[House Report 119-264]
[From the U.S. Government Publishing Office]


119th Congress   }                                      {       Report
                        HOUSE OF REPRESENTATIVES
 1st Session     }                                      {      119-264

======================================================================



 
    HEALTH PROFESSIONALS SCHOLARSHIP PROGRAM IMPROVEMENT ACT OF 2025

                                _______
                                

 September 10, 2025.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

   Mr. Bost, from the Committee on Veterans' Affairs, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 3767]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Veterans' Affairs, to whom was referred 
the bill (H.R. 3767) to amend title 38, United States Code, to 
provide for a time frame for the employment in the Department 
of Veterans Affairs of participants in the Health Professionals 
Scholarship Program, and for other purposes, having considered 
the same, reports favorably thereon with an amendment and 
recommends that the bill as amended do pass.

                                CONTENTS

                                                                   Page
Amendment........................................................     2
Purpose and Summary..............................................     2
Background and Need for Legislation..............................     3
Hearings.........................................................     4
Subcommittee Consideration.......................................     5
Committee Consideration..........................................     5
Committee Votes..................................................     5
Committee Oversight Findings.....................................     6
Statement of General Performance Goals and Objectives............     6
Earmarks and Tax and Tariff Benefits.............................     6
Committee Cost Estimate..........................................     6
Budget Authority and Congressional Budget Office Cost Estimate...     6
Federal Mandates Statement.......................................     7
Advisory Committee Statement.....................................     7
Applicability to Legislative Branch..............................     7
Statement on Duplication of Federal Programs.....................     7
Section-by-Section Analysis of the Legislation...................     7
Changes in Existing Law Made by the Bill, as Reported............     8
    The amendment is as follows:
  Strike out all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Health Professionals Scholarship 
Program Improvement Act of 2025'' or the ``HPSP Improvement Act of 
2025''.

SEC. 2. TIME FRAME FOR EMPLOYMENT OF PARTICIPANTS IN DEPARTMENT OF 
                    VETERANS AFFAIRS HEALTH PROFESSIONALS SCHOLARSHIP 
                    PROGRAM.

  (a) In General.--Section 7616 of title 38, United States Code, is 
amended by adding at the end the following new subsection:
  ``(d)(1) The Secretary shall ensure that a participant in the 
Scholarship Program receives a contract for employment in the full-time 
clinical practice of such participant's profession at a Department 
facility with the highest need, as determined by the Secretary, by not 
later than 90 days after the later of the following dates:
          ``(A) The date on which the participant completes the course 
        in the Scholarship Program.
          ``(B) The date on which participant obtains all required 
        licensure, certification, or credentialing necessary to 
        practice independently in their field.
  ``(2) A contract referred to in paragraph (1) shall include a 
competitive salary and benefits package consistent with the employment 
standards of the Department.''.
  (b) Report.--
          (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, and every 180 days thereafter until 
        the termination date specified in paragraph (2), the Secretary 
        of Veterans Affairs shall submit to the Committees on Veterans' 
        Affairs of the Senate and House of Representatives a report on 
        the implementation of subsection (d) of section 7616 of title 
        38, United States Code, as added by subsection (a).
          (2) Termination date.--The termination date specified in this 
        paragraph is September 30, 2027.

SEC. 3. PROHIBITION ON SMOKING IN FACILITIES OF THE VETERANS HEALTH 
                    ADMINISTRATION.

  (a) Prohibition.--Section 1715 of title 38, United States Code, is 
amended to read as follows:

``Sec. 1715. Prohibition on smoking in facilities of the Veterans 
                    Health Administration

  ``(a) Prohibition.--No person (including any veteran, patient, 
resident, employee of the Department, contractor, or visitor) may smoke 
on the premises of any facility of the Veterans Health Administration.
  ``(b) Definitions.--In this section:
          ``(1) The term `smoke' includes--
                  ``(A) the use of cigarettes, cigars, pipes, and any 
                other combustion or heating of tobacco; and
                  ``(B) the use of any electronic nicotine delivery 
                system, including electronic or e-cigarettes, vape 
                pens, and e-cigars.
          ``(2) The term `facility of the Veterans Health 
        Administration' means any land or building (including any 
        medical center, nursing home, domiciliary facility, outpatient 
        clinic, or center that provides readjustment counseling) that 
        is--
                  ``(A) under the jurisdiction of the Department of 
                Veterans Affairs;
                  ``(B) under the control of the Veterans Health 
                Administration; and
                  ``(C) not under the control of the General Services 
                Administration.''.
  (b) Conforming Amendments.--
          (1) Table of sections.--The table of sections at the 
        beginning of chapter 17 of such title is amended by striking 
        the item relating to section 1715 and inserting the following:

``1715. Prohibition on smoking in facilities of the Veterans Health 
Administration.''.

