[Congressional Record Volume 165, Number 39 (Tuesday, March 5, 2019)]
[House]
[Pages H2335-H2337]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
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VETERANS-SPECIFIC EDUCATION FOR TOMORROW'S HEALTH PROFESSIONALS ACT
General Leave
Mr. TAKANO. Mr. Speaker, I ask unanimous consent that all Members may
have 5 legislative days in which to revise and extend their remarks and
to insert extraneous material on H.R. 1271.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from California?
There was no objection.
Mr. TAKANO. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 1271) to establish in the Department of Veterans Affairs a
pilot program instituting a clinical observation program for pre-med
students preparing to attend medical school.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 1271
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 ``Veterans-Specific Education
for Tomorrow's Health Professionals Act'' or the ``Vet HP
Act''.
SEC. 2. SENSE OF CONGRESS REGARDING DEPARTMENT OF VETERANS
AFFAIRS PILOT PROGRAM FOR CLINICAL OBSERVATION
BY UNDERGRADUATE STUDENTS.
It is the sense of Congress that the pilot program
described in section 3(a) should be designed to--
(1) increase the awareness, knowledge, and empathy of
future health professionals toward the health conditions
common to veterans;
(2) increase the diversity of the recruitment pool of
future physicians of the Department; and
(3) expand clinical observation opportunities for all
students by encouraging students of all backgrounds to
consider a career in the health professions.
SEC. 3. DEPARTMENT OF VETERANS AFFAIRS PILOT PROGRAM FOR
CLINICAL OBSERVATION BY UNDERGRADUATE STUDENTS.
(a) Establishment.--The Secretary of Veterans Affairs shall
carry out a pilot program for a one-year period, beginning
not later than August 15, 2021, to provide certain students
described in subsection (d) a clinical observation experience
at medical centers of the Department of Veterans Affairs.
(b) Medical Center Selection.--The Secretary shall carry
out the pilot program under this section at not fewer than
five medical centers of the Department. In selecting such
medical centers, the Secretary shall ensure regional
diversity among such selected medical centers.
(c) Clinical Observation Sessions.--
(1) Frequency and duration.--In carrying out the pilot
program, the Secretary shall--
(A) provide at least one and not more than three clinical
observation sessions at each medical center selected during
each calendar year;
(B) ensure that each clinical observation session--
(i) lasts between four and six months; and
(ii) to the extent practicable, begins and ends
concurrently with one or more academic terms of an
institution of higher education (as defined in section 101 of
the Higher Education Act of 1965 (20 U.S.C. 1001)); and
(C) ensure that the clinical observation sessions provided
at a medical center have minimal overlap.
(2) Sessions.--The Secretary shall ensure that the pilot
program consists of clinical observation sessions as follows:
(A) Each session shall allow for not fewer than five
students nor greater than 15 students to participate in the
session.
(B) Each session shall consist of not fewer than 20
observational hours nor greater than 40 observational hours.
(C) A majority of the observational hours shall be spent
observing a health professional. The other observational
hours shall be spent in a manner that ensures a robust, well
rounded experience that exposes the students to a variety of
aspects of medical care and health care administration.
(D) Each session shall provide a diverse clinical
observation experience.
(d) Students.--
(1) Selection.--The Secretary shall select to participate
in the pilot program under subsection (a) students who are--
(A) nationals of the United States;
(B) enrolled in an accredited program of study at an
institution of higher education; and
(C) referred by their institution of higher education
following an internal application process.
(2) Priority.--In making such selection, the Secretary
shall give priority to each of the following five categories
of students:
(A) Students who, at the time of the completion of their
secondary education, resided in a health professional
shortage area (as defined in section 332 of the Public Health
Service Act (42 U.S.C. 254e)).
(B) First generation college students (as defined in
section 402A(h)(3) of the Higher Education Act of 1965 (20
U.S.C. 1067q(a))).
(C) Students who have been referred by minority-serving
institutions (as defined in section 371(a) of the Higher
Education Act of 1965 (20 U.S.C. 1067q(a))).
(D) Veterans (as defined in section 101 of title 38, United
States Code).
(E) Students who indicate an intention to specialize in a
health professional occupation identified by the Inspector
General of the Department under section 7412 of title 38,
United States Code, as having a staffing shortage.
