CHAPTER 73 —VETERANS HEALTH ADMINISTRATION—ORGANIZATION AND FUNCTIONS
SUBCHAPTER I—ORGANIZATION
SUBCHAPTER II—GENERAL AUTHORITY AND ADMINISTRATION
SUBCHAPTER III—PROTECTION OF PATIENT RIGHTS
SUBCHAPTER IV—RESEARCH CORPORATIONS
SUBCHAPTER V—RESEARCH AND DEVELOPMENT
Editorial Notes
Amendments
2022—
2021—
2018—
2016—
2013—
2010—
2008—
2006—
2004—
2003—
2002—
2001—
2000—
1997—
1996—
1994—
1992—
1991—
1990—
1988—
1986—
1985—
1980—
1976—
1975—
1973—
1972—
1966—
1965—
1964—
1962—
SUBCHAPTER I—ORGANIZATION
Editorial Notes
Prior Provisions
A prior subchapter I of this chapter consisting of sections 4101 to 4120, related to organization of Department of Medicine and Surgery, prior to repeal by
§7301. Functions of Veterans Health Administration: in general
(a) There is in the Department of Veterans Affairs a Veterans Health Administration. The Under Secretary for Health is the head of the Administration. The Under Secretary for Health may be referred to as the Chief Medical Director.
(b) The primary function of the Administration is to provide a complete medical and hospital service for the medical care and treatment of veterans, as provided in this title and in regulations prescribed by the Secretary pursuant to this title.
(Added
Editorial Notes
Amendments
1992—Subsec. (a).
§7302. Functions of Veterans Health Administration: health-care personnel education and training programs
(a) In order to carry out more effectively the primary function of the Veterans Health Administration and in order to assist in providing an adequate supply of health personnel to the Nation, the Secretary—
(1) to the extent feasible without interfering with the medical care and treatment of veterans, shall develop and carry out a program of education and training of health personnel; and
(2) shall carry out a major program for the recruitment, training, and employment of veterans with medical military occupation specialties as—
(A) physician assistants;
(B) expanded-function dental auxiliaries; and
(C) other medical technicians.
(b) In carrying out subsection (a)(1), the Secretary shall include in the program of education and training under that subsection the developing and evaluating of new health careers, interdisciplinary approaches, and career advancement opportunities.
(c) In carrying out subsection (a)(2), the Secretary shall include in the program of recruitment, training, and employment under that subsection measures to advise all qualified veterans with military occupation specialties referred to in that subsection, and all members of the armed forces about to be discharged or released from active duty who have such military occupation specialties, of employment opportunities with the Administration.
(d) The Secretary shall carry out subsection (a) in cooperation with the following institutions and organizations:
(1) Schools of medicine, osteopathy, dentistry, nursing, pharmacy, optometry, podiatry, public health, or allied health professions.
(2) Other institutions of higher learning.
(3) Medical centers.
(4) Academic health centers.
(5) Hospitals.
(6) Such other public or nonprofit agencies, institutions, or organizations as the Secretary considers appropriate.
(e)(1) In carrying out this section, the Secretary shall establish medical residency programs, or ensure that already established medical residency programs have a sufficient number of residency positions, at any medical facility of the Department that the Secretary determines—
(A) is experiencing a shortage of physicians; and
(B) is located in a community that is designated as a health professional shortage area (as defined in section 332 of the Public Health Service Act (
(2) In carrying out paragraph (1), the Secretary shall—
(A) allocate the residency positions under such paragraph among occupations included in the most current determination published in the Federal Register pursuant to
(B) give priority to residency positions and programs in primary care, mental health, and any other specialty the Secretary determines appropriate.
(Added
Editorial Notes
Amendments
2014—Subsec. (e).
Statutory Notes and Related Subsidiaries
Information on Certain Veterans With Prior Medical Occupations; Program on Intermediate Care Technicians of Department of Veterans Affairs
"(a)
"(1)
"(2)
"(A) Contact information for the veteran.
"(B) A history of the medical experience and trained competencies of the veteran.
"(3)
"(4)
"(A) State departments of veterans affairs.
"(B) Veterans service organizations.
"(C) State credentialing bodies.
"(D) State homes.
"(E) Other stakeholders involved in State-level credentialing, as determined appropriate by the Secretary of Veterans Affairs.
"(b)
"(1)
"(2)
"(3)
"(4)
"(c)
"(d)
"(1) The term 'covered veteran' means a veteran whom the Secretary of Veterans Affairs determines served as a basic health care technician while serving in the Armed Forces.
"(2) The terms 'State home' and 'veteran' have the meanings given those terms in
"(3) The term 'veterans service organization' means an organization that provides services to veterans, including organizations recognized by the Secretary of Veterans Affairs under
Pilot Program on Graduate Medical Education and Residency
"(a)
"(1)
"(2)
"(A) A health care facility of the Department of Veterans Affairs.
"(B) A health care facility operated by an Indian tribe or a tribal organization, as those terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act (
"(C) A health care facility operated by the Indian Health Service.
"(D) A Federally-qualified health center, as defined in section 1905(l)(2)(B) of the Social Security Act (
"(E) A health care facility operated by the Department of Defense.
"(F) Such other health care facility as the Secretary considers appropriate for purposes of this section.
"(3)
"(4)
"(A) The ratio of veterans to health care providers of the Department for a standardized geographic area surrounding a facility, including a separate ratio for general practitioners and specialists.
"(B) The range of clinical specialties of providers in standardized geographic areas surrounding a facility.
"(C) Whether the specialty of a provider is included in the most recent staffing shortage determination of the Department under
"(D) Whether the local community is designated by the Secretary of Veterans Affairs as underserved pursuant to criteria developed under section 401 of this Act [
"(E) Whether the facility is located in a community that is designated by the Secretary of Health and Human Services as a health professional shortage area under section 332 of the Public Health Service Act (
"(F) Whether the facility is located in a rural or remote area.
"(G) Such other criteria as the Secretary considers important in determining which facilities are not adequately serving area veterans.
"(5)
"(A) operated by the Indian Health Service;
"(B) operated by an Indian tribe;
"(C) operated by a tribal organization; or
"(D) located in communities designated by the Secretary as underserved pursuant to criteria developed under section 401 of this Act [
"(6)
"(b)
"(1) Curriculum development.
"(2) Recruitment and retention of faculty.
"(3) Accreditation of the program by the Accreditation Council for Graduate Medical Education.
"(4) The portion of faculty salaries attributable to duties under an agreement under subsection (a)(3).
"(5) Expenses relating to educating a resident under the pilot program.
"(c)
"(1)
"(2)
"(A) The number of veterans who received care from residents under the pilot program.
"(B) The number of veterans who received care from each resident per position described in subsection (a)(1) under the pilot program.
"(C) The number of veterans who received care from residents under the pilot program expressed as a percentage of all individuals who received care from such residents.
"(D) The number of clinical appointments for veterans conducted by each resident under the pilot program.
"(E) The number of clinical appointments for veterans conducted by residents per position described in subsection (a)(1) under the pilot program.
"(F) The number of clinical appointments for veterans expressed as a percentage of all clinical appointments conducted by residents under the pilot program.
"(G) The number of positions described in subsection (a)(1) at each covered facility under the pilot program.
"(H) For each position described in subsection (a)(1) in a residency program affiliated with a health care facility of the Department, the time a resident under the pilot program spent training at that facility of the Department, expressed as a percentage of the total training time for that resident position.
"(I) For each residency program affiliated with a health care facility of the Department, the time all residents under the pilot program spent training at that facility of the Department, expressed as a percentage of the total training time for those residents.
"(J) The time that all residents under the pilot program who are assigned to programs affiliated with health care facilities of the Department spent training at facilities of the Department, expressed as a percentage of the total training time for those residents.
"(K) The cost to the Department of Veterans Affairs under the pilot program in the year immediately preceding the report and since the beginning of the pilot program.
"(L) The cost to the Department of Veterans Affairs per resident placed under the pilot program at each covered facility.
"(M) The number of residents under the pilot program hired by the Secretary to work in the Veterans Health Administration after completion of residency in the year immediately preceding the report and since the beginning of the pilot program.
"(N) The medical specialties pursued by residents under the pilot program.
"(d)
Ten-year Increase
"(A)
"(B)
"(i) as of the date of the enactment of this Act, do not have a medical residency program; and
"(ii) are located in a community that has a high concentration of veterans."
[For definition of "facility of the Department" as used in section 301(b)(2) of
§7303. Functions of Veterans Health Administration: research programs
(a)(1) In order to carry out more effectively the primary function of the Administration and in order to contribute to the Nation's knowledge about disease and disability, the Secretary shall carry out a program of medical research in connection with the provision of medical care and treatment to veterans. Funds appropriated to carry out this section shall remain available until expended.
(2) Such program of medical research shall include biomedical research, mental illness research, prosthetic and other rehabilitative research, and health-care-services research.
(3) Such program shall stress—
(A) research into spinal-cord injuries and other diseases that lead to paralysis of the lower extremities; and
(B) research into injuries and illnesses particularly related to service.
(4) In carrying out such research program, the Secretary shall act in cooperation with the entities described in
(b) Prosthetic research shall include research and testing in the field of prosthetic, orthotic, and orthopedic appliances and sensory devices. In order that the unique investigative material and research data in the possession of the Government may result in the improvement of such appliances and devices for all disabled persons, the Secretary (through the Under Secretary for Health) shall make the results of such research available to any person, and shall consult and cooperate with the Secretary of Health and Human Services and the Secretary of Education, in connection with programs carried out under section 204(b)(3) of the Rehabilitation Act of 1973 (relating to the establishment and support of Rehabilitation Engineering Research Centers).
(c)(1) In conducting or supporting clinical research, the Secretary shall ensure that, whenever possible and appropriate—
(A) women who are veterans are included as subjects in each project of such research; and
(B) members of minority groups who are veterans are included as subjects of such research.
(2) In the case of a project of clinical research in which women or members of minority groups will under paragraph (1) be included as subjects of the research, the Secretary shall ensure that the project is designed and carried out so as to provide for a valid analysis of whether the variables being tested in the research affect women or members of minority groups, as the case may be, differently than other persons who are subjects of the research.
(d)(1) The Secretary, in carrying out the Secretary's responsibilities under this section, shall foster and encourage the initiation and expansion of research relating to the health of veterans who are women.
(2) In carrying out this subsection, the Secretary shall consult with the following to assist the Secretary in setting research priorities:
(A) Officials of the Department assigned responsibility for women's health programs and sexual trauma services.
(B) The members of the Advisory Committee on Women Veterans.
(C) Members of appropriate task forces and working groups within the Department (including the Women Veterans Working Group and the Task Force on Treatment of Women Who Suffer Sexual Abuse).
(Added
Editorial Notes
References in Text
Section 204(b)(3) of the Rehabilitation Act of 1973, referred to in subsec. (b), is classified to
Amendments
2003—Subsec. (e).
2002—Subsec. (e).
1998—Subsec. (b).
1994—
1992—Subsec. (b).
Statutory Notes and Related Subsidiaries
Expansion of Suicide Prevention and Mental Health Research
"(a)
"(b)
Use by Department of Veterans Affairs of Commercial Institutional Review Boards in Sponsored Research Trials
"(a)
"(b)
"(1) identify accredited commercial institutional review boards for use in connection with sponsored clinical research of the Department; and
"(2) establish a process to modify existing approvals in the event that a commercial institutional review board loses its accreditation during an ongoing clinical trial.
"(c)
"(1)
"(2)
"(A) The name of each clinical trial with respect to which the use of an institutional review board has been approved.
"(B) The institutional review board or institutional review boards used in the approval process for each clinical trial.
"(C) The amount of time between submission and approval."
Applicability to Fiscal Year 2002
Post-Traumatic Stress Disorder Research
Research Relating to Women Veterans' Health
§7304. Regulations
(a) Unless specifically otherwise provided, the Under Secretary for Health shall prescribe all regulations necessary to the administration of the Veterans Health Administration, including regulations relating to—
(1) travel, transportation of household goods and effects, and deductions from pay for quarters and subsistence; and
(2) the custody, use, and preservation of the records, papers, and property of the Administration.
(b) Regulations prescribed by the Under Secretary for Health are subject to the approval of the Secretary.
(Added
Editorial Notes
Amendments
1992—
§7305. Divisions of Veterans Health Administration
The Veterans Health Administration shall include the following:
(1) The Office of the Under Secretary for Health.
(2) A Medical Service.
(3) A Dental Service.
(4) A Podiatric Service.
(5) An Optometric Service.
(6) A Nursing Service.
(7) A Readjustment Counseling Service.
(8) Such other professional and auxiliary services as the Secretary may find to be necessary to carry out the functions of the Administration.
(Added
Editorial Notes
Amendments
2013—Pars. (7), (8).
1992—Par. (1).
§7306. Office of the Under Secretary for Health
(a) The Office of the Under Secretary for Health shall consist of the following:
(1) The Deputy Under Secretary for Health, who shall be the principal assistant of the Under Secretary for Health and who shall be a qualified doctor of medicine.
(2) The Associate Deputy Under Secretary for Health, who shall be an assistant to the Under Secretary for Health and the Deputy Under Secretary for Health and who shall be a qualified doctor of medicine.
(3) Not to exceed eight Assistant Under Secretaries for Health.
(4) Such Medical Directors as may be appointed to suit the needs of the Department, who shall be either a qualified doctor of medicine or a qualified doctor of dental surgery or dental medicine.
(5) A Director of Nursing Service, who shall be a qualified registered nurse and who shall be responsible to, and report directly to, the Under Secretary for Health for the operation of the Nursing Service.
(6) A Director of Pharmacy Service, a Director of Dietetic Service, and a Director of Optometric Service, who shall be responsible to the Under Secretary for Health for the operation of their respective Services.
(7) Such directors of such other professional or auxiliary services as may be appointed to suit the needs of the Department, who shall be responsible to the Under Secretary for Health for the operation of their respective services.
(8) The Director of the National Center for Preventive Health, who shall be responsible to the Under Secretary for Health for the operation of the Center.
(9) The Director of Physician Assistant Services, who shall—
(A) serve in a full-time capacity at the Central Office of the Department;
(B) be a qualified physician assistant; and
(C) be responsible and report directly to the Chief Patient Care Services Officer of the Veterans Health Administration on all matters relating to the education and training, employment, appropriate use, and optimal participation of physician assistants within the programs and initiatives of the Administration.
(10) A Podiatric Medical Director, who shall be a qualified doctor of podiatric medicine and who shall be responsible to the Under Secretary for Health for the operation of the Podiatric Service.
(11) The Chief Officer of Women's Health.
(12) Such other personnel as may be authorized by this chapter.
(b) Of the Assistant Under Secretaries for Health appointed under subsection (a)(3)—
(1) not more than two may be persons qualified in the administration of health services who are not doctors of medicine, podiatric medicine, dental surgery, or dental medicines;
(2) one shall be a qualified doctor of dental surgery or dental medicine who shall be directly responsible to the Under Secretary for Health for the operation of the Dental Service; and
(3) one shall be a qualified physician trained in, or having suitable extensive experience in, geriatrics who shall be responsible to the Under Secretary for Health for evaluating all research, educational, and clinical health-care programs carried out in the Administration in the field of geriatrics and who shall serve as the principal advisor to the Under Secretary for Health with respect to such programs.
(c) Appointments under subsection (a) shall be made by the Secretary. In the case of appointments under paragraphs (1), (2), (3), (4), (8), and (10) of that subsection, such appointments shall be made upon the recommendation of the Under Secretary for Health.
(d) Except as provided in subsection (e)—
(1) any appointment under this section shall be for a period of four years, with reappointment permissible for successive like periods,
(2) any such appointment or reappointment may be extended by the Secretary for a period not in excess of three years, and
(3) any person so appointed or reappointed or whose appointment or reappointment is extended shall be subject to removal by the Secretary for cause.
(e)(1) The Secretary may designate a member of the Chaplain Service of the Department as Director, Chaplain Service, for a period of two years, subject to removal by the Secretary for cause. Redesignation under this subsection may be made for successive like periods or for any period not exceeding two years.
(2) A person designated as Director, Chaplain Service, shall at the end of such person's period of service as Director revert to the position, grade, and status which such person held immediately before being designated Director, Chaplain Service, and all service as Director, Chaplain Service, shall be creditable as service in the former position.
(f) In organizing the Office and appointing persons to positions in the Office, the Under Secretary shall ensure that—
(1) the Office is staffed so as to provide the Under Secretary, through a designated clinician in the appropriate discipline in each instance, with expertise and direct policy guidance on—
(A) unique programs operated by the Administration to provide for the specialized treatment and rehabilitation of disabled veterans (including blind rehabilitation, care of spinal cord dysfunction, mental illness, and long-term care); and
(B) the programs established under
(2) with respect to the programs established under
(g) For purposes of applying any provision of
(Added
Editorial Notes
Amendments
2022—Subsec. (a)(6).
Subsec. (a)(10), (11).
Subsec. (a)(12).
Subsec. (b)(1).
Subsec. (c).
Subsec. (g).
2021—Subsec. (a)(10), (11).
2010—Subsec. (a)(9).
2002—Subsec. (a)(5).
2000—Subsec. (a)(9), (10).
1996—Subsec. (f).
1994—Subsec. (a)(3).
Pars. (7) to (9).
Subsec. (b).
Subsec. (c).
1992—
Subsec. (a).
Subsec. (a)(7).
Subsec. (a)(8).
Subsec. (b)(2), (3).
Subsec. (c).
Statutory Notes and Related Subsidiaries
Deadline for Implementation of 2010 Amendment
§7307. Office of Research Oversight
(a)
(2) The Office shall—
(A) monitor, review, and investigate matters of medical research compliance and assurance in the Department with respect to human subjects protections; and
(B) monitor, review, and investigate matters relating to the protection and safety of human subjects and Department employees participating in medical research in Department programs.
(b)
(2) Any person appointed as Director shall be—
(A) an established expert in the field of medical research, administration of medical research programs, or similar fields; and
(B) qualified to carry out the duties of the Office based on demonstrated experience and expertise.
