[House Report 115-389]
[From the U.S. Government Publishing Office]
115th Congress } { REPORT
HOUSE OF REPRESENTATIVES
1st Session } { 115-389
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VA MANAGEMENT ALIGNMENT ACT OF 2017
_______
November 6, 2017.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Roe of Tennessee, from the Committee on Veterans' Affairs,
submitted the following
R E P O R T
[To accompany H.R. 1066]
[Including cost estimate of the Congressional Budget Office]
The Committee on Veterans' Affairs, to whom was referred
the bill (H.R. 1066) to direct the Secretary of Veterans
Affairs to submit to the Committees on Veterans' Affairs of the
Senate and the House of Representatives a report regarding the
organizational structure of the Department of Veterans Affairs,
and for other purposes, having considered the same, report
favorably thereon without amendment and recommend that the bill
do pass.
CONTENTS
Page
Purpose and Summary.............................................. 2
Background and Need for Legislation.............................. 2
Hearings......................................................... 3
Subcommittee Consideration....................................... 4
Committee Consideration.......................................... 4
Committee Votes.................................................. 4
Committee Oversight Findings..................................... 4
Statement of General Performance Goals and Objectives............ 4
New Budget Authority, Entitlement Authority, and Tax Expenditures 4
Earmarks and Tax and Tariff Benefits............................. 4
Committee Cost Estimate.......................................... 4
Congressional Budget Office Estimate............................. 5
Federal Mandates Statement....................................... 5
Advisory Committee Statement..................................... 5
Constitutional Authority Statement............................... 6
Applicability to Legislative Branch.............................. 6
Statement on Duplication of Federal Programs..................... 6
Disclosure of Directed Rulemaking................................ 6
Section-by-Section Analysis of the Legislation................... 6
Changes in Existing Law Made by the Bill as Reported............. 7
PURPOSE AND SUMMARY
H.R. 1066, the ``VA Management Alignment Act of 2017,''
would require the Department of Veterans Affairs (VA) to submit
a report to Congress on VA's organizational structure.
BACKGROUND AND NEED FOR LEGISLATION
Section 2. Report on the organizational structure of the Department of
Veterans Affairs
In response to concerns about the quality of the care
provided to veterans through the VA healthcare system, section
201 of the Veterans Access, Choice and Accountability Act of
2014 (VACAA) (Public Law 113-146; 128 Stat. 1755) required VA
to contract with a private sector entity to conduct an
independent assessment of the health care furnished in VA
medical facilities. The resultant Independent Assessment of the
Health Care Delivery Systems and Management Processes of VA
(Independent Assessment) of the Veterans Health Administration
(VHA), which manages the VA healthcare system, found the
agency's organizational structure to be, ``intensely,
unnecessarily complex'' and rampant with mistrust and risk
aversion ``resulting in an inability to improve performance
consistently and fully across the system.''\1\ The Independent
Assessment also found VHA suffers from an expanding scope of
activities, confusion around leadership priorities and
strategic direction, limited role clarity, and fragmentation of
authority.\2\ The Independent Assessment further noted VHA's
workforce ``appears to be steadily losing its motivation''
while the attention of VHA's leadership is consumed by
addressing past crises rather than preparing for future
opportunities.\3\
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\1\Independent Assessment of the Health Care Delivery Systems and
Management Processes of the Department of Veterans Affairs. September
1, 2015. https://www.va.gov/opa/choiceact/documents/assessments/
integrated_report.pdf.
\2\Ibid.
\3\Ibid.
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Section 202 of VACAA also required VA to establish the
Commission on Care to examine veterans' access to VA care and
to strategically examine how best to organize the VA healthcare
system, locate VA health care resources, and deliver health
care to veterans through VA over the next 20 years. Like the
Independent Assessment, the Commission on Care also found
serious fault with the organization and management of VHA. For
example, the final report of the Commission on Care found,
``VHA currently lacks effective national policies, a rational
organizational structure, and clear role definitions that would
support effective leadership. . . .''\4\ The Commission on Care
also noted VHA has one the lowest organizational health scores
in all of government.\5\
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\4\Commission on Care Final Report. June 30, 2016. https://
s3.amazonaws.com/sitesusa/wp-content/uploads/sites/912/2016/07/
Commission-on-Care_Final-Report_063016_FOR-WEB.pdf.
\5\Ibid.
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Findings similar to those made by the Independent
Assessment and the Commission on Care regarding the
organization and management of VHA and of other VA entities
have been found in Government Accountability Office and VA
Inspector General reports; have been voiced by veterans,
veteran service organizations, and VA employees; and, have been
common themes in the Committee's recent oversight hearings and
site visits. Accordingly, the Committee believes it is
imperative to improving performance and increasing
accountability for VA to clarify the Department's
organizational structure and the roles, responsibilities, and
lines of authority for key leaders. Section 2 of the bill would
require VA to create a report on the Department's
organizational structure and submit it to the Committees on
Veterans' Affairs of the U.S. House of Representatives and U.S.
