[House Report 113-645]
[From the U.S. Government Publishing Office]


113th Congress   }                                        {      Report
                        HOUSE OF REPRESENTATIVES
 2d Session      }                                        {     113-645

======================================================================



 
                            ASK VETERANS ACT

                                _______
                                

December 3, 2014.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

    Mr. Miller of Florida, from the Committee on Veterans' Affairs, 
                        submitted the following

                              R E P O R T

                        [To accompany H.R. 4971]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Veterans' Affairs, to whom was referred 
the bill (H.R. 4971) to direct the Secretary of Veterans 
Affairs to conduct annual surveys of veterans on experiences 
obtaining hospital care and medical services from medical 
facilities of the Department of Veterans Affairs, and for other 
purposes, having considered the same, report favorably thereon 
with an amendment and recommend that the bill as amended do 
pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     3
Background and Need for Legislation..............................     4
Hearings.........................................................     6
Committee Consideration..........................................     7
Committee Votes..................................................     7
Committee Oversight Findings.....................................     7
Statement of General Performance Goals and Objectives............     7
New Budget Authority, Entitlement Authority, and Tax Expenditures     7
Earmarks and Tax and Tariff Benefits.............................     8
Committee Cost Estimate..........................................     8
Congressional Budget Office Cost Estimate........................     8
Federal Mandates Statement.......................................     9
Advisory Committee Statement.....................................     9
Statement of Constitutional Authority............................     9
Applicability to Legislative Branch..............................     9
Statement on Duplication of Federal Programs.....................     9
Disclosure of Directed Rulemaking................................     9
Section-by-Section Analysis of the Legislation...................     9
Changes in Existing Law Made by the Bill as Reported.............    11

    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Ask Veterans Act''.

SEC. 2. SURVEY OF VETERAN EXPERIENCES WITH DEPARTMENT OF VETERANS 
                    AFFAIRS MEDICAL CARE.

  (a) In General.--The Secretary of Veterans Affairs shall seek to 
enter into a contract with a non-government entity with significant 
experience conducting scientifically verifiable surveys and research to 
conduct an annual survey of a statistically significant sample of 
veterans who reside in the geographic area served by each of the 
medical facilities of the Department of Veterans Affairs to determine 
the nature of the experiences of such veterans in obtaining hospital 
care and medical services furnished by the Secretary at each such 
medical facility. Each such survey shall be conducted using scientific 
and verifiable methods. Such contract shall provide that the non-
government entity shall conduct such annual surveys during the five-
year period beginning on the date on which the Secretary enters into 
the contract with the non-government entity.
  (b) Contents.--The contract entered into under subsection (a) shall 
provide that each survey conducted pursuant to the contract shall be 
specific to a medical facility of the Department and shall include 
questions relating to the experiences of veterans in requesting and 
receiving appointments for hospital care and medical services furnished 
by the Secretary at that medical facility, including questions relating 
to each of the following:
          (1) The veteran's ability to obtain hospital care and medical 
        services at the facility in a timely manner.
          (2) The period of time between the date on which the veteran 
        requests an appointment at the facility and the date on which 
        the appointment is scheduled.
          (3) The frequency with which scheduled appointments are 
        cancelled by the facility.
          (4) The quality of hospital care or medical services the 
        veteran has received at the facility.
  (c) Consultation.--The contract entered into under subsection (a) 
shall provide that in designing and conducting the surveys for each 
medical facility of the Department pursuant to such contract, the non-
government entity shall consult with veterans service organizations.
  (d) Certification.--The contract entered into under subsection (a) 
shall provide that--
          (1) before conducting a survey pursuant to the contract, the 
        non-government entity shall submit the proposed survey to the 
        Comptroller General who shall assess whether the survey is 
        scientifically valid and whether the proposed sample size of 
        veterans to be surveyed is statistically significant; and
          (2) the non-government entity may not conduct such a survey 
        until the Comptroller General provides such a certification for 
        the survey.
  (e) Submittal of Results and Public Availability of Information.--Not 
later than 30 days after the completion of the surveys conducted 
pursuant to a contract entered into under subsection (a) for a year, 
the Secretary shall make the results of the surveys publicly available 
on the Internet website of the Department.
  (f) Paperwork Reduction.--Subchapter I of chapter 35 of title 44, 
United States Code shall not apply to this section.
  (g) Deadline for Implementation.--The Secretary shall enter into a 
contract under subsection (a) for each medical facility of the 
Department by not later than 180 days after the date of the enactment 
of this Act.