(c)
(2) The matters to be reported by the Director to the Under Secretary under paragraph (1) shall include allegations of research impropriety and misconduct by employees engaged in medical research programs of the Department.
(3)(A) When the Director determines that such a recommendation is warranted, the Director may recommend to the Under Secretary that a Department research activity be terminated, suspended, or restricted, in whole or in part.
(B) In a case in which the Director reasonably believes that activities of a medical research project of the Department place human subjects' lives or health at imminent risk, the Director shall direct that activities under that project be immediately suspended or, as appropriate and specified by the Director, be limited.
(d)
(2) The Director shall observe external accreditation activities conducted for accreditation of medical research programs conducted in facilities of the Department.
(3) The Director shall investigate allegations of research impropriety and misconduct in medical research projects of the Department.
(4) The Director shall submit to the Under Secretary for Health, the Secretary, and the Committees on Veterans' Affairs of the Senate and House of Representatives a report on any suspected lapse, from whatever cause or causes, in protecting safety of human subjects and others, including employees, in medical research programs of the Department.
(5) The Director shall carry out such other duties as the Under Secretary for Health may require.
(e)
(f)
(1) A summary of reviews of individual medical research programs of the Department completed by the Office.
(2) Directives and other communications issued by the Office to field activities of the Department.
(3) Results of any investigations undertaken by the Office during the reporting period consonant with the purposes of this section.
(4) Other information that would be of interest to those committees in oversight of the Department medical research program.
(g)
(Added
§7308. Office of Rural Health
(a)
(b)
(c)
(1) In cooperation with the medical, rehabilitation, health services, and cooperative studies research programs in the Office of Policy and the Office of Research and Development of the Veterans Health Administration, to assist the Under Secretary for Health in conducting, coordinating, promoting, and disseminating research into issues affecting veterans living in rural areas.
(2) To work with all personnel and offices of the Department of Veterans Affairs to develop, refine, and promulgate policies, best practices, lessons learned, and innovative and successful programs to improve care and services for veterans who reside in rural areas of the United States.
(3) To designate in each Veterans Integrated Service Network (VISN) an individual who shall consult on and coordinate the discharge in such Network of programs and activities of the Office for veterans who reside in rural areas of the United States.
(4) To perform such other functions and duties as the Secretary or the Under Secretary for Health considers appropriate.
(d)
(2) The veterans rural health resource centers have purposes as follows:
(A) To improve the understanding of the Office of the challenges faced by veterans living in rural areas.
(B) To identify disparities in the availability of health care to veterans living in rural areas.
(C) To formulate practices or programs to enhance the delivery of health care to veterans living in rural areas.
(D) To develop special practices and products for the benefit of veterans living in rural areas and for implementation of such practices and products in the Department systemwide.
(Added
Editorial Notes
Amendments
Subsec. (d).
§7309. Readjustment Counseling Service
(a)
(b)
(2) The Chief Officer shall be appointed by the Under Secretary for Health from among individuals who—
(A)(i) are psychologists who hold a diploma as a doctorate in clinical or counseling psychology from an authority approved by the American Psychological Association and who have successfully undergone an internship approved by that association;
(ii) are holders of a master in social work degree; or
(iii) hold such other advanced degrees related to mental health as the Secretary considers appropriate;
(B) have at least three years of experience providing direct counseling services or outreach services in the Readjustment Counseling Service;
(C) have at least three years of experience administrating direct counseling services or outreach services in the Readjustment Counseling Service;
(D) meet the quality standards and requirements of the Department; and
(E) are veterans who served in combat as members of the Armed Forces.
(c)
(2) The Readjustment Counseling Service shall provide counseling and services as described in subsection (a).
(3) The Chief Officer shall have direct authority over all Readjustment Counseling Service staff and assets, including Vet Centers.
(d)
(2) Amounts for activities of the Readjustment Counseling Service, including the operations of its Vet Centers, shall not be allocated through the Veterans Equitable Resource Allocation system.
(3) In each budget request submitted for the Department of Veterans Affairs by the President to Congress under
(e)
(2) Each report submitted under paragraph (1) shall include, with respect to the period covered by the report, the following:
(A) A summary of the activities of the Readjustment Counseling Service, including Vet Centers.
(B) A description of the workload and additional treatment capacity of the Vet Centers, including, for each Vet Center, the ratio of the number of full-time equivalent employees at such Vet Center and the number of individuals who received services or assistance at such Vet Center.
(C) A detailed analysis of demand for and unmet need for readjustment counseling services and the Secretary's plan for meeting such unmet need, including the resources required to meet such unmet need, such as additional staff, additional locations, additional infrastructure, infrastructure improvements, and additional mobile Vet Centers.
(D) A description of actions taken by the Secretary to reduce—
(i) vacancies in counselor positions in the Readjustment Counseling Service; and
(ii) the time it takes to hire such counselors.
(3) For each even numbered year in which the report required by paragraph (1) is submitted, the Secretary shall include in such report a prediction of—
(A) trends in demand for care;
(B) long-term investments required with respect to the provision of care;
(C) requirements relating to maintenance of infrastructure; and
(D) other capital investment requirements with respect to the Readjustment Counseling Service, including Vet Centers, mobile Vet Centers, and community access points.
(f)
(Added
Editorial Notes
Amendments
2022—Subsec. (e)(2)(D).
2020—Subsec. (e)(2)(C).
Subsec. (e)(3).
2016—Subsec. (e)(1).
2015—Subsec. (c)(1).
Statutory Notes and Related Subsidiaries
Improvement of Vet Centers at Department of Veterans Affairs
"(a)
"(1)
"(A) Any potential effects of productivity expectations, whether positive or negative, on client care and the welfare of readjustment counselors.
"(B) Distances readjustment counselors may travel to appointments, especially with respect to serving rural veterans.
"(C) The possibility that some veterans may not want to use nor benefit from telehealth or group counseling.
"(D) Availability and access of veteran populations to broadband and telehealth.
"(E) Any effect of productivity expectations on readjustment counselors, including with respect to recruitment, retention, and welfare.
"(F) Whether productivity expectations provide incentives or pressure to inaccurately report client visits.
"(G) Whether directors and readjustment counselors of Vet Centers need additional training or guidance on how productivity expectations are calculated.
"(H) Such other criteria as the Secretary considers appropriate.
"(2)
"(A)
"(i) make every effort to ensure that all readjustment counselors of Vet Centers are given the opportunity to fully provide feedback, positive or negative, including through a survey containing open- and close-ended questions, on all items under paragraph (1);
"(ii) in obtaining feedback under paragraph (1), ensure that the items under paragraph (1) are adequately and completely addressed in a way that permits responses to be relevant to the evaluation of productivity expectations;
"(iii) collect and safely store the feedback obtained under paragraph (1)—
"(I) in an electronic database that cannot be altered by any party;
"(II) in an anonymized manner, in order to protect the privacy of each respondent; and
"(III) in a manner that allows for evaluation by third parties of the feedback, such as audit of the feedback by the Government Accountability Office; and
"(iv) provide the feedback obtained under paragraph (1) in an anonymized manner to the working group established under subsection (c).
"(B)
"(3)
"(A) quality of care and access to care for veterans; and
"(B) the welfare of readjustment counselors.
"(4)
"(A) the findings of the evaluation; and
"(B) any planned or implemented changes described in paragraph (3).
"(5)
"(A)
"(i) reassessing productivity expectations for readjustment counselors of Vet Centers, in consultation with such counselors; and
"(ii) implementing any needed changes to such expectations, as the Secretary determines appropriate.
"(B)
"(b)
"(1)
"(2)
"(A) involve key stakeholders, including readjustment counselors, outreach specialists, and directors of Vet Centers;
"(B) incorporate key work activities and the frequency and time required to conduct such activities;
"(C) ensure the data used in the model is high quality to provide assurance that staffing estimates are reliable; and
"(D) incorporate—
"(i) risk factors, including case complexity;
"(ii) geography;
"(iii) availability, advisability, and willingness of veterans to use telehealth or group counseling; and
"(iv) such other factors as the Secretary considers appropriate.
"(3)
"(A) assessing and updating the staffing model developed and implemented under paragraph (1) not less frequently than once every four years; and
"(B) implementing any needed changes to such model, as the Secretary determines appropriate.
"(c)
"(1)
"(A) the efficacy, impact, and composition of performance metrics for such expectations with respect to—
"(i) quality of care and access to care for veterans; and
"(ii) the welfare of readjustment counselors and other employees of Vet Centers; and
"(B) key considerations for the development of such staffing model, including with respect to—
"(i) quality of care and access to care for veterans and other individuals eligible for care through Vet Centers; and
"(ii) recruitment, retention, and welfare of employees of Vet Centers.
"(2)
"(3)
"(A) feedback from readjustment counselors, outreach specialists, and directors of Vet Centers; and
"(B) recommendations on how to improve—
"(i) quality of care and access to care for veterans; and
"(ii) the welfare of readjustment counselors and other employees of Vet Centers.
"(d)
"(1)
"(A)
"(B)
"(2)
"(e)
"(1)
"(2)
"(A) An assessment of—
"(i) the condition of the physical infrastructure of all assets of Vet Centers, whether owned or leased by the Department of Veterans Affairs; and
"(ii) the short-, medium-, and long-term plans of the Department to maintain and upgrade the physical infrastructure of Vet Centers to address the operational needs of Vet Centers as of the date of the submittal of the report and future needs.
"(B) An assessment of management and strategic planning for the physical infrastructure of Vet Centers, including whether the Department should buy or lease existing or additional locations in areas with stable or growing populations of veterans.
"(C) An assessment of whether, as of the date of the submittal of the report, Vet Center buildings, mobile Vet Centers, community access points, and similar infrastructure are sufficient to care for veterans or if such infrastructure is negatively affecting care due to limited space for veterans and Vet Center personnel or other factors.
"(D) An assessment of the areas with the greatest need for investments in—
"(i) improved physical infrastructure, including upgraded Vet Centers; or
"(ii) additional physical infrastructure for Vet Centers, including new Vet Centers owned or leased by the Department.
"(E) A description of the authorities and resources that may be required for the Secretary to make such investments.
"(F) A review of all annual reports submitted under 7309(e) of
"(f)
"(1)
"(2)
"(3)
"(4)
"(A) a nonprofit organization;
"(B) an organization recognized by the Secretary for the representation of veterans under
"(C) a public agency;
"(D) a community-based organization; or
"(E) an institution of higher education.
"(5)
"(6)
"(A) Capacity of the applicant entity to serve veterans and family members of veterans.
"(B) Demonstrated need of the population the applicant entity would serve.
"(C) Demonstrated need of the applicant entity for assistance from the grant.
"(D) Such other criteria as the Secretary considers appropriate.
"(7)
"(8)
"(A) to coordinate with the Secretary with respect to the provision of assistance to address food insecurity among veterans and family members of veterans described in paragraph (1);
"(B) to increase participation in nutrition counseling programs and provide educational materials and counseling to veterans and family members of veterans to address food insecurity and healthy diets among those individuals;
"(C) to increase access to and enrollment in Federal assistance programs, including the supplemental nutrition assistance program under the Food and Nutrition Act of 2008 (
"(D) to fulfill such other criteria as the Secretary considers appropriate to further the purpose of the grant and serve veterans.
"(9)
"(A) the number of veterans and family members of veterans screened for, and enrolled in, programs described in subparagraphs (B) and (C) of paragraph (8);
"(B) other services provided by the entity to veterans and family members of veterans using funds from the grant; and
"(C) such other data as the Secretary may require.
"(10)
"(11)
"(A)
"(B)
"(i) A summary of the activities carried out under this subsection.
"(ii) An assessment of the effectiveness and outcomes of the grants awarded under this subsection, including with respect to eligibility screening contacts, application assistance consultations, and changes in food insecurity among the population served by the grant.
"(iii) Best practices regarding the use of partnerships to improve the effectiveness and outcomes of public benefit programs to address food insecurity among veterans and family members of veterans.
"(iv) An assessment of the feasibility and advisability of making the pilot program permanent and expanding to other locations.
"(12)
"(A)
"(B)
"(13)
"(A) The term 'appropriate committees of Congress' means—
"(i) the Committee on Veterans' Affairs, the Committee on Appropriations, and the Committee on Agriculture, Nutrition, and Forestry of the Senate; and
"(ii) the Committee on Veterans' Affairs, the Committee on Appropriations, and the Committee on Agriculture of the House of Representatives.
"(B) The term 'facilities of the Department' has the meaning given that term in
"(C) The term 'institution of higher education' has the meaning given that term in section 101 of the Higher Education Act of 1965 (
"(D) The term 'public agency' means a department, agency, other unit, or instrumentality of Federal, State, Tribal, or local government.
"(E) The term 'State' has the meaning given that term in
"(F) The term 'veteran' means an individual who served in the Armed Forces, including an individual who served in a reserve component of the Armed Forces, and who was discharged or released therefrom, regardless of the conditions of such discharge or release.
"(g)
§7309A. Office of Patient Advocacy
(a)
(b)
(2) The Director of the Office of Patient Advocacy shall be appointed by the Under Secretary for Health from among individuals qualified to perform the duties of the position and shall report directly to the Under Secretary for Health.
(c)
(2) In carrying out the Patient Advocacy Program of the Department, the Director shall ensure that patient advocates of the Department—
(A) advocate on behalf of veterans with respect to health care received and sought by veterans under the laws administered by the Secretary;
(B) carry out the responsibilities specified in subsection (d); and
(C) receive training in patient advocacy.
(3) Beginning not later than 18 months after the date of the enactment of this paragraph, the Director shall establish an information technology system that will allow a veteran (or the designated representative of a veteran) to electronically—
(A) file a complaint that will be received by the appropriate patient advocate; and
(B) at any time view the status of the complaint, including interim and final actions that have been taken to address the complaint.
(d)
(1) To resolve complaints by veterans with respect to health care furnished under the laws administered by the Secretary that cannot be resolved at the point of service or at a higher level easily accessible to the veteran.
(2) To present at various meetings and to various committees the issues experienced by veterans in receiving such health care at such medical facility.
(3) To express to veterans their rights and responsibilities as patients in receiving such health care.
(4) To manage the Patient Advocate Tracking System of the Department at such medical facility.
(5) To compile data at such medical facility of complaints made by veterans with respect to the receipt of such health care at such medical facility and the satisfaction of veterans with such health care at such medical facility to determine whether there are trends in such data.
(6) To ensure that a process is in place for the distribution of the data compiled under paragraph (5) to appropriate leaders, committees, services, and staff of the Department.
(7) To identify, not less frequently than quarterly, opportunities for improvements in the furnishing of such health care to veterans at such medical facility based on complaints by veterans.
(8) To ensure that any significant complaint by a veteran with respect to such health care is brought to the attention of appropriate staff of the Department to trigger an assessment of whether there needs to be a further analysis of the problem at the facility-wide level.
(9) To support any patient advocacy programs carried out by the Department.
(10) To ensure that all appeals and final decisions with respect to the receipt of such health care are entered into the Patient Advocate Tracking System of the Department.
(11) To understand all laws, directives, and other rules with respect to the rights and responsibilities of veterans in receiving such health care, including the appeals processes available to veterans.
(12) To ensure that veterans receiving mental health care, or the surrogate decision-makers for such veterans, are aware of the rights of veterans to seek representation from systems established under section 103 of the Protection and Advocacy for Mentally Ill Individuals Act of 1986 1 (
(13) To fulfill requirements established by the Secretary with respect to the inspection of controlled substances.
(14) To document potentially threatening behavior and report such behavior to appropriate authorities.
(e)
(f)
(Added
Editorial Notes
References in Text
The date of the enactment of this paragraph, referred to in subsec. (c)(3), is the date of enactment of
The Protection and Advocacy for Mentally Ill Individuals Act of 1986, referred to in subsec. (d)(12), was renamed the Protection and Advocacy for Individuals with Mental Illness Act by
Amendments
2022—Subsec. (c)(3).
Statutory Notes and Related Subsidiaries
Date Fully Operational
1 See References in Text note below.
§7310. Office of Women's Health
(a)
(2) The Office shall be located at the Central Office of the Department of Veterans Affairs.
(3)(A) The head of the Office is the Chief Officer of Women's Health (in this section referred to as the "Chief Officer").
(B) The Chief Officer shall report to the Under Secretary for Health.
(4) The Under Secretary for Health shall provide the Office with such staff and other support as may be necessary for the Office to carry out effectively the functions of the Office under this section.
(5) The Under Secretary for Health may reorganize existing offices within the Veterans Health Administration as of the date of the enactment of this section in order to avoid duplication with the functions of the Office.
(b)
(1) To provide a central office for monitoring and encouraging the activities of the Veterans Health Administration with respect to the provision, evaluation, and improvement of health care services provided to women veterans by the Department.
(2) To develop and implement standards of care for the provision of health care for women veterans by the Department.
(3) To monitor and identify deficiencies in standards of care for the provision of health care for women veterans by the Department, to provide technical assistance to medical facilities of the Department to address and remedy deficiencies, and to perform oversight of implementation of such standards of care.
(4) To monitor and identify deficiencies in standards of care for the provision of health care for women veterans provided through the community pursuant to this title and to provide recommendations to the appropriate office to address and remedy any deficiencies.
(5) To oversee distribution of resources and information related to health programming for women veterans under this title.
(6) To promote the expansion and improvement of clinical, research, and educational activities of the Veterans Health Administration with respect to the health care of women veterans.
(7) To provide, as part of the annual budgeting process, recommendations with respect to the amounts to be requested for furnishing hospital care and medical services to women veterans pursuant to
(8) To provide recommendations to the Under Secretary for Health with respect to modifying the Veterans Equitable Resource Allocation system, or successor system, to ensure that resource allocations under such system, or successor system, reflect the health care needs of women veterans.
(9) To carry out such other duties as the Under Secretary for Health may require.
(c)
(2) Each notification under paragraph (1) relating to a determination with respect to a recommendation shall include the following:
(A) The reasoning of the Under Secretary for Health in making the determination.
