S 456 IS

To amend title 38, United States Code, to enhance the assurance of efficiency, quality, and patient satisfaction in the furnishing of health care to veterans by the Department of Veterans Affairs, and for other purposes.

March 5, 2001

Ms. SNOWE introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs

To amend title 38, United States Code, to enhance the assurance of efficiency, quality, and patient satisfaction in the furnishing of health care to veterans by the Department of Veterans Affairs, and for other purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Veterans Health Care Quality Assurance Act of 2001'.

SEC. 2. FINDINGS.

Congress makes the following findings:

(1) The Department of Veterans Affairs administers the largest health care network in the United States, including 172 hospitals, 73 home care programs, more than 800 community-based outpatient clinics, and numerous other specialized care facilities.

(2) There are approximately 25,000,000 veterans in the United States, including approximately 19,300,000 veterans of a period of war.

(3) The number of veterans seeking medical care in Department medical facilities is increasing nationwide.

(4) The medical caseload of the Department in fiscal year 2000 was expected to total approximately 3,800,000 cases, an increase of 185,000 cases from fiscal year 1999. The medical caseload of the Department is further expected to increase to 3,900,000 cases in fiscal year 2001. In fiscal year 2001, outpatient visits to Department facilities are expected to increase by 2,600,000 visits to approximately 40,400,000 visits.

(5) The average age of veterans is increasing. The increase in the average age of veterans is expected to result in additional demands for health care services, including more frequent and long-term health needs.

(6) The Department is attempting to meet increasing demand for medical care without substantial increases in appropriations, mainly through efforts to increase efficiency.

(7) The need to treat more veterans without substantial increases in available resources has resulted in serious concerns about the potential for loss of quality of care and of patient satisfaction.

(8) Many of the regional networks and hospitals administered by the Veterans Health Administration report that timely access to high quality health care may be jeopardized by inadequate funding.

SEC. 3. SENSE OF CONGRESS ON MAXIMIZATION AND EFFICIENT USE OF HEALTH CARE RESOURCES BY THE DEPARTMENT OF VETERANS AFFAIRS.

It is the sense of Congress that the Secretary of Veterans Affairs should--

(1) require the directors of the Department of Veterans Affairs health care networks to systematically share information on means of maximizing resources and increasing efficiency without compromising quality of care and patient satisfaction;

(2) require exchange and mentoring programs among and between such networks in order to facilitate the sharing of such information;

(3) provide incentives to such networks to increase efficiency and meet uniform quality and patient satisfaction goals; and

(4) institute a formal oversight process to ensure that--

(A) all such networks meet uniform efficiency goals; and

(B) efforts to increase efficiency are equitable between and among such networks and their facilities.

SEC. 4. QUALITY ASSURANCE AUDITS BY INSPECTOR GENERAL OF THE DEPARTMENT OF VETERANS AFFAIRS.

Section 312 of title 38, United States Code, is amended by adding at the end the following:

`(c)(1) In addition to the other responsibilities of the Inspector General under this section, the Inspector General shall also conduct an audit of the quality of health care furnished by each health care network, and by each health care facility, of the Department.

`(2) Each audit under paragraph (1) shall measure the following:

`(A) The quality of health care furnished by the Department.

`(B) The satisfaction of patients with the health care furnished by the Department.

`(C) Resource and financial management.

`(D) The extent to which the funds allocated to health care programs of the Department are adequate to support such programs.

`(3) An audit shall be conducted under paragraph (1) for each health care network, and for each health care facility, not less often than once every three years.

`(4) The Inspector General may make such recommendations to the Secretary regarding means of improving the quality of health care furnished to veterans as the Inspector General considers appropriate as a result of the audits under this subsection.'.

SEC. 5. INFORMATION ON EFFICIENCY, QUALITY, AND PATIENT SATISFACTION IN PROVISION OF HEALTH CARE BY THE DEPARTMENT OF VETERANS AFFAIRS.

(a) DISSEMINATION AND SHARING OF INFORMATION ON EFFICIENT PROVISION OF HEALTH CARE- (1) The Secretary of Veterans Affairs, acting through the Under Secretary for Health of the Department of Veterans Affairs, shall provide for the dissemination and sharing within and among Department of Veterans Affairs health care networks of information designed to ensure that all Department medical care centers meet uniform efficiency standards in the provision of health care to veterans.

