[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 426 Introduced in Senate (IS)]

<DOC>






115th CONGRESS
  1st Session
                                 S. 426

   To increase educational assistance provided by the Department of 
Veterans Affairs for education and training of physician assistants of 
the Department, to establish pay grades and require competitive pay for 
    physician assistants of the Department, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 16, 2017

  Mr. Tester (for himself, Ms. Baldwin, and Mr. Brown) introduced the 
 following bill; which was read twice and referred to the Committee on 
                           Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
   To increase educational assistance provided by the Department of 
Veterans Affairs for education and training of physician assistants of 
the Department, to establish pay grades and require competitive pay for 
    physician assistants of the Department, 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 ``Grow Our Own Directive: Physician 
Assistant Employment and Education Act of 2017''.

SEC. 2. PILOT PROGRAM TO PROVIDE EDUCATIONAL ASSISTANCE TO PHYSICIAN 
              ASSISTANTS TO BE EMPLOYED AT THE DEPARTMENT OF VETERANS 
              AFFAIRS.

    (a) Pilot Program.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        carry out a pilot program to be known as the ``Grow Our Own 
        Directive'' or ``G.O.O.D.'' pilot program (in this section 
        referred to as the ``pilot program'') to provide educational 
        assistance to certain former members of the Armed Forces for 
        education and training as physician assistants of the 
        Department of Veterans Affairs.
            (2) Information on pilot program.--The Secretary shall 
        provide information on the pilot program to eligible 
        individuals under subsection (b), including information on 
        application requirements and a list of entities with which the 
        Secretary has partnered under subsection (i).
    (b) Eligible Individuals.--An individual is eligible to participate 
in the pilot program if the individual--
            (1) has medical or military health experience gained while 
        serving as a member of the Armed Forces;
            (2) has received a certificate, associate degree, 
        baccalaureate degree, master's degree, or postbaccalaureate 
        training in a science relating to health care;
            (3) has participated in the delivery of health care 
        services or related medical services, including participation 
        in military training relating to the identification, 
        evaluation, treatment, and prevention of diseases and 
        disorders; and
            (4) does not have a degree of doctor of medicine, doctor of 
        osteopathy, or doctor of dentistry.
    (c) Duration.--The pilot program shall be carried out during the 
five-year period beginning on the date that is 180 days after the date 
of the enactment of this Act.
    (d) Selection.--
            (1) In general.--The Secretary shall select eligible 
        individuals under subsection (b) to participate in the pilot 
        program.
            (2) Priority for selection.--In selecting individuals to 
        participate in the pilot program under paragraph (1), the 
        Secretary shall give priority to the following individuals:
                    (A) Individuals who participated in the 
                Intermediate Care Technician Pilot Program of the 
                Department that was carried out by the Secretary 
                between January 2011 and February 2015.
                    (B) Individuals who agree to be employed as a 
                physician assistant for the Veterans Health 
                Administration at a medical facility of the Department 
                located in a community that--
                            (i) is designated as a medically 
                        underserved population under section 
                        330(b)(3)(A) of the Public Health Service Act 
                        (42 U.S.C. 254b(b)(3)(A)); and
                            (ii) is in a State with a per capita 
                        population of veterans of more than 9 percent 
                        according to the National Center for Veterans 
                        Analysis and Statistics and the United States 
                        Census Bureau.
    (e) Educational Assistance.--
            (1) In general.--In carrying out the pilot program, the 
        Secretary shall provide educational assistance to individuals 
        participating in the pilot program, including through the use 
        of scholarships, to cover the costs to such individuals of 
        obtaining a master's degree in physician assistant studies or a 
        similar master's degree.
            (2) Use of existing programs.--In providing educational 
        assistance under paragraph (1), the Secretary shall use the 
        Department of Veterans Affairs Health Professionals Educational 
        Assistance Program under chapter 76 of title 38, United States 
        Code, and such other educational assistance programs of the 
        Department as the Secretary considers appropriate.
            (3) Use of scholarships.--The Secretary shall provide not 
        fewer than 35 new scholarships under the pilot program to 
        individuals participating in the pilot program during each year 
        in which the pilot program is carried out.
    (f) Period of Obligated Service.--
            (1) In general.--The Secretary shall enter into an 
        agreement with each individual participating in the pilot 
        program in which such individual agrees to be employed as a 
        physician assistant for the Veterans Health Administration for 
        a period of obligated service specified in paragraph (2).
            (2) Period specified.--With respect to each individual 
        participating in the pilot program, the period of obligated 
        service specified in this paragraph for the individual is--
                    (A) if the individual is participating in the pilot 
                program through a program described in subsection 
                (e)(2) that specifies a period of obligated service, 
                the period specified with respect to such program; or
                    (B) if the individual is participating in the pilot 
                program other than through a program described in such 
                subsection, or if such program does not specify a 
                period of obligated service, a period of three years or 
                such other period as the Secretary considers 
                appropriate for purposes of the pilot program.
    (g) Breach.--
            (1) Liability.--Except as provided in paragraph (2), an 
        individual who participates in the pilot program and fails to 
        satisfy the period of obligated service under subsection (f) 
        shall be liable to the United States, in lieu of such obligated 
        service, for the amount that has been paid or is payable to or 
        on behalf of the individual under the pilot program, reduced by 
        the proportion that the number of days served for completion of 
        the period of obligated service bears to the total number of 
        days in the period of obligated service of such individual.
            (2) Exception.--If an individual is participating in the 
        pilot program through a program described in subsection (e)(2) 
