[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6733 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 6733
To amend title 38, United States Code, to make certain improvements to
the administration of Veterans Integrated Service Networks under laws
administered by the Secretary of Veterans Affairs, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
December 16, 2025
Mr. Bost introduced the following bill; which was referred to the
Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to make certain improvements to
the administration of Veterans Integrated Service Networks under laws
administered by the Secretary 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 ``VISN Reform Act of 2025''.
SEC. 2. ADMINISTRATION OF VETERANS INTEGRATED SERVICE NETWORKS.
(a) Veterans Integrated Service Networks.--Subchapter I of chapter
73 of title 38, United States Code, is amended by inserting after
section 7305 following new section:
``Sec. 7305A. Veterans Integrated Service Networks
``(a) Organization.--The Secretary shall organize the Veterans
Health Administration in eight geographically defined Veterans
Integrated Service Networks (hereinafter referred to as `VISNs').
``(b) Alignment With Mission of Department.--The Secretary shall
ensure that the employees, services, and programs of each VISN are
aligned with the mission of the Department and the specific health care
requirements of each population of veterans in each Network.
``(c) Integrated Health Care System.--The Secretary shall maintain
a regional integrated health care system within the geographic area
served by each VISN by--
``(1) entering into agreements with such other
governmental, public, and private health care organizations and
practitioners as the Secretary considers appropriate to meet
the needs of veterans who reside in the geographic area served
by the VISN;
``(2) providing oversight and management of, and taking
responsibility for, a regional budget for the activities of
each VISN that--
``(A) is aligned with the budget guidelines of the
Department and the Veterans Health Administration; and
``(B) is balanced at the end of each fiscal year;
and
``(3) using national metrics to develop systems to provide
effective, efficient, and safe delivery of health care that is
rated as highly satisfactory by patients and families of
patients.
``(d) Reduction in Duplicate Functions.--The Secretary shall
identify functions that are duplicated across the clinical,
administrative, and operational processes and practices of the Veterans
Health Administration and operate the system of VISNs in a manner
designed to reduce the duplication of such functions.
``(e) Collaboration and Cooperation.--(1) The Secretary shall
operate the VISN system by working to achieve maximum effectiveness
with respect to the provision hospital care, medical services, and
nursing home care, graduate medical education, and research; and
``(2) The Secretary shall assess, on an ongoing basis, the
consolidation or realignment of institutional functions, including
capital asset, safety, and operational support functions, in
collaboration and cooperation with other VISNs and the following
offices or entities within the geographic area served by the VISN:
``(A) The offices of the Veterans Benefits Administration
and the National Cemetery Administration.
``(B) Offices of State and local agencies that have a
mission to provide assistance to veterans.
``(C) Medical schools and other affiliates.
``(D) Federal, State, and local emergency preparedness
organizations.
``(E) Such other offices of the Federal Government as the
Secretary considers appropriate.
``(3) The Director of each VISN shall be responsible for oversight
and for the enforcement of Department policies authorities applicable
to medical facilities of the Department with respect to such medical
facilities located in the geographic area served by such VISN.
``(f) Headquarters.--(1) There shall be only one headquarters
office for each VISN. The Secretary shall choose the location of each
such office and shall ensure each such office is colocated with a
medical center of the Department.
``(2)(A) Each headquarters office established under paragraph (1)
shall have not more than 50 full-time employees. Of such 50 full-time
employees, not more than 10 shall be contractor employees.
``(B)(i) The Secretary may waive the limitation under subparagraph
(A) with respect to a VISN headquarters if the Secretary--
``(I) determines the waiver is necessary to maintain
essential operations of the VISN headquarters during the
implementation of the plan required under paragraph (3); and
``(II) before the date on which the waiver becomes
effective, submits to the Committees on Veterans' Affairs of
the Senate and the House of Representatives a written
certification of such determination.
``(ii) The term of any wavier issued pursuant to clause (i) may not
exceed one year.
``(C) Not less frequently than once each fiscal year, the Secretary
shall submit to the Committees on Veterans' Affairs of the Senate and
the House of Representatives a report on employment at the VISN
headquarters offices during the preceding fiscal year. Each such report
shall include the following for the year covered by the report:
``(i) The number of individuals employed at each VISN
headquarters office.
``(ii) The number of individuals employed by the Veterans
Health Administration in each VISN who are not employed at the
same location as the headquarters office of that VISN.
``(iii) The title for each position of employment at a
headquarters office.
``(iv) The title for each position of employment with the
Veterans Health Administration in each VISN whose duty station
is not at the same location as the headquarters office of that
VISN.
``(v) An assessment of the effect of the employment of
individuals at VISN headquarters offices on the budget of the
Department.
