[Congressional Record (Bound Edition), Volume 163 (2017), Part 6]
[House]
[Pages 8286-8288]
[From the U.S. Government Publishing Office, www.gpo.gov]




                    VA SCHEDULING ACCOUNTABILITY ACT

  Mr. ROE of Tennessee. Mr. Speaker, I move to suspend the rules and 
pass the bill (H.R. 467) to direct the Secretary of Veterans Affairs to 
ensure that each medical facility of the Department of Veterans Affairs 
complies with requirements relating to scheduling veterans for health 
care appointments, to improve the uniform application of directives of 
the Department, and for other purposes.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 467

       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 ``VA Scheduling Accountability 
     Act''.

     SEC. 2. COMPLIANCE WITH SCHEDULING REQUIREMENTS.

       (a) Annual Certification.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     ensure that the director of each medical facility of the 
     Department of Veterans Affairs annually certifies to the 
     Secretary that the medical facility is in full compliance 
     with all provisions of law and regulations relating to 
     scheduling appointments for veterans to receive hospital care 
     and medical services, including pursuant to Veterans Health 
     Administration Directive 2010-027, or any successor 
     directive.
       (2) Prohibition on waiver.--The Secretary may not waive any 
     provision of the laws or regulations described in paragraph 
     (1) for a medical facility of the Department if such 
     provision otherwise applies to the medical facility.
       (b) Explanation of Noncompliance.--If a director of a 
     medical facility of the Department does not make a 
     certification under subsection (a)(1) for any year, the 
     director shall submit to the Secretary a report containing--
       (1) an explanation of why the director is unable to make 
     such certification; and
       (2) a description of the actions the director is taking to 
     ensure full compliance with the laws and regulations 
     described in such subsection.
       (c) Prohibition on Bonuses Based on Noncompliance.--
       (1) In general.--If a director of a medical facility of the 
     Department does not make a certification under subsection 
     (a)(1) for any year, each covered official described in 
     paragraph (2) may not receive an award or bonus under chapter 
     45 or 53 of title 5, United States Code, or any other award 
     or bonus authorized under such title or title 38, United 
     States Code, during the year following the year in which the 
     certification was not made.
       (2) Covered official.--A covered official described in this 
     paragraph is each official who serves in the following 
     positions at a medical facility of the Department during a 
     year, or portion thereof, for which the director does not 
     make a certification under subsection (a)(1):
       (A) The director.
       (B) The chief of staff.
       (C) The associate director.
       (D) The associate director for patient care.
       (E) The deputy chief of staff.
       (d) Annual Report.--The Secretary shall annually submit to 
     the Committees on Veterans' Affairs of the House of 
     Representative and the Senate a report containing, with 
     respect to the year covered by the report--
       (1) a list of each medical facility of the Department for 
     which a certification was made under subsection (a)(1); and
       (2) a list of each medical facility of the Department for 
     which such a certification was not made, including a copy of 
     each report submitted to the Secretary under subsection (b).

     SEC. 3. STANDARDIZED APPLICATION OF DIRECTIVES AND POLICIES 
                   OF DEPARTMENT OF VETERANS AFFAIRS.

       (a) In General.--The Secretary of Veterans Affairs shall 
     ensure that the directives and policies of the Department of 
     Veterans Affairs apply to, and are implemented by, each 
     office or facility of the Department in a standardized 
     manner, including such offices and facilities at the local 
     level.
       (b) Notification.--If the Secretary does not apply and 
     implement the directives and policies of the Department in a 
     standardized manner pursuant to subsection (a), including by 
     waiving such a directive or policy with respect to an office 
     or facility of the Department, the Secretary shall notify the 
     Committees on Veterans' Affairs of the House of 
     Representatives and the Senate of such nonstandardized 
     application or implementation, including an explanation for 
     the nonstandardized application or implementation, as the 
     case may be.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Tennessee (Mr. Roe) and the gentleman from Minnesota (Mr. Walz) 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 may have 5 legislative days in which to revise and extend their 
remarks and include 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 in support of H.R. 467, a bill that would codify 
the VA's own directives for outpatient scheduling into law.
  In June of 2010, the Veterans Health Administration issued VHA 
Directive 2010-27, VHA Outpatient Scheduling Processes and Procedures. 
This directive requires VHA facility directors to annually certify that 
their facility is in full compliance with the scheduling procedures 
outlined within the directive.
  It is important to note that this directive was issued 4 years before 
the scheduling scandal at the Phoenix VA broke, with no less than 40 
veterans dying while being kept on secret lists, waiting for an 
appointment. I believe this directive was a responsible way for the VA 
to ensure that veterans were receiving the care that they came to the 
VA for and were not slipping through the cracks.