          (2) Conforming repeal.--
                  (A) In general.--Section 526 of the Veterans Health 
                Care Act of 1992 (Public Law 102-585; 38 U.S.C. 1715 
                note) is repealed.
                  (B) Clerical amendment.--The table of contents of 
                such Act is amended by striking the item relating to 
                such section.

                          Purpose and Summary

    H.R. 3767, the ``Health Professionals Scholarship Program 
Improvement Act of 2025,'' was introduced by Representative 
Abraham J. Hamadeh of Arizona on June 5, 2025. H.R. 3767, as 
amended, would provide for a time frame for the employment in 
the Department of Veterans Affairs (VA) of participants in the 
Health Professionals Scholarship Program (HPSP). H.R. 3767, as 
amended, incorporates the text of H.R. 3855, introduced by 
Representative Neal P. Dunn of Florida, which was introduced on 
June 10, 2025. H.R. 3855 would prohibit smoking on the premises 
of any facility of the Veterans Health Administration (VHA).

                  Background and Need for Legislation


Section 1: Short Title

    This Act may be cited as the ``Health Professionals 
Scholarship Program Improvement Act of 2025,'' or the ``HPSP 
Improvement Act of 2025.''

Section 2. Time Frame for Employment of Participants in Department of 
        Veterans Affairs Health Professionals Scholarship Program

    For years, VA has faced difficulties in recruiting and 
retaining qualified healthcare professionals, especially in 
rural areas and in high-demand specialties. This created 
concerns about access to timely and quality healthcare for 
veterans. The HPSP was established to address chronic workforce 
shortages, particularly in critical healthcare occupations such 
as nursing, physician assistants, and mental health 
professionals. Under current law,\1\ scholarship participants 
must agree to a period of obligated service in the Veterans 
Health Administration (VHA) in return for payment of 
educational assistance. For physicians who attended school 
full-time, the period of obligation is 18 months for every 
school year. For other health professionals who attended school 
full-time, it is 12 months for every school year for not less 
than 2 years. For any professional who attended school part-
time, it is not less than 1 year.
---------------------------------------------------------------------------
    \1\38 U.S.C. Sec. 7604; 38 C.F.R. Sec. 17.607(c).
---------------------------------------------------------------------------
    As soon as possible after the participant's completion of 
the training program, licensure, or certification--whichever is 
later--VA must offer the participant an opportunity for 
employment. The statute does not specify exactly when this 
employment opportunity must be offered to participants in the 
program.
    This section would hold VA accountable by providing a 
deadline for VA to hire a participant. The Committee is aware 
of instances in which scholarship participants are unemployed 
for months before VA finally offers them a position. In some 
cases, participants are forced to break their service 
obligation and seek work elsewhere just to make ends meet. This 
represents not only the loss of a needed healthcare 
professional, but also the waste of a scholarship opportunity 
lasting up to four years. By requiring VA to provide a contract 
for employment to a scholarship participant within a specified 
period of time, the Committee believes that VA will lose fewer 
newly trained health professionals due to employment delays and 
increase veteran access to high quality healthcare.

Section 3. Prohibition on Smoking in Facilities of the Veterans Health 
        Administration

