Rule2024-13367
VA Health Professional Scholarship Program
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
June 18, 2024
Effective
July 18, 2024
Issuing agencies
Veterans Affairs Department
Abstract
The Department of Veterans Affairs (VA) adopts as final, without changes, a proposed rule to amend its regulations that govern the VA Health Professional Scholarship Program (HPSP) by implementing the mandates of the Consolidated Appropriations Act, which would expand the number of scholarships available to those who are pursuing degrees or training in occupations providing care within mental health programs. This rule also adopts as final technical corrections under the Paperwork Reduction Act section to correct an approved Office of Management and Budget (OMB) control number.
Full Text
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<title>Federal Register, Volume 89 Issue 118 (Tuesday, June 18, 2024)</title>
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[Federal Register Volume 89, Number 118 (Tuesday, June 18, 2024)]
[Rules and Regulations]
[Pages 51444-51446]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2024-13367]
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DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 17
RIN 2900-AR98
VA Health Professional Scholarship Program
AGENCY: Department of Veterans Affairs.
ACTION: Final rule.
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SUMMARY: The Department of Veterans Affairs (VA) adopts as final,
without changes, a proposed rule to amend its regulations that govern
the VA Health Professional Scholarship Program (HPSP) by implementing
the mandates of the Consolidated Appropriations Act, which would expand
the number of scholarships available to those who are pursuing degrees
or training in occupations providing care within mental health
programs. This rule also adopts as final technical corrections under
the Paperwork Reduction Act section to correct an approved Office of
Management and Budget (OMB) control number.
DATES: This rule is effective July 18, 2024.
FOR FURTHER INFORMATION CONTACT: Nicole Nedd, Director, Scholarships
and Clinical Education, Workforce Management and Consulting Office, 810
Vermont Ave. NW, Washington, DC 20420. ((504) 881-4036). (This is not a
toll-free telephone number.)
SUPPLEMENTARY INFORMATION: In a document published in the Federal
Register (FR) on August 14, 2023, VA proposed to revise its VA Health
Professional Scholarship Program (HPSP) regulations. The purpose of the
HPSP is to award scholarships to students pursuing a course of study
leading to a degree in certain health care occupations, listed in 38
U.S.C. 7401(1) and (3). See Sec. 17.600. The HPSP allows VA to provide
scholarship awards to facilitate recruitment and retention of employees
in several hard-to-fill health care occupations. Id. In the proposed
rule we stated that we would amend the HPSP to reflect statutory
changes made by section 104(a) of Division V of the Consolidated
Appropriations Act (the Act), Public Law 117-328, which expanded HPSP
by requiring VA to specifically award scholarships to applicants
pursuing degrees or training in mental health disciplines, including
advanced practice nursing (with a focus on mental health or substance
use disorder), psychology, and social work. Section 104(a) of the Act
also required that VA provide no fewer than an additional 50 awards (as
compared to academic year 2021, which provided 33 awards) to such
applicants per academic year starting in academic year 2022. 88 FR
54972. The rule also proposed to make a technical edit to the HPSP
regulations to correct an approved Office of Management and Budget
(OMB) control number. Id.
VA provided a 60-day comment period, which ended on October 13,
2023. VA received 13 comments on the proposed rule. One comment
supported the proposed rule and will not be further addressed in this
final rule. The remaining comments are summarized and addressed in the
discussion below.
Public Comments
Physician Assistants
VA received 11 comments regarding physician assistants (PAs). The
comments suggested or supported the inclusion of PAs as mental health
care professionals eligible to receive scholarships under proposed
Sec. 17.603(b)(2). For instance, a commenter suggested that generally
PAs should receive scholarships under proposed Sec. 17.603(b)(2) and
another stated that PAs are a core mental health profession. VA does
not make any changes based on these comments.
PAs are eligible to apply for and receive HPSP scholarships for
mental health disciplines under proposed Sec. 17.603(b)(2). Consistent
with section 104(a) of Division V of the Act, VA proposed to revise
Sec. 17.603(b)(2) to expand HPSP to applicants who are pursuing
degrees or training in mental health disciplines, including advanced
practice nursing (with a focus on mental health or substance use
disorder), psychology, and social work. As noted in the proposed rule,
this is not an exhaustive list and merely mirrors section 104(a) of
Division V of the Act. 88 FR 54974. VA acknowledges that PAs' training
includes core mental health training and mandatory psychiatry clinical
rotations, and they may provide mental health care. Thus, PAs are
eligible to apply for and may receive HPSP scholarships for mental
health disciplines under proposed Sec. 17.603(b)(2) once this rule is
final and effective.
Other commenters suggested that PAs be listed in proposed Sec.
