[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]




                              {time}  1700
  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

[[Page H2336]]

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.

[[Page H2337]]

  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.

                              {time}  1715

  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.

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