    The Veterans Health Care Act of 1992 [P.L. 102-585] became 
law on November 4, 1992. Under section 526 of that law, each VA 
medical center, nursing home, or domiciliary care facility is 
required, consistent with medical requirements and limitations, 
to establish a smoking area and provide access to such area for 
patients or residents of the facility who are receiving care or 
services and who desire to smoke tobacco products.
    Since that time, VHA has issued several nationwide policies 
for VA facilities to provide safer smoking environments. In 
March of 2019, VHA issued its most recent policy that required 
all VHA health care facilities to become smoke-free for 
patients, visitors, contractors, volunteers, and vendors 
effective October 1, 2019.\2\ This policy eliminated all 
designated smoking areas on VHA campuses because VHA determined 
that it was unable to establish smoking areas that would be 
consistent with medical requirements and limitations. Although 
permitted under current law,\3\ the policy also prohibited the 
sale of tobacco or other electronic nicotine delivery systems 
(ENDS) at VHA facilities.
---------------------------------------------------------------------------
    \2\VHA Directive 1085, Smoke-Free Policy for Patients, Visitors, 
Contractors, Volunteers, and Vendors at VA Health Care Facilities (Mar. 
5, 2019), https://www.va.gov/vhapublications/
ViewPublication.asp?pub_ID=8242.
    \3\38 U.S.C. Sec. 1715.
---------------------------------------------------------------------------
    This section, would prohibit the use of cigarettes, cigars, 
pipes, and any other combustion or heating of tobacco, as well 
as the use of any ENDS, including electronic or e-cigarettes, 
vape pens, and e-cigars. The prohibition would apply to any 
land or building that is under VA's jurisdiction, under the 
control of VHA, and not under the control of the General 
Services Administration (GSA). The bill, as amended, would also 
rescind the VA's authority to provide tobacco products to 
hospital, nursing home, and domiciliary patients.
    The Committee believes veteran patients and employees have 
a right to be protected as a matter of policy from preventable 
physical harm caused by another person--in this case secondhand 
smoke exposure--when seeking healthcare or working at a VHA 
facility. Many private sector healthcare systems have already 
implemented smoke-free policies. This legislation would codify 
current VHA policy and repeal the outdated law that gave the 
Secretary the authority to provide tobacco products to 
veterans. Given the overwhelming evidence that smoking and 
exposure to secondhand smoke create significant medical risks, 
the Committee finds current law is incompatible with VHA's 
health mission and supports the repeal of section 526 of the 
Veterans Health Care Act [P.L. 102-85] and codification of 
VHA's existing smoke-free policy.

                                Hearings

    On June 12, 2025, the Subcommittee on Health held a 
legislative hearing on H.R. 3767, H.R. 3855, and other bills 
pending before the subcommittee.
    The following witnesses testified:
          The Honorable Gregory F. Murphy, U.S. House of 
        Representatives, 3rd Congressional District, North 
        Carolina; The Honorable Morgan Luttrell, U.S. House of 
        Representatives, 8th Congressional District, Texas; The 
        Honorable Jennifer A. Kiggans, U.S. House of 
        Representatives, 2nd Congressional District, Virginia; 
        The Honorable Abraham J. Hamadeh, U.S. House of 
        Representatives, 8th Congressional District, Arizona; 
        The Honorable Kimberlyn King-Hinds, U.S. House of 
        Representatives, District At Large, Northern Mariana 
        Islands; The Honorable John J. McGuire, U.S. House of 
        Representatives, 5th Congressional District, Virginia; 
        The Honorable Joseph D. Morelle, U.S. House of 
        Representatives, 25th Congressional District, New York; 
        The Honorable Nikki Budzinski, U.S. House of 
        Representatives, 13th Congressional District, Illinois; 
        Dr. Antoinette V. Shappell, Deputy Assistant Under 
        Secretary for Health for Patient Care Services, 
        Veterans Health Administration, U.S. Department of 
        Veterans Affairs; Dr. Ilse Wiechers, Deputy Executive 
        Director, Office of Mental Health, Veterans Health 
        Administration, U.S. Department of Veterans Affairs; 
        Randy Johnson, Constituent, District At Large, Northern 
        Mariana Islands; Cole T. Lyle, Director, Veterans 
        Affairs & Rehabilitation Division, The American Legion; 
        David Coker, President, Fisher House Foundation; John 
        Schmitt, Chief Executive Officer, iXpressGenes, Inc.; 
        Caira Benson, Caregiver Fellow, Elizabeth Dole 
        Foundation.
    The following individuals and organizations submitted 
statements for the record:
          K9s for Warriors, Quality of Life Foundation, 
        National Association of State Veterans Homes, Military 
        Officers Association of America, National Association 
        of Veterans' Research and Education Foundations, 
        iXpressGenes, Inc., Paralyzed Veterans of America, The 
        Honorable Joseph D. Morelle, Concerned Veterans for 
        America, USAA, Student Veterans of America, American 
        Academy of Physician Associates, Veterans of Foreign 
        Wars of the United States.