SEC. 3. MENTAL HEALTH TREATMENT FOR VETERANS WHO SERVED IN CLASSIFIED 
                    MISSIONS.

  (a) Sense of Congress.--It is the sense of Congress that veterans who 
experience combat-related mental health wounds should have immediate, 
appropriate, and consistent access to comprehensive mental health care.
  (b) In General.--Subchapter II of chapter 17 of title 38, United 
States Code, is amended by adding at the end the following section:

``Sec. 1720H. Mental health treatment for veterans who served in 
                    classified missions

  ``(a) Establishment of Standards.--(1) The Secretary shall establish 
standards and procedures to ensure that each covered veteran may access 
mental health care provided by the Secretary in a manner that fully 
accommodates the obligation of the veteran to not improperly disclose 
classified information.
  ``(2) The Secretary shall disseminate guidance to employees of the 
Veterans Health Administration, including mental health professionals, 
on the standards and procedures established under paragraph (1) and how 
to best engage covered veterans during the course of mental health 
treatment with respect to classified information.
  ``(b) Identification.--In carrying out this section, the Secretary 
shall ensure that a veteran may elect to identify as a covered veteran 
on an appropriate form.
  ``(c) Definitions.--In this section:
          ``(1) The term `classified information' means any information 
        or material that has been determined by an official of the 
        United States pursuant to law, an Executive order, or 
        regulation to require protection against unauthorized 
        disclosure for reasons of national security.
          ``(2) The term `covered veteran' means a veteran who--
                  ``(A) is enrolled in the health care system 
                established under section 1705(a) of this title;
                  ``(B) is seeking mental health treatment; and
                  ``(C) in the course of serving in the Armed Forces, 
                participated in a sensitive mission or served in a 
                sensitive unit.
          ``(3) The term `sensitive mission' means a mission of the 
        Armed Forces that, at the time at which a covered veteran seeks 
        treatment, is classified.
          ``(4) The term `sensitive unit' has the meaning given that 
        term in section 130b(c)(4) of title 10.''.
  (c) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by adding after the item relating to section 
1720G the following new item:

``1720H. Mental health treatment for veterans who served in classified 
missions.''.

SEC. 4. BOARD OF VETERANS' APPEALS VIDEO HEARINGS.

  Section 7107 of title 38, United States Code, is amended--
          (1) in subsection (d), by amending paragraph (1) to read as 
        follows:
  ``(1)(A) Upon request for a hearing, the Board shall determine, for 
purposes of scheduling the hearing for the earliest possible date, 
whether a hearing before the Board will be held at its principal 
location or at a facility of the Department or other appropriate 
Federal facility located within the area served by a regional office of 
the Department. The Board shall also determine whether to provide a 
hearing through the use of the facilities and equipment described in 
subsection (e)(1) or by the appellant personally appearing before a 
Board member or panel.
  ``(B) The Board shall notify the appellant of the determinations of 
the location and type of hearing made under subparagraph (A). Upon 
notification, the appellant may request a different location or type of 
hearing as described in such subparagraph. If so requested, the Board 
shall grant such request and ensure that the hearing is scheduled at 
the earliest possible date without any undue delay or other prejudice 
to the appellant.''; and
          (2) in subsection (e), by amending paragraph (2) to read as 
        follows:
  ``(2) Any hearing provided through the use of the facilities and 
equipment described in paragraph (1) shall be conducted in the same 
manner as, and shall be considered the equivalent of, a personal 
hearing.''.

