[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2356 Introduced in Senate (IS)]
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115th CONGRESS
2d Session
S. 2356
To require the Secretary of Veterans Affairs to address staffing and
other issues at facilities, including underserved facilities, of the
Department of Veterans Affairs, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
January 30, 2018
Mr. Tester (for himself, Mrs. Murray, Mr. Sanders, and Mr. Manchin)
introduced the following bill; which was read twice and referred to the
Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To require the Secretary of Veterans Affairs to address staffing and
other issues at facilities, including underserved facilities, of the
Department of Veterans Affairs, and for other purposes.
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 ``Stronger Medical Workforce for
Veterans Act''.
SEC. 2. DEVELOPMENT OF CRITERIA FOR DESIGNATION OF CERTAIN MEDICAL
FACILITIES OF THE DEPARTMENT OF VETERANS AFFAIRS AS
UNDERSERVED FACILITIES AND PLAN TO ADDRESS PROBLEM OF
UNDERSERVED FACILITIES.
(a) In General.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall develop
criteria to designate medical centers, ambulatory care facilities, and
community based outpatient clinics of the Department of Veterans
Affairs as underserved facilities.
(b) Consideration.--Criteria developed under subsection (a) shall
include consideration of the following with respect to a facility:
(1) The ratio of veterans to health care providers of the
Department of Veterans Affairs for a standardized geographic
area surrounding the facility, including a separate ratio for
general practitioners and specialists.
(2) The range of clinical specialties covered by such
providers in such area.
(3) Whether the local community is medically underserved.
(4) The type, number, and age of open consults.
(5) Whether the facility is meeting the wait-time goals of
the Department.
(6) Such other criteria as the Secretary considers
important in determining which facilities are not adequately
serving area veterans.
(c) Analysis of Facilities.--Not less frequently than annually,
directors of Veterans Integrated Service Networks of the Department
shall perform an analysis to determine which facilities within that
Veterans Integrated Service Network qualify as underserved facilities
pursuant to criteria developed under subsection (a).
(d) Annual Plan To Address Underserved Facilities.--
(1) Plan required.--Not later than one year after the date
of the enactment of this Act, and not less frequently than once
each year thereafter, the Secretary shall submit to Congress a
plan to address the problem of underserved facilities of the
Department, as designated pursuant to criteria developed under
subsection (a).
(2) Contents.--Each plan submitted under paragraph (1)
shall address the following:
(A) Increasing personnel or temporary personnel
assistance, including mobile deployment teams.
(B) Providing special hiring incentives, including
under the Education Debt Reduction Program under
subchapter VII of chapter 76 of title 38, United States
Code, and recruitment, relocation, and retention
incentives.
(C) Using direct hiring authority.
(D) Improving training opportunities for staff.
(E) Such other actions as the Secretary considers
appropriate.
SEC. 3. PILOT PROGRAM ON TUITION REIMBURSEMENT AND LOAN REPAYMENT FOR
HEALTH CARE PROVIDERS OF THE DEPARTMENT OF VETERANS
AFFAIRS AT UNDERSERVED FACILITIES.
(a) In General.--Not later than 90 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall commence
a pilot program to assess the feasibility and advisability of providing
incentives to individuals to work at underserved facilities of the
Veterans Health Administration by providing tuition reimbursement and
loan repayment to medical students and health care providers who commit
to serving in underserved facilities selected under subsection (c).
(b) Duration.--The Secretary shall carry out the pilot program
during the six-year period beginning on the date of the commencement of
the pilot program.
(c) Selection of Locations.--
(1) In general.--The Secretary shall select not fewer than
three medical centers and seven ambulatory care facilities or
community based outpatient clinics of the Department to
participate in the pilot program.
(2) Rural and highly rural areas.--Not fewer than two of
the medical centers and five of the ambulatory care facilities
or community based outpatient clinics selected under paragraph
(1) shall be in States or United States territories that are
among the ten States or United States territories with--
(A) the highest percentage of land designated as
highly rural pursuant to the rural-urban commuting area
codes set forth by the Department of Agriculture; or
(B) the highest percentage of enrolled veterans
living in rural, highly rural, or insular island areas.
(3) States.--Facilities selected under paragraph (1) shall
be located in not fewer than eight different States.
(d) Use of Amounts.--Of the amounts used to provide tuition
reimbursement or loan repayment under the pilot program--
(1) one-half shall be used to provide tuition reimbursement
or loan repayment for individuals practicing in a general
practice position; and
(2) one-half shall be used to provide tuition reimbursement
or loan repayment for individuals practicing--
(A) in a specialist position; or
(B) in an occupation, other than a position
described in paragraph (1), included in the most recent
staffing shortage determination of the Department under
section 7412 of title 38, United States Code.
(e) Tuition Reimbursement.--Under the pilot program, the Secretary
may provide to an individual attending medical school and seeking a
degree as a Doctor of Medicine or a Doctor of Osteopathic Medicine full
tuition reimbursement in exchange for a five-year commitment to serve
at an underserved facility selected under subsection (c).
(f) Student Loan Repayment.--Under the pilot program, in exchange
for a three-year commitment to serve at an underserved facility
selected under subsection (c), the Secretary may provide--
(1) to an individual currently serving as a health care
provider at an underserved facility, an amount not to exceed
$30,000 to apply to any remaining student loan debt of the
individual; and
(2) to an individual other than an individual described in
paragraph (1), an amount not to exceed $50,000 to apply to any
remaining student loan debt of the individual.
(g) Breach.--An individual who participates in the pilot program
and fails to satisfy a period of obligated service under subsection (e)
or (f) shall be liable to the United States, in lieu of such obligated
service, for the amount that has been paid or is payable to or on
behalf of the individual under the pilot program, reduced by the
proportion that the number of days served for completion of the period
of obligated service bears to the total number of days in the period of
obligated service of such individual.
