Legislation introduced by U.S. Reps. Tulsi Gabbard (D-Hawaii) and Mike Bost (R-Ill.) to help remedy “the growing problem” of Veterans Affairs medical centers operating for extended periods without a permanent director passed unanimously in the House on Friday, Gabbard’s office said.

“The mission of the VA is to take care of our veterans, and to do so, they need strong, accountable leaders who are committed to that mission,” Gabbard said in a news release. “In Hawaii and many other states, veterans have gone without a permanent VA health center director for more than a year.”

The VA Pacific Islands Health Care System, headquartered on Oahu, has not had a permanent director since February 2016.

More than 20 VA medical centers across the country currently lack a permanent director, including some that have not been staffed by a permanent director in almost two years, according to Gabbard’s office. Interim directors are sometimes appointed for short stints.

“The revolving door of directors serving in an acting capacity undoubtedly hinders the ability to engage in long-term planning and other functions necessary to improve service delivery to our veterans,” Gabbard said.

According to Gabbard, the VA Health Center Management Stability and Improvement Act would:

>> Require the VA secretary to submit to Congress a plan to hire “highly qualified” medical directors for each medical center that lacks a permanent director within 120 days.

>> Identify possible impediments to staffing facilities with permanent directors.

>> Assess the possibility of promoting and training qualified candidates from within the VA for promotion to senior executive service positions.

Wayne Pfeffer, the last permanent head of VA Pacific Islands, abruptly resigned in February 2016. He sent an email to the VA staff saying in part, “It has not been an easy decision for me; however, due to personal reasons, I am retiring and returning to the mainland.”

“I won’t speculate on why he left, but I had long called for his resignation,” Gabbard, who is a major in the Hawaii Army National Guard and served in Iraq, said in an email. She noted that on Pfeffer’s watch, Hawaii had the longest waiting times in the country for new patients wanting to see a primary care physician.

Responding to why the VA has more than 20 medical centers with no permanent director, Gabbard said: “Current and former VA leaders have claimed this problem persists because there’s simply not enough qualified talent to fill vacant medical director positions. This is no excuse. The VA needs to actively recruit the best people to serve our veterans, whether it’s from within the department or not. Whatever the reason, the VA must take action now. There cannot be true accountability until you have a leader responsible for ensuring our veterans are receiving timely, top-quality care.”

Six acting directors have rotated through at VA Pacific Islands, spokeswoman Amy Rohlfs said. The latest is Bonnie Graham, director of the San Francisco VA Health Care System. By rotating in directors from health care systems in Hawaii, California and Nevada that are part of a regional network, continuity was maintained across that network while allowing other directors to bring in their expertise, Rohlfs said in an email.

“This has been a win-win outcome during a very difficult recruitment and hiring process,” she said. She added the VA is hopeful that a new Pacific Islands permanent director will be in place in May.

VA Pacific Islands said it serves about 50,000 veterans throughout Hawaii and the Pacific with facilities in Hawaii, American Samoa, Guam and Saipan. A Sept. 22 health care inspection report by the VA inspector general found that “in addition to the logistical challenges of coordinating care spanning multiple islands and thousands of miles, leadership and staff consistently reported difficulty in recruiting and retaining qualified employees due to the cost of living, distance and isolation of island life.”