17.603(b)(2) as a mental health profession eligible for a HPSP
scholarship pursuant to the Act. Relatedly, one commenter stated that
VA should provide an exhaustive list of health care professions that
may be awarded the HPSP scholarship under proposed Sec. 17.603(b)(2).
We do not make changes to the rule based on these comments.
As VA explained in the proposed rule, the list of mental health
disciplines in proposed Sec. 17.603(b)(2) is not an exhaustive list,
as there are other mental health disciplines not included in the Act.
(See 88 FR 54974). Other mental health disciplines may include licensed
professional mental health counselor, marriage and family therapist,
and rehabilitation counseling. The list in proposed Sec. 17.603(b)(2)
was merely meant to mirror the statutory language and is not
exclusionary of other mental health care professions. VA determined
that it should maintain a non-exhaustive list in the regulation to
permit flexibility so that new mental health professions can be
included without the need to amend the regulations. Therefore, other
occupations not listed in proposed Sec. 17.603(b)(2) that may provide
clinical care in mental health programs may,
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and are encouraged to, apply for and receive HPSP scholarships.
One commenter recommended that VA expand HPSP scholarships to
mandate inclusion for PAs. We are not making any changes based on this
comment.
To the extent that the commenter is suggesting that VA mandate that
PAs be prioritized over other potential applicants, VA cannot mandate
that PAs be selected over other health care professions. Under 38
U.S.C. 7612(D), VA may provide scholarships with a preference for
applicants who are veterans. VA does not have any other preferential
statutory authority. The awarding of HPSP scholarships is based on VA
recruitment needs. As previously stated in this rulemaking, an HPSP
scholarship will be awarded only when necessary to assist VA in
alleviating shortages or anticipated shortages of personnel in the
health professions.
One commenter raised concerns that the HPSP website indicates that
existing HPSP scholarships are limited to only those PAs with veteran
status. VA is not making any changes to the rule based on this comment.
VA acknowledges that its HPSP website previously indicated that the
PA scholarship is only open to those that have veteran status. VA has
since updated its HPSP website to ensure it clearly explains that all
PA students are allowed to apply for an HPSP scholarship, but that a
preference may be given to veterans, consistent with Sec. 17.605.
While the eligibility criteria for HPSP does not require that
applicants have any military experience (see Sec. 17.602), if there
are a larger number of equally qualified applicants than there are
awards to be made, VA will first select veterans, then use a random
method as the basis for further selection. See Sec. 17.605(a). This
provision applies to all health care professions eligible for HPSP
scholarships, not just PAs.
Awarding HPSP Scholarships in Academic Year 2023
One commenter encouraged VA to issue the 50 additional awards in
the 2023 academic year, as increasing access to mental health care is
critical.
Consistent with section 104(a) of Division V of the Act, VA
proposed to provide no fewer than an additional 50 awards (as compared
to academic year 2021) to applicants who are pursuing degrees or
training in mental health disciplines per academic year starting in
academic year 2022. See proposed Sec. 17.603(b)(2) and 88 FR 54973.
However, VA will not be able to implement this regulation until this
final rule is published and effective, which will be after the start of
the 2023 academic year. VA notes that under the current regulations, VA
is authorized to provide HPSP scholarships to disciplines that provide
clinical care within mental health programs and in academic year 2023,
VA offered 87 scholarships for professions providing clinical care
within mental health programs, which is more than the required 83
scholarships for mental health professions as required under the Act.
VA is not making any changes based on this comment.
Chaplains
While not entirely clear, one commenter appeared to request
chaplains be eligible for HPSP scholarships since they should be
considered mental health professionals who are eligible under the
changes VA proposed to make to Sec. 17.603(b)(2) in the proposed rule.
VA is not making changes based on this comment.
VA considers chaplains to be an integral part of the veteran's
mental health and individuals who are pursuing a degree that leads to
placement as a chaplain may be eligible to receive HPSP scholarships
under Sec. Sec. 17.603(b)(2) and (3) as revised and made final in this
rule. However, in order to be eligible under Sec. 17.603(b)(2) the
criteria in Sec. 17.603(b)(1) still needs to be met, which provides
that an HPSP scholarship will be awarded only when necessary to assist
VA in alleviating shortages or anticipated shortages of personnel in
the health professions stated in paragraph (b) of this section. These
occupations are identified in OIG's Determination of Veterans Health
Administration's Severe Occupational Staffing Shortages Fiscal Year
2023. However, the OIG's report did not list the chaplain occupation as
one of the severe shortage occupations within VA. Therefore, VA cannot
award HPSP scholarships to individuals who are pursuing a degree
leading to a position as a VA chaplain at this time. VA may offer HPSP
scholarships to these individuals in the future should there be a
shortage of VA chaplains.