                          Purpose and Summary

    H.R. 4971, the Ask Veterans Act, was introduced by 
Representative Beto O'Rourke of Texas, on July 23, 2014. H.R. 
4971, as amended, also reflects the Committee's consideration 
of H.R. 3387, the Classified Veterans Access to Care Act, which 
was introduced by Representative Kyrsten Sinema on October 30, 
2013; and, H.R. 2119, the Veterans' Access to Speedy Review 
Act, which was introduced by Representative Raul Ruiz on May 
22, 2013.
    H.R. 4971, as amended, would: (1) require the Department of 
Veterans Affairs (VA) to contract with an independent entity to 
conduct a survey of each VA medical center concerning the 
experience veterans have in requesting and receiving medical 
appointments at that facility; (2) require VA to establish 
standards and procedures and disseminate guidance regarding 
mental health care for veterans who served on classified or 
sensitive missions; (3) require the Board of Veterans' Appeals, 
for purposes of scheduling a veteran's appeal hearing at the 
earliest possible date, to determine and notify the appellant 
whether to provide such hearing at its principal location or at 
another VA or federal facility and through the use of 
videoconferencing or by an appellant's personal appearance; 
and, (4) allow an appellant before the Board of Veterans 
Appeals to request a different location or type of hearing, and 
allow the Board to grant such request while ensuring that the 
hearing is scheduled at the earliest possible date.

                  Background and Need for Legislation


Section 2. Survey of veteran experiences with Department of Veterans 
        Affairs Medical Care

    Prior to the wait time scheduling scandal in Phoenix, VA 
had been reporting wait time data individually to Members of 
Congress, upon request. For each month between March 2013 and 
March 2014, the El Paso VA Healthcare System (VAHCS) reported 
to Rep. O'Rourke (TX-16) that between 85% and 100% of new 
veteran patients seeking mental health appointments saw a VA 
provider within 14 days of their appointment request, in 
accordance with VA's 14-day wait time goal. However, during 
quarterly town halls with veterans, Rep. O'Rourke noted 
significant discrepancies between the wait times being reported 
by VA and anecdotal evidence received from local veterans. In 
response, Rep. O'Rourke's office developed a survey and 
released a report based on responses from approximately 700 El 
Paso area veterans. While VA was reporting wait times at 
effectively 0 days, the survey showed that, on average, 
veterans were waiting 71 days to see a mental health provider 
and more than 36% of veterans attempting to make an appointment 
were unable to see a mental health provider at all.
    In May 2014, VA initiated a nationwide Access Audit to 
determine if allegations regarding inappropriate scheduling 
practices were systemic across the VA health care system. 
According to the results of this audit, veterans in El Paso 
were waiting approximately 60 days to see a health-care 
provider and mental health patients had a 16-day wait before 
getting an appointment. These results are much more in line 
with the results of Rep. O'Rourke's survey than the results VA 
was reporting to individual Members of Congress prior to the 
access scandal.
    Section 2, which is based on Rep. O'Rourke's survey model, 
includes language from H.R. 4971, as introduced. It would 
direct VA to contract with an experienced non-government entity 
to conduct an annual survey over a five-year period of a 
statistically significant sample of veterans who reside in the 
geographic area served by each VA medical facility across the 
country. The survey would be specific to the medical facility 
being surveyed and include questions regarding the experiences 
veterans at that facility have in requesting and obtaining 
appointments in a timely manner.

