38 U.S.C. § 1706 — Management of health care: other requirements

(a) The Secretary must, as far as feasible, design and manage hospital and medical-care programs so care is delivered cost-effectively in the most clinically appropriate setting. (b)(1) The Secretary must ensure the Department and each Veterans Health Administration geographic service area maintain distinct programs or facilities for disabled veterans’ specialized treatment and rehabilitation, including for spinal-cord dysfunction, blindness, amputations, and mental illness. Veterans must have reasonable access, and nationwide capacity may not fall below the Department’s capacity on October 9, 1996. The Secretary must consult the Advisory Committee on Prosthetics and Special Disabilities Programs and the Committee on Care of Severely Chronically Mentally Ill Veterans. (2) Capacity for seriously mentally ill veterans must be measured by service area and nationally by: (A) the number of intensive community-care teams and veterans served; (B) annual opioid-substitution patients and spending; (C) annual dual-diagnosis patients and spending; (D) substance-use-disorder program beds and average occupancy, percentages of direct outpatient admissions with at least two further specialized visits within 30 days compared with 1996, inpatients with a specialized visit within three days after index discharge compared with 1996, outpatients with a specialized visit compared with 1996, and recidivism at each specialized clinic; (E) number and type of specialized mental-health staff at each facility, including satellite, outpatient, and community clinics, compared with 1996; (F) number of mental-health clinics, their staff, and their programs; and (G) total mental-health spending. (3) For spinal-cord dysfunction, traumatic brain injury, blindness, and prosthetics or sensory aids, capacity must be measured by area and nationally by (A) staffed beds and full-time-equivalent employees at spinal-cord and blind-rehabilitation centers, (B) annual prosthetics and sensory-aids spending, and (C) annual traumatic-brain-injury patients and spending. (4) Patient outcomes may not replace or equal the required capacity measurement. (5)(A) By April 1 each year, the Secretary must report to the Senate and House Veterans’ Affairs Committees on compliance by facility and service network, including substance-use-treatment recidivism. (B) Reports must use standardized data and definitions. (C) The Department Inspector General must audit each report and certify its accuracy to Congress. (6)(A) The Under Secretary for Health must set objective job-performance standards for employees responsible for allocating or managing resources related to paragraph (1), including workload, resource allocation, and quality-of-care measures. (B) Those are Veterans Health Administration positions with that responsibility. (C) The Under Secretary must develop the standards with the two named committees. (c) Each Department primary-care facility must develop and carry out a plan to provide mental-health services, directly or by referral, to veterans who need them.