[Congressional Record Volume 163, Number 128 (Friday, July 28, 2017)]
[House]
[Pages H6540-H6543]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
GROW OUR OWN DIRECTIVE: PHYSICIAN ASSISTANT EMPLOYMENT AND EDUCATION
ACT OF 2017
Mr. ROE of Tennessee. Mr. Speaker, I move to suspend the rules and
pass the bill (H.R. 3262) to require the Secretary of Veterans Affairs
to carry out a 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, to
establish pay grades and require competitive pay for physician
assistants of the Department, and for other purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 3262
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 (g).
(b) Eligible Individuals.--An individual is eligible to
participate in the pilot program if the individual--
[[Page H6541]]
(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) is not eligible to participate in educational
assistance under chapter 30, 31, 32, 33, 34, or 35 of title
38, United States Code, or chapter 1606 or 1607 of title 10,
United States Code;
(4) 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
(5) 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 not less than
250 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
less than 35 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 less 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 and assist the Secretary in providing mentors under
subsection (h) to participants in the pilot program; and
(ii) 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; 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
[[Page H6542]]
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. ESTABLISHMENT OF STANDARDS FOR THE DEPARTMENT OF
VETERANS AFFAIRS FOR USING EDUCATIONAL
ASSISTANCE PROGRAMS TO EDUCATE AND HIRE
PHYSICIAN ASSISTANTS.
(a) In General.--The Secretary of Veterans Affairs shall
establish standards described in subsection (b) 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.
(b) Standards.--The standards described in this subsection
are the following:
(1) Holding directors of medical centers of the Department
accountable for failure to use the educational assistance
programs described in subsection (a) and other incentives--
(A) to advance employees of the Department in their
education as physician assistants; and
(B) to improve recruitment and retention of physician
assistants.
(2) 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--
(A) including in all vacancy announcements for physician
assistant positions the availability of the Education Debt
Reduction Program; and
(B) informing applicants to physician assistant positions
of their eligibility for the Education Debt Reduction
Program.
(3) Monitoring compliance with the application process for
educational assistance programs described in subsection (a)
to ensure that such programs are being fully utilized to
carry out this section.
(4) 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.
(c) Regulations.--The Secretary shall prescribe such
regulations as the Secretary considers appropriate to carry
out this section.
SEC. 4. EXTENSION OF REQUIREMENT FOR COLLECTION OF FEES FOR
HOUSING LOANS GUARANTEED BY SECRETARY OF
VETERANS AFFAIRS.
Section 3729(b)(2) of title 38, United States Code, is
amended--
(1) in subparagraph (A)--
(A) in clause (iii), by striking ``September 30, 2024'' and
inserting ``December 31, 2024''; and
(B) in clause (iv), by striking ``September 30, 2024'' and
inserting ``December 31, 2024'';
(2) in subparagraph (B)--
(A) in clause (i), by striking ``September 30, 2024'' and
inserting ``December 31, 2024''; and
(B) in clause (ii), by striking ``September 30, 2024'' and
inserting ``December 31, 2024'';
(3) in subparagraph (C)--
(A) in clause (i), by striking ``September 30, 2024'' and
inserting ``December 31, 2024''; and
(B) in clause (ii), by striking ``September 30, 2024'' and
inserting ``December 31, 2024''; and
(4) in subparagraph (D)--
(A) in clause (i), by striking ``September 30, 2024'' and
inserting ``December 31, 2024''; and
(B) in clause (ii), by striking ``September 30, 2024'' and
inserting ``December 31, 2024''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Tennessee (Mr. Roe) and the gentleman from Minnesota (Mr. Walz) each
will control 20 minutes.
The Chair recognizes the gentleman from Tennessee.
General Leave
Mr. ROE of Tennessee. Mr. Speaker, I ask unanimous consent that all
Members have 5 legislative days in which to revise and extend their
remarks and include extraneous material.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Tennessee?
There was no objection.
Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I rise today in support of H.R. 3262, as amended, the
Grow Our Own Directive--or GOOD--Physician Assistant Employment and
Education Act of 2017.
