H.R. 6733 — VISN Reform Act of 2025

This section establishes a new section 7305A of title 38, United States Code, to organize the Veterans Health Administration (VHA) into eight geographically defined Veterans Integrated Service Networks (VISNs), reducing the current number of 18 VISNs. (As background, VISNs are VHA's regional networks that oversee health care delivery to veterans at medical facilities across the country.) The section requires the Secretary of Veterans Affairs to align each VISN's employees, services, and programs with the Department's mission and veterans' health care needs; maintain a regional integrated health care system through agreements with other health care entities, balanced regional budgets aligned with Department guidelines, and national metrics for effective, efficient, safe, and highly satisfactory care; reduce duplicated functions across VHA's clinical, administrative, and operational processes; and collaborate with other VISNs, VA administrations, state and local veteran agencies, medical affiliates, and emergency organizations to maximize effectiveness in hospital care, medical services, nursing home care, graduate medical education, and research, with VISN directors overseeing Department policies at medical facilities. The section further directs that each VISN have one headquarters office colocated with a Department medical center, limited to 50 full-time equivalent employees (FTEs) with no more than 10 contractor employees; authorizes the Secretary to waive this limit for up to one year with congressional certification if needed for a reorganization plan; requires annual reports to the congressional Veterans' Affairs Committees on VISN headquarters employment, including headcounts, position titles, duty stations, and budget effects; and mandates submission within 180 days of enactment of a comprehensive workforce reorganization plan for each VISN headquarters to achieve the 50-FTE limit, identifying all positions, distinguishing essential from duplicative ones, and providing a phased implementation schedule with any required realignments, reassignments, or separations.

This section directs the Secretary of Veterans Affairs to consolidate the 18 Veterans Integrated Service Networks (VISNs)—regional administrative structures that oversee Department of Veterans Affairs medical centers, clinics, and healthcare delivery for enrolled veterans—into 8 geographically defined VISNs not later than one year after enactment of this Act, as follows: (1) combines VISN 1, VISN 2, and VISN 4 into one VISN; (2) combines VISN 5, VISN 6, and VISN 9 into one VISN; (3) combines VISN 10, VISN 12, and VISN 23 into one VISN; (4) combines VISN 7, VISN 8, and VISN 16 into one VISN; (5) combines VISN 15 and VISN 19 into one VISN; (6) combines VISN 17 and VISN 22 into one VISN; (7) retains VISN 20 as a single VISN; and (8) retains VISN 21 as a single VISN.