(2) The Secretary shall meet the requirement in paragraph (1) through the publication of guidance materials and best practice summaries and by such other means as the Secretary considers appropriate.

(b) EFFICIENCY GOALS AND QUALITY AND PATIENT SATISFACTION STANDARDS- (1) The Secretary, acting through the Under Secretary for Health, shall issue on an annual basis efficiency goals and quality and patient satisfaction standards in the provision of health care to veterans for each Department health care facility. The efficiency goals and quality and patient satisfaction standards for each facility shall be consistent with such goals and standards as the Secretary shall establish for the Department as a whole.

(2)(A) The Secretary shall, on an annual basis, submit to Congress a report on the extent to which each Department health care facility met the efficiency goals and quality and patient satisfaction standards for such facility under paragraph (1) during the preceding year.

(B) Each report under subparagraph (A) shall set forth a comparison between the performance of each Department health care facility with respect to the efficiency goals and quality and satisfaction standards for such facility for the year involved and the average performance of all Department health care facilities with respect to such goals and standards for such year. The comparison shall be stated in a manner which permits a clear and understandable comparison of the performance of each facility with the average performance of all such facilities.

SEC. 6. OFFICE OF HEALTH CARE QUALITY ASSURANCE.

(a) ESTABLISHMENT- (1) Subchapter II of chapter 73 of title 38, United States Code, is amended by adding at the end the following:

`Sec. 7324. Office of Health Care Quality Assurance

`(a) IN GENERAL- There shall be within the Department an office to be known as the `Office of Health Care Quality Assurance' (in this section referred to as the `Office'). The Office shall be located for administrative purposes within the Office of the Under Secretary for Health.

`(b) DIRECTOR- The head of the Office is the Director of Health Care Quality Assurance.

`(c) STAFF AND SUPPORT- The Under Secretary for Health shall provide the Office with such staff and other support as may be necessary for the Office to carry out effectively its functions under this section.

`(d) FUNCTIONS- The functions of the Office are as follows:

`(1) To ensure the implementation of any recommendations of the Inspector General of the Department as a result of audits conducted by the Inspector General under section 312(c) of this title.

`(2) To collect and ensure the dissemination of information on initiatives, programs, policies, procedures, strategies, and best practices that have been proven to increase efficiency and resource utilization without undermining quality or patient satisfaction in the furnishing of health care to veterans.

`(3) To take such other actions relating to the assurance of quality in the furnishing of health care by the Veterans Health Administration as the Under Secretary for Health considers appropriate.'.

(2) The table of sections at the beginning of chapter 73 of such title is amended by inserting after the item relating to section 7323 the following new item:

`7324. Office of Health Care Quality Assurance.'.

(b) PLACEMENT IN OFFICE OF UNDER SECRETARY FOR HEALTH- Section 7306(a) of title 38, United States Code, is amended--

(1) by redesignating paragraph (9) as paragraph (10); and

(2) by inserting after paragraph (8) the following new paragraph (9):

`(9) The Director of Health Care Quality Assurance, who shall be responsible to the Under Secretary for Health for the operation of the Office of Health Care Quality Assurance.'.

(c) SENSE OF CONGRESS ON DIRECTOR AS ADVOCATE FOR VETERANS- It is the sense of Congress that the Director of the Office of Health Care Quality Assurance should act as an advocate for veterans in carrying out activities under section 7324 of title 38, United States Code, as added by subsection (a).

SEC. 7. REPORT ON EFFICIENCIES IN PROVISION OF HEALTH CARE BY THE DEPARTMENT OF VETERANS AFFAIRS.

(a) REQUIREMENT- Not later than six months after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to Congress a report on efficiencies in the furnishing of health care to veterans in the health care networks and facilities of the Department of Veterans Affairs.

(b) ELEMENTS- The report shall include the following:

(1) A survey of each health care network of the Department, including a summary of the efforts of each network to increase efficiency in the furnishing of health care to veterans.

(2) An assessment of the extent to which such networks, and the facilities within such networks, are or are not implementing uniform, Department-wide policies to increase efficiency in the furnishing of health care to veterans.

END