                       Subcommittee Consideration

    The Subcommittee on Health was discharged from further 
consideration of this legislation on July 23, 2025.

                        Committee Consideration

    On July 23, 2025, the full Committee met in an open markup 
session to consider H.R. 3767.
    An amendment in the nature of a substitute was offered by 
Representative Hamadeh. This amendment would add the text of 
H.R. 3855, to prohibit smoking on the premises of any facility 
of the VHA. This amendment was agreed to by voice vote.
    A motion by Ranking Member Takano of California to report 
H.R. 3767, as amended, favorably to the House of 
Representatives was agreed to by voice vote.

                            Committee Votes

    In compliance with clause 3(b) of rule XIII of the Rules of 
the House of Representatives, no recorded votes were taken on 
amendments or in connection with ordering H.R. 3767, as 
amended, reported to the House.

                      Committee Oversight Findings

    In compliance with clause 3(c)(1) of rule XIII and clause 
(2)(b)(1) of rule X of the Rules of the House of 
Representatives, the Committee's oversight findings and 
recommendations are reflected in the descriptive portions of 
this report.

         Statement of General Performance Goals and Objectives

    In accordance with clause 3(c)(4) of rule XIII of the Rules 
of the House of Representatives, the Committee's performance 
goals and objectives of H.R. 3767, as amended, would be to 
decrease critical staffing shortages and reduce loss of 
participants in the Health Professionals Scholarship Program by 
requiring an offer of employment within 90 days of completion 
of coursework or licensure to qualified program participants. 
The Committee's other performance goal for this bill would be 
to prohibit smoking on the premises of any facility of the 
Veterans Health Administration.

                  Earmarks and Tax and Tariff Benefits

    H.R. 3767, as amended, does not contain any Congressional 
earmarks, limited tax benefits, or limited tariff benefits as 
defined in clause 9 of rule XXI of the Rules of the House of 
Representatives.

                        Committee Cost Estimate

    The Committee adopts as its own the cost estimate on H.R. 
3767, as amended, prepared by the Director of the Congressional 
Budget.

           Budget Authority and Congressional Budget Office 
                             Cost Estimate

    Pursuant to clause (3)(c)(3) of rule XIII of the Rules of 
the House of Representatives, the following is the cost 
estimate for H.R. 3767, as amended, provided by the 
Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974:

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

    H.R. 3767 would require the Department of Veterans Affairs 
(VA) to issue employment contracts to participants in the 
Health Professionals Scholarship Program within 90 days of 
their completion of the program. The bill would also require VA 
to report to the Congress semiannually through 2027 on the 
implementation of that employment requirement. Because VA is 
already required to employ people who complete the scholarship 
program, CBO estimates that implementing the provision would 
not increase staffing levels. Satisfying the reporting 
requirement would cost less than $500,000 over the 2025-2030 
period, CBO estimates. Any spending would be subject to the 
availability of appropriated funds.
    The bill also would prohibit smoking on the premises of any 
Veterans Health Administration facility. According to VA, the 
department already maintains a smoke-free policy at all such 
facilities. Thus, CBO estimates that enacting this provision 
would not affect the federal budget.
    The CBO staff contact for this estimate is Noah Callahan. 
The estimate was reviewed by Christina Hawley Anthony, Deputy 
Director of Budget Analysis.
                                         Phillip L. Swagel,
                             Director, Congressional Budget Office.

                       Federal Mandates Statement

    Section 423 of the Congressional Budget and Impoundment 
Control Act (as amended by Section 101(a)(2) of the Unfunded 
Mandate Reform Act, P.L. 104-4), is inapplicable to H.R. 3767, 
as amended.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act would be created by H.R. 
3767, as amended.

                  Applicability to Legislative Branch

    The Committee finds that H.R. 3767, as amended, does not 
relate to the terms and conditions of employment or access to 
public services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

              Statement on Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII of the Rules of the 
House of Representatives, the Committee finds that no provision 
of H.R. 3767, as amended, establishes or reauthorizes a program 
of the Federal Government known to be duplicative of another 
Federal program, a program that was included in any report from 
the Government Accountability Office to Congress pursuant to 
section 21 of Public Law 111-139, or a program related to a 
program identified in the most recent Catalog of Federal 
Domestic Assistance.