Employment in a Mental Health Care Profession
A commenter questioned whether HPSP participants would be
guaranteed placement in positions in VA that are mental health related
if they are earning a degree that could be used to provide either
mental health care or a different type of health care. VA is not making
any changes based on this comment.
Pursuant to Sec. 17.607(a), each participant is obligated to
provide service as a Department of Veterans Affairs employee in full-
time clinical practice in the participant's discipline in an assignment
or location determined by the Secretary. Consistent with Sec. 17.607,
individuals who are awarded an HPSP scholarship under Sec.
17.603(b)(2), as revised and made final in this rule, will be placed in
positions that are mental health related.
Comments That Are Beyond the Scope of the Proposed Rule
Several comments were beyond the scope of the proposed rule. For
instance, one commenter indicated that health care professionals need
more mental health training. Another commenter requested changes be
made to other VA directives and policies to better incorporate PAs as
mental health providers. As these comments are beyond the scope of the
rulemaking, we will not address them further.
Based on the rationale set forth in the proposed rule and in this
final rule, VA is adopting the proposed rule as final with no changes.
Executive Orders 12866, 13563, and 14094
Executive Order 12866 (Regulatory Planning and Review) directs
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. Executive Order 14094 (Executive order on
Modernizing Regulatory Review) supplements and reaffirms the
principles, structures, and definitions governing contemporary
regulatory review established in Executive Order 12866 of September 30,
1993 (Regulatory Planning and Review), and Executive Order 13563 of
January 18, 2011 (Improving Regulation and Regulatory Review). The
Office of Information and Regulatory Affairs has determined that this
rulemaking is not a significant regulatory action under Executive Order
12866, as amended by Executive Order 14094. 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>.
Regulatory Flexibility Act
The Secretary hereby certifies that this final rule will not have a
significant
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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
final rule will solely be operated and administered within VA and will
only affect individuals who apply and are awarded an HPSP scholarship.
On this basis, the Secretary certifies that the adoption of 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. Therefore, under 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.
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.
Paperwork Reduction Act
Although this final rule contains an increase in the provisions
constituting a collection of information under the provisions of the
Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3521), this increase is
already captured in an existing collection of information. The
collection of information for 38 CFR 17.602 is currently approved by
the Office of Management and Budget (OMB) and has been assigned OMB
control number 2900-0793. However, Sec. 17.602 incorrectly reflects
OMB control number 2900-0352. VA is correcting this technical error in
this rulemaking by updating the reference in Sec. 17.602 to OMB
control number 2900-0793.
Congressional Review Act
Pursuant to Subtitle E of the Small Business Regulatory Enforcement
Fairness Act of 1996 (known as the Congressional Review Act) (5 U.S.C.
801 et seq.), the Office of Information and Regulatory Affairs
designated this rule as not satisfying the criteria under 5 U.S.C.
804(2).
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 June 12, 2024, 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 stated in the preamble, the Department of Veterans
Affairs amends 38 CFR part 17 as set forth below:
PART 17--MEDICAL
0
1. The authority citation for part 17 is amended by adding an entry for
Sec. Sec. 17.600 through 17.612, in numerical order, to read as
follows:
Authority: 38 U.S.C. 501, and as noted in specific sections.
* * * * *
Sections 17.600 through 17.612 are also issued under 38 U.S.C.
7601-7619, 7633, 7634, 7636, and sec. 104(a), div. V, Public Law
117-328.
* * * * *
Sec. 17.602 [Amended]
0
2. Amend Sec. 17.602 by revising the parenthetical at the end of the
section to read as follows:
Sec. 17.602 Eligibility.
* * * * *
(Approved by the Office of Management and Budget under control
number 2900-0793)
Sec. 17.603 [Amended]
0
3. Amend Sec. 17.603 by:
0
a. Redesignating paragraph (b)(2) as new paragraph (b)(3); and
0
b. Adding new paragraph (b)(2) to read as follows:
Sec. 17.603 Availability of HPSP scholarships.
* * * * *
(b) * * *
(2) Mental health disciplines. Notwithstanding paragraphs (b)(1)
and (3) of this section, VA will award not less than 83 HPSP
scholarships each year to individuals who are accepted for or are
enrolled in a program of education or training leading to employment in
a mental health discipline, including, but limited to, advanced
practice nursing (with a focus on mental health or substance use
disorder), psychology, or social work.
* * * * *
[FR Doc. 2024-13367 Filed 6-17-24; 8:45 am]
BILLING CODE 8320-01-P
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