(h) Expedited Hiring.--The Secretary shall ensure that the hiring
of individuals to serve in the Department under the pilot program is
conducted in an expedited manner.
(i) Continuation in Pilot Program.--An individual participating in
the pilot program in an occupation included in a staffing shortage
determination of the Department under section 7412 of title 38, United
States Code, may continue participating in the pilot program
notwithstanding that the occupation is no longer included in such
determination under such section.
(j) Annual Report.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, and not less frequently than once
each year thereafter, the Secretary shall submit to Congress a
report on the pilot program.
(2) Contents.--Each report submitted under paragraph (1)
shall include the following:
(A) The number of participants, including the
number receiving tuition reimbursement and student loan
repayment.
(B) The number of facilities where participants are
located.
(C) The number of individuals who have applied to
participate in the pilot program.
(D) A list of the five most common occupations of
the participants in the pilot program, other than
general practice.
(k) Definitions.--In this section:
(1) Enrolled veteran.--The term ``enrolled veteran'' means
a veteran who is enrolled in the system of annual patient
enrollment established and operated under section 1705(a) of
title 38, United States Code.
(2) Underserved facility.--The term ``underserved
facility'' means a medical center, ambulatory care facility, or
community based outpatient clinic of the Department of Veterans
Affairs designated by the Secretary of Veterans Affairs
pursuant to criteria developed under section 2.
SEC. 4. REPORT ON WORKFORCE VACANCIES WITHIN THE VETERANS HEALTH
ADMINISTRATION.
(a) In General.--Not later than 120 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall submit
to the Committee on Veterans' Affairs of the Senate and the Committee
on Veterans' Affairs of the House of Representatives a report on
vacancies within the Veterans Health Administration.
(b) Elements.--The report required by subsection (a) shall include
the following:
(1) With respect to vacancies of personnel appointed under
section 7401 of title 38, United States Code--
(A) the total number of such vacancies;
(B) the number of such vacancies disaggregated by
occupation, State, Veterans Integrated Service Network,
medical facility, and the central office of the
Department of Veterans Affairs; and
(C) a description of the plans of the Secretary to
fill such vacancies, including a timeline for filling
such vacancies, and an assessment of whether the
Secretary requires additional hiring authorities to
expedite the hiring process.
(2) With respect to vacancies of human resource specialists
of the Veterans Health Administration--
(A) the total number of such vacancies;
(B) the number of such vacancies disaggregated by
State and medical facility; and
(C) a description of the plans of the Secretary to
fill such vacancies, including a timeline for filling
such vacancies, and an assessment of whether the
Secretary requires additional hiring authorities to
expedite the hiring process.
(3) A description of any impediments to filling the
vacancies described in paragraphs (1) and (2) and any actions
the Secretary intends to take to address such impediments.
(4) An update on the implementation by the Secretary of--
(A) the Veterans Health Administration Workforce
and Succession Strategic Plan for 2016;
(B) the recommendation by the Office of the
Inspector General of the Department that the Under
Secretary for Health develop staffing models for
critical need occupations of the Veterans Health
Administration, as determined by the Secretary; and
(C) the recommendation by the Office of the
Inspector General that the Under Secretary for Health
establish milestones and timetables for further
development, piloting, and implementation of staffing
models for critical need occupations of the Veterans
Health Administration, as determined by the Secretary.
SEC. 5. ASSIGNMENT TO DEPARTMENT OF VETERANS AFFAIRS OF COMMISSIONED
OFFICERS OF THE REGULAR CORPS OF THE PUBLIC HEALTH
SERVICE.
(a) Assignment.--
(1) In general.--Not later than 180 days after the date of
the enactment of this Act, the Secretary of Veterans Affairs
and the Surgeon General shall enter into a memorandum of
understanding for the assignment of not fewer than 500
commissioned officers of the Regular Corps of the Public Health
Service to the Department of Veterans Affairs.
(2) Manner of assignment.--Assignments under paragraph (1)
shall be made in the same manner in which assignments are made
to other Federal agencies.
(b) Reimbursement.--The Secretary shall reimburse the Surgeon
General for such expenses as the Surgeon General may incur in assigning
commissioned officers pursuant to a memorandum of understanding entered
into under subsection (a).
(c) Report.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, the Secretary and the Surgeon
General shall each submit to the Committee on Veterans' Affairs
of the Senate and the Committee on Veterans' Affairs of the
House of Representatives a report on the memorandum of
understanding entered into under subsection (a) and the
commissioned officers assigned pursuant to such memorandum of
understanding.
(2) Contents.--The report required by paragraph (1) shall
include the following:
(A) The numbers, grades, and specialties of
commissioned officers assigned pursuant to the
memorandum of understanding entered into under
subsection (a).
(B) A description of any problems encountered in
such assignment.
SEC. 6. INCLUSION OF VET CENTER EMPLOYEES IN EDUCATION DEBT REDUCTION
PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--The Secretary of Veterans Affairs shall ensure
that clinical staff working at Vet Centers are eligible to participate
in the education debt reduction program of the Department of Veterans
Affairs under subchapter VII of chapter 76 of title 38, United States
Code.
(b) Report.--Not later than one year after the date of the
enactment of this Act, the Secretary shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs
of the House of Representatives a report on the number of participants
in the education debt reduction program of the Department under such
subchapter who work at Vet Centers.
(c) Vet Center Defined.--In this section, the term ``Vet Center''
has the meaning given that term in section 1712A(h) of title 38, United
States Code.
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