[[Page 8287]]

  Unfortunately, in May of 2013, then-Deputy Under Secretary for Health 
at the VA waived this requirement for the VA medical facility directors 
to adhere to the directive. As we now know, this waiver helped cover a 
practice of malfeasance within scheduling departments at VA medical 
facilities across the Nation.
  As I mentioned before, in 2014, the House Committee on Veterans' 
Affairs, with my friend, former Chairman Jeff Miller at the helm, 
discovered secret waiting lists at the Phoenix VA, as well as many 
other medical centers across the country. Had this directive still been 
in place, I honestly believe the scandal could have been prevented.
  Mr. Speaker, it is incumbent upon us to ensure that these scheduling 
processes do not and cannot be dismissed by VA bureaucrats ever again.
  I thank my good friend and former committee member, Representative 
Jackie Walorski from Indiana, for sponsoring this legislation.
  Mr. Speaker, I urge all of my colleagues to join me in supporting 
H.R. 467, and I reserve the balance of my time.
  Mr. WALZ. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I associate myself with the comments of Chairman Roe and 
I support H.R. 467. I also thank the gentlewoman from Indiana (Mrs. 
Walorski) for crafting this. She was, and still remains, a staunch 
supporter of veterans, always advocating for them. She taught me much, 
including, I think, the definition of Hoosier. I am still a little 
confused on that one, but we are working on it.
  By holding the VA leadership accountable, we can ensure that the VA 
is accessible to all veterans. While the VA has made progress to 
shorten wait times, we cannot rest on our laurels. If one veteran's 
health is compromised because she or he was unable to receive timely 
care, then the VA has failed in its mission.
  Mr. Speaker, for that reason, I ask my colleagues to stand in support 
of Mrs. Walorski's bill, and I reserve the balance of my time.
  Mr. ROE of Tennessee. Mr. Speaker, I yield 2 minutes to the gentleman 
from Florida (Mr. Bilirakis), the vice chair and one of the most active 
members of the committee.
  Mr. BILIRAKIS. Mr. Speaker, I appreciate Mrs. Walorski doing an 
outstanding job with this bill. The chairman and the ranking member are 
champions of veterans.
  Again, I rise today in support of H.R. 467, the VA Scheduling 
Accountability Act, because all veterans deserve timely access to 
quality health care.
  In 2014, the House Veterans' Affairs Committee uncovered the use of 
unauthorized waiting lists at the Phoenix VA healthcare system in 
Phoenix, Arizona. As a result of these waiting lists, no less than 40 
veterans died while waiting for care.
  This is unacceptable. It is heartbreaking and completely, as I said, 
unacceptable. These are true American heroes, and we cannot allow 
something like this to ever happen again.
  Our investigations found that noncompliance with the VA's scheduling 
policies was a widespread and systematic problem. This bill today 
requires that all VA medical center directors certify each year that 
their facility is in compliance with the scheduling directive. If a VA 
medical center is found noncompliant, H.R. 476 will hold those leaders 
accountable.
  Our bill makes certain that those who fail in their duty to serve our 
veterans will not be receiving bonuses or awards anytime soon. Lack of 
oversight, lack of accountability, and lack of transparency led to the 
2014 wait-times crisis. The VA Scheduling Accountability Act will help 
ensure those mistakes are not repeated, and improve access to timely 
care for our Nation's heroes.
  Again, I thank the sponsor of the bill, Mrs. Walorski. It is one of 
the most important bills that we will pass this year, in my opinion, 
and I urge its passage.
  Mr. WALZ. Mr. Speaker, I reserve the balance of my time.
  Mr. ROE of Tennessee. Mr. Speaker, I yield 5 minutes to the 
gentlewoman from Indiana (Mrs. Walorski), the sponsor of the bill and a 
former member of the committee.
  Mrs. WALORSKI. Mr. Speaker, I thank Chairman Roe and Ranking Member 
Walz. What an honor it is to work with these two gentlemen on veterans' 
issues.
  Mr. Speaker, I rise today in support of my bill, H.R. 467, the VA 
Scheduling Accountability Act.
  This commonsense legislation codifies an important measure of 
oversight and accountability of VA facilities to prevent scheduling 
manipulation or, in the vernacular, ``cooking the books,'' that has 
harmed veterans for so long.
  Hearings held by the House VA Committee and investigations by the VA 
inspector general and the GAO have, unfortunately, confirmed many of 
the allegations of cooking books and falsified wait-time data at 
facilities around the country.
  The VA has a procedure for scheduling veterans' medical appointments, 
which includes 19 different items, such as ensuring that a patient's 
desired appointment date is not altered and that staff are fully 
trained. Importantly, the directive requires each facility to certify 
compliance with all of these 19 items every year.
  However, an August 2014 VA inspector general report uncovered that, 
in May 2013, a senior VA official waived the certification requirement 
that year, essentially putting the facility on an honor system, 
allowing them to self-certify.
  Without this crucial accountability mechanism, bad actors were given 
free rein to manipulate wait-time data and ignore the VA's required 
scheduling practices. Meanwhile, veterans faced significant delays in 
getting the care they needed while, in some extreme cases, veterans 
died.
  Since that time, the VA has reinstated the certification 
requirements. However, serious problems remain, as evidenced by a 
recent VA investigation of a clinic in my own district that I requested 
after some brave individuals came forward with allegations of 
wrongdoing.

