[Congressional Record Volume 162, Number 175 (Tuesday, December 6, 2016)]
[House]
[Pages H7242-H7245]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
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FASTER CARE FOR VETERANS ACT OF 2016
Mr. ROE of Tennessee. Mr. Speaker, I move to suspend the rules and
pass the bill (H.R. 4352) to direct the Secretary of Veterans Affairs
to carry out a pilot program establishing a patient self-scheduling
appointment system, and for other purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 4352
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 ``Faster Care for Veterans Act
of 2016''.
SEC. 2. PILOT PROGRAM ESTABLISHING A PATIENT SELF-SCHEDULING
APPOINTMENT SYSTEM.
(a) Pilot Program.--Not later than 120 days after the date
of the enactment of this Act, the Secretary of Veterans
Affairs shall commence a pilot program under which veterans
use an Internet website or mobile application to schedule and
confirm medical appointments at medical facilities of the
Department of Veterans Affairs.
(b) Selection of Locations.--The Secretary shall select not
less than three Veterans Integrated Services Networks in
which to carry out the pilot program under subsection (a).
(c) Contracts.--
(1) Authority.--The Secretary shall seek to enter into a
contract using competitive procedures with one or more
contractors to provide the scheduling capability described in
subsection (a).
(2) Notice of competition.--Not later than 60 days after
the date of the enactment of this Act, the Secretary shall
issue a request for proposals for the contract described in
paragraph (1). Such request shall be full and open to any
contractor that has an existing commercially available, off-
the-shelf online patient self-scheduling system that includes
the capabilities specified in section 3(a).
(3) Selection.--Not later than 120 days after the date of
the enactment of this Act, the Secretary shall award a
contract to one or more contractors pursuant to the request
for proposals under paragraph (2).
(d) Duration of Pilot Program.--
(1) In general.--Except as provided by paragraph (2), the
Secretary shall carry out the pilot program under subsection
(a) for an 18-month period.
(2) Extension.--The Secretary may extend the duration of
the pilot program under subsection (a), and may expand the
selection of Veterans Integrated Services Networks under
subsection (b), if the Secretary determines that the pilot
program is reducing the wait times of veterans seeking
medical care and ensuring that more available appointment
times are filled.
(e) Mobile Application Defined.--In this section, the term
``mobile application'' means a software program that runs on
the operating system of a cellular telephone, tablet
computer, or similar portable computing device that transmits
data over a wireless connection.
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SEC. 3. CAPABILITIES OF PATIENT SELF-SCHEDULING APPOINTMENT
SYSTEM.
(a) Minimum Capabilities.--The Secretary of Veterans
Affairs shall ensure that the patient self-scheduling
appointment system used in the pilot program under section 2,
and any other patient self-scheduling appointment system
developed or used by the Department of Veterans Affairs,
includes, at a minimum, the following capabilities:
(1) Capability to schedule, modify, and cancel appointments
for primary care, specialty care, and mental health.
(2) Capability to support appointments for the provision of
health care regardless of whether such care is provided in
person or through telehealth services.
(3) Capability to view appointment availability in real
time.
(4) Capability to make available, in real time,
appointments that were previously filled but later cancelled
by other patients.
(5) Capability to provide prompts or reminders to veterans
to schedule follow-up appointments.
(6) Capability to be used 24 hours per day, seven days per
week.
(7) Capability to integrate with the Veterans Health
Information Systems and Technology Architecture of the
Department, or such successor information technology system.
(b) Independent Validation and Verification.--
(1) Independent entity.--
(A) The Secretary shall seek to enter into an agreement
with an appropriate non-governmental, not-for-profit entity
with expertise in health information technology to
independently validate and verify that the patient self-
scheduling appointment system used in the pilot program under
section 2, and any other patient self-scheduling appointment
system developed or used by the Department of Veterans
Affairs, includes the capabilities specified in subsection
(a).
(B) Each independent validation and verification conducted
under subparagraph (A) shall be completed as follows:
(i) With respect to the validation and verification of the
patient self-scheduling appointment system used in the pilot
program under section 2, by not later than 60 days after the
date on which such pilot program commences.
(ii) With respect to any other patient self-scheduling
appointment system developed or used by the Department of
Veterans Affairs, by not later than 60 days after the date on
which such system is deployed, regardless of whether such
deployment is on a limited basis, but not including any
deployments for testing purposes.
(2) GAO evaluation.--
(A) The Comptroller General of the United States shall
evaluate each validation and verification conducted under
paragraph (1).
(B) Not later than 30 days after the date on which the
Comptroller General completes an evaluation under paragraph
(1), the Comptroller General shall submit to the appropriate
congressional committees a report on such evaluation.
