Sec. 203. PROCEDURE FOR MAKING RECOMMENDATIONS
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## SEC. 203 PROCEDURE FOR MAKING RECOMMENDATIONS ###
(a)Selection Criteria ####
(1)Publication The Secretary shall, not later than February 1, 2021, and after consulting with veterans service organizations, publish in the Federal Register and transmit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives the criteria proposed to be used by the Department of Veterans Affairs in assessing and making recommendations regarding the modernization or realignment of facilities of the Veterans Health Administration under this subtitle. Such criteria shall include the preferences of veterans regarding health care furnished by the Department. ####
(2)Public comment The Secretary shall provide an opportunity for public comment on the proposed criteria under paragraph
(1)for a period of at least 90 days and shall include notice of that opportunity in the publication required under such paragraph. ####
(3)Publication of final criteria The Secretary shall, not later than May 31, 2021, publish in the Federal Register and transmit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives the final criteria to be used in making recommendations regarding the closure, modernization, or realignment of facilities of the Veterans Health Administration under this subtitle. ###
(b)Recommendations of the Secretary ####
(1)Publication in federal register The Secretary shall, not later than January 31, 2022, and after consulting with veterans service organizations, publish in the Federal Register and transmit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives and to the Commission a report detailing the recommendations regarding the modernization or realignment of facilities of the Veterans Health Administration on the basis of the final criteria referred to in subsection (a)(2) that are applicable. ####
(2)Factors for consideration In making recommendations under this subsection, the Secretary shall consider each of the following factors: #####
(A)The degree to which any health care delivery or other site for providing services to veterans reflect the metrics of the Department of Veterans Affairs regarding market area health system planning. #####
(B)The provision of effective and efficient access to high-quality health care and services for veterans. #####
(C)The extent to which the real property that no longer meets the needs of the Federal Government could be reconfigured, repurposed, consolidated, realigned, exchanged, outleased, replaced, sold, or disposed. #####
(D)The need of the Veterans Health Administration to acquire infrastructure or facilities that will be used for the provision of health care and services to veterans. #####
(E)The extent to which the operating and maintenance costs are reduced through consolidating, colocating, and reconfiguring space, and through realizing other operational efficiencies. #####
(F)The extent and timing of potential costs and savings, including the number of years such costs or savings will be incurred, beginning with the date of completion of the proposed recommendation. #####
(G)The extent to which the real property aligns with the mission of the Department of Veterans Affairs. #####
(H)The extent to which any action would impact other missions of the Department (including education, research, or emergency preparedness). #####
(I)Local stakeholder inputs and any factors identified through public field hearings. #####
(J)The assessments under paragraph (3).. #####
(K)The extent to which the Veterans Health Administration has appropriately staffed the medical facility, including determinations whether there has been insufficient resource allocation or deliberate understaffing. #####
(L)Any other such factors the Secretary determines appropriate. ####
(3)Capacity and commercial market assessments #####
(A)Assessments The Secretary shall assess the capacity of each Veterans Integrated Service Network and medical facility of the Department to furnish hospital care or medical services to veterans under chapter 17 of title 38, United States Code. Each such assessment shall— ######
(i)identify gaps in furnishing such care or services at such Veterans Integrated Service Network or medical facility; ######
(ii)identify how such gaps can be filled by— ######
(I)entering into contracts or agreements with network providers under this section or with entities under other provisions of law; ######
(II)making changes in the way such care and services are furnished at such Veterans Integrated Service Network or medical facility, including— ######
(aa)extending hours of operation; ######
(bb)adding personnel; or ######
(cc)expanding space through the construction, leasing, or sharing of health care facilities; and ######
(III)the building or realignment of Department resources or personnel; ######
(iii)forecast, based on future projections and historical trends, both the short- and long-term demand in furnishing care or services at such Veterans Integrated Service Network or medical facility and assess how such demand affects the needs to use such network providers; ######
(iv)include a commercial health care market assessment of designated catchment areas in the United States conducted by a non-governmental entity; and ######
(v)consider the unique ability of the Federal Government to retain a presence in an area otherwise devoid of commercial health care providers or from which such providers are at risk of leaving. #####
(B)Consultation In carrying out the assessments under subparagraph (A), the Secretary shall consult with veterans service organizations and veterans served by each such Veterans Integrated Service Network and medical facility. #####
(C)Submittal The Secretary shall submit such assessments to the Committees on Veterans’ Affairs of the House of Representatives and the Senate with the recommendations of the Secretary under this subsection and make the assessments publicly available. ####
(4)Summary of selection process The Secretary shall include, with the list of recommendations published and transmitted pursuant to paragraph (1), a summary of the selection process that resulted in the recommendation for each facility of the Veterans Health Administration, including a justification for each recommendation. The Secretary shall transmit the matters referred to in the preceding sentence not later than 7 days after the date of the transmittal to the Committees on Veterans’ Affairs of the Senate and the House of Representatives and the Commission of the report referred to in paragraph (1). ####
