[Federal Register Volume 85, Number 45 (Friday, March 6, 2020)]
[Rules and Regulations]
[Pages 13052-13054]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-04164]



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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AQ62


Health Professional Scholarship Program

AGENCY: Department of Veterans Affairs.

ACTION: Final rule.

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SUMMARY: The Department of Veterans Affairs (VA) is amending its 
regulations that govern the Health Professional Scholarship Program 
(HPSP). The amended regulations ensures that VA award not less than 50 
HPSP scholarships each year to students who are accepted for enrollment 
or are enrolled in a program of education or training that leads to 
employment as a physician or dentist until such a date as VA determines 
the current staffing shortage is reduced. The amended regulation will 
also expand the number of years of obligated service that a HPSP 
participant would have to serve in VA as a physician or a dentist. This 
rulemaking implements the mandates of the VA MISSION Act of 2018.

DATES: This final rule is effective April 6, 2020.

FOR FURTHER INFORMATION CONTACT: Nicole Nedd, Director, Scholarships 
and Clinical Education. 1250 Poydras Street, Suite 1000, New Orleans, 
LA 70113. (504) 507-4895 (This is not a toll-free number.)

SUPPLEMENTARY INFORMATION: In a document published in the Federal 
Register on June 25, 2019, VA published a proposed rule, which proposed 
to revise its regulations that govern VA's Health Professional 
Scholarship Program (HPSP). 84 FR 29824. VA provided a 60-day comment 
period, which ended on August 26, 2019. We received two comments on the 
proposed rule.
    On June 6, 2018, section 301 of Public Law 115-182, the John S. 
McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining 
Internal Systems and Strengthening Integrated Outside Networks Act of 
2018, or the VA MISSION Act of 2018, amended title 38 of the United 
States Code (U.S.C.) 7612(b) and 7617, which govern the HPSP. This 
program is regulated under title 38 of the Code of Federal Regulations 
(CFR) 17.600 through 17.612. Section 7612(b) of 38 U.S.C. was amended 
to state that VA will ensure that not less than 50 HPSP scholarships 
are awarded each year to students who are accepted for enrollment or 
are enrolled in a program of education or training that leads to 
employment as a physician or dentist until such a date as VA determines 
that there is a staffing shortage of less than 500 individuals in these 
health care professions in VA. The VA MISSION Act of 2018 further 
amended section 7612(b) to state that after such a date, VA will award 
HPSP scholarships each year to not less than 10 percent of the total 
staffing shortage of physicians and dentists. Section 7612 was also 
amended by expanding the number of years of obligated service that a 
participant who pursues a course of study leading to employment as a 
physician or dentist would have to serve in VA in a discipline for 
which the HPSP was awarded. For those individuals who are accepted for 
enrollment or enrolled in a program of education or training leading to 
employment as a physician or dentist, instead of one year of obligated 
service for each school year or part thereof for which the participant 
was awarded a scholarship, the VA MISSION Act of 2018 requires that the 
participant serve 18 months of obligated service for each school year 
or part thereof for which the participant was awarded a scholarship. 
The VA MISSION Act of 2018 additionally amended 38 U.S.C. 7617 by 
adding that a participant has breached the service agreement if the 
participant fails to successfully complete post-graduate training 
leading to eligibility for board certification for employment as a 
physician. This final rulemaking implements the mandates of section 301 
of the VA MISSION Act of 2018 by amending 38 CFR 17.603, 17.607, and 
17.610.
    One commenter was in favor of the rule and stated that making more 
scholarships available for students who are going to study in a field 
that is quite expensive is a great idea that will help society in the 
long run, especially fields leading to employment as a physician or 
dentist. However, the commenter recommended that the minimum 
scholarship number should always be 10 percent the number of vacancies 
so if there are 600 vacancies, VA should be required to give out 60 
scholarships instead of capping at 50 so that more and more people can 
be helped. As previously stated in this rule, 38 U.S.C. 7612(b) states 
that not less than 50 HPSP scholarships are awarded each year to 
students who are accepted for enrollment or are enrolled in a program 
of education or training that leads to employment as a physician or 
dentist until such a date as VA determines that there is a staffing 
shortage of less than 500 individuals in these health care professions 
in VA. Therefore, for instances where there are 600 vacancies, as the 
commenter stated, there would not be a cap at 50 scholarships. Fifty 
scholarships would be the minimum amount of scholarships that may be 
offered to qualifying individuals. The commenter requested that the 
minimum number of scholarships offered by VA always be ten percent of 
the shortage of VA physicians and dentists. However, the statutory ten 
percent requirement only comes into effect when the number of vacancies 
is less than 500. When there are more than 500 vacancies for physicians 
and dentists, VA may offer not less than 50 HPSP scholarships per year. 
VA has the authority to provide more than 50 scholarships, but VA 
chooses to maintain the statutory limit in order to allow VA to utilize 
HPSP funds in disciplines other than physician and dentists as allowed 
under Sec.  17.603(b)(2) for other healthcare disciplines experiencing 
severe staffing shortages. We are not making any changes based on this 
comment.
    Another commenter was in support of the rule stating that they are 
pleased that VA is making the HPSP available to other health care 
professionals and encourages VA to place priority on the inclusion of 
nurse practitioners in this program. The commenter further stated that 
VA has long recognized the value of nurse practitioner-led care and it 
is important that these scholarship opportunities be available to nurse 
practitioners as well as other health care professionals to provide 
veterans with a robust health care workforce. The HPSP has always been 
available to applicants who pursue a course leading to nurse 
practitioner. Current Sec.  17.603(b) states that VA will grant HPSP 
scholarships in a course of study in those disciplines or programs 
where recruitment is necessary for the improvement of health care of 
veterans. Those disciplines or programs are listed in 38 U.S.C. 7401(1) 
and (3), which includes nurse practitioners. However, the purpose of 
this rulemaking is to implement the mandates of the VA MISSION Act of 
2018 by expanding the number of HPSP that may be awarded to individuals 
who pursue a program of education or training that leads to employment 
as a physician or dentist, not nurse practitioners. Therefore, we are 
not making any changes based on this comment.
    Based on the rationale set forth in the Supplementary Information 
to the proposed rule and in this final rule, VA is adopting the 
proposed rule with no edits to the rule.

