Rule2021-22131
Educational Assistance for Certain Former Members of the Armed Forces
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
October 12, 2021
Effective
November 12, 2021
Issuing agencies
Veterans Affairs Department
Abstract
The Department of Veterans Affairs (VA) is amending its regulations that govern scholarships to certain health care professionals. This rulemaking implements the mandates of the Consolidated Appropriations Act 2018 by establishing a pilot program to provide educational assistance to certain former members of the Armed Forces for education and training leading to a degree as a physician assistant.
Full Text
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<title>Federal Register, Volume 86 Issue 194 (Tuesday, October 12, 2021)</title>
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[Federal Register Volume 86, Number 194 (Tuesday, October 12, 2021)]
[Rules and Regulations]
[Pages 56646-56652]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-22131]
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DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 17
RIN 2900-AQ74
Educational Assistance for Certain Former Members of the Armed
Forces
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 scholarships to certain health care
professionals. This rulemaking implements the mandates of the
Consolidated Appropriations Act 2018 by establishing a pilot program to
provide educational assistance to certain former members of the Armed
Forces for education and training leading to a degree as a physician
assistant.
DATES: This rule is effective November 12, 2021.
FOR FURTHER INFORMATION CONTACT: Scot Burroughs, Executive Director
Physician Assistant Services, 810 Vermont Avenue NW, Washington DC
20420, (319) 333-2845. (This is not a toll-free number.)
SUPPLEMENTARY INFORMATION: On July 27, 2020, VA published a proposed
rule in the Federal Register (85 FR 45135) that would establish a pilot
program to provide educational assistance to certain former members of
the Armed Forces for education and training leading to a degree as a
physician assistant, the Educational Assistance for Certain Former
Members of the Armed Forces (EACFMAF) program. VA provided a 60-day
comment period, which ended on September 25, 2020. VA received 21
comments on the proposed rule.
Section 246 of Public Law 115-141, the Consolidated Appropriations
Act, 2018 (March 23, 2018), established the authority for the EACFMAF.
See also 38 United States Code (U.S.C.) 7601 Note (2018) Physician
Assistant Education and Training Pilot Program for Former Members of
the Armed Forces. This pilot program provides an opportunity for
veterans who possess medical experience gained while in the military;
[[Page 56647]]
a certificate, undergraduate degree, or post baccalaureate training in
a science relating to health care; or participated in the delivery of
health care services or related medical services, to further their
medical education and become a physician assistant (PA) providing
medical care to fellow veterans. The EACFMAF would increase access to
VA health care by utilizing a veteran workforce that has received
training as a PA in the Armed Forces. Section 246 of Public Law 115-141
sets forth the eligibility criteria, the types of available funding,
established an agreement to be met by the participants, as well as the
consequences for a breach in such agreement. This final rule
establishes the regulations needed to carry out the EACFMAF.
Immediately following title 38 of the Code of Federal Regulations (CFR)
17.531, we are adding a new undesignated center heading titled
Educational Assistance for Certain Former Members of the Armed Forces
and new Sec. Sec. 17.535 through 17.539.
General Comments in Support of the Proposed Rule
Several commenters who were in favor of the rule stated that the
EACFMAF is an excellent way to support our veterans and it would
provide jobs for veterans with medical or military health experience
and would also become vested stakeholders as contributing employees.
Several commenters similarly stated that they strongly supported the
promoting of opportunities for veterans to transition into the PA
profession by providing educational assistance. A commenter also added
that the program is critical in maintaining a strong health care
workforce for the VA, staffed with people that are not only highly
trained, but that have had the experience of serving in the military.
Several commenters stated that having veteran PAs would increase
patient satisfaction as well as patient health care and will benefit VA
as the participants would have intimate knowledge of veteran issues and
understand better what the veteran patient is going through. A
commenter similarly stated that PAs with former military service gave
the best quality of care, explained the care the veteran would receive
in terms the veterans could readily understand, and had the needed
insight of what the veteran was going through to help such veterans
make an informed decision about their medical care. Another commenter
stated that this program is a great way to provide additional training
to already highly qualified individuals which will lead to a degree and
a VA career as a physician assistant.
