapter 17 of title 38, United 
States Code, is amended by inserting after section 1706 the following 
new section:
``Sec. 1706A. Management of health care: Hospital Quality Report Card 
              Initiative
    ``(a) In General.--Not later than 18 months after the date of the 
enactment of the Department of Veterans Affairs Hospital Quality Report 
Card Act of 2009, the Secretary shall establish and implement an 
initiative, to be known as the `Hospital Quality Report Card 
Initiative' (in this section referred to as the `Initiative'), to 
report on health care quality in Department medical centers.
    ``(b) Publication of Information on Quality and Performance of 
Department Medical Centers.--(1)(A) Under the Initiative, not less 
frequently than twice each year, the Secretary shall make available to 
the public a report containing the most current information on the 
quality and performance of each Department medical center. Such 
information shall include quality measures that allow for an assessment 
with respect to health care provided by Department medical centers, of 
the following:
            ``(i) Effectiveness.
            ``(ii) Safety.
            ``(iii) Timeliness.
            ``(iv) Efficiency.
            ``(v) Patient centered.
            ``(vi) Patient satisfaction.
            ``(vii) Satisfaction of health professionals employed at 
        Department medical centers.
            ``(viii) The equity of care provided to various patient 
        populations, including female, geriatric, disabled, rural, 
        homeless, mentally ill, and racial and ethnic minority 
        populations.
    ``(B) For each quality measure reported under subparagraph (A), the 
Secretary shall include a quality measure represented by an incremental 
letter grade scale, with `A+' being the highest and `F' being the 
lowest, based on information reported in paragraph (2) and such other 
information as the Secretary considers appropriate.
    ``(2)(A) In reporting information pursuant to paragraph (1), the 
Secretary shall, except as provided in subparagraph (B), include to the 
maximum extent practicable information about Department medical centers 
relating to--
            ``(i) staffing levels of nurses and other health 
        professionals, as appropriate;
            ``(ii) rates of nosocomial infections;
            ``(iii) the volume of each of the different types of 
        procedures performed;
            ``(iv) hospital sanctions and other violations;
            ``(v) the quality of care provided to various patient 
        populations, including female, geriatric, disabled, rural, 
        homeless, mentally ill, and racial and ethnic minority 
        populations;
            ``(vi) the availability of emergency rooms, intensive care 
        units, maternity care, and specialty services;
            ``(vii) the quality of care in various hospital settings, 
        including inpatient, outpatient, emergency, maternity, and 
        intensive care unit settings;
            ``(viii) ongoing patient safety initiatives;
            ``(ix) use of health information technology systems; and
            ``(x) such other matters the Secretary considers 
        appropriate.
    ``(B) In making a report available to the public under paragraph 
(1), the Secretary may provide information in addition to the 
information required by subparagraph (A) or provide information in lieu 
of the information required by subparagraph (A) if the Secretary--
            ``(i) not later than 15 days before the date on which such 
        report is made available to the public, submits to the 
        Committee on Veterans' Affairs of the Senate and the Committee 
        on Veterans' Affairs of the House of Representatives a 
        certification in writing that such additional or substituted 
        information is more appropriate for purposes of carrying out 
        the requirement of paragraph (2)(B); and
            ``(ii) includes in such report and certification an 
        indication of which information has been added or substituted 
        under this subparagraph.
    ``(3)(A) In reporting information as provided for under paragraph 
(1), the Secretary may risk adjust quality measures to account for 
differences relating to--
            ``(i) the characteristics of the reporting Department 
        medical center, such as licensed bed size, geography, and 
        teaching hospital status; and
            ``(ii) patient characteristics, such as health status, 
        severity of illness, and socioeconomic status.
    ``(B) If the Secretary reports data under paragraph (1) using risk-
adjusted quality measures, the Secretary shall establish procedures for 
making the unadjusted data available to the public in a manner 
determined appropriate by the Secretary.
    ``(4) Under the Initiative, the Secretary may verify information 
reported under this subsection to ensure accuracy and validity.
    ``(5) Before disclosing to the public any information under this 
subsection, the Secretary shall disclose the methodology for the 
reporting of such information and the nature and scope of such 
information to each--
            ``(A) organization the Secretary considers relevant to such 
        information; and
            ``(B) Department medical center that is the subject of such 
        information.
    ``(6)(A) For each report made available to the public under 
paragraph (1), 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 copy of such report.
    ``(B) The Secretary shall ensure that each report made available to 
the public under paragraph (1) is made available--
            ``(i) in an electronic format;
            ``(ii) in a manner that can be understood by individuals 
        who are not medical professionals and individuals with low 
        functional health literacy; and
            ``(iii) at each Department medical centers covered by the 
        report.
    ``(C) The Secretary shall ensure that information on health care 
quality is provided in a manner that is conducive for comparisons with 
other local hospitals or regional hospitals, as appropriate.
    ``(D) The Secretary shall establish procedures for making the 
information covered by reports made available to the public under 
paragraph (1) available to the public upon request in non-electronic 
format, such as through a toll-free telephone number.
    ``(7) The analytic methodologies and limitations on information 
sources utilized by the Secretary to develop and disseminate the 
comparative information under this subsection shall be identified and 
acknowledged in a notice or disclaimer as part of the dissemination of 
such information, and include the appropriate and inappropriate uses of 
such information.
    ``(c) Identifying and Reporting Actions That Could Lead to False or 
Artificial Improvements in Quality Measurements.--Not less frequently 
than annually, the Secretary shall compare quality measures data 
submitted by each Department medical center to the Secretary with 
quality measures data submitted to the Secretary in the prior year or 
years by each such Department medical center in order to identify and 
report actions that could lead to false or artificial improvements in 
the quality measurements of such Department medical centers.
    ``(d) Privacy and Security.--(1) The Secretary shall develop and 
implement effective safeguards to protect against the unauthorized use 
or disclosure of Department medical center data that is reported under 
this section.
    ``(2) The Secretary shall develop and implement effective 
safeguards to protect against the dissemination of inconsistent, 
incomplete, invalid, inaccurate, or subjective Department medical 
center data.
    ``(3) The Secretary shall ensure that identifiable patient data 
shall not be released to the public.
    ``(e) Periodic Reports.--(1) The Secretary shall periodically 
submit to Congress a report on the effectiveness of the Initiative.
    ``(2) Each report required by paragraph (1) shall include the 
following:
            ``(A) An assessment of the effectiveness of the Initiative 
        in meeting the purpose described in section 2(a) of the 
        Department of Veterans Affairs Hospital Quality Report Card Act 
        of 2009.
            ``(B) A description of the measures the Secretary can 
        undertake to ensure that the Initiative meets such purpose.
    ``(3) The Secretary shall carry out each measure the Secretary 
includes in a report under paragraph (2)(B).
    ``(4) The Secretary shall make each report submitted under 
paragraph (1) available to the public.
    ``(f) Department Medical Center Defined.--In this section, the term 
`Department medical center' means a Department of Veterans Affairs 
Medical Center administered by the Secretary.
    ``(g) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2010 through 2018.''.
    (c) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 of such title is amended by inserting after the item 
relating to section 1706 the following new item:

``1706A. Management of health care: Hospital Quality Report Card 
                            Initiative.''.
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