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Paperwork Reduction Act

    Although this action contains provisions constituting collections 
of information at 38 CFR 17.604, which is not being amended by this 
rule, under the provisions of the Paperwork Reduction Act of 1995 (44 
U.S.C. 3501-3521), no new or proposed revised collections of 
information are associated with this final rule. The information 
collection requirements for Sec.  17.604 are currently approved by the 
Office of Management and Budget (OMB) and have been assigned OMB 
control numbers 2900-0793.

Regulatory Flexibility Act

    The Secretary hereby certifies that this final rule will not have a 
significant economic impact on a substantial number of small entities 
as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-
612. The provisions associated with this rulemaking are not processed 
by any other entities outside of VA. Therefore, pursuant to 5 U.S.C. 
605(b), the initial and final regulatory flexibility analysis 
requirements of 5 U.S.C. 603 and 604 do not apply.

Executive Orders 12866, 13563 and 13771

    Executive Orders 12866 and 13563 direct agencies to assess the 
costs and benefits of available regulatory alternatives and, when 
regulation is necessary, to select regulatory approaches that maximize 
net benefits (including potential economic, environmental, public 
health and safety effects, and other advantages; distributive impacts; 
and equity). Executive Order 13563 (Improving Regulation and Regulatory 
Review) emphasizes the importance of quantifying both costs and 
benefits, reducing costs, harmonizing rules, and promoting flexibility. 
The Office of Information and Regulatory Affairs has determined that 
this rule is not a significant regulatory action under Executive Order 
12866. VA's impact analysis can be found as a supporting document at 
http://www.regulations.gov, usually within 48 hours after the 
rulemaking document is published. Additionally, a copy of the 
rulemaking and its impact analysis are available on VA's website at 
http://www.va.gov/orpm by following the link for VA Regulations 
Published from FY 2004 through FYTD.
    This final rule is not expected to be an E.O. 13771 regulatory 
action because this final rule is not significant under E.O. 12866.