        that specifies a period of obligated service, the liability of 
        the individual for failing to satisfy the period of obligated 
        service under subsection (f) shall be determined as specified 
        with respect to such program.
    (h) Mentors.--The Secretary shall ensure that a physician assistant 
mentor or mentors are available for individuals participating in the 
pilot program at each facility of the Veterans Health Administration at 
which a participant in the pilot program is employed.
    (i) Partnerships.--In carrying out the pilot program, the Secretary 
shall seek to partner with the following:
            (1) Not fewer than 15 institutions of higher education 
        that--
                    (A) offer a master's degree program in physician 
                assistant studies or a similar area of study that is 
                accredited by the Accreditation Review Commission on 
                Education for the Physician Assistant; and
                    (B) agree--
                            (i) to guarantee seats in such master's 
                        degree program for individuals participating in 
                        the pilot program who meet the entrance 
                        requirements for such master's degree program; 
                        and
                            (ii) to provide individuals participating 
                        in the pilot program with information on 
                        admissions criteria and the admissions process.
            (2) Other institutions of higher education that offer 
        programs in physician assistant studies or other similar areas 
        of studies that are accredited by the Accreditation Review 
        Commission on Education for the Physician Assistant.
            (3) The Transition Assistance Program of the Department of 
        Defense.
            (4) The Veterans' Employment and Training Service of the 
        Department of Labor.
            (5) Programs carried out under chapter 41 of title 38, 
        United States Code, for the purpose of marketing and 
        advertising the pilot program to veterans and members of the 
        Armed Forces who may be interested in the pilot program.
    (j) Administration of Pilot Program.--For purposes of carrying out 
the pilot program, the Secretary shall appoint or select within the 
Office of Physician Assistant Services of the Veterans Health 
Administration the following:
            (1) A Deputy Director for Education and Career Development 
        of Physician Assistants who--
                    (A) is a physician assistant, a veteran, and 
                employed by the Department as of the date of the 
                enactment of this Act;
                    (B) is responsible for--
                            (i) overseeing the pilot program;
                            (ii) recruiting candidates to participate 
                        in the pilot program;
                            (iii) coordinating with individuals 
                        participating in the pilot program and 
                        assisting those individuals in applying and 
                        being admitted to a master's degree program 
                        under the pilot program; and
                            (iv) providing information to eligible 
                        individuals under subsection (b) with respect 
                        to the pilot program; and
                    (C) may be employed in the field at a medical 
                center of the Department.
            (2) A Deputy Director of Recruitment and Retention who--
                    (A) is a physician assistant, a veteran, and 
                employed by the Department as of the date of the 
                enactment of this Act;
                    (B) is responsible for--
                            (i) identifying and coordinating the needs 
                        of the pilot program;
                            (ii) assisting the Secretary in providing 
                        mentors under subsection (h) to participants in 
                        the pilot program; and
                            (iii) coordinating the staff of facilities 
                        of the Veterans Health Administration with 
                        respect to identifying employment positions and 
                        mentors under subsection (h) for participants 
                        in the pilot program; and
                    (C) may be employed in the field at a medical 
                center of the Department.
            (3) A recruiter who--
                    (A) reports directly to the Deputy Director of 
                Recruitment and Retention appointed or selected under 
                paragraph (2); and
                    (B) works with the Workforce Management and 
                Consulting Office and the Healthcare Talent Management 
                Office of the Veterans Health Administration to develop 
                and implement national recruiting strategic plans for 
                the recruitment and retention of physician assistants 
                within the Department.
            (4) An administrative assistant, compensated at a rate not 
        less than level GS-6 of the General Schedule, or equivalent, 
        who assists with administrative duties relating to the pilot 
        program in the Office of Physician Assistant Services and such 
        other duties as determined by the Secretary to ensure that the 
        Office runs effectively and efficiently.
    (k) Report.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs, 
        in collaboration with the Secretary of Labor, the Secretary of 
        Defense, and the Secretary of Health and Human Services, shall 
        submit to Congress a report on the pilot program.
            (2) Elements.--The report required by paragraph (1) shall 
        include the following:
                    (A) The extent to which the pilot program is 
                effective in improving the ability of eligible 
                individuals under subsection (b) to become physician 
                assistants.
                    (B) An examination of whether the pilot program is 
                achieving the goals of--
                            (i) enabling individuals to build on 
                        medical skills gained as members of the Armed 
                        Forces by entering into the physician assistant 
                        workforce of the Department; and
                            (ii) helping to meet the shortage of 
                        physician assistants employed by the 
                        Department.
                    (C) An identification of such modifications to the 
                pilot program as the Secretary of Veterans Affairs, the 
                Secretary of Labor, the Secretary of Defense, and the 
                Secretary of Health and Human Services consider 
                necessary to meet the goals described in subparagraph 
                (B).
                    (D) An assessment of whether the pilot program 
                could serve as a model for other programs of the 
                Department to assist individuals in obtaining 
                certification and employment in other health care 
                fields.
    (l) Source of Amounts.--Not less than $8,000,000 of the amount 
necessary to carry out the pilot program shall be derived from amounts 
appropriated to the Department of Veterans Affairs before the date of 
the enactment of this Act.