Section 3. Mental health treatment for veterans who served in 
        classified missions

    According to the Department, VA mental health providers 
work with veteran patients who may have served on sensitive or 
classified missions during their military service to ensure 
appropriate and effective mental health treatment is available 
that does not disclose specific, identifying information that 
could compromise the veteran's confidentiality agreements. 
However, following the suicide death of a veteran who had 
served on a number classified missions and who was allegedly 
assigned by VA to attend group therapy despite hesitancy about 
inadvertently sharing classified information, concerns have 
been raised about the provision of care to such veterans.
    The veteran referenced in the case above and his family 
asked for help with flashbacks, nightmares, depression, and 
additional symptoms of post-traumatic stress disorder. 
Unfortunately, VA enrolled the patient in group therapy 
sessions, which this veteran did not attend for fear of 
disclosing classified information. Despite requests for 
individual counseling or some other reasonable accommodation to 
allow appropriate, on-going care for the patient, VA delayed 
providing appropriate support and care. In this case, the 
veteran did not get the help he needed and, tragically, he 
committed suicide in June 2013.
    Section 3 of H.R. 4971, as amended, would direct VA to 
establish standards and procedures to ensure that a veteran who 
participated in a classified mission or served in a sensitive 
unit may access mental health care in a manner that fully 
accommodates that veteran's obligation to not improperly 
disclose classified information. It would also direct VA to 
disseminate guidance to employees of the Veterans Health 
Administration, including mental health professionals, on such 
standards and procedures and on how to best engage such 
veterans during the course of mental health treatment with 
respect to classified information. This section includes 
language from H.R. 3387, as introduced.

Section 4. Board of Veterans' Appeals video hearings

    During the 113th Congress, VA's focus on working a defined 
set of backlogged initial and supplemental claims contributed 
to a situation whereby appeals of veterans' disability rating 
decisions steadily increased without mitigation. The neglect of 
appeals has created additional backlogs at both the VA Regional 
Offices, as well as at the Board of Veterans Appeals. As of 
October 18, 2014, over 350,000 veterans' claims remained 
unresolved within the VA appellate process. While the majority 
of these appeals are stalled at various phases of review within 
the VA Regional Offices, a significant and aged workload also 
sits at the Board of Veterans Appeals.
    There are concerns that recent VA initiatives aimed at the 
rapid processing of claims will continue to exacerbate the 
backlog of appeals existing at the Board of Veterans Appeals. 
Thus, Section 4 of H.R. 4971, as amended, would include 
language from H.R. 2119, which would permit the Board of 
Veterans Appeals to make initial determinations for purposes of 
scheduling veterans an opportunity for hearing at the earliest 
possible date, whether the hearing should be held in person, or 
via a remote teleconference or videoconference option. Section 
4 would also permit veterans, upon notification, to elect a 
different format than the expedient option selected by the 
Board of Veterans Appeals. By permitting the Board of Veterans 
Appeals to offer the initial selection of hearing format, this 
Section would potentially decrease hearing wait times for 
veterans, enhance efficiency within VA, and better focus Board 
resources toward issuing decisions. VA has indicated that the 
Board has historically been able to schedule video conference 
hearings more quickly than in-person hearings, saving valuable 
time in the appeals process. In FY 2013, on average, video 
conference hearings were held 110 days sooner than in-person 
hearings. Thus, this Section would contribute to both reduced 
wait times in resolve of veterans' appeals, as well as 
potential monetary savings for the Department, as VA estimates 
that this Section would result in a reduction in travel 
expenses over time.

