Improvement of Vet Centers at Department of Veterans Affairs

Pub. L. 117–263, div. E, title LI, § 5126, Dec. 23, 2022, 136 Stat. 3213, provided that:

“(a)

Productivity Expectations for Readjustment Counselors of Vet Centers.—

“(1)

Evaluation of productivity expectations.—

Not later than one year after the date of the enactment of this Act [Dec. 23, 2022], the Secretary of Veterans Affairs shall evaluate productivity expectations for readjustment counselors of Vet Centers, including by obtaining systematic feedback from counselors on such expectations, including with respect to following:

“(A)

Any potential effects of productivity expectations, whether positive or negative, on client care and the welfare of readjustment counselors.

“(B)

Distances readjustment counselors may travel to appointments, especially with respect to serving rural veterans.

“(C)

The possibility that some veterans may not want to use nor benefit from telehealth or group counseling.

“(D)

Availability and access of veteran populations to broadband and telehealth.

“(E)

Any effect of productivity expectations on readjustment counselors, including with respect to recruitment, retention, and welfare.

“(F)

Whether productivity expectations provide incentives or pressure to inaccurately report client visits.

“(G)

Whether directors and readjustment counselors of Vet Centers need additional training or guidance on how productivity expectations are calculated.

“(H)

Such other criteria as the Secretary considers appropriate.

“(2)

Systematic feedback.—

“(A)

In general.—

The Secretary shall—

“(i)

make every effort to ensure that all readjustment counselors of Vet Centers are given the opportunity to fully provide feedback, positive or negative, including through a survey containing open- and close-ended questions, on all items under paragraph (1);

“(ii)

in obtaining feedback under paragraph (1), ensure that the items under paragraph (1) are adequately and completely addressed in a way that permits responses to be relevant to the evaluation of productivity expectations;

“(iii)

collect and safely store the feedback obtained under paragraph (1)—

“(I)

in an electronic database that cannot be altered by any party;

“(II)

in an anonymized manner, in order to protect the privacy of each respondent; and

“(III)

in a manner that allows for evaluation by third parties of the feedback, such as audit of the feedback by the Government Accountability Office; and

“(iv)

provide the feedback obtained under paragraph (1) in an anonymized manner to the working group established under subsection (c).

“(B)

Government accountability office audit.—

Not less frequently than once each year during the five-year period beginning on the date of the enactment of this Act, the Comptroller General of the United States shall audit the feedback obtained from readjustment counselors of Vet Centers under paragraph (1).

“(3)

Implementation of changes.—

Not later than 90 days after the date of the completion of the evaluation required by paragraph (1), the Secretary shall implement any needed changes to the productivity expectations described in such paragraph in order to ensure—

“(A)

quality of care and access to care for veterans; and

“(B)

the welfare of readjustment counselors.

“(4)

Report to congress.—

Not later than 180 days after the date of the completion of the evaluation required by paragraph (1), the Secretary shall submit to Congress a report on—

“(A)

the findings of the evaluation; and

“(B)

any planned or implemented changes described in paragraph (3).

“(5)

Plan for reassessment and implementation.—

“(A)

Plan.—

Not later than one year after the date of the enactment of this Act, the Secretary shall develop and implement a plan for—

“(i)

reassessing productivity expectations for readjustment counselors of Vet Centers, in consultation with such counselors; and

“(ii)

implementing any needed changes to such expectations, as the Secretary determines appropriate.

“(B)

Reassessments.—

Under the plan required by subparagraph (A), the Secretary shall conduct a reassessment described in such paragraph not less frequently than once each year.

“(b)

Staffing Model for Vet Centers.—

“(1)

In general.—

Not later than one year after the date of the enactment of this Act [Dec. 23, 2022], the Secretary of Veterans Affairs shall develop and implement a staffing model for Vet Centers that incorporates key practices in the design of such staffing model.

“(2)

Elements.—

In developing the staffing model under paragraph (1), the Secretary shall—

“(A)

involve key stakeholders, including readjustment counselors, outreach specialists, and directors of Vet Centers;

“(B)

incorporate key work activities and the frequency and time required to conduct such activities;

“(C)

ensure the data used in the model is high quality to provide assurance that staffing estimates are reliable; and

“(D)

incorporate—

“(i)

risk factors, including case complexity;

“(ii)

geography;

“(iii)

availability, advisability, and willingness of veterans to use telehealth or group counseling; and

“(iv)

such other factors as the Secretary considers appropriate.

“(3)

Plan for assessments and updates.—

Not later than one year after the date of the enactment of this Act, the Secretary shall develop a plan for—

“(A)

assessing and updating the staffing model developed and implemented under paragraph (1) not less frequently than once every four years; and

“(B)

implementing any needed changes to such model, as the Secretary determines appropriate.

“(c)

Working Group of Readjustment Counselors, Outreach Specialists, and Directors of Vet Centers.—

“(1)

In general.—

In conducting the evaluation of productivity expectations under subsection (a) (1) and developing the staffing model for Vet Centers under subsection (b)(1), the Secretary of Veterans Affairs shall establish a working group to assess—

“(A)

the efficacy, impact, and composition of performance metrics for such expectations with respect to—

“(i)

quality of care and access to care for veterans; and

“(ii)

the welfare of readjustment counselors and other employees of Vet Centers; and

“(B)

key considerations for the development of such staffing model, including with respect to—

“(i)

quality of care and access to care for veterans and other individuals eligible for care through Vet Centers; and

“(ii)

recruitment, retention, and welfare of employees of Vet Centers.

“(2)

Membership.—

The working group established under paragraph (1) shall be composed of readjustment counselors, outreach specialists, and directors of Vet Centers.

“(3)

Feedback and recommendations.—

The working group established under paragraph (1) shall provide to the Secretary—

“(A)

feedback from readjustment counselors, outreach specialists, and directors of Vet Centers; and

“(B)

recommendations on how to improve—

“(i)

quality of care and access to care for veterans; and

“(ii)

the welfare of readjustment counselors and other employees of Vet Centers.

“(d)

Improvements of Hiring Practices at Vet Centers.—

“(1)

Standardization of position descriptions.—

“(A)

In general.—

Not later than one year after the date of the enactment of this Act [Dec. 23, 2022], the Secretary of Veterans Affairs shall standardize descriptions of position responsibilities at Vet Centers.

“(B)

Reporting requirement.—

In each of the first two annual reports submitted under section 7309(e) of title 38, United States Code, after the date of the enactment of this Act, the Secretary shall include a description of the actions taken by the Secretary to carry out subparagraph (A).

“(2)

Expansion of reporting requirements on readjustment counseling to include actions to reduce staffing vacancies and time to hire.—

[Amended this section.]

“(e)

Report by Government Accountability Office on Vet Center Infrastructure and Future Investments.—

“(1)

In general.—

Not later than one year after the date of the enactment of this Act [Dec. 23, 2022], the Comptroller General of the United States shall submit to Congress a report on physical infrastructure and future investments with respect to Vet Centers.

“(2)

Elements.—

The report required by paragraph (1) shall include the following:

“(A)

An assessment of—

“(i)

the condition of the physical infrastructure of all assets of Vet Centers, whether owned or leased by the Department of Veterans Affairs; and

“(ii)

the short-, medium-, and long-term plans of the Department to maintain and upgrade the physical infrastructure of Vet Centers to address the operational needs of Vet Centers as of the date of the submittal of the report and future needs.

“(B)

An assessment of management and strategic planning for the physical infrastructure of Vet Centers, including whether the Department should buy or lease existing or additional locations in areas with stable or growing populations of veterans.

“(C)