[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]
[[Page 13052]]
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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.
[[Page 13053]]
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.
* * * * *
[[Page 13054]]
(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