             Section-by-Section Analysis of the Legislation


Section 1: Short title

    This section would establish the short title as the 
``Health Professionals Scholarship Program Improvement Act of 
2025,'' or the ``HPSP Improvement Act of 2025.''

Section 2: Time frame for employment of participants in Department of 
        Veterans Affairs Health Professionals Scholarship Program

    This section would amend 38 U.S.C. Sec. 7616 by adding a 
new subsection (d). This new subsection would require VA to 
offer the scholarship participant a contract for employment 
within 90 days of either program completion or the date on 
which the participant obtains all required licensure, 
certification, or credentialing necessary to practice 
independently in their field. VA would determine which facility 
the participant would be offered a contract for full-time 
clinical employment based on the facility with the highest need 
for that occupation. The new subsection would also require that 
the contract offered to program participants includes a 
competitive salary and benefits package consistent with the 
employment standards of VA.
    This section would also require the Secretary to submit a 
report on the implementation of the new subsection (d) within 
180 days of enactment of the bill and every 180 days thereafter 
until September 30, 2027.

Section 3: Prohibition on smoking in facilities of the Veterans Health 
        Administration

    This section would amend 38 U.S.C. Sec. 1715 to repeal the 
requirement that VA furnish an area where veterans receiving 
hospital or domiciliary care may smoke. The bill, as amended, 
would prohibit any veteran, patient, resident, visitor, 
employee, or contractor from smoking on the premises of any VHA 
facility. The section defines smoking to include the combustion 
or heating of tobacco and any electronic nicotine delivery 
system. It also defines facilities of the VHA to include any 
land or building under the jurisdiction of VA and the control 
of VHA, but excludes buildings controlled by the GSA.

         Changes in Existing Law Made by the Bill, as Reported

    In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italics, existing law in which no change 
is proposed is shown in roman):

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italics, and existing law in which no 
change is proposed is shown in roman):

                      TITLE 38, UNITED STATES CODE



           *       *       *       *       *       *       *
PART II--GENERAL BENEFITS

           *       *       *       *       *       *       *


   CHAPTER 17--HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE

                          SUBCHAPTER I--GENERAL

Sec.
1701. Definitions.
     * * * * * * *

 SUBCHAPTER II--HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL 
                                TREATMENT

     * * * * * * *
[1715. Tobacco for hospitalized veterans.]
1715. Prohibition on smoking in facilities of the Veterans Health 
          Administration.

           *       *       *       *       *       *       *


SUBCHAPTER II--HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL 
TREATMENT

           *       *       *       *       *       *       *


[Sec. 1715. Tobacco for hospitalized veterans

  [The Secretary may furnish tobacco to veterans receiving 
hospital or domiciliary care.]

Sec. 1715. Prohibition on smoking in facilities of the Veterans Health 
                    Administration

  (a) Prohibition.--No person (including any veteran, patient, 
resident, employee of the Department, contractor, or visitor) 
may smoke on the premises of any facility of the Veterans 
Health Administration.
  (b) Definitions.--In this section:
          (1) The term ``smoke'' includes--
                  (A) the use of cigarettes, cigars, pipes, and 
                any other combustion or heating of tobacco; and
                  (B) the use of any electronic nicotine 
                delivery system, including electronic or e-
                cigarettes, vape pens, and e-cigars.
          (2) The term ``facility of the Veterans Health 
        Administration'' means any land or building (including 
        any medical center, nursing home, domiciliary facility, 
        outpatient clinic, or center that provides readjustment 
        counseling) that is--
                  (A) under the jurisdiction of the Department 
                of Veterans Affairs;
                  (B) under the control of the Veterans Health 
                Administration; and
                  (C) not under the control of the General 
                Services Administration.