``(3)(A) Not later than 180 days after the date of the enactment of
this section, the Secretary shall develop and submit to the Committees
on Veterans' Affairs of the Senate and the House of Representatives a
comprehensive plan for the reorganization and right-sizing of the
workforce of each VISN headquarters to achieve compliance with the
limitation under paragraph (2)(A).
``(B) The plan under subparagraph (A) shall include, for each VISN
headquarters--
``(i) an identification of all positions currently assigned
to the headquarters, including duty location, occupational
services, pay grade, and primary function;
``(ii) a determination of which positions--
``(I) are essential to execute the mission of the
VISN; and
``(II) are duplicative or administrative in nature;
``(iii) a phased implementation schedule for such plan;
``(iv) a description of any workforce realignments,
reassignments, or separations required to comply with the
limitation under paragraph (2)(A), including voluntary
separation incentive payments or retraining opportunities under
title 5; and
``(v) a certification that the implementation of such plan
will not result in a reduction in access to care or services
furnished to veterans under the laws administered by the
Secretary.
``(C) In developing and implementing the plan required under this
subsection, the Secretary shall--
``(i) ensure that each VISN headquarters is in compliance
with the limitation under paragraph (2)(A) not later than the
date that is three years after the date of the enactment of
this section; and
``(ii) to the maximum extent practicable, offer each
employee of a VISN headquarters who is a licensed physician,
nurse, psychologist, or other healthcare professional such the
opportunity to transfer, without loss of pay or benefits, to a
position appointed under chapter 74 of this title to furnish
direct patient care or clinical support at a Department medical
facility.
``(g) Personnel.--(1) The head of each VISN shall be the Director,
who shall be appointed by the President, by and with the advice and
consent of the Senate. The position of Director of a VISN shall be a
noncareer appointee position. The Director of a VISN shall--
``(A) be responsible for the functions of the VISN; and
``(B) have the authority and responsibility to enforce the
policies and standards of the Department with respect to all
Department personnel employed within the VISN.
``(2) Each employee employed at a facility of the Veterans Health
Administration located in the geographic area served by a VISN shall--
``(A) report directly to the Director of the VISN;
``(B) in the case of an employee who is licensed to
practice in a hospital, work at least one day each week in a
Department medical center located in such geographic area; and
``(C) visit routinely with service line chiefs at
Department medical centers, as directed by the Secretary.
``(h) Triennial Structure Review, Reassessment and Report.--(1) Not
later than three years after the date of the enactment of this section,
and not less frequently than once every three years thereafter, the
Secretary shall conduct a review and assessment of the structure and
operations of the VISNs.
``(2) Not later than 180 days after conducting a review and
assessment under paragraph (1), the Secretary shall submit to the
Committees on Veterans' Affairs of the Senate and the House of
Representatives a report on such review and assessment, which shall
include such recommendations for legislative or regulatory action as
the Secretary considers appropriate to improve the VISNs.''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 73 of such title is amended by inserting after the item
relating to section 7305 the following new item:
``7305A. Veterans Integrated Service Networks''.
SEC. 3. CONSOLIDATION OF VETERANS INTEGRATED SERVICE NETWORKS.
In order to comply with section 7305A of title 38, United States
Code, as added by section 2, not later than one year after the date of
the enactment of this Act, the Secretary of Veterans Affairs shall
geographically realign and combine the Veterans Integrated Service
Networks in effect on the day before the date of enactment of this Act
into geographically defined Veterans Integrated Service Networks as
follows:
(1) Veterans Integrated Service Network 1, Veterans
Integrated Service Network 2, and Veterans Integrated Service
Network 4 shall be Combined into a single Veterans Integrated
Service Network.
(2) Veterans Integrated Service Network 5, Veterans
Integrated Service Network 6, and Veterans Integrated Service
Network 9 shall be combined into a single Veterans Integrated
Service Network.
(3) Veterans Integrated Service Network 10, Veterans
Integrated Service Network 12, and Veteran Integrated Service
Network 23 shall be combined into a single Veterans Integrated
Service Network.
(4) Veterans Integrated Service Network 7, Veterans
Integrated Service Network 8, and Veteran Integrated Service
Network 16 shall be combined into a single Veterans Integrated
Service Network.
(5) Veterans Integrated Service Network 15 and Veteran
Integrated Service Network 19 shall be combined into a single
Veterans Integrated Service Network.
(6) Veterans Integrated Service Network 17 and Veteran
Integrated Service Network 22 shall be combined into a single
Veterans Integrated Service Network.
(7) Veterans Integrated Service Network 20 shall remain a
single Veterans Integrated Service Network.
(8) Veterans Integrated Service Network 21 shall remain a
single Veterans Integrated Service Network.
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