                                Hearings

    On March 26, 2014, the Subcommittee on Disability 
Assistance and Memorial Affairs conducted a legislative hearing 
on various bills introduced during the 113th Congress, 
including H.R. 2119.
    The following witnesses testified:
    The Honorable Al Green, U.S. House of Representatives, 9th 
District, Texas; The Honorable Timothy Walz, U.S. House of 
Representatives, 1st District, Minnesota; The Honorable Jeffrey 
Denham, U.S. House of Representatives, 10th District, 
California; The Honorable Ander Crenshaw, U.S. House of 
Representatives, 4th District, Florida; The Honorable Steven 
Stivers, U.S. House of Representatives, 15th District, Ohio; 
Jeffrey C. Hall, Assistant National Legislative Director, 
Disabled American Veterans; Alexander Nicholson, Legislative 
Director, Iraq and Afghanistan Veterans of America; Heather 
Ansley, Esq., MSW, Vice President of Veterans Policy, 
VetsFirst, a program of United Spinal Association; Diane M. 
Zumatto, National Legislative Director, AMVETS; Zachary Hearn, 
Deputy Director for Claims, Veterans Affairs and Rehabilitation 
Commission, The American Legion; Anthony A. Wallis, Legislative 
Director and Director of Government Affairs, Association of the 
United States Navy; Brendon Gehrke, Senior Legislative 
Associate, Veterans of Foreign Wars; Thomas Murphy, Director, 
Compensation Service, Veterans Benefits Administration, U.S. 
Department of Veterans Affairs, accompanied by Patricia Lynch 
Watts, Director, Legislative and Regulatory Service, National 
Cemetery Administration, and David Barrans, Deputy Assistant 
General Counsel.
    Statements for the Record were submitted by:
    The Honorable Steve Daines, U.S. House of Representatives, 
Montana; and, Paralyzed Veterans of America.
    On March 27, 2014, the Subcommittee on Health conducted a 
legislative hearing on various bills introduced during the 
113th Congress, including H.R. 3387.
    The following witnesses testified:
    The Honorable Michael Grimm, U.S. House of Representatives, 
11th District, New York; The Honorable Dina Titus, U.S. House 
of Representatives, 1st District, Nevada; The Honorable Jackie 
Walorski, U.S. House of Representatives, 2nd District, Indiana; 
The Honorable Sean Duffy, U.S. House of Representatives, 7th 
District, Wisconsin; The Honorable Marcy Kaptur, U.S. House of 
Representatives, 9th Disctrict, Ohio; The Honorable Kyrsten 
Sinema, U.S. House of Representatives, 9th District, Arizona; 
The Honorable David P. Roe, U.S. House of Representatives, 1st 
District, Tennessee; The Honorable Jeff Denham, U.S. House of 
Representatives, 10th District, California; Joy J. Ilem, Deputy 
National Legislative Director, Disabled American Veterans; 
Alethea Predeoux, Associate Director of Health Analysis, 
Paralyzed Veterans of America; Aleksandr Morosky, Senior 
Legislative Associate, National Legislative Service, Veterans 
of Foreign Wars; and, Madhulka Agarwal M.D., M.P.H., Deputy 
Under Secretary for Health for Policy and Services, Veterans 
Health Administration, U.S. Department of Veterans Affairs, 
accompanied by Philip Matkovsky, Assistant Deputy Under 
Secretary for Health for Operations and Management, and Renee 
L. Szybala, Acting Assistant General Counsel.
    Statements for the record were submitted by the following:
    The Honorable Kevin McCarthy, U.S. House of 
Representatives, 23rd District, California; American Academy of 
Otolaryngology--Head and Neck Surgery; Department of Veterans 
Affairs Office of the Inspector General; International Hearing 
Society; Iraq and Afghanistan Veterans of America; National 
Association of State Veterans Homes; Servicewomen's Action 
Network; The American Speech-Language-Hearing Association; 
Warrior Canine Connection; Wounded Warrior Project; and, 
VetsFirst.

                        Committee Consideration

    On September 10, 2014, the full Committee met in an open 
markup session, a quorum being present and ordered H.R. 4971, 
as amended, reported favorably to the House of Representatives 
by voice vote.

                            Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list the record votes 
on the motion to report the legislation and amendments thereto. 
There were no record votes taken on amendments or in connection 
with ordering H.R. 4971, as amended, reported to the House. A 
motion by Ranking Member Michael H. Michaud of Maine to report 
H.R. 4971, as amended, favorably to the House of 
Representatives was agreed to by voice vote.

                      Committee Oversight Findings

    In compliance with clause 3(c)(1) of rule XIII and clause 
(2)(b)(1) of rule X of the Rules of the House of 
Representatives, the Committee's oversight findings and 
recommendations are reflected in the descriptive portions of 
this report.

