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