[Congressional Record (Bound Edition), Volume 155 (2009), Part 5]
[Extensions of Remarks]
[Page 6432]
[From the U.S. Government Publishing Office, www.gpo.gov]




INTRODUCTION OF A BILL TO ESTABLISH THE POSITION OF PHYSICIAN ASSISTANT 
 SERVICES WITHIN THE OFFICE OF THE UNDER SECRETARY OF VETERANS AFFAIRS 
                               FOR HEALTH

                                 ______
                                 

                             HON. PHIL HARE

                              of illinois

                    in the house of representatives

                        Wednesday, March 4, 2009

  Mr. HARE. Madam Speaker, I am pleased to introduce a bill today that 
would elevate the current position of Physicians Assistant (PA) Advisor 
to a full-time Director of PA Services in the VA Central Office.
  I would like to thank my good friend Representative Jerry Moran for 
leading this effort with me, as well as Chairman Filner and Ranking 
Member Buyer and all of my colleagues who are original cosponsors of 
this legislation. I would also like to thank the American Academy of 
Physician Assistants for their tireless work on this bill.
  There are currently about 1,600 PAs serving in the Veterans' Health 
Administration (VHA), including many veterans, National Guard and 
Reservists. PAs are a critical component of the health care delivery 
system and are responsible for roughly one-quarter of all primary care 
patients seen in the VHA.
  The change from the current role of PA Advisor, who works part time 
and is based in the field, to a full-time Director is necessary in 
order to ensure that PAs are being appropriately and effectively 
utilized throughout the VHA. Right now, the PA Advisor is being left 
out of strategic planning discussions and long-term staffing 
initiatives, leaving PAs with no voice and no advocate.
  Additionally, there is a severe disparity throughout VHA facilities 
in how PAs are being utilized, what medical services they can perform, 
and even whether facilities can hire PAs.
  Most importantly, the unnecessary restrictions and widespread 
confusion are causing the VA to miss an important opportunity to 
improve the quality of health care for veterans.
  One of the biggest challenges facing current and future PAs in the VA 
system is their exclusion from any recruitment and retention efforts or 
benefits; the VA designates certain positions, such as physicians and 
nurses, as critical occupations, which are given priority in loan 
repayment and scholarship programs. Since PAs are not designated as a 
critical occupation, they are excluded from these monies, despite the 
fact that the VA has determined PAs and Nurse Practitioners are 
functionally interchangeable and equal in the work they perform.
  The underutilization, lack of recruitment and retention efforts, and 
pay disparity are all leading PAs to not consider the VHA as a viable 
employment option.
  PAs are very important for veterans living in rural areas, like those 
living in my congressional district. Veterans that live in underserved 
areas made the same sacrifices as their urban and suburban 
counterparts. With a disproportionate number of these brave men and 
women being cared for by PAs, it is critical that we establish a system 
that will best serve the needs of those veterans so as not to 
compromise their care.
  Considering the fact that nearly 40 percent of all VA PAs are 
projected to retire in the next five years, the VA is in danger of 
losing its PA workforce unless some attention is paid to this critical 
group.
  My bill will allow the Director of PA Services to become an integral 
component within the VA system, to proactively solve the many issues 
facing PAs, and give PAs a fair and long overdue voice within the VA.
  Madam Speaker, this commonsense legislation promotes quality medical 
care for our veterans and I am proud to introduce it again this 
Congress. This bill (H.R. 2790) passed the House in the 110th Congress, 
but stalled in the Senate. I look forward to working with my 
Congressional colleagues to once again bring this measure to the floor 
so our nation's heroes have access to the care they need and deserve.

                          ____________________