Another commenter was in favor of the rule and stated that the
EACFMAF will offer participants peace of mind in not having to worry
about tuition, books, and other expenses while in school and allow the
participants to concentrate their efforts in finishing their studies. A
commenter similarly stated that the EACFMAF will help reduce the number
of homeless veterans by ensuring that they maintain a steady cash flow
for their necessities. The commenter added that the concept of paying
back all the money that participants receive in the EACFMAF in case
they fail the classes sounds fair and will make the participants more
responsible in completing their studies. Another commenter agrees in
that the proposed rule specified up front the repayment requirements.
One commenter stated that the EACFMAF would be a perfect fit for a
veteran who served as a medic in a war zone. The commenter added that
they would love to be part of the program. Another commenter added that
this is a much-needed scholarship program and that it would improve
access to care for veterans. Lastly, the commenter stated that if the
EACFMAF should become permanent it would be a direct line of PAs to
seek employment in VA.
A commenter stated that other Federal agencies have recently waived
requirements for doctors to perform certain intake, vaccination, or
other medical procedures under the COVID-19 pandemic and having
increased numbers of PAs would save doctors' time as well as increase
the availability of health care services, which include examinations,
interviewing, and telemedicine procedures. The commenter added that
they are aware that veterans often have to travel long distances
because of the lack of available physicians in the VA medical facility
nearest them, and having PA's available could provide a benefit to
these veterans seeking medical care from VA, including through
telemedicine. We are not making any changes based on these comments.
Sec. 17.536 Eligibility
Military and training requirements. Several commenters suggested
that VA not limit the eligibility for the EACFMAF to individuals who
have medical or military health experience gained while serving in the
military. The commenters stated that there are many servicemembers who
decide to pursue a PA degree after leaving the military and should not
be limited to what their jobs were in the service. The commenter
suggested that the eligibility criteria for the EACFMAF be that the
servicemember gets accepted into PA school and not be limited to what
their previous job was in the service. Another commenter stated that
medical experience as a corpsman or medic may provide priority, but not
exclusivity for application to the EACFMAF.
We note that the eligibility criteria for the EACFMAF is set forth
in section 246(b) of the Consolidated Appropriations Act, 2018. The
applicant has to meet one of these criteria by law in order to qualify
for the EACFMAF; VA does not have any flexibility on amending the
criteria in the regulation. The second criteria in proposed Sec.
17.536(a) is that the individual has received a certificate, associate
degree, baccalaureate degree, master's degree, or post baccalaureate
training in a science relating to health care. The veteran does not
have to meet this criteria while in military service. This criteria can
be met once the veteran is discharged from service. As we have stated
in this rulemaking, the purpose EACFMAF is to provide an opportunity to
veterans to further their medical education and become a PA providing
medical care to fellow veterans. Based on the comments in the previous
paragraph, we are clarifying the regulation text to state that in order
to qualify for the EACFMAF, a claimant must meet one of the eligibility
criteria.
Several commenters were in favor of the rule, but suggested that VA
remove the stipulation that the applicants must have a science related
degree. A commenter added that PA schools require prerequisite science
and math courses to be completed prior to the application process and
this requirement is not needed in this proposal, and that the
applicants do not need a science degree to enter PA school, but are
required to demonstrate the ability to handle science related courses.
The commenter indicated that the proposed rule has the potential of
removing worthy veteran applicants from consideration because they do
not have a science related degree. The commenter also stated that
science majors are not the only individuals who make excellent clinical
providers. Another commenter similarly stated that the requirement for
a degree in health care, biology, physiology, etc. is also not required
if the individual has been accepted into a PA education program, and
that this requirement should merely give priority to individuals with a
health care related degree and not exclude other individuals with other
types of degrees.
VA notes that the second eligibility requirement in section 246 of
the Consolidated Appropriations Act, 2018
[[Page 56648]]
states that one of the eligibility requirements is that the individual
has received a certificate, associate degree, baccalaureate degree,
master's degree, or postbaccalaureate training in a science relating to
health care. We agree with the commenter in that the statutory
requirement in section 246 would prevent PAs that graduate from an ARC-
PA program and pass the National Commission on Certification of
Physician Assistants (NCCPA), from participating in the EACFMAF because
the PA does not have health science undergraduate degree. The
legislative history of the EACFMAF shows that this program, including
its eligibility requirements, is based on an earlier house bill H.R.
3794, 114th Congress, ``Grow Our Own Directive: Physician Assistant
Employment and Education Act of 2016''. The House Subcommittee on
Health held a hearing on several bills, including H.R. 3794 on April
20, 2016, and the bill was referred to the full House after markup.