The PA profession has a long and storied connection with veterans as
the first class of PAs was primarily composed of Army medics and Navy
corpsmen who served in the Vietnam war.
And I might add, when I did basic training at San Antonio, Texas, at
Fort Sam, one of the first PA classes was there.
Today, the Department of Veterans Affairs is the single largest
employer of PAs in the country. Nevertheless, PAs are consistently
identified as one of the top five professions where VA is experiencing
the largest staffing shortages.
H.R. 3262, as amended, would help solve that by creating a pilot
program to provide assistance to veterans who want to pursue education
and training to become a PA and to serve their fellow veterans by
working at VA medical facilities.
I am grateful to Congresswoman Ann Kuster for sponsoring this
legislation and shepherding it through the legislative process, and I
am confident that it will go a long way in resolving existing PA
recruitment and retention issues, ensuring that VA medical facilities
are appropriately staffed with high-quality PAs and, in turn,
increasing access to care for veteran patients.
Mr. Speaker, I urge all of my colleagues to join me in supporting
H.R. 3262, as amended, and I reserve the balance of my time.
{time} 1115
Mr. WALZ. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I, too, rise in support of H.R. 3262, as amended, the
GOOD Act of 2017, which was introduced by a good friend, someone who
has proven herself to be a dogged champion of veterans, the ranking
member of the Oversight and Investigations Subcommittee, Ms. Kuster.
This important piece of legislation will allow veterans who served as
medics and corpsmen in the military to receive scholarships to train as
physician assistants.
The VA has over 45,000 provider vacancies to fill so that veterans
are not waiting too long for care. In the United States, we face a
provider shortage in general, especially in our rural communities,
where most veterans live. This bill will help address these critical
shortages by providing veterans with an incredible opportunity to aid
their communities and their fellow veterans.
Ms. Kuster's hard work on this legislation and on behalf of veterans
is admirable, and I urge my colleagues to support this bill.
Mr. Speaker, I reserve the balance of my time.
Mr. ROE of Tennessee. Mr. Speaker, it is my privilege to yield 2
minutes to the gentleman from Michigan (Mr. Bergman), who is the
chairman of the Subcommittee on Oversight and Investigations on the
full Veterans' Affairs Committee.
Mr. BERGMAN. Mr. Speaker, for years, the Department of Veterans
Affairs has seen many of its medical personnel leave to pursue
opportunities outside of the VA healthcare system, resulting in fewer
healthcare providers and, ultimately, less access to care for our
veterans. In the First District of Michigan, which I represent, we are
largely a rural district, and our district and our veterans have
suffered more than most on this.
The GOOD Act utilizes a two-pronged approach to address VA's
continuing struggles in recruiting and retaining their physician
assistant workforce. This bill creates a pilot program to provide that
pathway for veterans to receive the education necessary to become a PA
while, simultaneously, requiring the VA to establish a national
strategic plan to recruit and retain a robust and long-term medical
staff.
Our veterans have given so much for our country at exceptional costs,
and they deserve access to timely and high-quality healthcare from
skilled professionals. I am proud to join Ranking Member Kuster from
our Oversight and Investigations Subcommittee in supporting this
bipartisan legislation on behalf of our Nation's veterans.
Mr. Speaker, I urge all of my colleagues to support the bill, H.R.
3262.
Mr. WALZ. Mr. Speaker, it is my pleasure to yield 5 minutes to the
gentlewoman from New Hampshire (Ms. Kuster), the author of this piece
of legislation, the ranking member of the Subcommittee on Oversight and
Investigations.
Ms. KUSTER of New Hampshire. Mr. Speaker, I rise to join my
colleague, General Bergman, in support of our bill, H.R. 3262, the Grow
Our Own Directive: Physician Assistant Employment and Education Act of
2017.
The Department of Veterans Affairs and the entire Nation are
experiencing a shortage of quality physicians and healthcare providers.
For doctors
[[Page H6543]]
alone, the Association of American Medical Colleges estimates that, by
2030, the country could face a doctor shortage of over 100,000
physicians. Access to care will only become a harder problem to solve
the longer it takes to be addressed.