                              {time}  1515

  The VA found that the clinic scheduled appointments for veterans 
without the veterans' knowledge and canceled them on the day of the 
appointment in order to fill their schedule for that day. If the VA had 
conducted proper audits of that facility's scheduling practices last 
year, this misconduct could have been prevented. The VA's report 
recommended a review of scheduling compliance for all medical 
facilities in the region.
  The VA's continued inability to reform itself from within is the 
reason we need to pass this bill. This bill will require each facility 
director to annually certify compliance with the current scheduling 
directive or any successive directive that replaces it, and, most 
importantly, it will prohibit any future waivers. The bill also 
provides accountability by making a director ineligible for salary 
bonuses if their facility fails to certify compliance, and it requires 
the VA to report to Congress a list of these facilities that are not in 
compliance. This will provide more oversight of the VA, ensure that 
Congress is aware of noncompliant facilities, and end the reckless 
practice of self-certification.
  Mr. Speaker, our veterans risked life and limb for our freedom, but 
too often the VA has let them down. It is time to put an end to this 
scheduling manipulation--the cooking of the books--and the false wait-
time data.
  Holding every VA facility accountable for following scheduling rules 
is an important, commonsense step as we work to fix the VA so it works 
for the veterans in our country.
  Mr. Speaker, I urge my colleagues to support H.R. 467, the VA 
Scheduling Accountability Act.
  Mr. WALZ. Mr. Speaker, again, I thank the gentlewoman from Indiana 
for her passion and for the chairman to bring this commonsense 
accountability piece to the floor.
  I encourage my colleagues to support it, and I yield back the balance 
of my time.
  Mr. ROE of Tennessee. Mr. Speaker, once again, I encourage all 
Members to

[[Page 8288]]

support this legislation, and I yield back the balance of my time.
  The SPEAKER pro tempore. 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. 467.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. ROE of Tennessee. Mr. Speaker, on that I demand the yeas and 
nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

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