(5)Treatment of facilities In assessing facilities of the Veterans Health Administration, the Secretary shall consider all such facilities equally without regard to whether the facility has been previously considered or proposed for reuse, closure, modernization, or realignment by the Department of Veterans Affairs. ####
(6)Availability of information to congress In addition to making all information used by the Secretary to prepare the recommendations under this subsection available to Congress (including any committee or Member of Congress), the Secretary shall also make such information available to the Commission and the Comptroller General of the United States. ####
(7)Certification of accuracy #####
(A)In general Each person referred to in subparagraph (B), when submitting information to the Secretary or the Commission concerning the modernization or realignment of a facility of the Veterans Health Administration, shall certify that such information is accurate and complete to the best of that person’s knowledge and belief. #####
(B)Covered persons Subparagraph
(A)applies to the following persons: ######
(i)Each Under Secretary of the Department of Veterans Affairs. ######
(ii)Each director of a Veterans Integrated Service Network. ######
(iii)Each director of a medical center of the Department of Veterans Affairs. ######
(iv)Each director of a program office of the Department of Veterans Affairs. ######
(v)Each person who is in a position the duties of which include personal and substantial involvement in the preparation and submission of information and recommendations concerning the modernization or realignment of facilities of the Veterans Health Administration. ###
(c)Review and Recommendations by the Commission ####
(1)Public hearings #####
(A)In general After receiving the recommendations from the Secretary pursuant to subsection (b), the Commission shall conduct public hearings on the recommendations. #####
(B)Locations The Commission shall conduct public hearings in regions affected by a recommendation of the Secretary to close a facility of the Veterans Health Administration. To the greatest extent practicable, the Commission shall conduct public hearings in regions affected by a recommendation of the Secretary to modernize or realign such a facility. #####
(C)Required witnesses Witnesses at each public hearing shall include at a minimum— ######
(i)a veteran— ######
(I)enrolled under section 1705 of title 38, United States Code; and ######
(II)identified by a local veterans service organization; and ######
(ii)a local elected official. ####
(2)Transmittal to president #####
(A)In general The Commission shall, not later than January 31, 2023, transmit to the President a report containing the Commission’s findings and conclusions based on a review and analysis of the recommendations made by the Secretary, together with the Commission’s recommendations, for modernizations and realignments of facilities of the Veterans Health Administration. #####
(B)Authority to make changes to recommendations Subject to subparagraph (C), in making its recommendations, the Commission may change any recommendation made by the Secretary if the Commission— ######
(i)determines that the Secretary deviated substantially from the final criteria referred to in subsection (a)(2) in making such recommendation; ######
(ii)determines that the change is consistent with the final criteria referred to in subsection (a)(2); ######
(iii)publishes a notice of the proposed change in the Federal Register not less than 45 days before transmitting its recommendations to the President pursuant to subparagraph (A); and ######
(iv)conducts public hearings on the proposed change. ####
(3)Justification for changes The Commission shall explain and justify in its report submitted to the President pursuant to paragraph
(2)any recommendation made by the Commission that is different from the recommendations made by the Secretary pursuant to subsection (b). The Commission shall transmit a copy of such report to the Committees on Veterans’ Affairs of the Senate and the House of Representatives on the same date on which it transmits its recommendations to the President under paragraph (2). ####
(4)Provision of information to congress After the Commission transmits its report to the President, the Commission shall promptly provide, upon request, to any Member of Congress, information used by the Commission in making its recommendations. ###
(d)Review by the President ####
(1)Report The President shall, not later than February 15, 2023, transmit to the Commission and to the Congress a report containing the President’s approval or disapproval of the Commission’s recommendations. ####
(2)Presidential approval If the President approves all the recommendations of the Commission, the President shall transmit a copy of such recommendations to the Congress, together with a certification of such approval. ####
(3)Presidential disapproval If the President disapproves the recommendations of the Commission, in whole or in part, the President shall transmit to the Commission and the Congress, not later than March 1, 2023, the reasons for that disapproval. The Commission, after consideration of the President’s reasons for disapproval, shall then transmit to the President, not later than March 15, 2023, a report containing— #####
(A)the Commission’s findings and conclusions based on a review and analysis of those reasons for disapproval provided by the President; and #####
(B)recommendations that the Commission determines are appropriate for modernizations and realignments of facilities of the Veterans Health Administration. ####
(4)Transmittal of recommendations to congress If the President approves all recommendations of the Commission transmitted to the President under paragraph (3), the President shall transmit a copy of such recommendations to the Congress, together with a certification of such approval. ####
(5)Failure to transmit If the President does not transmit to the Congress an approval and certification described in paragraph
(2)or
(4)by March 30, 2023, the process by which facilities of the Veterans Health Administration may be selected for modernization or realignment under this subtitle shall be terminated.