Unfunded Mandates

    The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 
1532, that agencies prepare an assessment of anticipated costs and 
benefits before issuing any rule that may result in the expenditure by 
State, local, and tribal governments, in the aggregate, or by the 
private sector, of $100 million or more (adjusted annually for 
inflation) in any one year. This final rule would have no such effect 
on State, local, and tribal governments, or on the private sector.

Congressional Review Act

    Pursuant to the Congressional Review Act (5 U.S.C. 801 et seq.), 
the Office of Information and Regulatory Affairs designated this rule 
as not a major rule, as defined by 5 U.S.C. 804(2).

Catalog of Federal Domestic Assistance

    There are no Catalog of Federal Domestic Assistance numbers and 
titles for this rule.

List of Subjects in 38 CFR Part 17

    Administrative practice and procedure, Alcohol abuse, Alcoholism, 
Claims, Day care, Dental health, Drug abuse, Foreign relations, 
Government contracts, Grant programs--health, Grant programs--veterans, 
Health care, Health facilities, Health professions, Health records, 
Homeless, Medical and dental schools, Medical devices, Medical 
research, Mental health programs, Nursing homes, Philippines, Reporting 
and recordkeeping requirements, Scholarships and fellowships, Travel 
and transportation expenses, Veterans.

Signing Authority

    The Secretary of Veterans Affairs, or designee, approved this 
document and authorized the undersigned to sign and submit the document 
to the Office of the Federal Register for publication electronically as 
an official document of the Department of Veterans Affairs. Pamela 
Powers, Chief of Staff, Department of Veterans Affairs, approved this 
document on January 24, 2020, for publication.

Consuela Benjamin,
Regulation Development Coordinator, Office of Regulation Policy & 
Management, Office of the Secretary, Department of Veterans Affairs.

    For the reasons set forth in the preamble, we are amending 38 CFR 
part 17 as follows:

PART 17--MEDICAL

0
1. The general authority citation for part 17 continues to read as 
follows:

    Authority: 38 U.S.C. 501, and as noted in specific sections.
* * * * *

0
2. Amend Sec.  17.603 by revising paragraph (b) to read as follows:


Sec.  17.603  Availability of HPSP scholarships.

* * * * *
    (b) Qualifying fields of education--(1) Physicians and dentists--
(i) VA will award not less than 50 HPSP scholarships each year to 
individuals who are accepted for enrollment or are enrolled in a 
program of education or training leading to employment as a physician 
or dentist until such date as VA determines that the staffing shortage 
of physicians and dentists in VA is less than 500.
    (ii) Once the staffing shortage of physicians and dentists is less 
than 500, VA will award HPSP scholarships to individuals in an amount 
equal to not less than ten percent of the staffing shortage of 
physicians and dentists in VA.
    (2) Other health care professions. VA will grant HPSP scholarships 
in a course of study in those disciplines or programs other than 
physician or dentist where recruitment is necessary for the improvement 
of health care of veterans as listed in 38 U.S.C. 7401(1) and (3).
* * * * *

0
3. Amend Sec.  17.607 by revising paragraph (c)(1) to read as follows.


Sec.  17.607  Obligated service.

* * * * *
    (c) Duration of service--(1) Full-time student--(i) Physician or 
dentist. A participant who attended school as a full-time student will 
agree to serve as a full-time physician or dentist in the Veterans 
Health Administration for 18 months for each school year or part 
thereof for which a scholarship was awarded.
    (ii) Other health care profession. A participant who attended 
school as a full-time student in a health care profession other than 
physician or dentist will agree to serve as a full-time clinical 
employee in the Veterans Health Administration for 1 calendar year for 
each school year or part thereof for which a scholarship was awarded, 
but for no less than 2 years.
* * * * *

0
4. Amend Sec.  17.610 by:
0
a. Redesignating paragraphs (b)(4) and (b)(5) as paragraphs (b)(5) and 
(b)(6).
0
b. Adding a new paragraph (b)(4).
    The addition to read as follows


Sec.  17.610  Failure to comply with terms and conditions of 
participation.

* * * * *

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    (b) * * *
    (4) Who is enrolled in a program or education or training leading 
to employment as a physician, fails to successfully complete post-
graduate training leading to eligibility for board certification in a 
specialty.
* * * * *
[FR Doc. 2020-04164 Filed 3-5-20; 8:45 am]
BILLING CODE 8320-01-P