Nonphysician providers, like physician assistants, are an important
part of the solution to this shortage. Physician assistants are highly
trained providers that often focus their training on specialties like
psychiatry, orthopedics, and internal medicine.
It is fitting that my bill would help get more PAs into the VA to
serve veterans. After all, the profession started when a small group of
four Navy corpsmen completed the first PA program started at Duke
University. That first program was based on the fast-tracked training
of doctors during World War II. Veterans and the military have always
been a part of the physician assistant profession.
The PA workforce offers unique value to rural and underserved areas.
In places like northern New Hampshire, in my district, PAs help resolve
shortages for family physicians and primary care physicians, shortages
that have existed for decades.
My bill would leverage the Department of Veterans Affairs to improve
access to quality care for veterans and rural locations alike. It would
create a pilot scholarship program that awards no less than 250
scholarships over 5 years to PAs.
Currently, the VA has approximately 2,000 PAs. My bill would increase
the PA workforce at the VA by over 10 percent.
In exchange for these scholarships, PAs would be required to work at
the VA, and their placement would be focused on sending providers to
rural and underserved areas. We know that if a provider is placed in
New Hampshire, they tend to stay there.
This bill would also help get veterans with medical training in the
workforce and with good-paying jobs. It is crucial that we help our
veterans find excellent career paths that utilize the skills they
learned while in the military service, and it is an added bonus that
these veterans get to take care of their brothers and sisters in arms.
The final provision in my bill was included in the Choice funding
bill we debated just moments ago. This provision would provide PAs in
the VA with competitive pay based on the community they serve. This
provision is crucial because it helps recruit and retain these critical
providers. The GAO recently reported that PAs experience the highest
loss rate of any critical occupation, higher than doctors and nurse
practitioners.
I would like to applaud my colleagues for coming together in a
bipartisan way to craft the Choice funding bill. Not only will the bill
fund the Choice Program for another 6 months, but it includes a number
of important reforms that will improve service for all of our veterans.
These provisions include improved authority for hiring in job shortage
areas, measures to increase accountability within the VA, and my
provision to boost the pay of PAs.
I would like to thank my esteemed colleague on the House Veterans
Affairs' Subcommittee on Oversight and Investigations, Chairman
Bergman. His support for this legislation was crucial to its passage
today. I thank our chairman, Dr. Roe, and our ranking member.
Mr. Speaker, I ask my colleagues to immediately pass this bill.
Mr. ROE of Tennessee. Mr. Speaker, I reserve the balance of my time.
Mr. WALZ. Mr. Speaker, as you heard, I urge my colleagues to support
this smart piece of legislation. But I would like to close by adding,
also, a thank-you to the chairman and to the majority side, once again
showing bipartisanship offering two bills introduced by our side of the
aisle that are being heard here on the floor which can be signed into
law. It is greatly appreciated. It shows that the care of veterans
always comes first. We on the minority side are appreciative of that
courtesy.
Mr. Speaker, I urge my colleagues to support the bill, and I yield
back the balance of my time.
Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I certainly support this bill, and I want to thank both
General Bergman and Ms. Kuster. We made a trip to Afghanistan together
a couple of years ago. She has a dogged--and I will say ``dogged''--
commitment to the veterans in her district and to this country, and I
want to thank her for bringing this piece of legislation up. I believe
it will make a difference, I truly do, when it is implemented.
And I want to thank the ranking member, and his staff and mine, for
bringing a lot of pieces of legislation to the House floor in the last
couple of weeks. This week, especially, we have had some success here,
and that means veterans had success. Certainly, the post-9/11 GI Bill
that was passed this week is an enormous bill and will do good
generations after no one ever remembers who was on this floor debating
that bill. So I want to thank them and thank my colleagues and wish
everyone a safe recess and a healthy recess.
Mr. Speaker, I yield back the balance of my time.
The SPEAKER pro tempore (Mr. Shimkus). The question is on the motion
offered by the gentleman from Tennessee (Mr. Roe) that the House
suspend the rules and pass the bill, H.R. 3262, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
The title of the bill was amended so as to read: ``A bill to require
the Secretary of Veterans Affairs to carry out a 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, and for other purposes.''.
A motion to reconsider was laid on the table.
____________________