House Report 114-710 (September 6, 2016). While there are minor
differences between H.R. 3794 and enacted section 246 of the
Consolidated Appropriations Act, 2018, the eligibility requirements
remained unchanged. VA does not have the authority to change
eligibility requirements for this pilot program absent a change in the
law.
However, VA notes that if the veteran otherwise meets one of the
other two eligibility criteria, such veteran may be eligible to
participate in the EACFMAF: That the veteran has medical or military
health experience gained while serving as a member of the Armed Forces,
or has participated in the delivery of health care services or related
medical services, including participation in military training relating
to the identification, evaluation, treatment, and prevention of disease
and disorders. VA has other scholarship programs for participants to
receive financial assistance for their health care education, including
as a PA, such as the Health Professional Scholarship Program, found at
38 CFR 17.600-17.612. Individuals who do not meet the eligibility
criteria for the EACFMAF, may apply for these other scholarship
programs if they otherwise meet the eligibility criteria for such
scholarship programs. However, these other programs and their
eligibility criteria are beyond the scope of the proposed rule. We are
not making any changes based on these comments.
School and Individual requirements. Another commenter was in favor
of the rule, but requested that the requirement in proposed Sec.
17.536(b)(1) be amended to include students who are enrolled or
accepted for enrollment in an accredited school located in a State as
part-time students. The commenter indicated that veterans could have
families and other job requirements that would limit their ability to
attend school as a full-time student. The commenter added that if VA
allowed participants of the EACFMAF to be enrolled part-time and
provide a longer time frame to complete their degree, more veterans
would have the opportunity to apply for the scholarship and complete
their degree.
VA understands that some students may not be able to attend school
on a full-time basis. Proposed Sec. 17.536(b)(1) states that to be
eligible for the EACFMAF, an applicant must be unconditionally accepted
for enrollment or be enrolled as a full-time student in an accredited
school located in a State. These school requirements are in alignment
with similar VA scholarship programs. See 38 CFR 17.602. Allowing
enrollment on a less than full-time basis will not meet the needs of
the EACFMAF, which is a pilot program that will expire unless renewed
in five years. As such, we proposed only to provide financial
assistance for one to three years under proposed Sec. 17.536(b) and we
do not believe that education to become a PA or related professional
can be completed on a less than full-time basis prior to the pilot
expiring. We are not making any changes based on this comment.
Sec. 17.537 Award Procedures
Priority. A commenter was in favor of the proposed rule, but
requested that proposed Sec. 17.537(a)(3) be removed because it
unfairly favors States that already have adequate PA populations in
urban areas and consequently draws viable candidates away from rural
locations where their services and expertise are more acutely needed.
The commenter also stated that Sec. 17.537(a)(3) goes against the
agency's core values of commitment and advocacy by giving priority to
eligible individuals who agree to be employed as physician assistants
in a VA medical facility that is in a State with a per capita
population of veterans of more than five percent. The commenter stated
that while VA has the best intentions, the proposed section fails to
consider that PA shortages prevalently continue predominantly along an
urban-rural dichotomy, and that over 84 percent of PAs already provide
services in an urban market. The commenter indicated that dedicating
future PAs to the States with the largest per capita of veterans in the
U.S., such as California, Texas, and Florida, all of which boast large
urban populations, therefore ignores the larger problem that veterans
in rural areas are in need of more support. The commenter recommends
that VA remove Sec. 17.537(a)(3) because the previous subsection
already achieves VA's goal of providing more support to medically
underserved facilities without providing an unnecessary limitation.
VA agrees that PAs are needed to serve in medically underserved
populations. However, we do not agree that Sec. 17.537(a)(3) provides
an unnecessary limitation or that it unfairly favors States that
already have adequate PA populations in urban areas. Read in its
entirety, proposed Sec. 17.537(a)(3) priority is not limited to the
sole factor of veteran population. Rather, it states that VA will give
priority to eligible individuals who agree to be employed as physician
assistants in a VA medical facility that: (1) Is located in a community
that is designated as a medically underserved population as defined by
42 U.S.C. 254b(b)(3)(A); (2) Is designated by VA as a medically
underserved facility; and (3) Is in a State with a per capita
population of veterans of more than five percent, according to the
National Center for Veterans Analysis and Statistics and the United
States Census Bureau. Proposed Sec. 17.537(a)(3) is also a requirement
established under section 246(d)(2) of the Consolidated Appropriations
Act, 2018, which is meant to allow VA to provide health care to a State
with a per capita population of veterans of more than five percent, but
is not meant to be exclusive of an urban population. All other
conditions in Sec. 17.537(a) must also be met, which includes
medically underserved communities and VA medical facilities. VA intends
to utilize the EACFMAF to expand health care services in VA medical
facilities where recruitment and retention of PAs is difficult due to
the location of the VA medical facility. In addition, establishing the
five percent requirement allows VA to serve a larger number of veterans
in communities that would otherwise benefit from increased health care
professionals. We are not making any changes based on this comment.