(3) Assignment to medical centers.--The Secretary shall
assign students selected under paragraph (1) to medical
centers selected under subsection (b) without regard for
whether such medical centers have staffing shortages in any
health professional occupation pursuant to section 7412 of
title 38, United States Code.
(e) Other Matters.--In carrying out the pilot program under
this section, the Secretary shall--
(1) establish a formal status to facilitate the access to
medical centers of the Department by student observers
participating in the pilot program;
(2) establish standardized legal, privacy, and ethical
requirements for the student observers, including with
respect to--
(A) ensuring that no student observer provides any care to
patients while participating as an observer; and
(B) ensuring the suitability of a student to participate in
the pilot program to ensure that the student poses no risk to
patients;
(3) develop and implement a partnership strategy with
minority-serving institutions to encourage referrals;
(4) create standardized procedures for student observers;
(5) create an online information page about the pilot
program on the internet website of the Department;
(6) publish on the online information page created under
paragraph (5) the locations of such centers, and other
information on the pilot program, not later than 180 days
before the date on which applications are required to be
submitted by potential student observers;
(7) identify medical centers and specific health
professionals participating in the pilot program; and
(8) notify the Committees on Veterans' Affairs of the House
of Representatives and the Senate of the medical centers
selected under subsection (c) within 30 days of selection, to
facilitate program awareness.
(f) Report.--Not later than 180 days after the completion
of the pilot program under subsection (a), the Secretary
shall submit to the Committees on Veterans' Affairs of the
House of Representatives and the Senate a report on the
results of the pilot program, including--
(1) the number and demographics of all applicants, those
accepted to participate in the pilot program, and those who
completed the pilot program; and
(2) if participating institutions of higher education
choose to administer satisfaction surveys that assess the
experience of those who completed the pilot program, the
results of any such satisfaction surveys, provided at the
discretion of the institution of higher education.
SEC. 4. NO ADDITIONAL FUNDS AUTHORIZED.
No additional funds are authorized to be appropriated to
carry out the requirements of this Act. Such requirements
shall be carried out using amounts otherwise authorized to be
appropriated.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
California (Mr. Takano) and the gentleman from Tennessee (Mr. David P.
Roe) each will control 20 minutes.
The Chair recognizes the gentleman from California.
Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in strong support of H.R. 1271, the Vet HP Act.
The Department of Veterans Affairs reported last month that it has
48,985 vacancies. That means about 10 percent of the positions at VA
are unfilled.
Sadly, a majority of these vacancies are Veterans Health
Administration vacancies. VA does not have enough doctors, nurses,
nurse practitioners, physician assistants, and other medical
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providers and support staff to make sure veterans have timely access to
the high quality healthcare delivered by VA. With shortages in areas
like mental health and primary care, it can become increasingly
difficult to maintain a facility's efficiency and quality. That is why
it is so important that VA does everything it can to fill every last
vacancy.
The committee is not blind to the challenge of meeting this laudable
goal. Hospital systems throughout the country also face health provider
shortages. Rural areas and some urban areas are often the most in need
of providers. However, that should not be an excuse for inaction, and
relying solely on community providers who also face shortages and lack
the expertise and cultural competency to provide for veterans' specific
healthcare needs is an incomplete, problematic, and high-cost solution.
The VA must work to recruit and retain talented and mission-driven
clinicians and employees who are guided by one goal: to provide the
best possible care to veterans when they need it.
The bill offered by Congresswoman Kaptur from Ohio is a creative and
necessary step towards ensuring VA is able to fill each vacant
position. The Vet HP Act seeks to expose undergraduate students
considering careers in medicine to experience the VA healthcare
environment directly. By allowing undergraduates to observe the work of
staff at VA medical centers firsthand, the department can begin
recruiting early--by sowing interest in students about the VA's mission
and the healthcare, research, academic, and professional opportunities
available to clinicians at VA medical centers. As an educator of 70
percent of the Nation's healthcare providers, VA can create an early
familiarity with VA among students thinking about or preparing for
careers in medicine.
Our Nation's future healthcare providers may be more likely to choose
residencies at academic affiliates of VA medical centers and careers at
VA if they are more familiar with VA's mission and are able to observe
the improvements VA clinicians are able to make in the lives of those
who have served our Nation.