(B) An alternative, if one is selected, to the recommendation that the Under Secretary for Health will carry out to fulfill the health care needs of women veterans.
(d)
(1) A requirement for—
(A) at least one designated women's health primary care provider at each medical center of the Department whose duties include, to the extent practicable, providing training to other health care providers of the Department with respect to the needs of women veterans; and
(B) at least one designated women's health primary care provider at each community-based outpatient clinic of the Department who may serve women patients as a percentage of the total duties of the provider.
(2) Other requirements as determined by the Under Secretary for Health.
(e)
(1) not less frequently than biannually, each medical facility of the Department holds a public forum for women veterans that occurs outside of regular business hours; and
(2) not less frequently than quarterly, each medical facility of the Department convenes a focus group of women veterans that includes a discussion of harassment occurring at such facility.
(f)
(1) The term "appropriate congressional committees" has the meaning given that term in
(2) The term "facility of the Department" has the meaning given the term "facilities of the Department" in
(3) The term "Veterans Equitable Resource Allocation system" means the resource allocation system established pursuant to section 429 of the Departments of Veterans Affairs and Housing and Urban Development, and Independent Agencies Appropriations Act, 1997 (
(Added
Editorial Notes
References in Text
The date of the enactment of this section, referred to in subsec. (a)(5), is the date of enactment of
Section 429 of the Departments of Veterans Affairs and Housing and Urban Development, and Independent Agencies Appropriations Act, 1997, referred to in subsec. (f)(3), is section 429 of title IV of
Statutory Notes and Related Subsidiaries
References to Health Care and Services
§7310A. Annual reports on Women's Health
(a)
(b)
(1) actions taken by the Office of Women's Health established under
(2) any identified deficiencies related to the provision of health care by the Department to women veterans and the standards of care established in such section and the plan of the Department to address such deficiencies;
(3) the funding and personnel provided to the Office and whether additional funding or personnel are needed to meet the requirements of such section; and
(4) other information that would be of interest to the appropriate congressional committees with respect to oversight of the provision of health care by the Department to women veterans.
(c)
(2) The analysis under paragraph (1) shall include data and performance measures for the availability of gender-specific services described in such paragraph, including—
(A) the average wait time between the preferred appointment date of the veteran and the date on which the appointment is completed;
(B) the average driving time required for veterans to attend appointments; and
(C) reasons why appointments could not be scheduled with non-Department medical providers.
(d)
(2) The analysis under paragraph (1) shall include the following:
(A) The number of facilities of the Department that fall into each delivery of care model described in such paragraph, disaggregated by Veterans Integrated Service Network and State.
(B) A description of the criteria used by the Department to determine which such model is most appropriate for each facility of the Department.
(C) An assessment of how the Department decides to make investments to modify facilities to a different model.
(D) A description of what, if any, plans the Department has to modify facilities from general primary care clinics to another model.
(E) An assessment of whether any facilities could be modified to a separate but shared space for a women's health center within planned investments under the strategic capital investment planning process of the Department.
(F) An assessment of whether any facilities could be modified to a separate or shared space or a women's health center with minor modifications to existing plans under the strategic capital investment planning process of the Department.
(G) An assessment of whether the Department has a goal for how many facilities should fall into each such model.
(e)
(1) The number of women's health centers.
(2) The number of patient aligned care teams of the Department relating to women's health.
(3) The number of full- and part-time gynecologists of the Department.
(4) The number of designated women's health care providers of the Department, disaggregated by facility of the Department.
(5) The number of health care providers of the Department who have completed a mini-residency for women's health care through the Women Veterans Health Care Mini-Residency Program of the Department during the one-year period preceding the submittal of the report and the number of mini-residency training slots for such program that are available during the one-year period following such date.
(6) The number of designated women's health care providers of the Department who have sufficient women patient loads or case complexities to retain their competencies and proficiencies.
(f)
(1) An assessment of wheelchair accessibility of women's health centers of the Department, including, with respect to each such center, an assessment of accessibility for each kind of treatment provided at the center, including with respect to radiology and mammography, that addresses all relevant factors, including door sizes, hoists, and equipment.
(2) The options for women veterans to access mental health providers and primary care providers who are women.
(3) The options for women veterans at medical facilities of the Department with respect to clothing sizes, including for gowns, drawstring pants, and pajamas.
(g)
(1) The term "appropriate congressional committees" means—
(A) the Committee on Appropriations and the Committee on Veterans' Affairs of the Senate; and
(B) the Committee on Appropriations and the Committee on Veterans' Affairs of the House of Representatives.
(2) The term "gender-specific services" means mammography, obstetric care, gynecological care, and such other services as the Secretary determines appropriate.
(Added
Statutory Notes and Related Subsidiaries
References to Health Care and Services
For references to health care and services in this section as references to health care and services included in medical benefits package provided by the Department as in effect on the day before Jan. 5, 2021, see
Initial Report
SUBCHAPTER II—GENERAL AUTHORITY AND ADMINISTRATION
Editorial Notes
Prior Provisions
A prior subchapter II of this chapter consisting of sections 4121 to 4124, related to Regional Medical Education Centers, prior to repeal by
§7311. Quality assurance
(a) The Secretary shall—
(1) establish and conduct a comprehensive program to monitor and evaluate the quality of health care furnished by the Veterans Health Administration (hereinafter in this section referred to as the "quality-assurance program"); and
(2) delineate the responsibilities of the Under Secretary for Health with respect to the quality-assurance program, including the duties prescribed in this section.
(b)(1) As part of the quality-assurance program, the Under Secretary for Health shall periodically evaluate—
(A) whether there are significant deviations in mortality and morbidity rates for surgical procedures performed by the Administration from prevailing national mortality and morbidity standards for similar procedures; and
(B) if there are such deviations, whether they indicate deficiencies in the quality of health care provided by the Administration.
(2) The evaluation under paragraph (1)(A) shall be made using the information compiled under subsection (c)(1). The evaluation under paragraph (1)(B) shall be made taking into account the factors described in subsection (c)(2)(B).
(3) If, based upon an evaluation under paragraph (1)(A), the Under Secretary for Health determines that there is a deviation referred to in that paragraph, the Under Secretary for Health shall explain the deviation in the report submitted under subsection (f).1
(4) As part of the quality-assurance program, the Under Secretary for Health shall establish mechanisms through which employees of Veterans Health Administration facilities may submit reports, on a confidential basis, on matters relating to quality of care in Veterans Health Administration facilities to the quality management officers of such facilities under
(c)(1) The Under Secretary for Health shall—
(A) determine the prevailing national mortality and morbidity standards for each type of surgical procedure performed by the Administration; and
(B) collect data and other information on mortality and morbidity rates in the Administration for each type of surgical procedure performed by the Administration and (with respect to each such procedure) compile the data and other information so collected—
(i) for each medical facility of the Department, in the case of cardiac surgery, heart transplant, and renal transplant programs; and
(ii) in the aggregate, for each other type of surgical procedure.
(2) The Under Secretary for Health shall—
(A) compare the mortality and morbidity rates compiled under paragraph (1)(B) with the national mortality and morbidity standards determined under paragraph (1)(A); and
(B) analyze any deviation between such rates and such standards in terms of the following:
(i) The characteristics of the respective patient populations.
(ii) The level of risk for the procedure involved, based on—
(I) patient age;
(II) the type and severity of the disease;
(III) the effect of any complicating diseases; and
(IV) the degree of difficulty of the procedure.
(iii) Any other factor that the Under Secretary for Health considers appropriate.
(d) Based on the information compiled and the comparisons, analyses, evaluations, and explanations made under subsections (b) and (c), the Under Secretary for Health, in the report under subsection (f),1 shall make such recommendations with respect to quality assurance as the Under Secretary for Health considers appropriate.
(e)(1) The Secretary shall allocate sufficient resources (including sufficient personnel with the necessary skills and qualifications) to enable the Administration to carry out its responsibilities under this section.
(2) The Inspector General of the Department shall allocate sufficient resources (including sufficient personnel with the necessary skills and qualifications) to enable the Inspector General to monitor the quality-assurance program.
(Added
Editorial Notes
References in Text
Subsection (f), referred to in subsecs. (b)(3) and (d), was repealed by
Amendments
2010—Subsec. (b)(4).
1994—Subsecs. (f), (g).
"(f)(1) Not later than February 1, 1991, the Under Secretary for Health shall submit to the Secretary a report on the experience through the end of the preceding fiscal year under the quality-assurance program carried out under this section.
"(2) Such report shall include—
"(A) the data and other information compiled and the comparisons, analyses, and evaluations made under subsections (b) and (c) with respect to the period covered by the report; and
"(B) recommendations under subsection (d).
"(g)(1) Not later than 60 days after receiving such report, the Secretary shall submit to the Committees on Veterans' Affairs of the Senate and House of Representatives a copy of the report, together with any comment concerning the report that the Secretary considers appropriate.
"(2) A report submitted under paragraph (1) shall not be considered to be a record or document as described in
1992—Subsecs. (a) to (d), (f).
Statutory Notes and Related Subsidiaries
Comprehensive Policy on Pain Management
"(a)
"(b)
"(1) The Department-wide management of acute and chronic pain experienced by veterans.
"(2) The standard of care for pain management to be used throughout the Department.
"(3) The consistent application of pain assessments to be used throughout the Department.
"(4) The assurance of prompt and appropriate pain care treatment and management by the Department, system-wide, when medically necessary.
"(5) Department programs of research related to acute and chronic pain suffered by veterans, including pain attributable to central and peripheral nervous system damage characteristic of injuries incurred in modern warfare.
"(6) Department programs of pain care education and training for health care personnel of the Department.
"(7) Department programs of patient education for veterans suffering from acute or chronic pain and their families.
"(c)
"(d)
"(e)
"(1)
"(2)
"(A) A description of the policy developed and implemented under subsection (a) and any revisions to such policy under subsection (c).
"(B) A description of the performance measures used to determine the effectiveness of such policy in improving pain care for veterans system-wide.
"(C) An assessment of the adequacy of Department pain management services based on a survey of patients managed in Department clinics.
"(D) An assessment of the research projects of the Department relevant to the treatment of the types of acute and chronic pain suffered by veterans.
"(E) An assessment of the training provided to Department health care personnel with respect to the diagnosis, treatment, and management of acute and chronic pain.
"(F) An assessment of the patient pain care education programs of the Department.
"(f)
Evaluation of Department of Veterans Affairs Nurse Managed Clinics
Quality Assurance Activities
Regulations for Standards of Performance in Laboratories
"(a)
"(2) Such regulations—
"(A) may include appropriate provisions respecting waivers described in section 353(d) of such Act and accreditations described in section 353(e) of such Act; and
"(B) shall include appropriate provisions respecting compliance with such requirements.
"(b)
"(c)
1 See References in Text note below.
§7311A. Quality management officers
(a)
(2) The National Quality Management Officer shall report directly to the Under Secretary for Health in the discharge of responsibilities and duties of the Officer under this section.
(3) The National Quality Management Officer shall be the official within the Veterans Health Administration who is principally responsible for the quality-assurance program referred to in paragraph (1). In carrying out that responsibility, the Officer shall be responsible for the following:
(A) Establishing and enforcing the requirements of the program referred to in paragraph (1).
(B) Developing an aggregate quality metric from existing data sources, such as the Inpatient Evaluation Center of the Department, the National Surgical Quality Improvement Program, and the External Peer Review Program of the Veterans Health Administration, that could be used to assess reliably the quality of care provided at individual Department medical centers and associated community based outpatient clinics.
(C) Ensuring that existing measures of quality, including measures from the Inpatient Evaluation Center, the National Surgical Quality Improvement Program, System-Wide Ongoing Assessment and Review reports of the Department, and Combined Assessment Program reviews of the Office of Inspector General of the Department, are monitored routinely and analyzed in a manner that ensures the timely detection of quality of care issues.
(D) Encouraging research and development in the area of quality metrics for the purposes of improving how the Department measures quality in individual facilities.
(E) Carrying out such other responsibilities and duties relating to quality management in the Veterans Health Administration as the Under Secretary for Health shall specify.
(4) The requirements under paragraph (3) shall include requirements regarding the following:
(A) A confidential system for the submittal of reports by Veterans Health Administration personnel regarding quality management at Department facilities.
(B) Mechanisms for the peer review of the actions of individuals appointed in the Veterans Health Administration in the position of physician.
(b)
(2) The quality management officer for a Veterans Integrated Services Network shall report to the Regional Director of the Veterans Integrated Services Network, and to the National Quality Management Officer, regarding the discharge of the responsibilities and duties of the officer under this section.
(3) The quality management officer for a Veterans Integrated Services Network shall—
(A) direct the quality management office in the Network; and
(B) coordinate, monitor, and oversee the quality management programs and activities of the Administration medical facilities in the Network in order to ensure the thorough and uniform discharge of quality management requirements under such programs and activities throughout such facilities.
(c)
(2) The quality management officer for a facility shall report directly to the director of the facility, and to the quality management officer of the Veterans Integrated Services Network in which the facility is located, regarding the discharge of the responsibilities and duties of the quality management officer under this section.
(3) The quality management officer for a facility shall be responsible for designing, disseminating, and implementing quality management programs and activities for the facility that meet the requirements established by the National Quality Management Officer under subsection (a).
(d)
(2) There is authorized to be appropriated to carry out the provisions of subparagraphs (B), (C), and (D) of subsection (a)(3), $25,000,000 for the two-year period of fiscal years beginning after the date of the enactment of this section.
(Added
Editorial Notes
References in Text
The date of the enactment of this section, referred to in subsec. (d)(2), is the date of enactment of
§7312. Special medical advisory group
(a) The Secretary shall establish an advisory committee to be known as the special medical advisory group. The advisory group shall advise the Secretary, through the Under Secretary for Health, and the Under Secretary for Health directly, relative to the care and treatment of disabled veterans and other matters pertinent to the Administration.
(b) Members of the special medical advisory group shall be appointed by the Secretary upon the recommendation of the Under Secretary for Health. The special medical advisory group shall be composed of—
(1) members of the medical, dental, podiatric, optometric, and allied scientific professions;
(2) other individuals considered by the Under Secretary for Health to have experience pertinent to the mission of the Administration; and
(3) a disabled veteran.
(c) The special medical advisory group shall meet on a regular basis as prescribed by the Secretary. The number, terms of service, pay, and allowances of members of the advisory group shall be prescribed in accordance with existing law and regulations.
(d) Not later than February 1 of each year, the special medical advisory group shall submit to the Secretary and the Congress a report on the activities of the advisory group during the preceding fiscal year. No report shall be required under this subsection after December 31, 2004.
(Added
Editorial Notes
Amendments
2000—Subsec. (d).
1994—Subsec. (d).
1992—Subsecs. (a), (b).
§7313. Advisory committees: affiliated institutions
(a) In each case where the Secretary has a contract or agreement with any school, institution of higher learning, medical center, hospital, or other public or nonprofit agency, institution, or organization for the training or education of health personnel, the Secretary shall establish an advisory committee to advise the Secretary and the Under Secretary for Health with respect to policy matters arising in connection with, and the operation of, the program with respect to which it was appointed. Such a committee may be a dean's committee, a medical advisory committee, or the like.
(b) Any such advisory committee may be established on an institution-wide, multi-disciplinary basis or on a regional basis whenever establishment on such a basis is found to be feasible.
(c) Members of each such advisory committee shall be appointed by the Secretary and shall include personnel of the Department (including appropriate representation from the full-time staff) and of the entity with which the Secretary has entered into the contract or agreement. The number of members, and terms of members, of each advisory committee shall be prescribed by the Secretary.
(d) The Secretary shall require that the Chief of the Nursing Service (or the designee of the Chief) at each Department health-care facility be included in the membership of each policymaking committee at that facility. Such committees include: (1) committees relating to matters such as budget, education, position management, clinical executive issues, planning, and resource allocation, and (2) the dean's committee or other advisory committee established under subsection (a).
(Added
Editorial Notes
Amendments
1992—Subsec. (a).
§7314. Geriatric research, education, and clinical centers
(a) The Secretary, upon the recommendation of the Under Secretary for Health and pursuant to the provisions of this section, shall designate not more than 25 Department health-care facilities as the locations for centers of geriatric research, education, and clinical activities and (subject to the appropriation of sufficient funds for such purpose) shall establish and operate such centers at such locations in accordance with this section.
(b) In designating locations for centers under subsection (a), the Secretary, upon the recommendation of the Under Secretary for Health, shall—
(1) designate each Department health-care facility that as of August 26, 1980, was operating a geriatric research, education, and clinical center unless (on the recommendation of the Under Secretary for Health) the Secretary determines that such facility does not meet the requirements of subsection (c) or has not demonstrated effectiveness in carrying out the established purposes of such center or the purposes of title III of the Veterans' Administration Health-Care Amendments of 1980 (
(2) assure appropriate geographic distribution of such facilities.
(c) The Secretary may not designate a health-care facility as a location for a center under subsection (a) unless the peer review panel established under subsection (d) has determined under that subsection that the proposal submitted by such facility as a location for a new center under subsection (a) is among those proposals which have met the highest competitive standards of scientific and clinical merit, and the Secretary (upon the recommendation of the Under Secretary for Health) determines that the facility has (or may reasonably be anticipated to develop) each of the following:
(1) An arrangement with an accredited medical school which provides education and training in geriatrics and with which such facility is affiliated under which residents receive education and training in geriatrics through regular rotation through such center and through nursing home, extended care, or domiciliary units of such facility so as to provide such residents with training in the diagnosis and treatment of chronic diseases of older individuals, including cardiopulmonary conditions, senile dementia, and neurological disorders.
(2) An arrangement under which nursing or allied health personnel receive training and education in geriatrics through regular rotation through nursing home, extended care, or domiciliary units of such facility.
(3) The ability to attract the participation of scientists who are capable of ingenuity and creativity in health-care research efforts.
(4) A policymaking advisory committee composed of appropriate health-care and research representatives of the facility and of the affiliated school or schools to advise the directors of such facility and such center on policy matters pertaining to the activities of such center during the period of the operation of such center.