         Statement of General Performance Goals and Objectives

    In accordance with clause 3(c)(4) of rule XIII of the Rules 
of the House of Representatives, the Committee's performance 
goals and objectives are reflected in the descriptive portions 
of this report.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee adopts as its 
own the estimate of new budget authority, entitlement 
authority, or tax expenditures or revenues contained in the 
cost estimate prepared by the Director of the Congressional 
Budget Office pursuant to section 402 of the Congressional 
Budget Act of 1974.

                  Earmarks and Tax and Tariff Benefits

    H.R. 4971, as amended, does not contain any congressional 
earmarks, limited tax benefits, or limited tariff benefits as 
defined in clause 9 of rule XXI of the Rules of the House of 
Representatives.

                        Committee Cost Estimate

    The Committee adopts as its own the cost estimate on H.R. 
4971, as amended, prepared by the Director of the Congressional 
Budget Office pursuant to section 402 of the Congressional 
Budget Act of 1974.

               Congressional Budget Office Cost Estimate

    Pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate 
for H.R. 4971, as amended, provided by the Congressional Budget 
Office pursuant to section 402 of the Congressional Budget Act 
of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                Washington, DC, September 22, 2014.
Hon. Jeff Miller,
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 4971, the Ask 
Veterans Act.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Ann E. 
Futrell.
            Sincerely,
                                              Douglas W. Elmendorf.
    Enclosure.

H.R. 4971--Ask Veterans Act

    H.R. 4971 would require the Department of Veterans Affairs 
(VA) to enter into a contract with a nongovernment entity to 
conduct annual surveys of veterans on wait times, appointment 
cancellations, and the quality of health care at VA medical 
facilities. The system-wide surveys would take place over a 
five-year period. Based on the cost of VA's previous contracts 
with nongovernment entities for surveys and studies, CBO 
estimates that implementing this provision would cost $5 
million over the 2015-2019 period, assuming appropriation of 
the necessary amounts.
    The bill also would require VA to establish and disseminate 
standards and procedures to ensure that veterans who served in 
classified missions do not have to disclose classified 
information while being treated for mental health conditions. 
Based on information from VA, CBO estimates that this provision 
would have costs of less than $500,000 over the 2015-2019 
period.
    Enacting H.R. 4971 would not affect direct spending or 
revenues; therefore, pay-as-you-go procedures do not apply.
    H.R. 4971 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act and 
would not affect the budgets of state, local, or tribal 
governments.
    The CBO staff contact for this estimate is Ann E. Futrell. 
The estimate was approved by Theresa Gullo, Deputy Assistant 
Director for Budget Analysis.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates regarding H.R. 4971, as amended, prepared by the 
Director of the Congressional Budget Office pursuant to section 
423 of the Unfunded Mandates Reform Act.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act would be created by H.R. 
4971, as amended.

                 Statement of Constitutional Authority

    Pursuant to Article I, section 8 of the United States 
Constitution, the reported bill is authorized by Congress' 
power to ``provide for the common Defense and general Welfare 
of the United States.''

                  Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

              Statement on Duplication of Federal Programs

    Pursuant to section 3(j) of H. Res. 5, 113th Cong. (2013), 
the Committee finds that no provision of H.R. 4971, as amended, 
establishes or reauthorizes a program of the Federal Government 
known to be duplicative of another Federal program, a program 
that was included in any report from the Government 
Accountability Office to Congress pursuant to section 21 of 
Public Law 111-139, or a program related to a program 
identified in the most recent Catalog of Federal Domestic 
Assistance.

                   Disclosure of Directed Rulemaking

    Pursuant to section 3(k) of H. Res. 5, 113th Cong. (2013), 
the Committee estimates that H.R. 4971, as amended, does not 
require any directed rule makings.

                Section-by-Section Analysis of H.R. 4971


Section 1. Short title

    Section 1 of the bill would provide the short title of H.R. 
4971 as the ``Ask Veterans Act.''