           *       *       *       *       *       *       *


PART V--BOARDS, ADMINISTRATIONS, AND SERVICES

           *       *       *       *       *       *       *


CHAPTER 76--HEALTH PROFESSIONALS EDUCATIONAL ASSISTANCE PROGRAM

           *       *       *       *       *       *       *


SUBCHAPTER II--SCHOLARSHIP PROGRAM

           *       *       *       *       *       *       *


Sec. 7616. Obligated service

  (a) Each participant in the Scholarship Program shall provide 
service as a full-time employee of the Department for the 
period of obligated service provided in the agreement of the 
participant entered into under section 7603 of this title. Such 
service shall be provided in the full-time clinical practice of 
such participant's profession or in another health-care 
position in an assignment or location determined by the 
Secretary.
  (b)(1) Not later than 60 days before the participant's 
service commencement date, the Secretary shall notify the 
participant of that service commencement date. That date is the 
date for the beginning of the participant's period of obligated 
service.
  (2) As soon as possible after the participant's service 
commencement date, the Secretary shall--
          (A) in the case of a participant who is not a full-
        time employee in the Veterans Health Administration, 
        appoint such participant as such an employee; and
          (B) in the case of a participant who is an employee 
        in the Veterans Health Administration but is not 
        serving in a position for which such participant's 
        course of education or training prepared such 
        participant, assign such participant to such a 
        position.
  (3)(A)(i) In the case of a participant receiving a degree 
from a school of medicine, osteopathy, dentistry, optometry, or 
podiatry, the participant's service commencement date is the 
date upon which the participant becomes licensed to practice 
medicine, osteopathy, dentistry, optometry, or podiatry, as the 
case may be, in a State. However, the Secretary may, at the 
request of such participant, defer such date until the end of 
the period of time required for the participant to complete an 
internship or residency or other advanced clinical training. If 
the participant requests such a deferral, the Secretary shall 
notify the participant that such deferral could lead to an 
additional period of obligated service in accordance with 
paragraph (4) of this subsection.
  (ii) No such period of internship or residency or other 
advanced clinical training shall be counted toward satisfying a 
period of obligated service under this subchapter.
  (B) In the case of a participant receiving a degree from a 
school of nursing, the participant's service commencement date 
is the later of (i) the participant's course completion date, 
or (ii) the date upon which the participant becomes licensed as 
a registered nurse in a State.
  (C) In the case of a participant not covered by subparagraph 
(A) or (B) of this paragraph, the participant's service 
commencement date is the later of (i) the participant's course 
completion date, or (ii) the date the participant meets any 
applicable licensure or certification requirements.
  (4) A participant whose period of obligated service is 
deferred under paragraph (3)(A) of this subsection shall be 
required to undertake internship or residency or other advanced 
clinical training in an accredited program in an educational 
institution which is an affiliated institution (as defined in 
section 7423(d)(1) of this title) and with respect to which the 
affiliation agreement provides that all or part of the 
internship or residency or other advanced clinical training 
will be undertaken in a Department health-care facility. Such a 
participant may, at the discretion of the Secretary and upon 
the recommendation of the Under Secretary for Health, incur an 
additional period of obligated service--
          (A) at the rate of one-half of a calendar year for 
        each year of internship or residency or other advanced 
        clinical training (or a proportionate ratio thereof), 
        if the internship, residency, or advanced clinical 
        training is in a medical specialty necessary to meet 
        the health-care requirements of the Department (as 
        determined under regulations prescribed by the 
        Secretary); or
          (B) at the rate of three-quarters of a calendar year 
        for each year of internship or residency or other 
        advanced clinical training (or a proportionate ratio 
        thereof), if the internship, residency, or advanced 
        clinical training is not in a medical specialty 
        necessary to meet the health-care requirements of the 
        Department (as determined under regulations prescribed 
        by the Secretary).
  (5) The Secretary shall by regulation prescribe the service 
commencement date for participants who were part-time students. 
Such regulations shall prescribe terms as similar as 
practicable to the terms set forth in paragraph (3) of this 
subsection.
  (c)(1) Except as provided in paragraph (2) of this 
subsection, a participant in the Scholarship Program shall be 
considered to have begun serving such participant's period of 
obligated service--
          (A) on the date, after such participant's course 
        completion date, on which such participant (in 
        accordance with subsection (b) of this section) is 
        appointed under this chapter as a full-time employee in 
        the Veterans Health Administration; or
          (B) if the participant is a full-time employee in the 
        Veterans Health Administration on such course 
        completion date, on the date thereafter on which such 
        participant is assigned to a position for which such 
        participant's course of training prepared such 
        participant.
  (2) A participant in the Scholarship Program who on such 
participant's course completion date is a full-time employee in 
the Veterans Health Administration serving in a capacity for 
which such participant's course of training prepared such 
participant shall be considered to have begun serving such 
participant's period of obligated service on such course 
completion date.
  (3) For the purposes of this section, the term ``course 
completion date'' means the date on which a participant in the 
Scholarship Program completes such participant's course of 
education or training under the program.
  (d)(1) The Secretary shall ensure that a participant in the 
Scholarship Program receives a contract for employment in the 
full-time clinical practice of such participant's profession at 
a Department facility with the highest need, as determined by 
the Secretary, by not later than 90 days after the later of the 
following dates:
          (A) The date on which the participant completes the 
        course in the Scholarship Program.
          (B) The date on which participant obtains all 
        required licensure, certification, or credentialing 
        necessary to practice independently in their field.
  (2) A contract referred to in paragraph (1) shall include a 
competitive salary and benefits package consistent with the 
employment standards of the Department.