Senate. In preparing the report, VA would be required to use
the findings and recommendations of the Independent Assessment,
the Commission on Care, and other relevant studies or reports
including an internal report dated February 28, 2015, entitled,
``Task Force on Improving Effectiveness of VHA Governance:
Report to the VHA Under Secretary for Health.'' VA would also
be required to include in the report clearly delineated roles
and responsibilities of each key leader of the Department and
for each administration, staff office, staff organization or
subordinate entity thereof as well as recommendations for
legislation the Secretary considers appropriate. Section 2 of
the bill defines a ``key leader'' as the Secretary, Deputy
Secretary, Under Secretary, Assistant Secretary, Deputy
Assistant Secretary, Chief Financial Officer, Chief Information
Officer, General Counsel, Inspector General, Director of
Construction and Facilities Management, Chief of Staff,
Chairman of the Board of Veterans' Appeals, Vice Chairman of
the Board of Veterans' Appeals, VISN Director, and medical
facility Director.
HEARINGS
There were no full Committee hearings held on H.R. 1066.
On September 26, 2017, the Subcommittee on Health conducted
a legislative hearing on a number of bills including H.R. 1066.
The following witnesses testified:
The Honorable Debbie Dingell, U.S. House of
Representatives, 12th District, Michigan; The Honorable
Beto O'Rourke, U.S. House of Representatives, 16th
Congressional District, Texas; The Honorable Derek
Kilmer, U.S. House of Representatives, 6th
Congressional District, Washington; The Honorable Steve
King, U.S. House of Representatives, 4th Congressional
District, Iowa; The Honorable Lloyd Smucker, U.S. House
of Representatives, 16th Congressional District,
Pennsylvania; The Honorable Mike Coffman, U.S. House of
Representatives, 6th Congressional District, Colorado;
The Honorable Steve Stivers, U.S. House of
Representatives, 15th Congressional District, Ohio; The
Honorable Ron DeSantis, U.S. House of Representatives,
6th Congressional District, Florida; The Honorable John
Rutherford, U.S. House of Representatives, 4th
Congressional District, Florida; Keronica Richardson,
Assistant Director of Women and Minority Veterans
Outreach for the National Security Division of The
American Legion; Amy Webb, National Legislative Policy
Advisor for AMVETS; and, Harold Kudler M.D., Acting
Assistant Deputy Under Secretary for Health for Patient
Care Services for the Veterans Health Administration of
the U.S. Department of Veterans Affairs, accompanied by
Catherine Biggs-Silvers, Executive Director for
Mission, Planning, and Analysis for the Human Resources
and Administration of the U.S. Department of Veterans
Affairs.
Statements for the record were submitted by:
Blinded Veterans Association, Veterans of Foreign
Wars of the United States, Disabled American Veterans,
Paralyzed Veterans of America, Justice for Vets, and,
Make a Difference America.
SUBCOMMITTEE CONSIDERATION
There was no Subcommittee consideration of H.R. 1066.
COMMITTEE CONSIDERATION
On October 12, 2017, the full Committee met in open markup
session, a quorum being present, and ordered H.R. 1066 to be
reported favorably to the House of Representatives by voice
vote.
COMMITTEE VOTES
In compliance with clause 3(b) of rule XIII of the Rules of
the House of Representatives, there were no recorded votes
taken on amendments or in connection with ordering H.R. 1066
reported to the House. A motion by Representative Tim Walz of
Minnesota, Ranking Member of the Committee on Veterans'
Affairs, to report H.R. 1066 favorably to the House of
Representatives was agreed to by voice vote.
COMMITTEE OVERSIGHT FINDINGS
In compliance with clause 3(c)(1) of rule XIII and clause
(2)(b)(1) of rule X of the Rules of the House of
Representatives, the Committee's oversight findings and
recommendations are reflected in the descriptive portions of
this report.
STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES
In accordance with clause 3(c)(4) of rule XIII of the Rules
of the House of Representatives, the Committee's performance
goals and objectives are to require VA to report on the
different organizational elements of the Department and the
roles and responsibilities of key VA leaders.
NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX EXPENDITURES
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee adopts as its
own the estimate of new budget authority, entitlement
authority, or tax expenditures or revenues contained in the
cost estimate prepared by the Director of the Congressional
Budget Office pursuant to section 402 of the Congressional
Budget Act of 1974.
EARMARKS AND TAX AND TARIFF BENEFITS
H.R. 1066 does not contain any Congressional earmarks,
limited tax benefits, or limited tariff benefits as defined in
clause 9 of rule XXI of the Rules of the House of
Representatives.
COMMITTEE COST ESTIMATE
The Committee adopts as its own the cost estimate on H.R.
1066 prepared by the Director of the Congressional Budget
Office pursuant to section 402 of the Congressional Budget Act
of 1974.
CONGRESSIONAL BUDGET OFFICE COST ESTIMATE
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate
for H.R. 1066 provided by the Congressional Budget Office
pursuant to section 402 of the Congressional Budget Act of
1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, October 19, 2017.