Sec. 17.538 Agreement and Obligated Service
Obligated service--General. A commenter stated that if there was
not an employment vacancy for a PA at a VA medical facility that is
located in the vicinity of the participant's residence within 90 days
after the date that the participant completes their education, then the
90 day requirement should be extended to 180 days for such individual.
[[Page 56649]]
We stated in proposed Sec. 17.538(b)(1) that the obligated service
would begin on the date on which the eligible individual begins full-
time permanent employment with VA as a clinical practice employee as a
physician assistant, but no later than 90 days after the date that the
eligible individual completes a master's degree in physician assistant
studies or similar master's degree or the date the eligible individual
becomes licensed in a State and certified as required by the Secretary,
whichever is later. VA has been successful in placing participants of
similar scholarship programs into full-time VA employment within an
even shorter 60-day time frame. See 38 CFR 17.607(b). In addition, the
participant must be willing to relocate to another geographic location
to carry out their service obligation. We are not making any changes
based on this comment.
A commenter stated that the fulltime service requirement to begin
within 90 days after completion of the PA degree assumes that VA will
have full time permanent positions available. The commenter suggested
that the requirement should be that an individual will undertake at
least 50 percent time employment on a fulltime or temporary basis, in
order to give the maximum flexibility to both the individual and the
VA. The commenter added that VA hospitals may have limited hiring
ability and may not wish to hire full time permanent employees, but
could still benefit from having more physician assistants.
VA currently has PA vacancies nationwide, especially in VA medical
facility located in communities that are designated as medically
underserved under 42 U.S.C. 245b(b)(3)(A) and those VA medical
facilities that VA has determined as medically underserved. In
addition, VA anticipates the need for PA's will remain, particularly in
the medically underserved areas. Under proposed Sec. 17.538(a)(3) a
participant agrees to be employed as a full-time clinical practice
employee in VA as a physician assistant for a period of obligated
service for one calendar year for each school year or part thereof for
which the EACFMAF was awarded, but for no less than three years. The
full-time employment requirement is also similar to other VA
scholarship programs. Reducing the service to anything other than full
time would defeat the purpose of the EACFMAF. We are not making any
changes based on this comment.
One commenter stated that Sec. 17.538(b)(1) does not provide
enough flexibility to account for unforeseeable delays in attaining
certification as it does not account for possible extenuating
circumstances outside of an individual's control. The commenter added
that the COVID-19 pandemic has clearly demonstrated that unforeseen
events can arise, which can delay intended plans indefinitely, and that
there is arguably a lack of compassion in a provision that can cause an
individual to be in breach of their contract when they are not at fault
because of major outside influences. The commenter suggests that VA
consider extending the length of time before an individual is in breach
to one year and revise the consequence of failing to acquire licensure
or certification due to unforeseen circumstances by placing the
participant under review, subject to breach if the failure was due to
the individual's actions.
We stated in the proposed rule that section 246 of the Consolidated
Appropriations Act, 2018 does not establish a time frame for when an
eligible individual will repay the amount of damages when such eligible
individual breaches their terms of agreement, and that proposed Sec.
17.539(b) would mirror the repayment period language from similar
scholarship programs. See 38 U.S.C. 7617(c)(2) and 38 CFR 17.610(c). We
stated in part in proposed Sec. 17.538(b)(1) that VA will actively
assist and monitor eligible individuals to ensure State licenses and
certificates are obtained in a minimal amount of time following
graduation. We also stated that if an eligible individual fails to
obtain his or her degree, or fails to become licensed in a State or
become certified no later than 180 days after receiving the degree, the
eligible individual is considered to be in breach of the acceptance
agreement. Participants of similar VA scholarship programs have been
successfully able to obtain the required certification within the 180-
day time frame, and we believe that will be the case in EACFMAF as
well. However, we are aware that there may be instances where the
participant of the EACFMAF may not be able to obtain their
certification due to unforeseen circumstances such as the COVID-19
National Emergency. VA's engagement in assisting and monitoring the
eligible individuals obtain their State license and certificates will
alert VA of any potential unforeseen circumstance. VA will examine
these unforeseen circumstances as they arise on a case by case basis
and may provide general guidance to all participants if the unforeseen
circumstance affects all participants. We are not making any changes
based on this comment.
