[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.

                          ____________________