(5) The capability to conduct effectively evaluations of the activities of such center.
(d)(1) In order to provide advice to assist the Secretary and the Under Secretary for Health in carrying out their responsibilities under this section, the Assistant Under Secretary for Health described in
(2) The membership of the panel shall consist of experts in the fields of geriatric and gerontological research, education, and clinical care. Members of the panel shall serve as consultants to the Department for a period of no longer than six months.
(3) The panel shall review each proposal submitted to the panel by the Assistant Under Secretary and shall submit its views on the relative scientific and clinical merit of each such proposal to the Assistant Under Secretary.
(4) The panel shall not be subject to
(e) Before providing funds for the operation of any such center at a health-care facility other than a health-care facility designated under subsection (b)(1), the Secretary shall assure that the center at each facility designated under such subsection is receiving adequate funding to enable such center to function effectively in the areas of geriatric research, education, and clinical activities.
(f) There are authorized to be appropriated such sums as may be necessary for the support of the research and education activities of the centers established pursuant to subsection (a). The Under Secretary for Health shall allocate to such centers from other funds appropriated generally for the Department medical services account and medical and prosthetics research account, as appropriate, such amounts as the Under Secretary for Health determines appropriate.
(g) Activities of clinical and scientific investigation at each center established under subsection (a) shall be eligible to compete for the award of funding from funds appropriated for the Department medical and prosthetics research account and shall receive priority in the award of funding from such account insofar as funds are awarded to projects for research in geriatrics and gerontology.
(Added
Editorial Notes
References in Text
The Veterans' Administration Health-Care Amendments of 1980, referred to in subsec. (b)(1), is
Amendments
2022—Subsec. (d)(4).
2008—Subsec. (f).
1994—Subsec. (b)(1).
Subsec. (d)(1).
Subsec. (d)(3).
1992—Subsecs. (a), (b).
Subsec. (c).
Subsec. (d).
Subsec. (e).
Subsecs. (f), (g).
1991—Subsec. (b)(1).
Statutory Notes and Related Subsidiaries
Effective Date of 1994 Amendment
Congressional Declaration of Purpose in Creating Centers of Geriatric Research, Education, and Clinical Activities
§7315. Geriatrics and Gerontology Advisory Committee
(a) The Secretary shall establish in the Veterans Health Administration a Geriatrics and Gerontology Advisory Committee (hereinafter in this section referred to as the "Committee"). The membership of the Committee shall be appointed by the Secretary, upon the recommendation of the Under Secretary for Health, and shall include individuals who are not employees of the Federal Government and who have demonstrated interest and expertise in research, education, and clinical activities related to aging and at least one representative of a national veterans service organization. The Secretary, upon the recommendation of the Under Secretary for Health, shall invite representatives of other appropriate departments and agencies of the United States to participate in the activities of the Committee and shall provide the Committee with such staff and other support as may be necessary for the Committee to carry out effectively its functions under this section.
(b) The Committee shall—
(1) advise the Under Secretary for Health on all matters pertaining to geriatrics and gerontology;
(2) assess, through an evaluation process (including a site visit conducted not later than three years after the date of the establishment of each new center and not later than two years after the date of the last evaluation of those centers in operation on August 26, 1980), the ability of each center established under
(3) assess the capability of the Department to provide high quality geriatric services, extended services, and other health-care services to eligible older veterans, taking into consideration the likely demand for such services from such veterans;
(4) assess the current and projected needs of eligible older veterans for geriatric services, extended-care services, and other health-care services from the Department and its activities and plans designed to meet such needs; and
(5) perform such additional functions as the Secretary or Under Secretary for Health may direct.
(c)(1) The Committee shall submit to the Secretary, through the Under Secretary for Health, such reports as the Committee considers appropriate with respect to its findings and conclusions under subsection (b). Such reports shall include the following:
(A) Descriptions of the operations of the centers of geriatric research, education, and clinical activities established pursuant to
(B) Assessments of the quality of the operations of such centers.
(C) An assessment of the extent to which the Department, through the operation of such centers and other health-care facilities and programs, is meeting the needs of eligible older veterans for geriatric services, extended-care services, and other health-care services.
(D) Assessments of and recommendations for correcting any deficiencies in the operations of such centers.
(E) Recommendations for such other geriatric services, extended-care services, and other health-care services as may be needed to meet the needs of older veterans.
(2) Whenever the Committee submits a report to the Secretary under paragraph (1), the Committee shall at the same time transmit a copy of the report in the same form to the appropriate committees of Congress. Not later than 90 days after receipt of a report under that paragraph, the Secretary shall submit to the appropriate committees of Congress a report containing any comments and recommendations of the Secretary with respect to the report of the Committee.
(Added
Editorial Notes
References in Text
The Veterans' Administration Health-Care Amendments of 1980, referred to in subsec. (b)(2), is
Amendments
2002—Subsec. (a).
1994—Subsec. (b)(2).
1992—Subsecs. (a), (b)(1), (5), (c)(1).
Subsec. (c)(2).
1991—Subsec. (b)(2).
Statutory Notes and Related Subsidiaries
Effective Date of 1994 Amendment
Termination of Advisory Committees
Advisory committees established after Jan. 5, 1973, to terminate not later than the expiration of the 2-year period beginning on the date of their establishment, unless, in the case of a committee established by the President or an officer of the Federal Government, such committee is renewed by appropriate action prior to the expiration of such 2-year period, or in the case of a committee established by the Congress, its duration is otherwise provided for by law. See
§7316. Malpractice and negligence suits: defense by United States
(a)(1) The remedy—
(A) against the United States provided by
(B) through proceedings for compensation or other benefits from the United States as provided by any other law, where the availability of such benefits precludes a remedy under
for damages for personal injury, including death, allegedly arising from malpractice or negligence of a health care employee of the Administration in furnishing health care or treatment while in the exercise of that employee's duties in or for the Administration shall be exclusive of any other civil action or proceeding by reason of the same subject matter against the health care employee (or employee's estate) whose act or omission gave rise to such claim.
(2) For purposes of paragraph (1), the term "health care employee of the Administration" means a physician, dentist, podiatrist, chiropractor, optometrist, nurse, physician assistant, expanded-function dental auxiliary, pharmacist, or paramedical (such as medical and dental technicians, nursing assistants, and therapists), or other supporting personnel.
(b) The Attorney General shall defend any civil action or proceeding brought in any court against any person referred to in subsection (a) (or such person's estate) for any such damage or injury. Any such person against whom such civil action or proceeding is brought shall deliver within such time after date of service or knowledge of service as determined by the Attorney General, all process served upon such person or an attested true copy thereof to such person's immediate superior or to whomever was designated by the Secretary to receive such papers and such person shall promptly furnish copies of the pleading and process therein to the United States attorney for the district embracing the place wherein the proceeding is brought, to the Attorney General, and to the Secretary.
(c) Upon a certification by the Attorney General that the defendant was acting in the scope of such person's employment in or for the Administration at the time of the incident out of which the suit arose, any such civil action or proceeding commenced in a State court shall be removed without bond at any time before trial by the Attorney General to the district court of the United States of the district and division embracing the place wherein it is pending and the proceeding deemed a tort action brought against the United States under the provisions of title 28 and all references thereto. After removal the United States shall have available all defenses to which it would have been entitled if the action had originally been commenced against the United States. Should a United States district court determine on a hearing on a motion to remand held before a trial on the merits that the employee whose act or omission gave rise to the suit was not acting within the scope of such person's office or employment, the case shall be remanded to the State court.
(d) The Attorney General may compromise or settle any claim asserted in such civil action or proceeding in the manner provided in
(e) The Secretary may, to the extent the Secretary considers appropriate, hold harmless or provide liability insurance for any person to whom the immunity provisions of this section apply (as described in subsection (a)), for damage for personal injury or death, or for property damage, negligently caused by such person while furnishing medical care or treatment (including the conduct of clinical studies or investigations) in the exercise of such person's duties in or for the Administration, if such person is assigned to a foreign country, detailed to State or political division thereof, or is acting under any other circumstances which would preclude the remedies of an injured third person against the United States, provided by
(f) The exception provided in
(Added
Editorial Notes
Amendments
2003—Subsec. (a)(1).
Subsec. (a)(2).
Statutory Notes and Related Subsidiaries
Effective Date of 2003 Amendment
§7317. Hazardous research projects: indemnification of contractors
(a)(1) With the approval of the Secretary, any contract or research authorized by
(2) Indemnity under paragraph (1) is indemnity against either or both of the following:
(A) Liability (including reasonable expenses of litigation or settlement) to third persons, except liability under State or Federal workers' injury compensation laws to employees of the contractor employed at the site of and in connection with the contract for which indemnification is granted, for death, bodily injury, or loss of or damage to property, from a risk that the contract defines as unusually hazardous.
(B) Loss of or damage to property of the contractor from a risk that the contract defines as unusually hazardous.
(b) A contract that provides for indemnification in accordance with subsection (a) must also provide for—
(1) notice to the United States of any claim or suit against the contractor for death, bodily injury, or loss of or damage to property; and
(2) control of or assistance in the defense by the United States, at its election, of any such suit or claim for which indemnification is provided hereunder.
(c) A payment may not be made under subsection (a) unless the Secretary certifies that the amount is just and reasonable.
(d) Upon approval by the Secretary, payments under subsection (a) may be made from—
(1) funds obligated for the performance of the contract concerned;
(2) funds available for research or development or both, and not otherwise obligated; or
(3) funds appropriated for those payments.
(e) Each contractor which is a party to an indemnification agreement under subsection (a) shall have and maintain financial protection of such type and in such amounts as the Secretary shall require to cover liability to third persons and loss of or damage to the contractor's property. The amount of financial protection required shall be the maximum amount of insurance available from private sources, except that the Secretary may establish a lesser amount, taking into consideration the cost and terms of private insurance. Such financial protection may include private insurance, private contractual indemnities, self-insurance, other proof of financial responsibility, or a combination of such measures.
(f) In administering the provisions of this section, the Secretary may use the facilities and services of private insurance organizations and may contract to pay a reasonable compensation therefor. Any contract made under the provisions of this section may be made without regard to the provisions of section 6101(b) to (d) of title 41, upon a showing by the Secretary that advertising is not reasonably practicable, and advance payments may be made under any such contract.
(g) The authority to indemnify contractors under this section does not create any rights in third persons which would not otherwise exist by law.
(h) Funds appropriated to carry out this section shall remain available until expended.
(i) In this section, the term "contractor" includes subcontractors of any tier under a contract containing an indemnification provision pursuant to subsection (a).
(Added
Editorial Notes
Amendments
2011—Subsec. (f).
§7318. National Center for Preventive Health
(a)(1) The Under Secretary for Health shall establish and operate in the Veterans Health Administration a National Center for Preventive Health (hereinafter in this section referred to as the "Center"). The Center shall be located at a Department health care facility.
(2) The head of the Center is the Director of Preventive Health (hereinafter in this section referred to as the "Director").
(3) The Under Secretary for Health shall provide the Center with such staff and other support as may be necessary for the Center to carry out effectively its functions under this section.
(b) The purposes of the Center are the following:
(1) To provide a central office for monitoring and encouraging the activities of the Veterans Health Administration with respect to the provision, evaluation, and improvement of preventive health services.
(2) To promote the expansion and improvement of clinical, research, and educational activities of the Veterans Health Administration with respect to such services.
(c) In carrying out the purposes of the Center, the Director shall do the following:
(1) Develop and maintain current information on clinical activities of the Veterans Health Administration relating to preventive health services, including activities relating to—
(A) the on-going provision of regularly-furnished services; and
(B) patient education and screening programs carried out throughout the Administration.
(2) Develop and maintain detailed current information on research activities of the Veterans Health Administration relating to preventive health services.
(3) In order to encourage the effective provision of preventive health services by Veterans Health Administration personnel—
(A) ensure the dissemination to such personnel of any appropriate information on such services that is derived from research carried out by the Administration; and
(B) acquire and ensure the dissemination to such personnel of any appropriate information on research and clinical practices relating to such services that are carried out by researchers, clinicians, and educators who are not affiliated with the Administration.
(4) Facilitate the optimal use of the unique resources of the Department for cooperative research into health outcomes by initiating recommendations, and responding to requests of the Under Secretary for Health and the Director of the Medical and Prosthetic Research Service, for such research into preventive health services.
(5) Provide advisory services to personnel of Department health-care facilities with respect to the planning or furnishing of preventive health services by such personnel.
(d) There is authorized to be appropriated $1,500,000 to the Medical Care General and Special Fund of the Department of Veterans Affairs for each fiscal year for the purpose of permitting the National Center for Preventive Health to carry out research, clinical, educational, and administrative activities under this section. Such activities shall be considered to be part of the operation of health-care facilities of the Department without regard to the location at which such activities are carried out.
(e) In this section, the term "preventive health services" has the meaning given such term in
(Added
Editorial Notes
Amendments
1994—Subsecs. (a)(1), (3), (c)(4).
Statutory Notes and Related Subsidiaries
Selection of Facility at Which Center To Be Established
§7319. Mammography quality standards
(a) A mammogram may not be performed at a Department facility unless that facility is accredited for that purpose by a private nonprofit organization designated by the Secretary. An organization designated by the Secretary under this subsection shall meet the standards for accrediting bodies established under subsection (e) of section 354 of the Public Health Service Act (
(b) The Secretary, in consultation with the Secretary of Health and Human Services, shall prescribe quality assurance and quality control standards relating to the performance and interpretation of mammograms and use of mammogram equipment and facilities of the Department of Veterans Affairs consistent with the requirements of section 354(f)(1) of the Public Health Service Act. Such standards shall be no less stringent than the standards prescribed by the Secretary of Health and Human Services under section 354(f) of the Public Health Service Act.
(c)(1) The Secretary, to ensure compliance with the standards prescribed under subsection (b), shall provide for an annual inspection of the equipment and facilities used by and in Department health care facilities for the performance of mammograms. Such inspections shall be carried out in a manner consistent with the inspection of certified facilities by the Secretary of Health and Human Services under section 354(g) of the Public Health Service Act.
(2) The Secretary may not provide for an inspection under paragraph (1) to be performed by a State agency.
(d) The Secretary shall ensure that mammograms performed for the Department under contract with any non-Department facility or provider conform to the quality standards prescribed by the Secretary of Health and Human Services under section 354 of the Public Health Service Act.
(e) For the purposes of this section, the term "mammogram" has the meaning given such term in paragraph (5) of section 354(a) of the Public Health Service Act.
(Added
Editorial Notes
References in Text
Section 354 of the Public Health Service Act, referred to in text, is section 354 of act July 1, 1944, ch. 373, which is classified to
Statutory Notes and Related Subsidiaries
Deadline for Prescribing Standards
Implementation Report
§7320. Centers for mental illness research, education, and clinical activities
(a) The purpose of this section is to provide for the improvement of the provision of health-care services and related counseling services to eligible veterans suffering from mental illness (especially mental illness related to service-related conditions) through—
(1) the conduct of research (including research on improving mental health service facilities of the Department and on improving the delivery of mental health services by the Department);
(2) the education and training of health care personnel of the Department; and
(3) the development of improved models and systems for the furnishing of mental health services by the Department.
(b)(1) The Secretary shall establish and operate centers for mental illness research, education, and clinical activities. Such centers shall be established and operated by collaborating Department facilities as provided in subsection (c)(1). Each such center shall function as a center for—
(A) research on mental health services;
(B) the use by the Department of specific models for furnishing services to treat serious mental illness;
(C) education and training of health-care professionals of the Department; and
(D) the development and implementation of innovative clinical activities and systems of care with respect to the delivery of such services by the Department.
(2) The Secretary shall, upon the recommendation of the Under Secretary for Health, designate the centers under this section. In making such designations, the Secretary shall ensure that the centers designated are located in various geographic regions of the United States. The Secretary may designate a center under this section only if—
(A) the proposal submitted for the designation of the center meets the requirements of subsection (c);
(B) the Secretary makes the finding described in subsection (d); and
(C) the peer review panel established under subsection (e) makes the determination specified in subsection (e)(3) with respect to that proposal.
(3) Not more than five centers may be designated under this section.
(4) The authority of the Secretary to establish and operate centers under this section is subject to the appropriation of funds for that purpose.
(c) A proposal submitted for the designation of a center under this section shall—
(1) provide for close collaboration in the establishment and operation of the center, and for the provision of care and the conduct of research and education at the center, by a Department facility or facilities in the same geographic area which have a mission centered on care of the mentally ill and a Department facility in that area which has a mission of providing tertiary medical care;
(2) provide that no less than 50 percent of the funds appropriated for the center for support of clinical care, research, and education will be provided to the collaborating facility or facilities that have a mission centered on care of the mentally ill; and
(3) provide for a governance arrangement between the collaborating Department facilities which ensures that the center will be established and operated in a manner aimed at improving the quality of mental health care at the collaborating facility or facilities which have a mission centered on care of the mentally ill.
(d) The finding referred to in subsection (b)(2)(B) with respect to a proposal for designation of a site as a location of a center under this section is a finding by the Secretary, upon the recommendation of the Under Secretary for Health, that the facilities submitting the proposal have developed (or may reasonably be anticipated to develop) each of the following:
(1) An arrangement with an accredited medical school that provides education and training in psychiatry and with which one or more of the participating Department facilities is affiliated under which medical residents receive education and training in psychiatry through regular rotation through the participating Department facilities so as to provide such residents with training in the diagnosis and treatment of mental illness.
(2) An arrangement with an accredited graduate program of psychology under which students receive education and training in clinical, counseling, or professional psychology through regular rotation through the participating Department facilities so as to provide such students with training in the diagnosis and treatment of mental illness.
(3) An arrangement under which nursing, social work, counseling, or allied health personnel receive training and education in mental health care through regular rotation through the participating Department facilities.
(4) The ability to attract scientists who have demonstrated achievement in research—
(A) into the evaluation of innovative approaches to the design of mental health services; or
(B) into the causes, prevention, and treatment of mental illness.