Location and position of obligated service. One commenter was in
favor of the rule, but stated that more clarity is needed regarding
exactly which VA medical facilities are considered to be given
preference under the criteria set forth in the rule. The commenter
added that the proposed regulation text is vague and subject to changes
based on classification of various sites, for which the criteria is
unclear.
We agree with the commenter in that the proposed rule did not
specify how VA would alert potential participants of VA locations that
have vacancies. We, therefore, revise Sec. 17.538(b)(2) as proposed to
state that VA will publish a list of VA medical facilities where the
participants may perform their period of obligated service in a notice
in the Federal Register on a yearly basis. Participants of the EACFMAF
may select their preference for service from this list to serve the
period of obligated service, however, VA reserves the right to make the
final decision on location. By providing this list of vacancies,
prospective participants will know prior to applying for the program
the VA medical facilities that will have vacancies in which the
participants of the EACFMAF may perform their period of obligated
service.
Several commenters stated that students receiving EACFMAF should,
at the very least, have relocation costs reimbursed if their assigned
facility is outside the area of their current residence or have the
participant agree before their service begins where their term is to be
served, and commit via contract. These commenters asserted that these
changes would reduce financial hardship for students with families with
already limited resources and lessen the burden of a mandated move.
We stated in the proposed rule that VA reserves the right to make
final decisions on the location and position of the obligated service.
We also stated that an eligible individual who receives an EACFMAF must
be willing to relocate to another geographic location to carry out
their service obligation. This language is consistent with similar
scholarship programs. See 38 CFR 17.607(d). We appreciate that
relocation expenses can be burdensome to some applicants. However,
paying relocation expenses to a participant of the EACFMAF would reduce
the amount of funds available for the program. In addition, Public Law
115-141 section 246 does not give VA specific authority to pay
relocation expenses. We are not
[[Page 56650]]
making any changes based on this comment.
One commenter disagreed with the statement in the proposed rule's
Supplementary Section where VA stated that several branches of the
Armed Forces train individuals to perform the duties of a physician
assistant without the required educational training. The commenter
stated that corpsman and medics are very highly trained and provide
exceptional medical care to their fellow servicemembers but they are
not trained perform to the duties of a PA, and that the training is
extensive but one cannot be called a PA without going through PA
school.
We agree with the commenter that being trained in potential PA
duties does not equate with being a PA, and that is exactly the
function of the EACFMAF, to allow an individual without formal PA
training to receive such training. We stated in the proposed rule that
the EACFMAF would allow such individuals the opportunity to complete
their education and training in order to be employed by VA as a
physician assistant. We are not making any changes based on this
comment.
Technical Edit
We are making one technical edit to Sec. 17.536(b)(4). Proposed
Sec. 17.536(b)(4) stated that an applicant must submit an application
to participate in the Scholarship Program together with a signed
contract. We are amending the term ``contract'' to now state
``agreement'' to be consistent in the use of the term as stated in
Sec. 17.538. We are not making any changes to the meaning of Sec.
17.536(b)(4).
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 the changes described in this final rule.
Paperwork Reduction Act
The Paperwork Reduction Act of 1995 (44 U.S.C. 3507(d)) requires
that VA consider the impact of paperwork and other information
collection burdens imposed on the public. According to the 1995
amendments to the Paperwork Reduction Act (5 CFR 1320.8(b)(2)(vi)), an
agency may not collect or sponsor the collection of information, nor
may it impose an information collection requirement unless it displays
a currently valid Office of Management and Budget (OMB) control number.
This final rule includes provisions constituting an amendment of an
existing collection of information under the Paperwork Reduction Act of
1995 that require approval by the OMB. The existing OMB control number
that will be amended by this action is 2900-0793. Accordingly, under 44
U.S.C. 3507(d), VA has submitted a copy of this rulemaking action to
OMB for review.