           *       *       *       *       *       *       *

                              ----------                              


                    VETERANS HEALTH CARE ACT OF 1992

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

  (a) Short Title.--This Act may be cited as the ``Veterans 
Health Care Act of 1992''.
  (b) Table of Contents.--The table of contents of this Act is 
as follows:

Sec. 1. Short title; table of contents.
     * * * * * * *

             TITLE V--GENERAL HEALTH CARE AND ADMINISTRATION

     * * * * * * *

          Subtitle C--Health Care Administration and Personnel

     * * * * * * *
[Sec. 526. Use of Tobacco Products in Department Facilities.]

           *       *       *       *       *       *       *


TITLE V--GENERAL HEALTH CARE AND ADMINISTRATION

           *       *       *       *       *       *       *


Subchapter C--Health Care Administration and Personnel

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[SEC. 526. USE OF TOBACCO PRODUCTS IN DEPARTMENT FACILITIES

  [(a) In General.--The Secretary of Veterans Affairs shall 
take appropriate actions to ensure that, consistent with 
medical requirements and limitations, each facility of the 
Department described in subsection (b)--(1) establishes and 
maintains--
                  [(A) a suitable indoor area in which patients 
                or residents may smoke and which is ventilated 
                in a manner that, to the maximum extent 
                feasible, prevents smoke from entering other 
                areas of the facility; or
                  [(B) an area in a building that--
                          [(i) is detached from the facility;
                          [(ii) is accessible to patients or 
                        residents of the facility; and
                          [(iii) has appropriate heating and 
                        air conditioning; and
          [(2) provides access to an area established and 
        maintained under paragraph (1), consistent with medical 
        requirements and limitations, for patients or residents 
        of the facility who are receiving care or services and 
        who desire to smoke tobacco products.
  [(b) Covered Facilities.--A Department facility referred to 
in subsection (a) is any Department of Veterans Affairs medical 
center, nursing home, or domiciliary care facility.
  [(c) Reports.--(1) Not later than 180 days after the date of 
the enactment of this Act, the Comptroller General shall submit 
to the Committees on Veterans' Affairs of the Senate and House 
of Representatives a report on the feasibility of the 
establishment and maintenance of areas for smoking in 
Department facilities under this section. The report shall 
include information on--
                  [(A) the cost of, and a proposed schedule 
                for, the establishment of such an area at each 
                Department facility covered by this section;
                  [(B) the extent to which the ventilating 
                system of each facility is adequate to ensure 
                that use of the area for smoking does not 
                result in health problems for other patients or 
                residents of the facility; and
                  [(C) the effect of the establishment and 
                maintenance of an area for smoking in each 
                facility on the accreditation score issued for 
                the facility by the Joint Commission on the 
                Accreditation of Health Organizations.
          [(2) Not later than 120 days after the effective date 
        of this section, the Secretary shall submit to the 
        committees referred to in paragraph (1) a report on the 
        implementation of this section. The report shall 
        include a description of the actions taken at each 
        covered facility to ensure compliance with this 
        section.
  [(d) Effective Date.--The requirement to establish and 
maintain areas for smoking under subsection (a) shall take 
effect 60 days after the date on which the Comptroller General 
submits to the committees referred to in subsection (c)(1) that 
report required under that subsection.]

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