(5) The capability to evaluate effectively the activities of the center, including activities relating to the evaluation of specific efforts to improve the quality and effectiveness of mental health services provided by the Department at or through individual facilities.
(e)(1) In order to provide advice to assist the Secretary and the Under Secretary for Health to carry out their responsibilities under this section, the official within the central office of the Veterans Health Administration responsible for mental health and behavioral sciences matters shall establish a peer review panel to assess the scientific and clinical merit of proposals that are submitted to the Secretary for the designation of centers under this section.
(2) The panel shall consist of experts in the fields of mental health research, education and training, and clinical care. Members of the panel shall serve as consultants to the Department.
(3) The panel shall review each proposal submitted to the panel by the official referred to in paragraph (1) and shall submit to that official its views on the relative scientific and clinical merit of each such proposal. The panel shall specifically determine with respect to each such proposal whether that proposal is among those proposals which have met the highest competitive standards of scientific and clinical merit.
(4) The panel shall not be subject to
(f) Clinical and scientific investigation activities at each center established under this section—
(1) may compete for the award of funding from amounts appropriated for the Department of Veterans Affairs medical and prosthetics research account; and
(2) shall receive priority in the award of funding from such account insofar as funds are awarded to projects and activities relating to mental illness.
(g) The Under Secretary for Health shall ensure that at least three centers designated under this section emphasize research into means of improving the quality of care for veterans suffering from mental illness through the development of community-based alternatives to institutional treatment for such illness.
(h) The Under Secretary for Health shall ensure that information produced by the research, education and training, and clinical activities of centers established under this section that may be useful for other activities of the Veterans Health Administration is disseminated throughout the Veterans Health Administration. Such dissemination shall be made through publications, through programs of continuing medical and related education provided through regional medical education centers under subchapter VI of
(i) The official within the central office of the Veterans Health Administration responsible for mental health and behavioral sciences matters shall be responsible for supervising the operation of the centers established pursuant to this section and shall provide for ongoing evaluation of the centers and their compliance with the requirements of this section.
(j)(1) There are authorized to be appropriated to the Department of Veterans Affairs for the basic support of the research and education and training activities of centers established pursuant to this section amounts as follows:
(A) $3,125,000 for fiscal year 1998.
(B) $6,250,000 for each of fiscal years 1999 through 2001.
(2) In addition to funds appropriated for a fiscal year pursuant to the authorization of appropriations in paragraph (1), the Under Secretary for Health shall allocate to such centers from other funds appropriated for that fiscal year generally for the Department of Veterans Affairs medical services account and the Department of Veterans Affairs medical and prosthetics research account such amounts as the Under Secretary for Health determines appropriate to carry out the purposes of this section.
(Added
Editorial Notes
Amendments
2022—Subsec. (e)(4).
2008—Subsec. (j)(2).
Statutory Notes and Related Subsidiaries
Annual Reports On and Designation of Centers
§7321. Committee on Care of Severely Chronically Mentally Ill Veterans
(a) The Secretary, acting through the Under Secretary for Health, shall establish in the Veterans Health Administration a Committee on Care of Severely Chronically Mentally Ill Veterans. The Under Secretary shall appoint employees of the Department with expertise in the care of the chronically mentally ill to serve on the committee.
(b) The committee shall assess, and carry out a continuing assessment of, the capability of the Veterans Health Administration to meet effectively the treatment and rehabilitation needs of mentally ill veterans whose mental illness is severe and chronic and who are eligible for health care furnished by the Department, including the needs of such veterans who are women. In carrying out that responsibility, the committee shall—
(1) evaluate the care provided to such veterans through the Veterans Health Administration;
(2) identify systemwide problems in caring for such veterans in facilities of the Veterans Health Administration;
(3) identify specific facilities within the Veterans Health Administration at which program enrichment is needed to improve treatment and rehabilitation of such veterans; and
(4) identify model programs which the committee considers to have been successful in the treatment and rehabilitation of such veterans and which should be implemented more widely in or through facilities of the Veterans Health Administration.
(c) The committee shall—
(1) advise the Under Secretary regarding the development of policies for the care and rehabilitation of severely chronically mentally ill veterans; and
(2) make recommendations to the Under Secretary—
(A) for improving programs of care of such veterans at specific facilities and throughout the Veterans Health Administration;
(B) for establishing special programs of education and training relevant to the care of such veterans for employees of the Veterans Health Administration;
(C) regarding research needs and priorities relevant to the care of such veterans; and
(D) regarding the appropriate allocation of resources for all such activities.
(d)(1) Not later than April 1, 1997, the Secretary shall submit to the Committees on Veterans' Affairs of the Senate and House of Representatives a report on the implementation of this section. The report shall include the following:
(A) A list of the members of the committee.
(B) The assessment of the Under Secretary for Health, after review of the initial findings of the committee, regarding the capability of the Veterans Health Administration, on a systemwide and facility-by-facility basis, to meet effectively the treatment and rehabilitation needs of severely chronically mentally ill veterans who are eligible for Department care.
(C) The plans of the committee for further assessments.
(D) The findings and recommendations made by the committee to the Under Secretary for Health and the views of the Under Secretary on such findings and recommendations.
(E) A description of the steps taken, plans made (and a timetable for their execution), and resources to be applied toward improving the capability of the Veterans Health Administration to meet effectively the treatment and rehabilitation needs of severely chronically mentally ill veterans who are eligible for Department care.
(2) Not later than June 1 of each year through 2012, the Secretary shall submit to the Committees on Veterans' Affairs of the Senate and House of Representatives a report containing information updating the reports submitted under this subsection before the submission of such report.
(Added
Editorial Notes
Amendments
2008—Subsec. (d)(2).
2003—Subsec. (d)(2).
2000—Subsec. (d)(2).
§7321A. Committee on Care of Veterans with Traumatic Brain Injury
(a)
(b)
(1) evaluate the care provided to such veterans through the Veterans Health Administration;
(2) identify systemwide problems in caring for such veterans in facilities of the Veterans Health Administration;
(3) identify specific facilities within the Veterans Health Administration at which program enrichment is needed to improve treatment and rehabilitation of such veterans; and
(4) identify model programs which the committee considers to have been successful in the treatment and rehabilitation of such veterans and which should be implemented more widely in or through facilities of the Veterans Health Administration.
(c)
(1) advise the Under Secretary regarding the development of policies for the care and rehabilitation of veterans with traumatic brain injury; and
(2) make recommendations to the Under Secretary—
(A) for improving programs of care of such veterans at specific facilities and throughout the Veterans Health Administration;
(B) for establishing special programs of education and training relevant to the care of such veterans for employees of the Veterans Health Administration;
(C) regarding research needs and priorities relevant to the care of such veterans; and
(D) regarding the appropriate allocation of resources for all such activities.
(d)
(1) A list of the members of the committee.
(2) The assessment of the Under Secretary for Health, after review of the findings of the committee, regarding the capability of the Veterans Health Administration, on a systemwide and facility-by-facility basis, to meet effectively the treatment and rehabilitation needs of veterans with traumatic brain injury.
(3) The plans of the committee for further assessments.
(4) The findings and recommendations made by the committee to the Under Secretary for Health and the views of the Under Secretary on such findings and recommendations.
(5) A description of the steps taken, plans made (and a timetable for the execution of such plans), and resources to be applied toward improving the capability of the Veterans Health Administration to meet effectively the treatment and rehabilitation needs of veterans with traumatic brain injury.
(Added
§7322. Breast cancer mammography policy
(a)
(b)
(1) specify standards of mammography screening;
(2) provide recommendations with respect to screening, and the frequency of screening, for—
(A) women veterans who are over the age of 39; and
(B) veterans, without regard to age, who have clinical symptoms, risk factors, a record of service in a location and during a period specified in subsection (d), or family history of breast cancer; and
(3) provide for clinician discretion.
(c)
(d)
(A) Iraq during following periods:
(i) The period beginning on August 2, 1990, and ending on February 28, 1991.
(ii) The period beginning on March 19, 2003, and ending on such date as the Secretary determines burn pits are no longer used in Iraq.
(B) The Southwest Asia theater of operations, other than Iraq, during the period beginning on August 2, 1990, and ending on such date as the Secretary determines burn pits are no longer used in such location, including the following locations:
(i) Kuwait.
(ii) Saudi Arabia.
(iii) Oman.
(iv) Qatar.
(C) Afghanistan during the period beginning on September 11, 2001, and ending on such date as the Secretary determines burn pits are no longer used in Afghanistan.
(D) Djibouti during the period beginning on September 11, 2001, and ending on such date as the Secretary determines burn pits are no longer used in Djibouti.
(E) Syria during the period beginning on September 11, 2001, and ending on such date as the Secretary determines burn pits are no longer used in Syria.
(F) Jordan during the period beginning on September 11, 2001, and ending on such date as the Secretary determines burn pits are no longer used in Jordan.
(G) Egypt during the period beginning on September 11, 2001, and ending on such date as the Secretary determines burn pits are no longer used in Egypt.
(H) Lebanon during the period beginning on September 11, 2001, and ending on such date as the Secretary determines burn pits are no longer used in Lebanon.
(I) Yemen during the period beginning on September 11, 2001, and ending on such date as the Secretary determines burn pits are no longer used in Yemen.
(J) Such other locations and corresponding periods as set forth by the Airborne Hazards and Open Burn Pit Registry established under section 201 of the Dignified Burial and Other Veterans' Benefits Improvement Act of 2012 (
(K) Such other locations and corresponding periods as the Secretary, in collaboration with the Secretary of Defense, may determine appropriate in a report submitted under paragraph (2).
(2) Not later than two years after the date of the enactment of the Dr. Kate Hendricks Thomas Supporting Expanded Review for Veterans In Combat Environments Act, and not less frequently than once every two years thereafter, the Secretary of Veterans Affairs, in collaboration with the Secretary of Defense, shall submit to Congress a report specifying other locations and corresponding periods for purposes of paragraph (1)(K).
(3) A location under this subsection shall not include any body of water around or any airspace above such location.
(4) In this subsection, the term "burn pit" means an area of land that—
(A) is used for disposal of solid waste by burning in the outdoor air; and
(B) does not contain a commercially manufactured incinerator or other equipment specifically designed and manufactured for the burning of solid waste.
(Added
Editorial Notes
References in Text
The date of the enactment of the Dr. Kate Hendricks Thomas Supporting Expanded Review for Veterans In Combat Environments Act, referred to in subsec. (d)(2), is the date of enactment of
Amendments
2022—Subsec. (a).
Subsec. (b).
Subsec. (b)(2)(B).
Subsecs. (c), (d).
Statutory Notes and Related Subsidiaries
Effective Date
Making Advances in Mammography and Medical Options for Veterans
"SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
"(a)
"(b)
"TITLE I—SCREENING AND EARLY DETECTION
"SEC. 101. STRATEGIC PLAN FOR BREAST IMAGING SERVICES FOR VETERANS.
"(a)
"(b)
"(1) cover the evolving needs of women veterans;
"(2) address geographic disparities of breast imaging furnished at a facility of the Department of Veterans Affairs and the use of breast imaging through non-Department providers in the community;
"(3) address the use of digital breast tomosynthesis (DBT–3D breast imaging);
"(4) address the needs of male veterans who require breast cancer screening services; and
"(5) provide recommendations on—
"(A) potential expansion of breast imaging services furnished at facilities of the Department, including infrastructure and staffing needs;
"(B) the use of digital breast tomosynthesis;
"(C) the use of mobile mammography; and
"(D) other access and equity improvements for breast imaging.
"SEC. 102. TELESCREENING MAMMOGRAPHY PILOT PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS.
"(a)
"(1) States where the Department of Veterans Affairs does not offer breast imaging services at a facility of the Department; or
"(2) locations where access to breast imaging services at a facility of the Department is difficult or not feasible, as determined by the Secretary.
"(b)
"(c)
"(d)
"(1) mammography images generated shall be sent to a telescreening mammography center of the Department for interpretation by qualified radiologists; and
"(2) results shall be shared with the veteran and their primary care provider in accordance with policies established by the Secretary.
"(e)
"(1)
"(2)
"(A) An assessment of the quality of the mammography provided under the pilot program under subsection (a).
"(B) Feedback from veterans and providers participating in the pilot program.
"(C) A recommendation of the Secretary on the continuation or discontinuation of the pilot program.
"SEC. 103. UPGRADE OF BREAST IMAGING AT FACILITIES OF DEPARTMENT OF VETERANS AFFAIRS TO THREE-DIMENSIONAL DIGITAL MAMMOGRAPHY.
"Not later than two years after the date of the enactment of this Act [June 7, 2022], the Secretary of Veterans Affairs shall—
"(1) upgrade all mammography services at facilities of the Department of Veterans Affairs that provide such services to use digital breast tomosynthesis technology, also known as three-dimensional breast imaging; and
"(2) submit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives a report—
"(A) indicating that the upgrade under paragraph (1) has been completed; and
"(B) listing the facilities or other locations of the Department at which digital breast tomosynthesis technology is used.
"SEC. 104. STUDY ON AVAILABILITY OF TESTING FOR BREAST CANCER GENE AMONG VETERANS AND EXPANSION OF AVAILABILITY OF SUCH TESTING.
"(a)
"(1)
"(2)
"(A) the feasibility of expanding the Joint Medicine Service of the Department of Veterans Affairs to provide genetic testing and counseling for veterans with breast cancer across the country; and
"(B) access to such testing and counseling for veterans living in rural or highly rural areas, and any gaps that may exist with respect to such access.
"(b)
"(1)
"(2)
"(c)
"(1) the results of the study under subsection (a);
"(2) any updates to guidelines or new guidelines instituted under subsection (b);
"(3) breast cancer clinical pathways implemented by the Department of Veterans Affairs and the utilization of those pathways across the Department; and
"(4) any progress of the Department in improving access to and usage of molecular and genetic testing among veterans diagnosed with breast cancer, including for veterans living in rural or highly rural areas.
"(d)
"SEC. 105. MAMMOGRAPHY ACCESSIBILITY FOR PARALYZED AND DISABLED VETERANS.
"(a)
"(1)
"(2)
"(3)
"(A)
"(B)
"(4)
"(A) the rates of screening among veterans with a spinal cord injury or disorder, including veterans living in rural or highly rural areas, as required under paragraph (3)(A); or
"(B) if such rates are not available, a description of the method developed to measure such rates as required under paragraph (3)(B).
"(b)
"(1) confirm with the provider the accessibility of the breast imaging site, including the imaging equipment, transfer assistance, and the room in which services will be provided; and
"(2) provide additional information to the provider on best practices for screening and treating veterans with a spinal cord injury or disorder.
"(c)
"SEC. 106. REPORT ON ACCESS TO AND QUALITY OF MAMMOGRAPHY SCREENINGS FURNISHED BY DEPARTMENT OF VETERANS AFFAIRS.
"(a)
"(b)
"(1) the access of veterans to mammography screenings, whether at a facility of the Department or through a non-Department provider, including any staffing concerns of the Department in providing such screenings;
"(2) the quality of such screenings and reading of the images from such screenings, including whether such screenings use three-dimensional mammography;
"(3) the communication of the results of such screenings, including whether results are shared in a timely manner, whether results are shared via the Joint Health Information Exchange or another electronic mechanism, and whether results are incorporated into the electronic health record of the veteran;
"(4) the performance of the Women's Breast Oncology System of Excellence of the Department; and
"(5) the access of veterans diagnosed with breast cancer to a comprehensive breast cancer care team of the Department.
"(c)
"TITLE II—PARTNERSHIPS FOR RESEARCH AND ACCESS TO CARE
"SEC. 201. PARTNERSHIPS WITH NATIONAL CANCER INSTITUTE TO EXPAND ACCESS OF VETERANS TO CANCER CARE.
"(a)
"(1)
"(2)
"(b)
"(1) how the Secretary will ensure that the advancements made through the existing partnership between the Department of Veterans Affairs and the National Cancer Institute to provide veterans with access to clinical cancer research trials (commonly referred to as 'NAVIGATE') are permanently implemented; and
"(2) the determination of the Secretary of whether expansion of such partnership to more than the original 12 facilities of the Department that were selected under such partnership is feasible.
"(c)
"(1) assessing how the partnerships entered into under subsection (a)(1) have impacted access by veterans to cancer centers of the National Cancer Institute, including an assessment of the telehealth options made available and used pursuant to such partnerships; and
"(2) describing the advancements made with respect to access by veterans to clinical cancer research trials through the partnership described in subsection (b)(1), including how many of those veterans were women veterans, minority veterans (including racial and ethnic minorities), and rural veterans, and identifying opportunities for further innovation.
"SEC. 202. REPORT BY DEPARTMENT OF VETERANS AFFAIRS AND DEPARTMENT OF DEFENSE ON INTERAGENCY COLLABORATION ON TREATING AND RESEARCHING BREAST CANCER.
"(a)
"(b)
"(1) shall include a description of potential opportunities for future interagency collaboration between the Department of Veterans Affairs and the Department of Defense with respect to treating and researching breast cancer; and
"(2) may include a focus on—
"(A) with respect to women members of the Armed Forces with a diagnosis of or who are undergoing screening for breast cancer, transition of such members from receiving care from the Department of Defense to receiving care from the Department of Veterans Affairs;
"(B) collaborative breast cancer research opportunities between the Department of Veterans Affairs and the Department of Defense;
"(C) access to clinical trials; and
"(D) such other matters as the Secretary of Veterans Affairs and the Secretary of Defense consider appropriate."
Sense of Congress
§7323. Required consultations with nurses
The Under Secretary for Health shall ensure that—
(1) the director of a geographic service area, in formulating policy relating to the provision of patient care, shall consult regularly with a senior nurse executive or senior nurse executives; and
(2) the director of a medical center shall include a registered nurse as a member of any committee used at that medical center to provide recommendations or decisions on medical center operations or policy affecting clinical services, clinical outcomes, budget, or resources.