OMB assigns control numbers to collections of information it
approves. VA may not conduct or sponsor, and a person is not required
to respond to, a collection of information unless it displays a
currently valid OMB control number. Proposed 38 CFR 17.538 contains a
collection of information under the Paperwork Reduction Act of 1995. If
OMB does not approve the collection of information as requested, VA
will immediately remove the provision containing a collection of
information or take such other action as is directed by OMB.
The amended proposed collection of information is comprised of an
agreement between VA and the eligible individual who accepts funding
for the Educational Assistance for Certain Former Members of the Armed
Forces (EACFMAF).
VA estimates there will be 100 veteran applicants per year, which
will require them to complete an application package. This application
package is comprised of the application itself, academic verification,
evaluation & recommendation, and an addendum to the application. VA
estimates it will take an applicant 3.7 hours to complete the
application package, for a total PRA cost of $10,061.02 (100 applicants
x 3.7 hrs. x $27.07 \1\).
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\1\ For the proposed collection of information, VA used general
wage data from the May 2020 Bureau of Labor Statistics (BLS)
website, <a href="https://www.bls.gov/oes/current/oes_nat.htm">https://www.bls.gov/oes/current/oes_nat.htm</a>, VA used the
BLS wage code of ``00-0000 All Occupations, which has a mean hourly
wage/salary workers of $27.07.
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Additionally, there will be further collections for applicants
selected for the program. VA intends to select 25 Veterans for the
scholarship each year. Those selected to receive the scholarship will
be required to fill out agreements for the scholarship, a mobility
agreement, an offer response, notice of change/annual academic report,
notice of approaching graduation, education program completion, request
for deferment for advanced education, and an annual VA employment/
deferment verification. VA estimates it will take 1.75 hours to
complete the acceptance package, for a total PRA cost of $ 1,184.31 (25
applicants x 1.75 hrs. x $27.07 \2\). VA estimates the total annual
burden cost to all respondents to be $11,245.33 ($10,061.02 for the
application + $1,184.31 acceptance package).
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\2\ For the proposed collection of information, VA used general
wage data from the May 2020 Bureau of Labor Statistics (BLS)
website, <a href="https://www.bls.gov/oes/current/oes_nat.htm">https://www.bls.gov/oes/current/oes_nat.htm</a>, VA used the
BLS wage code of ``00-0000 All Occupations, which has a mean hourly
wage/salary workers of $27.07.
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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. This rulemaking does not change VA's policy regarding small
businesses, does not have an economic impact to individual businesses,
and there are no increased or decreased costs to small business
entities. On this basis, the final rule will not have an economic
impact on a substantial number of small entities as they are defined in
the Regulatory Flexibility Act, 5 U.S.C. 601-612. 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 and 13563
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. The Regulatory Impact Analysis associated with this rulemaking
can be found as a supporting document at <a href="http://www.regulations.gov">www.regulations.gov</a>.
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 will have no such effect on
State, local, and tribal governments, or on the private sector.
[[Page 56651]]
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, Health care, Health
facilities, Health professions, Scholarships and fellowships.
Signing Authority
Denis McDonough, Secretary of Veterans Affairs, approved this
document on October 4, 2021, 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.
Consuela Benjamin,
Regulations Development Coordinator, Office of Regulation Policy &
Management, Office of General Counsel, 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 authority citation for part 17 continues to read as follows:
Authority: 38 U.S.C. 501, and as noted in specific sections.
* * * * *
Sections 17.535 through 17.539 are also issued under Public Law
115-141, sec. 246.
* * * * *
0
2. Add an undesignated center heading and Sec. Sec. 17.535 through
17.539 immediately following Sec. 17.531 to read as follows.
Sec.
* * * * *
Educational Assistance for Certain Former Members of the Armed
Forces
17.535 Purpose.
17.536 Eligibility.
17.537 Award procedures.
17.538 Agreement and obligated service.
17.539 Failure to comply with terms and conditions of agreement.
* * * * *
Sec. 17.535 Purpose.
The purpose of Sec. Sec. 17.535 through 17.539 is to establish the
Educational Assistance for Certain Former Members of the Armed Forces
(EACFMAF). The EACFMAF will provide a scholarship to certain former
members of the Armed Forces for the education and training leading to
employment as a VA physician assistant.
Sec. 17.536 Eligibility.