Moreover, as the veteran population becomes increasingly more
diverse, VA should strive to recruit students from backgrounds as
diverse as the military and veteran population so that VA staff and
clinicians reflect that growing diversity and are better equipped and
able to understand the needs of the veterans they serve.
In an effort to create a pipeline of diverse, mission-focused
students, this bill focuses specifically on students who graduated from
high schools in health professional shortage areas, students who attend
Historically Black Colleges and Universities and other institutions of
higher education that serve minorities, and first-generation college
students.
Giving students this exposure to VA's mission will help address the
VA's 48,985 vacancies so that it can continue to provide the healthcare
veterans need.
I reserve the balance of my time, Mr. Speaker.
Mr. DAVID P. ROE of Tennessee. Mr. Speaker, I yield myself such time
as I may consume.
Mr. Speaker, I rise today in support of H.R. 1271, the Veterans-
Specific Education for Tomorrow's Health Professionals--or Vet HP--Act.
The bill would create a pilot program to provide undergraduate students
with a clinical observation experience at Department of Veterans
Affairs' medical centers.
This bill is sponsored by Congresswoman Marcy Kaptur of Ohio. I
appreciate her efforts to support aspiring medical students by giving
them a window into the healthcare profession. This bill would further
VA's mission to educate the Nation's future clinicians by giving those
who have expressed interest in the medical field an early introduction
to the VA healthcare system.
It is my sincere hope that, if enacted, this pilot program would
inspire the students it serves to pursue careers serving veteran
patients. While this bill did not move through regular order in the
committee this Congress, it did move through regular order last
Congress where it was supported by various veteran service
organizations.
Mr. Speaker, I was proud to work with my Democratic colleagues to get
this bill passed through the House last year, and I am pleased to do so
again here today. I urge all of my colleagues to join me in supporting
this bill, and I reserve the balance of my time.
Mr. TAKANO. Mr. Speaker, I yield 5 minutes to the gentlewoman from
Ohio (Ms. Kaptur), who is my good friend and the author of this bill.
Ms. KAPTUR. Mr. Speaker, I want to thank Chairman Takano for his
staunch leadership for veterans in so many arenas and for moving this
bill through his committee. I also want to thank Ranking Member Phil
Roe for his continued bipartisan support and encouragement.
H.R. 1271, the Vet Health Professionals Act, Vet HP Act for short,
also called the Veterans-Specific Education for Tomorrow's Health
Professionals Act; I am honored to speak on its behalf this evening.
By expanding opportunities for future physicians interested in
serving our Nation's veterans, this legislation will lay the groundwork
to help fill, as was mentioned earlier, the Department of Veterans
Affairs' nearly 50,000 medical vacancies by creating a viable pipeline
for future physicians.
The Vet HP Act creates a 3-year pilot program that will operate in at
least five VA medical centers for premed students to gain clinical
observation experience, allowing them to gain a deeper understanding of
veterans' specific health needs and experiences. We have heard about
some of those this evening.
Several years ago, three premed students--and I will put their names
into the Record--Andrew Frank, Seamus Caragher, and Michael McNamara--
highlighted to my team that included Andrea Kaman, Nora Sarsour, Carrie
Swope, and more recently Margaret McGuinness, our legislative
assistants, the struggles that disadvantaged minority and other young
people who lack personal connections face as they apply for medical
school.
Health schools recommend or require clinical observation hours, but
there is no formal process to apply for these hours. Let me tell you,
Mr. Speaker, in the field of neuropsychiatry it is particularly
difficult. Opportunities to shadow are limited and are often based on
where you go to school or whom you know.
Students who attend schools outside major cities as well as those
whose families lack connections to the medical community find it harder
to shadow and are disadvantaged in medical school admissions. This
places an unfair burden on otherwise qualified students who come from
less affluent communities or even rural areas.
Through their own struggle to access clinical observation experience,
the students realized an immense opportunity. This bill prioritizes
students in medically underserved areas, first-generation college
students, students referred by minority-serving institutions, and
veterans themselves.