Section 2. Survey of veteran experiences with Department of Veterans 
        Affairs Medical Care

    Section 2(a) of the bill would require the Secretary of 
Veterans' Affairs to conduct annual surveys in each 
geographical area served by VA medical facilities. These 
surveys would be taken by a statistically significant sample of 
veterans, conducted by a non-government contractor, and would 
be used to determine the nature of the experiences of veterans 
in obtaining hospital care and medical services provided at 
each facility. These annual surveys must be conducted using 
scientific and verifiable methods. The five year period shall 
begin on the date on which the Secretary enters into the 
contract with the non-government entity.
    Section 2(b) of the bill would direct that each survey 
conducted shall be specific to a medical facility in the 
Department and shall include questions related to the 
experiences of veterans in terms of requesting and receiving 
appointments and medical services provided by that facility.
    Section 2(b)(1-4) of the bill would direct each survey to 
ask questions as it relates to the following areas.
    Section 2(b)(1) of the bill would direct the survey to ask 
about the veterans' ability to obtain care and medical services 
at the facility in a timely manner.
    Section 2(b)(2) of the bill would direct the survey to ask 
about the period of time between the date on which the veteran 
requests an appointment and the date on which the appointment 
is scheduled.
    Section 2(b)(3) of the bill would direct the survey to ask 
about the frequency with which scheduled appointments are 
cancelled at the facility.
    Section 2(b)(4) of the bill would direct the survey to ask 
about the quality of care or services that the veteran has 
received at the facility.
    Section 2(c) of the bill would direct the Department to 
consult with veteran service organizations when designing and 
conducting the surveys of each medical facility.
    Section 2(d) of the bill would establish certification 
procedures prior to conducting the survey.
    Section 2(d)(1) of the bill would direct the non-government 
contractor to submit the proposed survey to the Comptroller 
General who will assess whether the survey follows the 
instructions in Section 2(a).
    Section 2(d)(2) of the bill would direct the non-government 
contractor not to conduct the survey until certified by the 
Comptroller General.
    Section 2(e) of the bill would direct the Secretary to make 
the results of the survey publicly available for one year on 
the Department's website within 30 days of completion of the 
survey.
    Section 2(f) of the bill would stipulate that subchapter I 
of chapter 35 of title 44 U.S.C. shall not apply.
    Section 2(g) of the bill would direct the Secretary to 
enter into a contract for conducting the survey at each medical 
facility within 180 days following enactment of this Act.

Section 3. Mental health treatment for veterans who served in 
        classified missions

    Section 3(a) of the bill would provide the sense of 
Congress that veterans who experience combat-related mental 
health wounds have immediate, appropriate, and consistent 
access to comprehensive mental health care.
    Section 3(b) of the bill would amend at the end of 
subchapter II of chapter 17 of title 38 U.S.C. by adding 
``Sec. 1720H. Mental health treatment for veterans who served 
in classified missions.'' This section establishes standards 
and procedures by which each covered veteran may access care 
while accommodating the veterans' obligation to not improperly 
disclose classified information. This is accomplished by 
disseminating guidance to employees of the Veterans Health 
Administration on standards and procedures and how best to 
engage these veterans. This section also establishes the 
following definitions of `classified information', `covered 
veteran', `sensitive mission', and `sensitive unit'.
    Section 3(c) of the bill would amend the table of sections 
at the beginning of the chapter to include section 1720H 
following section 1720G.

Section 4. Board of Veterans' Appeals video hearings

    Section 4 of the bill would amend section 7107 of title 38 
U.S.C. by amending paragraph (1) to describe the process by 
which the Board shall determine the location of the hearing, 
for the purposes of scheduling the hearing at the earliest 
possible date. The Board will also decide whether to provide 
the hearing through the use of facilities and equipment as 
described in Sec. 7107(e)(1) or by the appellant personally 
appearing before the Board member and panel. Once notified by 
the Board of the location and type of hearing, the appellant 
may request a different location or type of hearing. The Board 
may grant the request and ensure that the hearing is scheduled 
at the earliest possible date without any undue delay or 
prejudice to the appellant. Subsection(e)(2) is amended so that 
any hearing provided through the use of facilities and 
equipment shall be conducted in the same manner, and will be 
considered the equivalent, of a personal hearing.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

                      TITLE 38, UNITED STATES CODE




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PART II--GENERAL BENEFITS

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   CHAPTER 17--HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE


                          SUBCHAPTER I--GENERAL

Sec.
1701. Definitions.
     * * * * * * *

 SUBCHAPTER II--HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL 
                                TREATMENT

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1720H. Mental health treatment for veterans who served in classified 
          missions.