(a) Military and Training requirements. An individual is eligible
to participate in the EACFMAF if such individual is a former member of
the Armed Forces who was discharged or released therefrom under
conditions other than dishonorable and meets one of the following
criteria:
(1) Has medical or military health experience gained while serving
as a member of the Armed Forces;
(2) Has received a certificate, associate degree, baccalaureate
degree, master's degree, or post baccalaureate training in a science
relating to health care; or
(3) Has participated in the delivery of health care services or
related medical services, including participation in military training
relating to the identification, evaluation, treatment, and prevention
of disease and disorders.
(b) School and Individual requirements. To be eligible for the
EACFMAF, an applicant must:
(1) Be unconditionally accepted for enrollment or be enrolled as a
full-time student in an accredited school located in a State;
(2) Be pursuing a degree leading to employment as a physician
assistant;
(3) Be a citizen of the United States; and
(4) Submit an application to participate in the Scholarship Program
together with a signed agreement as specified in Sec. 17.538.
Sec. 17.537 Award procedures.
(a) Priority. In awarding EACFMAF, VA will give priority to
eligible individuals who agree to be employed as physician assistants
in a VA medical facility that:
(1) Is located in a community that is designated as a medically
underserved population under 42 U.S.C. 254b(b)(3)(A);
(2) Is designated by VA as a medically underserved facility; and
(3) Is in a State with a per capita population of veterans of more
than five percent, according to the National Center for Veterans
Analysis and Statistics and the United States Census Bureau.
(b) Amount of funds. VA will provide a scholarship to individuals
who participate in the EACFMAF to cover the costs of such individuals
obtaining a master's degree in physician assistant studies or similar
master's degree for a period of one to three years. All such payments
to scholarship participants are exempt from Federal taxation. The
payments will consist of:
(1) Tuition and required fees;
(2) Other educational expenses, including books and laboratory
equipment.
Sec. 17.538 Agreement and obligated service.
(a) Agreement. Each eligible individual who accepts funds from the
EACFMAF will enter into an agreement with VA where the eligible
individual agrees to the following:
(1) Maintain enrollment, attendance, and acceptable level of
academic standing as defined by the school;
(2) Complete a master's degree in physician assistant studies or
similar master's degree; and
(3) Be employed as a full-time clinical practice employee in VA as
a physician assistant for a period of obligated service for one
calendar year for each school year or part thereof for which the
EACFMAF was awarded, but for no less than three years.
(b) Obligated service--(1) General. An eligible individual's
obligated service will begin on the date on which the eligible
individual begins full-time permanent employment with VA as a clinical
practice employee as a physician assistant, but no later than 90 days
after the date that the eligible individual completes a master's degree
in physician assistant studies or similar master's degree, or the date
the eligible individual becomes licensed in a State and certified as
required by the Secretary, whichever is later. VA will actively assist
and monitor eligible individuals to ensure State licenses and
certificates are obtained in a minimal amount of time following
graduation. If an eligible individual fails to obtain his or her
degree, or fails to become licensed in a State or become certified no
later than 180 days after receiving the degree, the eligible individual
is considered to be in breach of the acceptance agreement.
(2) Location and position of obligated service. VA will publish a
list of VA medical facilities where the participants may perform their
period of obligated service in a notice in the Federal Register on a
yearly basis. Participants of the EACFMAF may select their preference
for service from this list to serve the period of obligated service. VA
reserves the right to make final decisions on the location and position
of the obligated service. An eligible individual who receives an
EACFMAF must be willing to relocate to another geographic location to
carry out their service obligation.
(The Office of Management and Budget has approved the information
collection
[[Page 56652]]
requirements in this section under control number 2900-0793.)
Sec. 17.539 Failure to comply with terms and conditions of
agreement.
(a) Participant fails to satisfy terms of agreement. If an eligible
individual who accepts funding for the EACFMAF fails to satisfy the
terms of agreement, the United States is entitled to recover damages in
an amount equal to the total amount of EACFMAF funding paid or is
payable to or on behalf of the individual, reduced by the total number
of obligated service days the individual has already served minus the
total number of days in the individual's period of obligated service.
(b) Repayment period. The eligible individual will pay the amount
of damages that the United States is entitled to recover under this
section in full to the United States no later than one year after the
date of the breach of the agreement.
[FR Doc. 2021-22131 Filed 10-8-21; 8:45 am]
BILLING CODE 8320-01-P
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</html>Indexed from Federal Register on October 12, 2021.
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