It also prioritizes training for students who specialize in health
professions where there is an identified staffing shortage. This
important bill will help narrow the professional gap and ensure we are
training premed students in careers that are in demand and necessary.
For example, the three VA medical centers that service our constituents
in Ohio are located in Cleveland, Ohio; Ann Arbor, Michigan; and the
city of Detroit. They currently have--this is an amazing number--542
medical and dental staff vacancies.
How are we to serve veterans when we don't have enough doctors and
medical professionals to do it?
This bill creates an important shadowing opportunity for health
students and will help strengthen the workforce with a pathway going
into the Department of Veterans Affairs.
Importantly, premed students in this pilot program will gain a deeper
understanding of veterans' specific health needs and experiences, which
is critical for health professionals who treat veterans.
One of our top responsibilities as a Congress is to ensure that
America's veterans receive top quality and timely healthcare from
highly trained professionals. This bill furthers that effort, and I am
pleased it will get a vote this evening.
I would like to thank, again, Chairman Takano and Ranking Member Roe
for bringing this bill to the floor.
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I urge my colleagues on both sides of the aisle to support the bill's
passage to strengthen medical care inside our veterans' healthcare
system and help the future be built through our work here tonight.
Mr. DAVID P. ROE of Tennessee. Mr. Speaker, I yield myself the
balance of my time.
Mr. Speaker, in closing, I strongly support this bill. I have spent
much of my time over the years mentoring students both in high school,
college, and in medical school. I have taught on the clinical faculty
at East Tennessee State University College of Medicine.
I tell the students: Look, you really need to think about going into
medicine if you like to work nights, weekends, and holidays.
That is not usually how I start the conversation. But I look back as
a young man when I started, and I ask myself, having now been serving
in the U.S. Congress, what would I do if I had those choices all over
again?
Unequivocally, I would go back to the examining room and back to the
operating room and take care of patients. It is a phenomenal way to
help people. I think we have to share that.
I am a first-generation college graduate in my family, as many of us
are who serve in this body, and I want to thank both the chairman for
his tremendous support for medical education in the Choice bill that we
passed--it is hard to believe--5 years ago, Mr. Speaker, when the
scandal in Phoenix occurred. We put in that bill 1,500 residency slots
at VAs in primary care so that we would encourage those young doctors
to stay where they are training. Many of us will do that; we will stay
where we have done our training.
So I want to thank Congresswoman Kaptur for her interest in this. I
thank the students she brought up. Those are the future doctors who are
going to be caring for all of us.
Mr. Speaker, I strongly support this bill, I urge my colleagues to,
and I yield back the balance of my time.
Mr. TAKANO. Mr. Speaker, I yield myself the balance of my time.
Mr. Speaker, I appreciate the comments of my colleague, the ranking
member, about our effort to insert 1,500 medical residencies into the
Choice bill. That was one of the great accomplishments of that
particular Congress.
I would point out that we still face shortages nationally of
physicians and specialists, and we face a great challenge with our
medical workforce and our healthcare workforce, and that impacts the
VA's ability to fill these positions.
I particularly want to highlight the gentlewoman from Ohio's comments
about young people who do not have the connections to medical
professionals, or they are not necessarily connected to the
professional segments of our society where they might be exposed to
what it means to be a medical professional and what it means to serve
the VA's mission. I think that her insights and her experience and what
she brings to this bill is a tremendous understanding of the need for
those of our young people who come from lower incomes or who come from
segments of society that could be left behind. We have Americans of
great ability whom we need to recruit and expose to the opportunities
that await them in organizations like the VA.
Let me just say that filling these vacancies is going to be a high
priority of the committee and to poke, prod, cajole, and urge the VA to
do what it needs to do to reform itself in order to make sure that
these positions are filled. Let me emphasize that these positions are
funded, that these are funded positions. They are empty, and that, to
me, also indicates that we have a workforce training challenge before
us.
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H.R. 1271, offered by my colleague, Ms. Kaptur, is one of the
necessary steps that we need to take in order to fill those vacancies.
Mr. Speaker, I urge my colleagues to join me in passing H.R. 1271,
the Vet HP Act, and I yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from California (Mr. Takano) that the House suspend the rules
and pass the bill, H.R. 1271.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill was passed.
A motion to reconsider was laid on the table.
____________________