(Added
§7324. Annual report on use of authorities to enhance retention of experienced nurses
(a)
(1) The authorities under
(2) The authority under VA Directive 5102.1, relating to the Department of Veterans Affairs nurse qualification standard, dated November 10, 1999, or any successor directive.
(3) Any other authorities available to the Secretary for those purposes.
(b)
(1) The number of waivers requested under the authority referred to in subsection (a)(2), and the number of waivers granted under that authority, to promote to the Nurse II grade or Nurse III grade under the Nurse Schedule under section 7404(b)(1) 1 of this title any nurse who has not completed a baccalaureate degree in nursing in a recognized school of nursing, set forth by age, race, and years of experience of the individuals subject to such waiver requests and waivers, as the case may be.
(2) The programs carried out to facilitate the use of nursing education programs by experienced nurses, including programs for flexible scheduling, scholarships, salary replacement pay, and on-site classes.
(Added
Editorial Notes
References in Text
Statutory Notes and Related Subsidiaries
Initial Report
1 See References in Text note below.
§7325. Medical emergency preparedness centers
(a)
(2) The Under Secretary for Health shall be responsible for supervising the operation of the centers established under this section. The Under Secretary shall provide for ongoing evaluation of the centers and their compliance with the requirements of this section.
(3) The Under Secretary shall carry out the Under Secretary's functions under paragraph (2) in consultation with the Assistant Secretary of Veterans Affairs with responsibility for operations, preparedness, security, and law enforcement functions.
(b)
(1) To carry out research on, and to develop methods of detection, diagnosis, prevention, and treatment of injuries, diseases, and illnesses arising from the use of chemical, biological, radiological, incendiary or other explosive weapons or devices posing threats to the public health and safety.
(2) To provide education, training, and advice to health care professionals, including health care professionals outside the Veterans Health Administration, through the National Disaster Medical System established pursuant to section 2812 of the Public Health Service Act (
(3) In the event of a disaster or emergency referred to in
(c)
(2) A finding by the Secretary referred to in paragraph (1) with respect to a proposal for designation of a site as a location of a center under this section is a finding by the Secretary, upon the recommendations of the Under Secretary for Health and the Assistant Secretary with responsibility for operations, preparedness, security, and law enforcement functions, that the facility or facilities submitting the proposal have developed (or may reasonably be anticipated to develop) each of the following:
(A) An arrangement with a qualifying medical school and a qualifying school of public health (or a consortium of such schools) under which physicians and other persons in the health field receive education and training through the participating Department medical facilities so as to provide those persons with training in the detection, diagnosis, prevention, and treatment of injuries, diseases, and illnesses induced by exposures to chemical and biological substances, radiation, and incendiary or other explosive weapons or devices.
(B) An arrangement with a graduate school specializing in epidemiology under which students receive education and training in epidemiology through the participating Department facilities so as to provide such students with training in the epidemiology of contagious and infectious diseases and chemical and radiation poisoning in an exposed population.
(C) An arrangement under which nursing, social work, counseling, or allied health personnel and students receive training and education in recognizing and caring for conditions associated with exposures to toxins through the participating Department facilities.
(D) The ability to attract scientists who have made significant contributions to the development of innovative approaches to the detection, diagnosis, prevention, or treatment of injuries, diseases, and illnesses arising from the use of chemical, biological, radiological, incendiary or other explosive weapons or devices posing threats to the public health and safety.
(3) For purposes of paragraph (2)(A)—
(A) a qualifying medical school is an accredited medical school that provides education and training in toxicology and environmental health hazards and with which one or more of the participating Department medical centers is affiliated; and
(B) a qualifying school of public health is an accredited school of public health that provides education and training in toxicology and environmental health hazards and with which one or more of the participating Department medical centers is affiliated.
(d)
(e)
(2) The Secretary shall ensure that the work of the centers is conducted in close coordination with other Federal departments and agencies and that research products or other information of the centers shall be coordinated and shared with other Federal departments and agencies.
(f)
(1) in close coordination with the Department of Defense, the Department of Health and Human Services, and other departments, agencies, and elements of the Government charged with coordination of plans for United States homeland security; and
(2) after taking into consideration applicable recommendations of the working group on the prevention, preparedness, and response to bioterrorism and other public health emergencies established under section 319F(a) of the Public Health Service Act (
(g)
(h)
(i)
(2) In addition to funds appropriated for a fiscal year specifically for the activities of the centers pursuant to paragraph (1), the Under Secretary for Health shall allocate to such centers from other funds appropriated for that fiscal year generally for the Department medical services account and the Department medical and prosthetics research account such amounts as the Under Secretary determines appropriate to carry out the purposes of this section. Any determination by the Under Secretary under the preceding sentence shall be made in consultation with the Assistant Secretary with responsibility for operations, preparedness, security, and law enforcement functions.
(3) There are authorized to be appropriated for the centers under this section $20,000,000 for each of fiscal years 2003 through 2007.
(Added
Editorial Notes
Amendments
2010—Subsec. (b)(2).
2008—Subsec. (i)(2).
Statutory Notes and Related Subsidiaries
Transfer of Functions
For transfer of functions, personnel, assets, and liabilities of the National Disaster Medical System, including the functions of the Secretary of Homeland Security and the Under Secretary for Emergency Preparedness and Response relating thereto, to the Secretary of Health and Human Services, see title III of
For transfer of functions, personnel, assets, and liabilities of the National Disaster Medical System of the Department of Health and Human Services, including the functions of the Secretary of Health and Human Services and the Assistant Secretary for Public Health Emergency Preparedness [now Assistant Secretary for Preparedness and Response] relating thereto, to the Secretary of Homeland Security, and for treatment of related references, see former section 313(5) and
Peer Review for Designation of Centers
"(1) In order to assist the Secretary of Veterans Affairs and the Under Secretary of Veterans Affairs for Health in selecting sites for centers under
"(2) The peer review panel shall include experts in the fields of toxicological research, infectious diseases, radiology, clinical care of patients exposed to such hazards, and other persons as determined appropriate by the Secretary. Members of the panel shall serve as consultants to the Department of Veterans Affairs.
"(3) The panel shall review each proposal submitted to the panel by the officials referred to in paragraph (1) and shall submit to the Under Secretary for Health its views on the relative scientific and clinical merit of each such proposal. The panel shall specifically determine with respect to each such proposal whether that proposal is among those proposals which have met the highest competitive standards of scientific and clinical merit.
"(4) The panel shall not be subject to
§7326. Education and training programs on medical response to consequences of terrorist activities
(a)
(b)
(c)
(1) Recognition of chemical, biological, radiological, incendiary, or other explosive agents, weapons, or devices that may be used in terrorist activities.
(2) Identification of the potential symptoms of exposure to those agents.
(3) Understanding of the potential long-term health consequences, including psychological effects, resulting from exposure to those agents, weapons, or devices.
(4) Emergency treatment for exposure to those agents, weapons, or devices.
(5) An appropriate course of followup treatment, supportive care, and referral.
(6) Actions that can be taken while providing care for exposure to those agents, weapons, or devices to protect against contamination, injury, or other hazards from such exposure.
(7) Information on how to seek consultative support and to report suspected or actual use of those agents.
(d)
(e)
(Added
Statutory Notes and Related Subsidiaries
Implementation
§7327. Centers for research, education, and clinical activities on complex multi-trauma associated with combat injuries
(a)
(1) the development of improved models and systems for the furnishing by the Department of health care, rehabilitation, and education services to veterans;
(2) the conduct of research to support the provision of such services in accordance with the most current evidence on multi-trauma injuries; and
(3) the education and training of health care personnel of the Department with respect to the provision of such services.
(b)
(2) Each center designated under paragraph (1) shall function as a center for—
(A) research on the long-term effects of injuries sustained as a result of combat in order to support the provision of services for such injuries in accordance with the most current evidence on complex multi-trauma;
(B) the development of rehabilitation methodologies for treating individuals with complex multi-trauma; and
(C) the continuous and consistent coordination of care from the point of referral throughout the rehabilitation process and ongoing follow-up after return to home and community.
(3) The Secretary shall designate one of the centers designated under paragraph (1) as the lead center for activities referred to in that paragraph. As the lead center for such activities, such center shall—
(A) develop and provide periodic review of research priorities, and implement protocols, to ensure that projects contribute to the activities of the centers designated under paragraph (1);
(B) oversee the coordination of the professional and technical activities of such centers to ensure the quality and validity of the methodologies and statistical services for research project leaders;
(C) develop and ensure the deployment of an efficient and cost-effective data management system for such centers;
(D) develop and distribute educational materials and products to enhance the evaluation and care of individuals with combat injuries by medical care providers of the Department who are not specialized in the assessment and care of complex multi-trauma;
(E) develop educational materials for individuals suffering from combat injuries and for their families; and
(F) serve as a resource for the clinical and research infrastructure of such centers by disseminating clinical outcomes and research findings to improve clinical practice.
(4) The Secretary shall designate centers under paragraph (1) upon the recommendation of the Under Secretary for Health.
(5) The Secretary may designate a center under paragraph (1) only if the center meets the requirements of subsection (c).
(c)
(1) be a regional lead center for the care of traumatic brain injury;
(2) be located at a tertiary care medical center and have on-site availability of primary and subspecialty medical services relating to complex multi-trauma;
(3) have, or have the capacity to develop, the capability of managing impairments associated with combat injuries;
(4) be affiliated with a school of medicine;
(5) have, or have experience with, participation in clinical research trials;
(6) provide amputation care and rehabilitation;
(7) have pain management programs;
(8) provide comprehensive brain injury rehabilitation; and
(9) provide comprehensive general rehabilitation.
(d)
(1) the upgrading of blind rehabilitation services by employing or securing the services of blind rehabilitation specialists;
(2) employing or securing the services of occupational therapists with blind rehabilitation training;
(3) employing or securing the services of additional mental health services providers; and
(4) employing or securing additional rehabilitation nursing staff to meet care needs.
(e)
(A) making available, in a manner that the Secretary of Veterans Affairs considers appropriate, certified rehabilitation registered nurses of the Department of Veterans Affairs to such facilities to assess and coordinate the care of such members; and
(B) making available, in a manner that the Secretary of Veterans Affairs considers appropriate, blind rehabilitation specialists of the Department of Veterans Affairs to such facilities to consult with the medical staff of such facilities on the special needs of such members who have visual impairment as a consequence of combat injury.
(2) Assistance shall be provided under this subsection through agreements for the sharing of health-care resources under
(f)
(g)
(2) Information shall be disseminated under this subsection through publications, through programs of continuing medical and related education provided through regional medical education centers under subchapter VI of
(h)
(i)
(A) $7,000,000 for fiscal year 2005.
(B) $8,000,000 for each of fiscal years 2006 through 2008.
(2) In addition to amounts authorized to be appropriated by paragraph (1) for a fiscal year, the Under Secretary for Health may allocate to each center designated under this section, from other funds authorized to be appropriated for such fiscal year for the Department generally for medical and for medical and prosthetic research, such amounts as the Under Secretary for Health determines appropriate to carry out the purposes of this section.
(Added
Statutory Notes and Related Subsidiaries
Center of Excellence in the Mitigation, Treatment, and Rehabilitation of Traumatic Extremity Injuries and Amputations
"(a)
"(b)
"(c)
"(1) To implement a comprehensive plan and strategy for the Department of Defense and the Department of Veterans Affairs for the mitigation, treatment, and rehabilitation of traumatic extremity injuries and amputations.
"(2) To conduct research to develop scientific information aimed at saving injured extremities, avoiding amputations, and preserving and restoring the function of injured extremities. Such research shall address military medical needs and include the full range of scientific inquiry encompassing basic, translational, and clinical research.
"(3) To carry out such other activities to improve and enhance the efforts of the Department of Defense and the Department of Veterans Affairs for the mitigation, treatment, and rehabilitation of traumatic extremity injuries and amputations as the Secretary of Defense and the Secretary of Veterans Affairs consider appropriate."
Designation of Centers
§7328. Medical preparedness centers
(a)
(2) The Under Secretary for Health shall be responsible for supervising the operation of the centers established under this section. The Under Secretary shall provide for ongoing evaluation of the centers and their compliance with the requirements of this section.
(3) The Under Secretary shall carry out the Under Secretary's functions under paragraph (2) in consultation with the Assistant Secretary of Veterans Affairs with responsibility for operations, preparedness, security, and law enforcement functions.
(b)
(1) To carry out research on, and to develop methods of detection, diagnosis, prevention, and treatment of injuries, diseases, and illnesses arising from the use of chemical, biological, radiological, incendiary or other explosive weapons or devices posing threats to the public health and safety.
(2) To provide education, training, and advice to health care professionals, including health care professionals outside the Veterans Health Administration, through the National Disaster Medical System established pursuant to section 2811(b) of the Public Health Service Act (
(3) In the event of a disaster or emergency referred to in
(c)
(2) A finding by the Secretary referred to in paragraph (1) with respect to a proposal for designation of a site as a location of a center under this section is a finding by the Secretary, upon the recommendations of the Under Secretary for Health and the Assistant Secretary with responsibility for operations, preparedness, security, and law enforcement functions, that the facility or facilities submitting the proposal have developed (or may reasonably be anticipated to develop) each of the following:
(A) An arrangement with a qualifying medical school and a qualifying school of public health (or a consortium of such schools) under which physicians and other persons in the health field receive education and training through the participating Department medical facilities so as to provide those persons with training in the detection, diagnosis, prevention, and treatment of injuries, diseases, and illnesses induced by exposures to chemical and biological substances, radiation, and incendiary or other explosive weapons or devices.
(B) An arrangement with a graduate school specializing in epidemiology under which students receive education and training in epidemiology through the participating Department facilities so as to provide such students with training in the epidemiology of contagious and infectious diseases and chemical and radiation poisoning in an exposed population.
(C) An arrangement under which nursing, social work, counseling, or allied health personnel and students receive training and education in recognizing and caring for conditions associated with exposures to toxins through the participating Department facilities.
(D) The ability to attract scientists who have made significant contributions to the development of innovative approaches to the detection, diagnosis, prevention, or treatment of injuries, diseases, and illnesses arising from the use of chemical, biological, radiological, incendiary or other explosive weapons or devices posing threats to the public health and safety.
(3) For purposes of paragraph (2)(A)—
(A) a qualifying medical school is an accredited medical school that provides education and training in toxicology and environmental health hazards and with which one or more of the participating Department medical centers is affiliated; and
(B) a qualifying school of public health is an accredited school of public health that provides education and training in toxicology and environmental health hazards and with which one or more of the participating Department medical centers is affiliated.
(d)
(e)
(2) The Secretary shall ensure that the work of the centers is conducted in close coordination with other Federal departments and agencies and that research products or other information of the centers shall be coordinated and shared with other Federal departments and agencies.
(f)
(1) in close coordination with the Department of Defense, the Department of Health and Human Services, and other departments, agencies, and elements of the Government charged with coordination of plans for United States homeland security; and
(2) after taking into consideration applicable recommendations of the working group on the prevention, preparedness, and response to bioterrorism and other public health emergencies established under section 319F(a) of the Public Health Service Act (
(g)
(h)
(i)
(2) In addition to any amounts appropriated for a fiscal year specifically for the activities of the centers pursuant to paragraph (1), the Under Secretary for Health shall allocate to the centers from other funds appropriated for that fiscal year generally for the Department medical services account and the Department medical and prosthetic research account such amounts as the Under Secretary determines necessary in order to carry out the purposes of this section.
(Added
Editorial Notes
References in Text
Section 2811(b) of the Public Health Service Act, referred to in subsec. (b)(2), was redesignated section 2812(a) of the Public Health Service Act by
Codification
The text of subsecs. (a) to (h) of this section consists of the text of section 7325(a) to (h) of this title, as duplicated in this section by
Amendments
2008—Subsec. (i)(2).
Statutory Notes and Related Subsidiaries
Transfer of Functions
For transfer of functions, personnel, assets, and liabilities of the National Disaster Medical System, including the functions of the Secretary of Homeland Security and the Under Secretary for Emergency Preparedness and Response relating thereto, to the Secretary of Health and Human Services, see title III of
For transfer of functions, personnel, assets, and liabilities of the National Disaster Medical System of the Department of Health and Human Services, including the functions of the Secretary of Health and Human Services and the Assistant Secretary for Public Health Emergency Preparedness [now Assistant Secretary for Preparedness and Response] relating thereto, to the Secretary of Homeland Security, and for treatment of related references, see former section 313(5) and
Enhancement of Medical Preparedness of Department of Veterans Affairs
"(a)
"(b)
1 See References in Text note below.
§7329. Parkinson's Disease research, education, and clinical centers
(a)
(2) Subject to the availability of appropriations for such purpose, the Secretary shall establish and operate centers of Parkinson's Disease research, education, and clinical activities centers at the locations designated pursuant to paragraph (1).
(b)
(2) Except as provided in paragraph (3), the Secretary shall designate as the location for a center of Parkinson's Disease research, education, and clinical activities pursuant to subsection (a)(1) each Department health-care facility that as of January 1, 2005, was operating a Parkinson's Disease research, education, and clinical center.
(3) The Secretary may not under subsection (a) designate a facility described in paragraph (2) if (on the recommendation of the Under Secretary for Health) the Secretary determines that such facility—
(A) does not meet the requirements of subsection (c); or
(B) has not demonstrated—
(i) effectiveness in carrying out the established purposes of such center; or
(ii) the potential to carry out such purposes effectively in the reasonably foreseeable future.
(c)
(2) The Secretary may not designate a Department health-care facility as a location for a center under subsection (a) unless the Secretary (upon the recommendation of the Under Secretary for Health) determines that the facility has (or may reasonably be anticipated to develop) each of the following:
(A) An arrangement with an accredited medical school that provides education and training in neurology and with which the Department health-care facility is affiliated under which residents receive education and training in innovative diagnosis and treatment of chronic neurodegenerative diseases and movement disorders, including Parkinson's Disease.
(B) The ability to attract the participation of scientists who are capable of ingenuity and creativity in health-care research efforts.