Hon. Phil Roe, M.D.,
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 1066, the VA
Management Alignment Act of 2017.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Ann E.
Futrell.
Sincerely,
Keith Hall.
Enclosure.
H.R. 1066--VA Management Alignment Act of 2017
H.R. 1066 would require the Department of Veterans Affairs
(VA), within 180 days of enactment, to submit a report to the
Congress on the organizational structure of the department. The
bill would direct the report to include the results from
existing studies to assess the roles, responsibilities, and
accountability of employees and offices within the department
and to include recommendations for legislation. Based on an
analysis of information from VA about the necessary resources
to produce such a report, CBO estimates that implementing the
bill would cost less than $500,000 over the 2018-2022 period;
any such spending would be subject to the availability of
appropriated funds.
Enacting H.R. 1066 would not affect direct spending or
revenues; therefore, pay-as-you-go procedures do not apply.
CBO estimates that enacting H.R. 1066 would not increase
net direct spending or on-budget deficits in any of the four
consecutive 10-year periods beginning in 2028.
H.R. 1066 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act.
The CBO staff contact for this estimate is Ann E. Futrell.
The estimate was approved by H. Samuel Papenfuss, Deputy
Assistant Director for Budget Analysis.
FEDERAL MANDATES STATEMENT
The Committee adopts as its own the estimate of Federal
mandates regarding H.R. 1066 prepared by the Director of the
Congressional Budget Office pursuant to section 423 of the
Unfunded Mandates Reform Act.
ADVISORY COMMITTEE STATEMENT
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act would be created by H.R.
1066.
STATEMENT OF CONSTITUTIONAL AUTHORITY
Pursuant to Article I, section 8 of the United States
Constitution, H.R. 1066 is authorized by Congress' power to
``provide for the common Defense and general Welfare of the
United States.''
APPLICABILITY TO LEGISLATIVE BRANCH
The Committee finds that H.R. 1066 does not relate to the
terms and conditions of employment or access to public services
or accommodations within the meaning of section 102(b)(3) of
the Congressional Accountability Act.
STATEMENT ON DUPLICATION OF FEDERAL PROGRAMS
Pursuant to section 3(g) of H. Res. 5, 115th Cong. (2017),
the Committee finds that no provision of H.R. 1066 establishes
or reauthorizes a program of the Federal Government known to be
duplicative of another Federal program, a program that was
included in any report from the Government Accountability
Office to Congress pursuant to section 21 of Public Law 111-
139, or a program related to a program identified in the most
recent Catalog of Federal Domestic Assistance.
DISCLOSURE OF DIRECTED RULEMAKING
Pursuant to section 3(i) of H. Res. 5, 114th Cong. (2015),
the Committee estimates that H.R. 1066 contains no directed
rulemaking that would require the Secretary to prescribe
regulations.
SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION
Section 1. Short title
Section 1 of the bill would provide the short title for
H.R. 1066, as the ``VA Management Alignment Act of 2017.''
Section 2. Report on the organizational structure of the Department of
Veterans Affairs
Section 2(a) of the bill would require the Secretary of
Veterans Affairs to submit a report not later than 180 days
after the date of enactment to the Committees on Veterans'
Affairs of the Senate and House of Representatives regarding
the roles, responsibility, and accountability of elements and
individuals of the Department of Veterans Affairs and include
recommendations for legislation the Secretary considers
appropriate.
Section 2(b) of the bill would require the Secretary, in
creating the report that would be required under section 2(a)
of the bill, to utilize the following: the results of the
Independent Assessment of the Health Care Delivery Systems and
Management Process of the Department of Veterans Affairs
established by section 201 of the Veterans Access, Choice, and
Accountability Act of 2014 (Public Law 113-146); any study or
report by the Commission on Care established by section 202 of
the Veterans Access, Choice and Accountability Act of 2014
(Public Law 113-146); and, other studies or reports including a
report entitled ``Task Force on Improving Effectiveness of VHA
Governance: Report to the VHA Under Secretary for Health''
dated February 28, 2015. Section 2(b) of the bill would also
require the Secretary, in creating the report that would be
required under section 2(a) of the bill, to specify clearly
delineated roles and responsibilities to optimize the
organizational effectiveness and accountability of each:
Administration, staff office, or staff organization;
subordinate organization of each Administration, staff office,
or staff organization; and, key leader of the Department in
relation to any Administration, staff office, staff
organization, Veterans Integrated Service Network, or medical
facility.
Section 2(c) of the bill would define the term ``key leader
of the Department'' to include: the Secretary, the Deputy
Secretary, each Under Secretary, each Assistant Secretary, each
Deputy Assistant Secretary, the Chief Financial Officer, the
Chief Information Officer, the General Counsel, the Inspector
General, the Director of Construction and Facilities
Management, the Chief of Staff, the Chairman of the Board of
Veterans' Appeals, the Vice Chairman of the Board of Veterans'
Appeals, the Director of each Veterans Integrated Service
Network, and the Director of each medical facility.
CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED
If enacted, this bill would make no changes in existing
law.
[all]