(C) In this paragraph, the term ``appropriate congressional
committees'' means--
(i) the Committees on Veterans' Affairs of the House of
Representatives and the Senate; and
(ii) the Committees on Appropriations of the House of
Representatives and the Senate.
(c) Certification.--
(1) Capabilities included.--Not later than December 31,
2017, the Secretary shall certify to the Committees on
Veterans' Affairs of the House of Representatives and the
Senate that the patient self-scheduling appointment system
used in the pilot program under section 2, and any other
patient self-scheduling appointment system developed or used
by the Department of Veterans Affairs as of the date of the
certification, includes the capabilities specified in
subsection (a).
(2) New systems.--If the Secretary develops or begins using
a new patient self-scheduling appointment system that is not
covered by a certification made under paragraph (1), the
Secretary shall certify to such committees that such new
system includes the capabilities specified in subsection (a)
by not later than 30 days after the date on which the
Secretary determines to replace the previous patient self-
scheduling appointment system.
(3) Effect of capabilities not included.--If the Secretary
does not make a timely certification under paragraph (1) or
paragraph (2), the Secretary shall replace any patient self-
scheduling appointment system developed by the Secretary that
is in use with a commercially available, off-the-shelf online
patient self-scheduling system that includes the capabilities
specified in subsection (a).
SEC. 4. PROHIBITION ON NEW APPROPRIATIONS.
No additional funds are authorized to carry out the
requirements of this Act. Such requirements shall be carried
out using amounts otherwise authorized.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Tennessee (Mr. Roe) and the gentleman from California (Mr. Takano) each
will control 20 minutes.
The Chair recognizes the gentleman from Tennessee.
General Leave
Mr. ROE of Tennessee. Mr. Speaker, I ask unanimous consent that all
Members have 5 legislative days in which to revise and extend their
remarks and to add extraneous material.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Tennessee?
There was no objection.
Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I rise today in support of H.R. 4352, as amended, the
Faster Care for Veterans Act of 2016.
The wait time scandals that continue to plague the Department of
Veterans Affairs have highlighted the need for veterans to be able to
schedule their own medical appointments. Everyone agrees that the
veterans who want this capability should have it.
A self-scheduling option would reduce the workload on overburdened
schedulers, allow the VA to use taxpayer resources more efficiently,
and grant veterans who would prefer to schedule their own appointments
the ability and flexibility to do so. It would also encourage
accountability by giving veterans verifiable records of their own
appointment bookings.
VA has been considering self-scheduling since at least 2013. However,
projects start and stop, priorities shift, and nothing usable has so
far emerged from those considerations. Unfortunately, this seems to be
the result of a tug of war between some VA officials who favor a
commercial off-the-shelf system and others who favor a government-
developed system.
VA has been developing a self-scheduling mobile application based on
its VISTA management system and plans to roll it out in January 2017. I
have high hopes for that effort, but VA's IT development record is
mixed--to put it mildly--and past experience shows that meeting high
standards and firm deadlines are crucial to success.
The time has come to settle this issue once and for all. H.R. 4352,
as amended, establishes capability standards reflecting the state of
the art that apply to any commercial or government self-scheduling
system in VA. It also directs VA to pilot the best available commercial
software in three locations. The bill tasks an independent expert to
verify whether that commercial system and the government system meet
those standards, and by the end of 2017, VA must certify whether or not
they do.
The concept is, in other words, a bake-off to create the most
successful possible software for our veterans. Ideally, both systems
will meet the standards, but if the government system cannot make the
grade, VA will have a commercial alternative thoroughly piloted and
ready to go to work for VA patients.
H.R. 4352, as amended, is sponsored by Congressman Seth Moulton from
Massachusetts and Congresswoman Cathy McMorris Rodgers from Washington.
I thank them both for their leadership on this issue.
This broadly bipartisan legislation is an efficient, timely solution
to a longstanding problem, and I encourage all of my colleagues to join
me in supporting it.
Mr. Speaker, I reserve the balance of my time.
Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise today in support of H.R. 4352, as amended,
sponsored by my friend, the gentleman from Massachusetts and a veteran
himself, Representative Moulton.
This important legislation authorizes the VA to administer a pilot
program where veterans use an Internet Web site to schedule and confirm
medical appointments at medical facilities of the Department of
Veterans Affairs. The VA has been working to bring the power of
scheduling to veterans since the wait time scandal at the Phoenix VA
Medical Center in 2014.
The Department of Veterans Affairs had developed and is rolling out
the Veterans Appointment Request, otherwise known as VAR, for primary
care. This is a mobile application, and the approach will allow
veterans to directly schedule or request primary care appointments and
request mental health appointments at facilities where they are already
receiving care. With the app, veterans can also view appointment
details, track the status of requests, send messages about the
requested appointments, get notifications about appointments, and
cancel most appointments.