(C) An advisory committee composed of veterans and appropriate health-care and research representatives of the Department health-care facility and of the affiliated school or schools to advise the directors of such facility and such center on policy matters pertaining to the activities of the center during the period of the operation of such center.
(D) The capability to conduct effectively evaluations of the activities of such center.
(E) The capability to coordinate (as part of an integrated national system) education, clinical, and research activities within all facilities with such centers.
(F) The capability to jointly develop a consortium of providers with interest in treating neurodegenerative diseases, including Parkinson's Disease and other movement disorders, at facilities without centers established under subsection (a) in order to ensure better access to state-of-the-art diagnosis, care, and education for neurodegenerative disorders throughout the health-care system of the Department.
(G) The capability to develop a national repository in the health-care system of the Department for the collection of data on health services delivered to veterans seeking care for neurodegenerative diseases, including Parkinson's Disease, and other movement disorders.
(d)
(2)(A) The membership of the panel shall consist of experts in neurodegenerative diseases, including Parkinson's Disease and other movement disorders.
(B) Members of the panel shall serve for a period of no longer than two years, except as specified in subparagraph (C).
(C) Of the members first appointed to the panel, one half shall be appointed for a period of three years and one half shall be appointed for a period of two years, as designated by the Under Secretary at the time of appointment.
(3) The panel shall review each proposal submitted to the panel by the Under Secretary and shall submit its views on the relative scientific and clinical merit of each such proposal to the Under Secretary.
(4) The panel shall not be subject to
(e)
(f)
(g)
(Added
Editorial Notes
Codification
A substantially identical section enacted by
Amendments
2022—Subsec. (d)(4).
Statutory Notes and Related Subsidiaries
Effective Date
§7330. Multiple sclerosis centers of excellence
(a)
(2) Subject to the availability of appropriations for such purpose, the Secretary shall establish and operate multiple sclerosis centers of excellence at the locations designated pursuant to paragraph (1).
(b)
(2) Except as provided in paragraph (3), the Secretary shall designate as the location for a center pursuant to subsection (a)(1) each Department health-care facility that as of January 1, 2005, was operating a multiple sclerosis center of excellence.
(3) The Secretary may not under subsection (a) designate a facility described in paragraph (2) if (on the recommendation of the Under Secretary for Health) the Secretary determines that such facility—
(A) does not meet the requirements of subsection (c); or
(B) has not demonstrated—
(i) effectiveness in carrying out the established purposes of such center; or
(ii) the potential to carry out such purposes effectively in the reasonably foreseeable future.
(c)
(2) The Secretary may not designate a Department health-care facility as a location for a center under subsection (a) unless the Secretary (upon the recommendation of the Under Secretary for Health) determines that the facility has (or may reasonably be anticipated to develop) each of the following:
(A) An arrangement with an accredited medical school that provides education and training in neurology and with which the Department health-care facility is affiliated under which residents receive education and training in innovative diagnosis and treatment of autoimmune diseases affecting the central nervous system, including multiple sclerosis.
(B) The ability to attract the participation of scientists who are capable of ingenuity and creativity in health-care research efforts.
(C) An advisory committee composed of veterans and appropriate health-care and research representatives of the Department health-care facility and of the affiliated school or schools to advise the directors of such facility and such center on policy matters pertaining to the activities of the center during the period of the operation of such center.
(D) The capability to conduct effectively evaluations of the activities of such center.
(E) The capability to coordinate (as part of an integrated national system) education, clinical, and research activities within all facilities with such centers.
(F) The capability to jointly develop a consortium of providers with interest in treating multiple sclerosis at facilities without such centers in order to ensure better access to state-of-the-art diagnosis, care, and education for autoimmune disease affecting the central nervous system throughout the health-care system of the Department.
(G) The capability to develop a national repository in the health-care system of the Department for the collection of data on health services delivered to veterans seeking care for autoimmune disease affecting the central nervous system.
(d)
(2)(A) The membership of the panel shall consist of experts in autoimmune disease affecting the central nervous system.
(B) Members of the panel shall serve for a period of no longer than two years, except as specified in subparagraph (C).
(C) Of the members first appointed to the panel, one half shall be appointed for a period of three years and one half shall be appointed for a period of two years, as designated by the Under Secretary at the time of appointment.
(3) The panel shall review each proposal submitted to the panel by the Under Secretary and shall submit its views on the relative scientific and clinical merit of each such proposal to the Under Secretary.
(4) The panel shall not be subject to
(e)
(f)
(g)
(Added
Editorial Notes
Codification
A substantially identical section enacted by
Amendments
2022—Subsec. (d)(4).
Statutory Notes and Related Subsidiaries
Effective Date
Section effective at the end of the 30-day period beginning Dec. 22, 2006, see section 209(b) of
§7330A. Epilepsy centers of excellence
(a)
(2) Of the facilities designated under paragraph (1), not less than two shall be centers designated under
(3) Of the facilities designated under paragraph (1), not less than two shall be facilities that are not centers designated under
(4) Subject to the availability of appropriations for such purpose, the Secretary shall establish and operate an epilepsy center of excellence at each location designated under paragraph (1).
(b)
(2) The Secretary may not designate a facility as a location for an epilepsy center of excellence under subsection (a) unless the peer review panel established under subsection (c) has determined under that subsection that the proposal submitted by such facility seeking designation as a location for an epilepsy center of excellence is among those proposals that meet the highest competitive standards of scientific and clinical merit.
(3) In choosing from among the facilities meeting the requirements of paragraph (2), the Secretary shall also consider appropriate geographic distribution when designating the epilepsy centers of excellence under subsection (a).
(c)
(2)(A) The membership of the peer review panel shall consist of experts on epilepsy, including post-traumatic epilepsy.
(B) Members of the peer review panel shall serve for a period of no longer than two years, except as specified in subparagraph (C).
(C) Of the members first appointed to the panel, one half shall be appointed for a period of three years and one half shall be appointed for a period of two years, as designated by the Under Secretary at the time of appointment.
(3) The peer review panel shall review each proposal submitted to the panel by the Under Secretary for Health and shall submit its views on the relative scientific and clinical merit of each such proposal to the Under Secretary.
(4) The peer review panel shall, in conjunction with the national coordinator designated under subsection (e), conduct regular evaluations of each epilepsy center of excellence established and operated under subsection (a) to ensure compliance with the requirements of this section.
(5) The peer review panel shall not be subject to
(d)
(1) An affiliation with an accredited medical school that provides education and training in neurology, including an arrangement with such school under which medical residents receive education and training in the diagnosis and treatment of epilepsy (including neurosurgery).
(2) The ability to attract the participation of scientists who are capable of ingenuity and creativity in health care research efforts.
(3) An advisory committee composed of veterans and appropriate health care and research representatives of the facility and of the affiliated school or schools to advise the directors of such facility and such center on policy matters pertaining to the activities of the center during the period of the operation of such center.
(4) The capability to conduct effectively evaluations of the activities of such center.
(5) The capability to assist in the expansion of the Department's use of information systems and databases to improve the quality and delivery of care for veterans enrolled within the Department's health care system.
(6) The capability to assist in the expansion of the Department telehealth program to develop, transmit, monitor, and review neurological diagnostic tests.
(7) The ability to perform epilepsy research, education, and clinical care activities in collaboration with Department medical facilities that have centers for research, education, and clinical care activities on complex multi-trauma associated with combat injuries established under
(e)
(2) The duties of the national coordinator for epilepsy programs shall include the following:
(A) To supervise the operation of the centers established pursuant to this section.
(B) To coordinate and support the national consortium of providers with interest in treating epilepsy at Department health care facilities lacking such centers in order to ensure better access to state-of-the-art diagnosis, research, clinical care, and education for traumatic brain injury and epilepsy throughout the health care system of the Department.
(C) To conduct, in conjunction with the peer review panel established under subsection (c), regular evaluations of the epilepsy centers of excellence to ensure compliance with the requirements of this section.
(D) To coordinate (as part of an integrated national system) education, clinical care, and research activities within all facilities with an epilepsy center of excellence.
(E) To develop jointly a national consortium of providers with interest in treating epilepsy at Department health care facilities lacking an epilepsy center of excellence in order to ensure better access to state-of-the-art diagnosis, research, clinical care, and education for traumatic brain injury and epilepsy throughout the health care system of the Department. Such consortium should include a designated epilepsy referral clinic in each Veterans Integrated Service Network.
(3) In carrying out duties under this subsection, the national coordinator for epilepsy programs shall report to the official of the Veterans Health Administration responsible for neurology.
(f)
(2) There are authorized to be appropriated for each fiscal year after fiscal year 2013 such sums as may be necessary for the support of the clinical care, research, and education activities of the epilepsy centers of excellence established and operated pursuant to subsection (a)(2).
(3) The Secretary shall ensure that funds for such centers are designated for the first three years of operation as a special purpose program for which funds are not allocated through the Veterans Equitable Resource Allocation system.
(4) In addition to amounts authorized to be appropriated under paragraphs (1) and (2) for a fiscal year, the Under Secretary for Health shall allocate to such centers from other funds appropriated generally for the Department medical services account and medical and prosthetics research account, as appropriate, such amounts as the Under Secretary for Health determines appropriate.
(5) In addition to amounts authorized to be appropriated under paragraphs (1) and (2) for a fiscal year, there are authorized to be appropriated such sums as may be necessary to fund the national coordinator established by subsection (e).
(Added
Editorial Notes
References in Text
The date of the enactment of the Veterans' Mental Health and Other Care Improvements Act of 2008, referred to in subsec. (a)(1), is the date of enactment of
Amendments
2022—Subsec. (c)(5).
§7330B. Annual report on Veterans Health Administration and furnishing of hospital care, medical services, and nursing home care
(a)
(1) the furnishing of hospital care, medical services, and nursing home care under the laws administered by the Secretary; and
(2) the administration of the furnishing of such care and services by the Veterans Health Administration.
(b)
(1) An evaluation of the effectiveness of the Veterans Health Administration in increasing the access of veterans to hospital care, medical services, and nursing home care furnished by the Secretary for which such veterans are eligible.
(2) An evaluation of the effectiveness of the Veterans Health Administration in improving the quality of health care provided to veterans, without increasing the costs incurred for such health care by the Federal Government or veterans, including relevant information for each medical center and Veterans Integrated Service Network of the Department set forth separately.
(3) An assessment of—
(A) the workload of physicians and other employees of the Veterans Health Administration;
(B) patient demographics and utilization rates;
(C) physician compensation;
(D) the productivity of physicians and other employees of the Veterans Health Administration;
(E) the percentage of hospital care, medical services, and nursing home care provided to veterans in facilities of the Department and in non-Department facilities and any changes in such percentages compared to the year preceding the year covered by the report;
(F) pharmaceutical prices; and
(G) third-party health billings owed to the Department, including the total amount of such billings and the total amount collected by the Department, set forth separately for claims greater than $1,000 and for claims equal to or less than $1,000.
(c)
(Added
§7330C. Quadrennial Veterans Health Administration review
(a)
(2) Each market area assessment established under paragraph (1) shall include the following:
(A) An assessment of the demand for health care from the Department, disaggregated by geographic market areas as determined by the Secretary, including the number of requests for health care services under the laws administered by the Secretary.
(B) An inventory of the health care capacity of the Department across the Department's system of facilities.
(C) An assessment of the health care capacity to be provided through contracted community care providers and providers who entered into a provider agreement with the Department under
(D) An assessment obtained from other Federal direct delivery systems of their capacity to provide health care to veterans.
(E) An assessment of the health care capacity of non-contracted providers where there is insufficient network supply.
(F) An assessment of the health care capacity of academic affiliates and other collaborations of the Department as it relates to providing health care to veterans.
(G) An assessment of the effects on health care capacity of the access standards and standards for quality established under
(H) The number of appointments for health care services under the laws administered by the Secretary, disaggregated by—
(i) appointments at facilities of the Department; and
(ii) appointments with non-Department health care providers.
(3)(A) The Secretary shall submit to the appropriate committees of Congress the market area assessments established in paragraph (1).
(B) The Secretary also shall submit to the appropriate committees of Congress the market area assessments completed by or being performed on the day before the date of the enactment of the Caring for Our Veterans Act of 2018.
(4)(A) The Secretary shall use the market area assessments established under paragraph (1) to—
(i) determine the capacity of the health care provider networks established under
(ii) inform the Department budget, in accordance with subparagraph (B); and
(iii) inform and assess the appropriateness of the access standards established under
(B) The Secretary shall ensure that the Department budget for any fiscal year (as submitted with the budget of the President under
(b)
(A) the demand for health care from the Department, disaggregated by geographic area as determined by the Secretary;
(B) the health care capacity to be provided at each medical center of the Department; and
(C) the health care capacity to be provided through community care providers.
(2) In preparing the strategic plan under paragraph (1), the Secretary shall—
(A) assess the access standards and standards for quality established under
(B) assess the market area assessments established under subsection (a);
(C) assess the needs of the Department based on identified services that provide management of conditions or disorders related to military service for which there is limited experience or access in the national market, the overall health of veterans throughout their lifespan, or other services as the Secretary determines appropriate;
(D) consult with key stakeholders within the Department, the heads of other Federal agencies, and other relevant governmental and nongovernmental entities, including State, local, and tribal government officials, members of Congress, veterans service organizations, private sector representatives, academics, and other policy experts;
(E) identify emerging issues, trends, problems, and opportunities that could affect health care services furnished under the laws administered by the Secretary;
(F) develop recommendations regarding both short- and long-term priorities for health care services furnished under the laws administered by the Secretary;
(G) after consultation with veterans service organizations and other key stakeholders on survey development or modification of an existing survey, consider a survey of veterans who have used hospital care, medical services, or extended care services furnished by the Veterans Health Administration during the most recent 2-year period to assess the satisfaction of the veterans with service and quality of care;
(H) conduct a comprehensive examination of programs and policies of the Department regarding the delivery of health care services and the demand of health care services for veterans in future years;
(I) assess the remediation of medical service lines of the Department as described in
(J) consider such other matters as the Secretary considers appropriate.
(c)
(1) overseeing the transformation and organizational change across the Department to achieve a high-performing integrated health care network;
(2) developing the capital infrastructure planning and procurement processes, whether minor or major construction projects or leases; and
(3) developing a multi-year budget process that is capable of forecasting future year budget requirements and projecting the cost of delivering health care services under such a high-performing integrated health care network.
(d)
(1) the Committee on Veterans' Affairs and the Committee on Appropriations of the Senate; and
(2) the Committee on Veterans' Affairs and the Committee on Appropriations of the House of Representatives.
(Added
Editorial Notes
References in Text
The date of the enactment of the Caring for Our Veterans Act of 2018, referred to in subsecs. (a)(3)(B) and (b), is the date of enactment of
Amendments
2018—Subsec. (a)(1).
Subsec. (a)(2)(B).
Subsec. (a)(2)(C).
Subsec. (a)(2)(H)(i).
Subsec. (a)(4)(A)(iii).
Subsec. (a)(4)(B).
Subsec. (b)(2)(I).
Subsec. (c)(1).
Subsec. (c)(3).
§7330D. Inapplicability of Paperwork Reduction Act to research activities
Subchapter I of
(Added
SUBCHAPTER III—PROTECTION OF PATIENT RIGHTS
§7331. Informed consent
The Secretary, upon the recommendation of the Under Secretary for Health and pursuant to the provisions of
(Added
Editorial Notes
Amendments
1992—
1991—
Statutory Notes and Related Subsidiaries
Effective Date
Subchapter effective Oct. 21, 1976, see section 211 of
§7332. Confidentiality of certain medical records
(a)(1) Records of the identity, diagnosis, prognosis, or treatment of any patient or subject which are maintained in connection with the performance of any program or activity (including education, training, treatment, rehabilitation, or research) relating to drug abuse, alcoholism or alcohol abuse, infection with the human immunodeficiency virus, or sickle cell anemia which is carried out by or for the Department under this title shall, except as provided in subsections (e) and (f), be confidential, and (
(2) Paragraph (1) prohibits the disclosure to any person or entity other than the patient or subject concerned of the fact that a special written consent is required in order for such records to be disclosed.
(b)(1) The content of any record referred to in subsection (a) may be disclosed by the Secretary in accordance with the prior written consent of the patient or subject with respect to whom such record is maintained, but only to such extent, under such circumstances, and for such purposes as may be allowed in regulations prescribed by the Secretary.
(2) Whether or not any patient or subject, with respect to whom any given record referred to in subsection (a) is maintained, gives written consent, the content of such record may be disclosed by the Secretary as follows:
(A) To medical personnel to the extent necessary to meet a bona fide medical emergency.
(B) To qualified personnel for the purpose of conducting scientific research, management audits, financial audits, or program evaluation, but such personnel may not identify, directly or indirectly, any individual patient or subject in any report of such research, audit, or evaluation, or otherwise disclose patient or subject identities in any manner.
(C)(i) In the case of any record which is maintained in connection with the performance of any program or activity relating to infection with the human immunodeficiency virus, to a Federal, State, or local public-health authority charged under Federal or State law with the protection of the public health, and to which Federal or State law requires disclosure of such record, if a qualified representative of such authority has made a written request that such record be provided as required pursuant to such law for a purpose authorized by such law.
(ii) A person to whom a record is disclosed under this paragraph may not redisclose or use such record for a purpose other than that for which the disclosure was made.
(D) If authorized by an appropriate order of a court of competent jurisdiction granted after application showing good cause therefor. In assessing good cause the court shall weigh the public interest and the need for disclosure against the injury to the patient or subject, to the physician-patient relationship, and to the treatment services. Upon the granting of such order, the court, in determining the extent to which any disclosure of all or any part of any record is necessary, shall impose appropriate safeguards against unauthorized disclosure.
(E) To an entity described in paragraph (1)(B) of
(F)(i) To a representative of a patient who lacks decision-making capacity, when a practitioner deems the content of the given record necessary for that representative to make an informed decision regarding the patient's treatment.
