38 U.S.C. § 1706 : US Code - Section 1706: Management of health care: other requirements

Search 38 U.S.C. § 1706 : US Code - Section 1706: Management of health care: other requirements

      (a) In managing the provision of hospital care and medical
    services under section 1710(a) of this title, the Secretary shall,
    to the extent feasible, design, establish and manage health care
    programs in such a manner as to promote cost-effective delivery of
    health care services in the most clinically appropriate setting.
      (b)(1) In managing the provision of hospital care and medical
    services under such section, the Secretary shall ensure that the
    Department (and each geographic service area of the Veterans Health
    Administration) maintains its capacity to provide for the
    specialized treatment and rehabilitative needs of disabled veterans
    (including veterans with spinal cord dysfunction, blindness,
    amputations, and mental illness) within distinct programs or
    facilities of the Department that are dedicated to the specialized
    needs of those veterans in a manner that (A) affords those veterans
    reasonable access to care and services for those specialized needs,
    and (B) ensures that overall capacity of the Department (and each
    geographic service area of the Veterans Health Administration) to
    provide such services is not reduced below the capacity of the
    Department, nationwide, to provide those services, as of October 9,
    1996. The Secretary shall carry out this paragraph in consultation
    with the Advisory Committee on Prosthetics and Special Disabilities
    Programs and the Committee on Care of Severely Chronically Mentally
    Ill Veterans.
      (2) For purposes of paragraph (1), the capacity of the Department
    (and each geographic service area of the Veterans Health
    Administration) to provide for the specialized treatment and
    rehabilitative needs of disabled veterans (including veterans with
    spinal cord dysfunction, traumatic brain injury, blindness,
    prosthetics and sensory aids, and mental illness) within distinct
    programs or facilities shall be measured for seriously mentally ill
    veterans as follows (with all such data to be provided by
    geographic service area and totaled nationally):
        (A) For mental health intensive community-based care, the
      number of discrete intensive care teams constituted to provide
      such intensive services to seriously mentally ill veterans and
      the number of veterans provided such care.
        (B) For opioid substitution programs, the number of patients
      treated annually and the amounts expended.
        (C) For dual-diagnosis patients, the number treated annually
      and the amounts expended.
        (D) For substance-use disorder programs - 
          (i) the number of beds (whether hospital, nursing home, or
        other designated beds) employed and the average bed occupancy
        of such beds;
          (ii) the percentage of unique patients admitted directly to
        outpatient care during the fiscal year who had two or more
        additional visits to specialized outpatient care within 30 days
        of their first visit, with a comparison from 1996 until the
        date of the report;
          (iii) the percentage of unique inpatients with substance-use
        disorder diagnoses treated during the fiscal year who had one
        or more specialized clinic visits within three days of their
        index discharge, with a comparison from 1996 until the date of
        the report;
          (iv) the percentage of unique outpatients seen in a facility
        or geographic service area during the fiscal year who had one
        or more specialized clinic visits, with a comparison from 1996
        until the date of the report; and
          (v) the rate of recidivism of patients at each specialized
        clinic in each geographic service area of the Veterans Health
        Administration.

        (E) For mental health programs, the number and type of staff
      that are available at each facility to provide specialized mental
      health treatment, including satellite clinics, outpatient
      programs, and community-based outpatient clinics, with a
      comparison from 1996 to the date of the report.
        (F) The number of such clinics providing mental health care,
      the number and type of mental health staff at each such clinic,
      and the type of mental health programs at each such clinic.
        (G) The total amounts expended for mental health during the
      fiscal year.

      (3) For purposes of paragraph (1), the capacity of the Department
    (and each geographic service area of the Veterans Health
    Administration) to provide for the specialized treatment and
    rehabilitative needs of disabled veterans within distinct programs
    or facilities shall be measured for veterans with spinal cord
    dysfunction, traumatic brain injury, blindness, or prosthetics and
    sensory aids as follows (with all such data to be provided by
    geographic service area and totaled nationally):
        (A) For spinal cord injury and dysfunction specialized centers
      and for blind rehabilitation specialized centers, the number of
      staffed beds and the number of full-time equivalent employees
      assigned to provide care at such centers.
        (B) For prosthetics and sensory aids, the annual amount
      expended.
        (C) For traumatic brain injury, the number of patients treated
      annually and the amounts expended.

      (4) In carrying out paragraph (1), the Secretary may not use
    patient outcome data as a substitute for, or the equivalent of,
    compliance with the requirement under that paragraph for
    maintenance of capacity.
      (5)(A) Not later than April 1 of each year through 2008, the
    Secretary shall submit to the Committees on Veterans' Affairs of
    the Senate and House of Representatives a report on the Secretary's
    compliance, by facility and by service-network, with the
    requirements of this subsection. Each such report shall include
    information on recidivism rates associated with substance-use
    disorder treatment.
      (B) In preparing each report under subparagraph (A), the
    Secretary shall use standardized data and data definitions.
      (C) Each report under subparagraph (A) shall be audited by the
    Inspector General of the Department, who shall submit to Congress a
    certification as to the accuracy of each such report.
      (6)(A) To ensure compliance with paragraph (1), the Under
    Secretary for Health shall prescribe objective standards of job
    performance for employees in positions described in subparagraph
    (B) with respect to the job performance of those employees in
    carrying out the requirements of paragraph (1). Those job
    performance standards shall include measures of workload,
    allocation of resources, and quality-of-care indicators.
      (B) Positions described in this subparagraph are positions in the
    Veterans Health Administration that have responsibility for
    allocating and managing resources applicable to the requirements of
    paragraph (1).
      (C) The Under Secretary shall develop the job performance
    standards under subparagraph (A) in consultation with the Advisory
    Committee on Prosthetics and Special Disabilities Programs and the
    Committee on Care of Severely Chronically Mentally Ill Veterans.
      (c) The Secretary shall ensure that each primary care health care
    facility of the Department develops and carries out a plan to
    provide mental health services, either through referral or direct
    provision of services, to veterans who require such services.