SEC. 3. MINIMUM NUMBER OF SCHOLARSHIPS FOR PHYSICIAN ASSISTANTS UNDER 
              EDUCATION ASSISTANCE PROGRAMS OF THE DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) Health Professional Scholarship Program.--
            (1) In general.--Subchapter II of chapter 76 of title 38, 
        United States Code, is amended by inserting after the item 
        relating to section 7618 the following new item:
``Sec. 7618A. Scholarships for education and training to become 
              physician assistants
    ``(a) In General.--The Secretary shall ensure that not fewer than 
25 new scholarships are awarded each year to individuals for education 
and training to become physician assistants.
    ``(b) New Scholarship Defined.--In this section, the term `new 
scholarship' means a scholarship awarded under the Scholarship Program 
to an individual who has not previously received a scholarship under 
the Scholarship Program.''.
            (2) Clerical amendment.--Chapter 76 of such title is 
        amended by inserting after the item relating to section 7618 
        the following new item:

``7618A. Scholarships for education and training to become physician 
                            assistants.''.
    (b) Employee Incentive Scholarship Program.--
            (1) In general.--Subchapter VI of chapter 76 of title 38, 
        United States Code, is amended by inserting after the item 
        relating to section 7675 the following new item:
``Sec. 7676. Scholarships for education and training to become 
              physician assistants
    ``(a) In General.--The Secretary shall ensure that not fewer than 
25 new scholarships are awarded each year to individuals for education 
and training to become physician assistants.
    ``(b) New Scholarship Defined.--In this section, the term `new 
scholarship' means a scholarship awarded under the Program to an 
individual who has not previously received a scholarship under the 
Program.''.
            (2) Clerical amendment.--Chapter 76 of such title is 
        amended by inserting after the item relating to section 7675 
        the following new item:

``7676. Scholarships for education and training to become physician 
                            assistants.''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on the date that is 180 days after the date of the enactment of 
this Act.