The VA has also implemented the Audiology and Optometry Direct
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Scheduling Initiative. This program began as a successful pilot at
three sites in 2015 and is now being expanded to all VA medical
centers.
Veterans can schedule a routine appointment for audiology or
optometry directly by calling the scheduling department or by speaking
directly with audiology or optometry staff. The covered services
include hearing tests, eye exams, vision prescriptions, eyeglass
fittings, and other routine appointments.
This important legislation will allow veterans to better control
their VA experience no matter what services they need. Ensuring
veterans are comfortable with the scheduling platform ultimately used
is a critical factor. Whether that is a smartphone, Internet Web site
or calling directly to make that appointment, the primary consideration
is the ease of use by the veteran.
The only way to make sure it works is to test it. This legislation
will ensure that the technology fits the veteran and also fits the VA.
For those reasons, I support this legislation and urge my colleagues
to do the same.
Mr. Speaker, I reserve the balance of my time.
Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, this is long overdue. One of the problems we have in VA
is that we know the scandal at Phoenix where there were secret waiting
lists for appointments for honorably discharged veterans to see a
doctor.
This is one of the ways in which we can put veterans back in charge.
One of the things I want to do is put veterans and doctors--healthcare
providers--in charge of the health care and not bureaucrats,
schedulers, and so forth. This puts the power back in front of the
veterans.
We are at the Christmas season. Many of us order packages on Amazon
or wherever. Guess what we can do? We can track that through our own
personal device anywhere that package is so that it reaches our
doorstep. Veterans should have that command so they can have an
appointment when they want it; they can make it. The technology is
available. I can't think of a better thing to do than to have a private
and public competition to see which is the most effective for the
veteran. I think in a year we are going to know. It will be simple to
implement. Almost everyone has a smart device now that we can use for
this process.
Mr. Speaker, I reserve the balance of my time.
Mr. TAKANO. Mr. Speaker, I yield 5 minutes to the gentleman from
Massachusetts (Mr. Moulton).
Mr. MOULTON. Mr. Speaker, I rise today in support of H.R. 4352, the
Faster Care for Veterans Act, which I introduced with Congresswoman
Cathy McMorris Rodgers.
The idea behind the bill is simple. Our Nation's veterans deserve the
same technological innovations and level of service at VA healthcare
facilities as patients in the private market. One such innovation is
patient self-scheduling technology. Patients can log on to an app on
their phone or on a Web site, indicate the type of appointment they
need, select their location, and schedule their own appointments at a
time convenient for them--no middle men, no obnoxious hold music, and
no unending carousel of options on an automated phone menu; just a
quick and easy medical appointment that works for your schedule.
This technology is not just beneficial for patients, it is good for
medical providers as well. In the private market, the introduction of
patient self-scheduling has dramatically decreased wait times, saving
time and money. The VA ought to chase these same innovations so our
veterans receive the best health care and user experience in the world.
As a Member of Congress, I declined congressional health care and
pledged to receive my care at the VA. I receive excellent service from
terrific doctors and nurses at my home VA facility in Bedford,
Massachusetts. However, scheduling an appointment here in D.C. or at
home in Bedford has never been easy.
Dennis Magnasco, my veterans' liaison in my office in Salem,
Massachusetts, learned this the hard way. Shortly after I introduced
the Faster Care for Veterans Act, Dennis called our local VA hospital
to make an appointment himself. He listened to the options on the
automated menu and pressed one to schedule an appointment. After
several more pushed buttons, rather than connecting him to the talented
schedulers who work in the Bedford VA, the automated menu started over
again. It went into an endless cycle. He hung up, and after multiple
unsuccessful further attempts, he recorded himself doing this in a
video.
I put this video on my Facebook page, and the response was
astonishing. Four million people saw the video, 35,000 people shared
the video, and 2,000 people commented. People from all over the country
shared their experience trying to schedule their own appointments at
the VA. The frustration is nationwide.
A veteran from Walcott, Arkansas, said: I can tell you this is for
real. It happens every time I call. I usually give up and drive to the
clinic 18 or 20 miles away so I can talk to a person face to face.
A veteran from El Paso, Texas, said: This is exactly what happens
every time you try to call for an appointment or even get general
information about an existing appointment. This is exactly why lots of
us vets end up giving up on the system.
A veteran from Philadelphia, Pennsylvania, said: The longest I have
been on hold with the VA was an hour and 45 minutes before I gave up.
This is not an issue of quality of care, it is an issue of access to
care. The Faster Care for Veterans Act is a solution.
