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