SEC. 4. ESTABLISHMENT OF STANDARDS FOR THE DEPARTMENT OF VETERANS 
              AFFAIRS FOR USING EDUCATIONAL ASSISTANCE PROGRAMS TO 
              EDUCATE AND HIRE PHYSICIAN ASSISTANTS AND INCREASE OF 
              AMOUNTS AVAILABLE FOR PHYSICIAN ASSISTANTS.

    (a) Establishment of Standards.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        establish standards described in paragraph (2) to improve the 
        use by the Department of Veterans Affairs of the Department of 
        Veterans Affairs Health Professionals Educational Assistance 
        Program under chapter 76 of title 38, United States Code, and 
        other educational assistance programs of the Department, 
        including the pilot program under section 2, to educate and 
        hire physician assistants of the Department.
            (2) Standards described.--The standards described in this 
        subsection are the following:
                    (A) Holding directors of medical centers of the 
                Department accountable for failure to use the 
                educational assistance programs described in paragraph 
                (1) and other incentives--
                            (i) to advance employees of the Department 
                        in their education as physician assistants; and
                            (ii) to improve recruitment and retention 
                        of physician assistants.
                    (B) Ensuring that the Department of Veterans 
                Affairs Education Debt Reduction Program under 
                subchapter VII of chapter 76 of such title is available 
                for participants in the pilot program under section 2 
                to fill vacant physician assistant positions at the 
                Department, including by--
                            (i) including in all vacancy announcements 
                        for physician assistant positions a statement 
                        regarding the availability of the Education 
                        Debt Reduction Program; and
                            (ii) informing applicants to physician 
                        assistant positions of their eligibility for 
                        the Education Debt Reduction Program.
                    (C) Monitoring compliance with the application 
                process for educational assistance programs described 
                in paragraph (1) to ensure that such programs are being 
                fully utilized to carry out this section.
                    (D) Creating programs, including through the use of 
                the Department of Veterans Affairs Employee Incentive 
                Scholarship Program under subchapter VI of chapter 76 
                of such title, to encourage employees of the Department 
                to apply to accredited physician assistant programs.
    (b) Increase of Amounts.--To the maximum extent practicable, for 
each year during the five-year period beginning on the date of the 
enactment of this Act, the Secretary shall increase (as compared to the 
previous year) the scholarship amounts provided to individuals under 
subchapters II and VI of chapter 76 of title 38, United States Code, 
and any other relevant educational assistance programs of the 
Department of Veterans Affairs, for courses of education or training to 
become physician assistants of the Department.
    (c) Regulations.--The Secretary shall prescribe such regulations as 
the Secretary considers appropriate to carry out this section.

SEC. 5. PAY GRADES FOR PHYSICIAN ASSISTANTS OF THE DEPARTMENT OF 
              VETERANS AFFAIRS AND COMPETITIVE PAY REQUIREMENTS.

    (a) Establishment of Pay Grades.--Section 7404(b) of title 38, 
United States Code, is amended by adding at the end the following:

``PHYSICIAN ASSISTANT SCHEDULE
``Physician Assistant IV.
``Physician Assistant III.
``Physician Assistant II.
``Physician Assistant I.''.
    (b) Competitive Pay.--Section 7451(a)(2) of such title is amended--
            (1) by redesignating subparagraph (B) as subparagraph (C);
            (2) by inserting after subparagraph (A) the following new 
        subparagraph (B):
            ``(B) Physician assistant.''; and
            (3) in subparagraph (C), as redesignated by paragraph (1), 
        by striking ``and registered nurse'' and inserting ``registered 
        nurse, and physician assistant''.
    (c) National Strategic Plan.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        implement a national strategic plan for the retention and 
        recruitment of physician assistants of the Department of 
        Veterans Affairs that includes the establishment and adoption 
        of standards for the provision of competitive pay to physician 
        assistants of the Department in comparison to the pay of 
        physician assistants in the private sector.
            (2) Report.--Not later than one year after the date of the 
        enactment of this Act, the Secretary shall submit to the 
        Committee on Veterans' Affairs of the Senate and the Committee 
        on Veterans' Affairs of the House of Representatives a report 
        on the implementation of the national strategic plan under 
        paragraph (1).
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