First, this bill directs the VA to conduct a pilot program to test
commercial off-the-shelf self-scheduling technology at three locations
across the country while allowing the VA to continue developing its
inhouse solution.
Second, the bill requires both the pilot program and the VA's
solution to meet several capabilities currently available in the
private market. These requirements will ensure our veterans get the
same level of service as every other American.
Third, the bill provides for an independent assessment to verify if
the pilot program or the VA's solution meets the minimum capabilities.
Lastly, the bill requires the VA to replace any system used by the VA
that does not meet those minimum requirements with a commercially
available off-the-shelf technology that does meet those capabilities.
The bill is supported by the Iraq and Afghanistan Veterans of
America, the American College of Neurosurgeons, and the American
Osteopathic Association; and this bill is cosponsored by more than half
of the House of Representatives. Our veterans are demanding a 21st
century VA healthcare system. This bill is one step in that direction.
Mr. Speaker, I urge my colleagues to support this legislation.
Mr. ROE of Tennessee. Mr. Speaker, I yield such time as she may
consume to the gentlewoman from Washington (Mrs. McMorris Rodgers), who
is our conference chair. Cathy McMorris Rodgers is a very passionate
supporter of veterans' issues.
Mrs. McMORRIS RODGERS. Mr. Speaker, I rise today, more than 2 years
after we were all shocked by the news that Phoenix veterans had died
waiting for appointments at their local VA. Yet, after all this time,
little has changed.
Every week veterans contact my office seeking help to get the care
that they need, like the veteran who couldn't access urgent care and
was afraid he would be billed if he went to the hospital for help, or
the veteran who got cancer from atomic testing but had to jump through
all kinds of hoops to prove it.
Is this how a grateful nation should treat its veterans? Absolutely
not.
The best way we show our gratitude to those who have served is to get
them the care that they have earned. When a veteran contacts the VA,
they should have the red carpet rolled out for them, period; but,
instead, these stories are repeated over and over and over in
communities all across the country: The VA won't listen; the VA doesn't
return calls; we can't see a doctor.
There is a disconnect between the service of our military and the
service they receive when they return home.
Mr. Moulton of Massachusetts and I introduced the Faster Care for
Veterans Act to leverage technology to cut
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back on wait times. Our veterans should have the same options that
people have in doctors' offices across the country. They should be able
to use an app, go online to schedule; or if they want to call, they can
do that, too.
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The point is the technology to make it easier to self-schedule
already exists. Why not provide it to our veterans?
With this bill, we are demonstrating to the VA that innovative
technology can work. It can get our veterans the care that they have
earned more quickly without all the red tape.
But wait times are just the tip of this bureaucratic iceberg. The
terrible stories this past week of HIV exposure and a veteran dying
with maggots in his wounds are graphic reminders to all of us that the
VA has lost sight of its sole mission: serving veterans.
Veterans should be in control of all aspects of their health care.
That is not what is happening right now. After all the years, all the
money, no more excuses. It is time for a deeper look into rethinking
this outdated government bureaucracy.
Mr. Speaker, I never again want to hear a war hero cry because of how
the VA has treated him. I urge my colleagues to join us in supporting
the Faster Care for Veterans Act.
Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
I have no further speakers. Before I close, I would like to say that
I fully appreciate the work of my friend and colleague, the gentleman
from Massachusetts (Mr. Moulton), for the work he has done on this bill
and for the way in which he is able to reach out to veterans and those
who care for veterans across the country.
I am especially pleased that included in this legislation is a
specific way to independently assess the off-the-shelf technology as
compared to the technology that is being developed in-house at the VA.
I think these provisions will ensure that the taxpayer is protected in
terms of cost, efficiency, and effectiveness. And, of course, bottom
line, this means effectiveness for our veterans. We want to make sure
that the best technology is put forward, whether it is in-house or
whether it is the off-the-shelf choice, that we have a way to
independently verify which is best.
I want to encourage all of my colleagues to support this important
legislation and join me in passing H.R. 4352.
I yield back the balance of my time.
Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may
consume.
I want to thank Mr. Moulton and one of our leaders, Cathy McMorris
Rodgers, for bringing this very important piece of legislation to the
floor. One of the reasons is that it shows when you bring someone with
real-world experiences who uses the VA how they can then take that and
convert that into meaningful legislation that will actually help
veterans around the country.
I encourage all Members to support this legislation.
I yield back the balance of my time.
The SPEAKER pro tempore (Mr. Hultgren). The question is on the motion
offered by the gentleman from Tennessee (Mr. Roe) that the House
suspend the rules and pass the bill, H.R. 4352, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
A motion to reconsider was laid on the table.
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