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SUBCHAPTER II--HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL 
TREATMENT

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Sec. 1720H. Mental health treatment for veterans who served in 
                    classified missions

  (a) Establishment of Standards.--(1) The Secretary shall 
establish standards and procedures to ensure that each covered 
veteran may access mental health care provided by the Secretary 
in a manner that fully accommodates the obligation of the 
veteran to not improperly disclose classified information.
  (2) The Secretary shall disseminate guidance to employees of 
the Veterans Health Administration, including mental health 
professionals, on the standards and procedures established 
under paragraph (1) and how to best engage covered veterans 
during the course of mental health treatment with respect to 
classified information.
  (b) Identification.--In carrying out this section, the 
Secretary shall ensure that a veteran may elect to identify as 
a covered veteran on an appropriate form.
  (c) Definitions.--In this section:
          (1) The term ``classified information'' means any 
        information or material that has been determined by an 
        official of the United States pursuant to law, an 
        Executive order, or regulation to require protection 
        against unauthorized disclosure for reasons of national 
        security.
          (2) The term ``covered veteran'' means a veteran 
        who--
                  (A) is enrolled in the health care system 
                established under section 1705(a) of this 
                title;
                  (B) is seeking mental health treatment; and
                  (C) in the course of serving in the Armed 
                Forces, participated in a sensitive mission or 
                served in a sensitive unit.
          (3) The term ``sensitive mission'' means a mission of 
        the Armed Forces that, at the time at which a covered 
        veteran seeks treatment, is classified.
          (4) The term ``sensitive unit'' has the meaning given 
        that term in section 130b(c)(4) of title 10.

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PART V--BOARDS, ADMINISTRATIONS, AND SERVICES

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CHAPTER 71--BOARD OF VETERANS' APPEALS

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Sec. 7107. Appeals: dockets; hearings

  (a) * * *

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  (d)[(1) An appellant may request that a hearing before the 
Board be held at its principal location or at a facility of the 
Department located within the area served by a regional office 
of the Department.]
  (1)(A) Upon request for a hearing, the Board shall determine, 
for purposes of scheduling the hearing for the earliest 
possible date, whether a hearing before the Board will be held 
at its principal location or at a facility of the Department or 
other appropriate Federal facility located within the area 
served by a regional office of the Department. The Board shall 
also determine whether to provide a hearing through the use of 
the facilities and equipment described in subsection (e)(1) or 
by the appellant personally appearing before a Board member or 
panel.
  (B) The Board shall notify the appellant of the 
determinations of the location and type of hearing made under 
subparagraph (A). Upon notification, the appellant may request 
a different location or type of hearing as described in such 
subparagraph. If so requested, the Board shall grant such 
request and ensure that the hearing is scheduled at the 
earliest possible date without any undue delay or other 
prejudice to the appellant.

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  (e)(1) * * *
  [(2) When such facilities and equipment are available, the 
Chairman may afford the appellant an opportunity to participate 
in a hearing before the Board through the use of such 
facilities and equipment in lieu of a hearing held by 
personally appearing before a Board member or panel as provided 
in subsection (d). Any such hearing shall be conducted in the 
same manner as, and shall be considered the equivalent of, a 
personal hearing. If the appellant declines to participate in a 
hearing through the use of such facilities and equipment, the 
opportunity of the appellant to a hearing as provided in such 
subsection (d) shall not be affected.]
  (2) Any hearing provided through the use of the facilities 
and equipment described in paragraph (1) shall be conducted in 
the same manner as, and shall be considered the equivalent of, 
a personal hearing.

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