(ii) In this subparagraph, the term "representative" means an individual, organization, or other body authorized under
(G) To a State controlled substance monitoring program, including a program approved by the Secretary of Health and Human Services under section 399O of the Public Health Service Act (
(H)(i) To a non-Department entity (including private entities and other Federal agencies) for purposes of providing health care, including hospital care, medical services, and extended care services, to patients or performing other health care-related activities or functions.
(ii) An entity to which a record is disclosed under this subparagraph may not disclose or use such record for a purpose other than that for which the disclosure was made or as permitted by law.
(I) To a third party in order to recover or collect reasonable charges for care furnished to, or paid on behalf of, a patient in connection with a non-service connected disability as permitted by
(3) In the event that the patient or subject who is the subject of any record referred to in subsection (a) is deceased, the content of any such record may be disclosed by the Secretary only upon the prior written request of the next of kin, executor, administrator, or other personal representative of such patient or subject and only if the Secretary determines that such disclosure is necessary for such survivor to obtain benefits to which such survivor may be entitled, including the pursuit of legal action, but then only to the extent, under such circumstances, and for such purposes as may be allowed in regulations prescribed pursuant to
(c) Except as authorized by a court order granted under subsection (b)(2)(D), no record referred to in subsection (a) may be used to initiate or substantiate any criminal charges against, or to conduct any investigation of, a patient or subject.
(d) The prohibitions of this section shall continue to apply to records concerning any person who has been a patient or subject, irrespective of whether or when such person ceases to be a patient.
(e) The prohibitions of this section shall not prevent any interchange of records—
(1) within and among those components of the Department furnishing health care to veterans, or determining eligibility for benefits under this title; or
(2) between such components furnishing health care to veterans and the Armed Forces.
(f)(1) Notwithstanding subsection (a) but subject to paragraph (2), a physician or a professional counselor may disclose information or records indicating that a patient or subject is infected with the human immunodeficiency virus if the disclosure is made to (A) the spouse of the patient or subject, or (B) to an individual whom the patient or subject has, during the process of professional counseling or of testing to determine whether the patient or subject is infected with such virus, identified as being a sexual partner of such patient or subject.
(2)(A) A disclosure under paragraph (1) may be made only if the physician or counselor, after making reasonable efforts to counsel and encourage the patient or subject to provide the information to the spouse or sexual partner, reasonably believes that the patient or subject will not provide the information to the spouse or sexual partner and that the disclosure is necessary to protect the health of the spouse or sexual partner.
(B) A disclosure under such paragraph may be made by a physician or counselor other than the physician or counselor referred to in subparagraph (A) if such physician or counselor is unavailable by reason of absence or termination of employment to make the disclosure.
(g) Any person who violates any provision of this section or any regulation issued pursuant to this section shall be fined, in the case of a first offense, up to the maximum amount provided under
(Added
Editorial Notes
References in Text
Amendments
2018—Subsec. (b)(2)(H), (I).
"(i) To a non-Department entity (including private entities and other Federal agencies) that provides hospital care or medical services to veterans as authorized by the Secretary.
"(ii) An entity to which a record is disclosed under this subparagraph may not redisclose or use such record for a purpose other than that for which the disclosure was made."
2017—Subsec. (b)(2)(H).
2011—Subsec. (b)(2)(G).
2010—Subsec. (b)(2)(F).
2006—Subsec. (b)(2)(E).
1991—
Subsec. (a)(1).
Subsec. (a)(2).
Subsec. (b)(1).
Subsec. (b)(2).
Subsec. (b)(3).
Subsec. (c).
Subsec. (e)(1).
Subsec. (f)(1).
Subsec. (f)(2)(A).
Subsec. (f)(2)(B).
Subsec. (g).
1988—Subsec. (a).
Subsec. (b)(1).
Subsec. (b)(2)(C), (D).
Subsec. (c).
Subsec. (f).
Subsec. (g).
§7333. Nondiscrimination against alcohol and drug abusers and persons infected with the human immunodeficiency virus
(a) Veterans eligible for treatment under
(b) The Secretary shall prescribe regulations for the enforcement of this section. Such regulations, with respect to the admission and treatment of such veterans who are alcohol or drug abusers, shall be prescribed in accordance with
(Added
Editorial Notes
Amendments
1991—
Subsec. (a).
Subsec. (b).
1988—
Statutory Notes and Related Subsidiaries
Restriction on Testing for Infection With Human Immunodeficiency Virus
§7334. Regulations
(a) Regulations prescribed by the Secretary under
(b) The regulations referred to in subsection (a) are—
(1) regulations governing human experimentation and informed consent prescribed by the Secretary of Health and Human Services, based on the recommendations of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, established by section 201 of the National Research Act (
(2) regulations governing (A) the confidentiality of drug and alcohol abuse medical records, and (B) the admission of drug and alcohol abusers to private and public hospitals, prescribed pursuant to the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970 (
(c) Regulations prescribed by the Secretary under
(d) In prescribing and implementing such regulations, the Secretary shall, from time to time, consult with the Secretary of Health and Human Services and, as appropriate, with the President (or the delegate of the President) in order to achieve the maximum possible coordination of the regulations, and the implementation of the regulations, which they and the Secretary prescribe.
(Added
Editorial Notes
References in Text
Section 201 of the National Research Act, referred to in subsec. (b)(1), is section 201 of
The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970 (
The Drug Abuse Office and Treatment Act of 1972, referred to in subsec. (b)(2), which was redesignated the Drug Abuse Prevention, Treatment, and Rehabilitation Act, is
Amendments
1991—
Subsec. (a).
Subsec. (b).
Subsec. (c).
Subsec. (d).
1988—
1982—Subsec. (a).
1 See References in Text note below.
SUBCHAPTER IV—RESEARCH CORPORATIONS
Editorial Notes
Prior Provisions
A prior subchapter IV of this chapter consisted of sections 4141 and 4142 prior to amendment by
Amendments
1991—
§7361. Authority to establish; status
(a) The Secretary may authorize the establishment at any Department medical center of a nonprofit corporation to provide a flexible funding mechanism for the conduct of approved research and education at the medical center. Such a corporation may be established to facilitate either research or education or both research and education.
(b)(1) Subject to paragraph (2), a corporation established under this subchapter may facilitate the conduct of research, education, or both at more than one medical center. Such a corporation shall be known as a "multi-medical center research corporation".
(2) The board of directors of a multi-medical center research corporation under this subsection shall include the official at each Department medical center concerned who is, or who carries out the responsibilities of, the medical center director of such center as specified in
(3) In facilitating the conduct of research, education, or both at more than one Department medical center under this subchapter, a multi-medical center research corporation may administer receipts and expenditures relating to such research, education, or both, as applicable, performed at the Department medical centers concerned.
(c) Any corporation established under this subchapter shall be established in accordance with the nonprofit corporation laws of the State in which the applicable Department medical center is located and shall, to the extent not inconsistent with any Federal law, be subject to the laws of such State. In the case of any multi-medical center research corporation that facilitates the conduct of research, education, or both at Department medical centers located in different States, the corporation shall be established in accordance with the nonprofit corporation laws of the State in which one of such Department medical centers is located.
(d)(1) Except as otherwise provided in this subchapter or under regulations prescribed by the Secretary, any corporation established under this subchapter, and its officers, directors, and employees, shall be required to comply only with those Federal laws, regulations, and executive orders and directives that apply generally to private nonprofit corporations.
(2) A corporation under this subchapter is not—
(A) owned or controlled by the United States; or
(B) an agency or instrumentality of the United States.
(e) If by the end of the four-year period beginning on the date of the establishment of a corporation under this subchapter the corporation is not recognized as an entity the income of which is exempt from taxation under section 501(c)(3) of the Internal Revenue Code of 1986, the Secretary shall dissolve the corporation.
(f) A corporation established under this subchapter may act as a multi-medical center research corporation under this subchapter in accordance with subsection (b) if—
(1) the board of directors of the corporation approves a resolution permitting facilitation by the corporation of the conduct of research, education, or both at the other Department medical center or medical centers concerned; and
(2) the Secretary approves the resolution of the corporation under paragraph (1).
(Added
Editorial Notes
References in Text
Section 501(c)(3) of the Internal Revenue Code of 1986, referred to in subsec. (e), is classified to
Amendments
2010—Subsec. (a).
Subsecs. (b) to (d).
Subsec. (e).
Subsec. (f).
1999—Subsec. (a).
1996—Subsec. (b).
1992—Subsec. (b).
1991—
Subsec. (a).
Subsec. (b).
Statutory Notes and Related Subsidiaries
Effective Date of 1992 Amendment
Ratification of Actions of Secretary of Veterans Affairs During Lapsed Period
"(1) A failure to dissolve a nonprofit corporation established under
"(2) The establishment of a nonprofit corporation for approved research under
§7362. Purpose of corporations
(a) A corporation established under this subchapter shall be established to provide a flexible funding mechanism for the conduct of approved research and education at one or more Department medical centers and to facilitate functions related to the conduct of research as described in
(b) For purposes of this section, the term "education" includes education and training and means the following:
(1) In the case of employees of the Veterans Health Administration, such term means work-related instruction or other learning experiences to—
(A) improve performance of current duties;
(B) assist employees in maintaining or gaining specialized proficiencies; and
(C) expand understanding of advances and changes in patient care, technology, and health care administration.
(2) In the case of veterans under the care of the Veterans Health Administration, such term means instruction or other learning experiences related to improving and maintaining the health of veterans and includes education and training for patients and families and guardians of patients.
(Added
Editorial Notes
References in Text
Amendments
2010—Subsec. (a).
Subsec. (b).
Subsec. (b)(1).
Subsec. (b)(2).
1999—
1991—
1 See References in Text note below.
§7363. Board of directors; executive director
(a) The Secretary shall provide for the appointment of a board of directors for any corporation established under this subchapter. The board shall include—
(1) with respect to the Department medical center—
(A)(i) the director (or directors of each Department medical center, in the case of a multi-medical center research corporation);
(ii) the chief of staff; and
(iii) as appropriate for the activities of such corporation, the associate chief of staff for research and the associate chief of staff for education; or
(B) in the case of a Department medical center at which one or more of the positions referred to in subparagraph (A) do not exist, the official or officials who are responsible for carrying out the responsibilities of such position or positions at the Department medical center; and
(2) subject to subsection (c), not less than two members who are not officers or employees of the Federal Government and who have backgrounds, or business, legal, financial, medical, or scientific expertise, of benefit to the operations of the corporation.
(b) Each such corporation shall have an executive director who shall be appointed by the board of directors with the concurrence of the Under Secretary for Health of the Department. The executive director of a corporation shall be responsible for the operations of the corporation and shall have such specific duties and responsibilities as the board may prescribe.
(c) An individual appointed under subsection (a)(2) to the board of directors of a corporation established under this subchapter may not be affiliated with or employed by any entity that is a source of funding for research or education by the Department unless that source of funding is a governmental entity or an entity the income of which is exempt from taxation under the Internal Revenue Code of 1986.
(Added
Editorial Notes
References in Text
The Internal Revenue Code of 1986, referred to in subsec. (c), is classified generally to Title 26, Internal Revenue Code.
Amendments
2010—Subsec. (a)(1).
Subsec. (a)(2).
Subsec. (c).
1999—Subsec. (a)(1).
Subsec. (a)(2).
Subsec. (c).
1996—Subsec. (c).
1992—Subsec. (b).
1991—
Subsec. (a).
Subsec. (a)(2).
Subsec. (b).
Subsec. (c).
§7364. General powers
(a)
(A) accept, administer, retain, and spend funds derived from gifts, contributions, grants, fees, reimbursements, and bequests from individuals and public and private entities;
(B) enter into contracts and agreements with individuals and public and private entities;
(C) subject to paragraph (2), set fees for education and training facilitated under
(D) reimburse amounts to the applicable appropriation account of the Department for the Office of General Counsel for any expenses of that Office in providing legal services attributable to research and education agreements under this subchapter; and
(E) employ such employees as the corporation considers necessary for such purposes and fix the compensation of such employees.
(2) Fees charged pursuant to paragraph (1)(C) for education and training described in that paragraph to individuals who are officers or employees of the Department may not be paid for by any funds appropriated to the Department.
(3) Amounts reimbursed to the Office of General Counsel under paragraph (1)(D) shall be available for use by the Office of the General Counsel only for staff and training, and related travel, for the provision of legal services described in that paragraph and shall remain available for such use without fiscal year limitation.
(b)
(2) A Department medical center may reimburse the corporation for all or a portion of the pay, benefits, or both of an employee of the corporation who is assigned to the Department medical center if the assignment is carried out pursuant to subchapter VI of
(3) A Department medical center may retain and use funds provided to it by a corporation established under this subchapter. Such funds shall be credited to the applicable appropriation account of the Department and shall be available, without fiscal year limitation, for the purposes of that account.
(c)
(d)
(e)
(Added
Editorial Notes
References in Text
Section 501(c)(3) of the Internal Revenue Code of 1986, referred to in subsec. (e), is classified to
Amendments
2021—Subsec. (b)(1).
2010—
1999—Subsec. (c).
1992—Subsec. (b).
1991—
Subsec. (b).
[§7364A. Renumbered §7365]
§7365. Coverage of employees under certain Federal tort claims laws
(a) An employee of a corporation established under this subchapter who is described by subsection (b) shall be considered an employee of the Government, or a medical care employee of the Veterans Health Administration, for purposes of the following provisions of law:
(1)
(2)
(3)
(b) An employee described in this subsection is an employee who—
(1) has an appointment with the Department, whether with or without compensation;
(2) is directly or indirectly involved or engaged in research or education and training that is approved in accordance with procedures established by the Under Secretary for Health for research or education and training; and
(3) performs such duties under the supervision of Department personnel.
(Added
Editorial Notes
Prior Provisions
A prior section 7365, added
Amendments
2010—
§7366. Accountability and oversight
(a)(1)(A) The records of a corporation established under this subchapter shall be available to the Secretary.
(B) For the purposes of
(2) Such a corporation shall be considered an agency for the purposes of
(b)(1) Each corporation shall submit to the Secretary each year a report providing a detailed statement of the operations, activities, and accomplishments of the corporation during that year.
(2)(A) A corporation with revenues in excess of $500,000 for any year shall obtain an audit of the corporation for that year.
(B) A corporation with annual revenues between $100,000 and $500,000 shall obtain an audit of the corporation at least once every three years.
(C) Any audit under this paragraph shall be performed by an independent auditor.
(3) The corporation shall include in each report to the Secretary under paragraph (1) the following:
(A) The most recent audit of the corporation under paragraph (2).
(B) The most recent Internal Revenue Service Form 990 "Return of Organization Exempt from Income Tax" or equivalent and the applicable schedules under such form.
(c) Each director, officer, and employee of a corporation established under this subchapter shall be subject to a conflict of interest policy adopted by that corporation.
(d) The Secretary shall submit to the Committees on Veterans' Affairs of the Senate and House of Representatives an annual report on the corporations established under this subchapter. The report shall set forth the following information:
(1) The location of each corporation.
(2) The amount received by each corporation during the previous year, including—
(A) the total amount received;
(B) the amount received from governmental entities for research and the amount received from governmental entities for education;
(C) the amount received from all other sources for research and the amount received from all other sources for education; and
(D) if an amount received from a source referred to in subparagraph (C) exceeded $25,000, information that identifies the source.
(3) The amount expended by each corporation during the year, including—
(A) the amount expended for salary for research staff, the amount expended for salary for education staff, and the amount expended for salary for support staff;
(B) the amount expended for direct support of research and the amount expended for direct support of education; and
(C) if the amount expended with respect to any payee exceeded $50,000, information that identifies the payee.
(4) The amount expended by each corporation during the year for travel conducted in conjunction with research and the amount expended for travel in conjunction with education.
(Added
Editorial Notes
Amendments
2022—Subsec. (a)(1)(B).
2010—Subsec. (b).
Subsec. (c).
"(c)(1) Each member of the board of directors of a corporation established under this subchapter, each employee of such a corporation, and each employee of the Department who is involved in the functions of the corporation during any year shall be subject to Federal laws and regulations applicable to Federal employees with respect to conflicts of interest in the performance of official functions.
"(2) Each corporation established under this subchapter shall each year submit to the Secretary a statement signed by the executive director of the corporation verifying that each director and employee has certified awareness of the laws and regulations referred to in paragraph (1) and of the consequences of violations of those laws and regulations in the same manner as Federal employees are required to so certify."
Subsec. (d)(3)(C).
2003—Subsec. (c).
2001—Subsec. (d)(2)(D).
1999—Subsec. (d)(2)(B).
Subsec. (d)(2)(C).
Subsec. (d)(2)(D).
Subsec. (d)(3)(A).
Subsec. (d)(3)(B).
Subsec. (d)(4).
1996—Subsec. (b).
Subsec. (c)(2).
Subsec. (d).
1991—
Subsec. (a)(1)(A).
Subsec. (a)(1)(B).
Subsec. (b).
Subsec. (c).
Subsec. (c)(2).
Subsec. (d).
Statutory Notes and Related Subsidiaries
Effective Date of 2001 Amendment
[§7367. Repealed. Pub. L. 107–14, §8(a)(14)(A), June 5, 2001, 115 Stat. 35 ]
Section, added
[§7368. Repealed. Pub. L. 110–387, title VIII, §806(a), Oct. 10, 2008, 122 Stat. 4141 ]
Section, added
SUBCHAPTER V—RESEARCH AND DEVELOPMENT
Editorial Notes
Prior Provisions
A prior subchapter V of this chapter consisting of sections 4151 and 4152, related to quality assurance, prior to repeal by
A prior subchapter VI of this chapter was redesignated as subchapter V.
Amendments
2022—
§7381. Office of Research and Development
(a)
(b)
(c)
(d)
(Added
§7382. Research personnel
(a)
(b)
(A) the research has been approved in accordance with procedures prescribed by the Under Secretary for Health;
(B) the employee conducts research under the supervision of personnel of the Department; and
(C) the Secretary agreed to the terms of such compensation in writing.
(2) An employee described in this subsection is an employee who has an appointment within the Department, whether with or without compensation, and without regard to the source of such compensation.
(Added