I 

114TH CONGRESS 

1ST SESSION H. R. 4134 

To require the Secretary of Veterans Affairs to carry out a program to 

increase efficiency in the recruitment and hiring by the Department 

of Veterans Affairs of health care workers that are undergoing separation 

from the Armed Forces, to create uniform credentialing standards for 

certain health care professionals of the Department, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 30, 2015 

Mr. DEFAZIO (for himself and Ms. KUSTER) introduced the following bill; 

which was referred to the Committee on Veterans’ Affairs, and in addition to the Committee on Armed Services, for a period to be subsequently 

determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To require the Secretary of Veterans Affairs to carry out 

a program to increase efficiency in the recruitment and 

hiring by the Department of Veterans Affairs of health 

care workers that are undergoing separation from the 

Armed Forces, to create uniform credentialing standards 

for certain health care professionals of the Department, 

and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Veterans Health Care 

3 Staffing Improvement Act’’. 

4 SEC. 2. PROGRAM TO INCREASE EFFICIENCY IN THE RE5 CRUITMENT AND HIRING BY THE DEPART6 MENT OF VETERANS AFFAIRS OF HEALTH 

7 CARE WORKERS UNDERGOING SEPARATION 

8 FROM THE ARMED FORCES. 

9 (a) PROGRAM.—The Secretary of Veterans Affairs 

10 shall, in coordination with the Secretary of Defense, carry 

11 out a program to recruit individuals who are undergoing 

12 separation from the Armed Forces and who served in a 

13 health care capacity while serving as a member of the 

14 Armed Forces. The program shall be known as the ‘‘Docs15 to-Doctors Program’’. 

16 (b) SHARING OF INFORMATION.— 

17 (1) SUBMITTAL OF LIST.—For purposes of car18 rying out the program, not less frequently than once 

19 per year (or a shorter period that the Secretary of 

20 Veterans Affairs and the Secretary of Defense may 

21 jointly specify), the Secretary of Defense shall sub22 mit to the Secretary of Veterans Affairs a list of 

23 members of the Armed Forces, including the reserve 

24 components, who— 

25 (A) served in a health care capacity while 

26 serving as a member of the Armed Forces; 


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1 (B) are undergoing or have undergone sep2 aration from the Armed Forces during the pe3 riod covered by the list; and 

4 (C) will be discharged from the Armed 

5 Forces under honorable conditions, as deter6 mined by the Secretary of Defense, or have 

7 been discharged from the Armed Forces under 

8 honorable conditions during the period covered 

9 by the list. 

10 (2) USE OF OCCUPATIONAL CODES.—Each list 

11 submitted under paragraph (1) shall include mem12 bers of the Armed Forces who were assigned a Mili13 tary Occupational Specialty code, an Air Force Spe14 cialty Code, or a United States Navy rating indic15 ative of service in a health care capacity. 

16 (3) INFORMATION INCLUDED.—Each list sub17 mitted under paragraph (1) shall include the fol18 lowing information, to the extent such information is 

19 available to the Secretary of Defense, with respect to 

20 each member of the Armed Forces included in such 

21 list: 

22 (A) Contact information. 

23 (B) Rank upon separation from the Armed 

24 Forces. 


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1 (C) A description of health care experience 

2 while serving as a member of the Armed Forces 

3 and other relevant health care experience, in4 cluding any relevant credential, such as a cer5 tificate, certification, or license, including the 

6 name of the institution or organization that 

7 issued the credential. 

8 (4) CONSULTATION WITH SECRETARY OF

9 HOMELAND SECURITY.—In submitting each list 

10 under paragraph (1), the Secretary of Defense shall 

11 consult with the Secretary of Homeland Security 

12 with respect to matters concerning the Coast Guard 

13 when it is not operating as a service in the Navy. 

14 (c) RESOLUTION OF BARRIERS TO EMPLOYMENT.— 

15 (1) IN GENERAL.—In carrying out the program, 

16 the Secretary of Veterans Affairs shall, in coordina17 tion with the Secretary of Defense, work to resolve 

18 any barriers relating to credentialing or to specific 

19 hiring rules, procedures, and processes of the De20 partment of Veterans Affairs that may delay or pre21 vent the hiring of individuals who are undergoing 

22 separation from the Armed Forces and who served 

23 in a health care capacity while serving as a member 

24 of the Armed Forces, including by reconciling dif25 ferent credentialing processes and standards between 


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1 the Department of Veterans Affairs and the Depart2 ment of Defense. 

3 (2) REPORT.—If the Secretary of Veterans Af4 fairs determines that a barrier described in para5 graph (1) cannot be resolved under such paragraph, 

6 the Secretary shall, not later than 90 days after the 

7 discovery of the barrier, submit to Congress a report 

8 that includes such recommendations for legislative 

9 and administrative action as the Secretary considers 

10 appropriate to resolve the barrier, including any bar11 rier imposed by a State. 

12 (d) TREATMENT OF APPLICATIONS FOR EMPLOY13 MENT.—An application for employment in the Depart14 ment of Veterans Affairs in a health care capacity received 

15 by the Secretary of Veterans Affairs from a member or 

16 former member of the Armed Forces who is on a list sub17 mitted to the Secretary under subsection (b) shall not be 

18 considered an application from outside the work force of 

19 the Department for purposes of section 3330 of title 5, 

20 United States Code, and section 335.105 of title 5, Code 

21 of Federal Regulations (as in effect on the date of the 

22 enactment of this Act), if the application is received not 

23 later than one year after the separation of the member 

24 or former member from the Armed Forces. 


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1 SEC. 3. UNIFORM CREDENTIALING STANDARDS FOR CER2 TAIN HEALTH CARE PROFESSIONALS OF THE 

3 DEPARTMENT OF VETERANS AFFAIRS. 

4 (a) IN GENERAL.—Subchapter II of chapter 74 of 

5 title 38, United States Code, is amended by inserting after 

6 section 7423 the following new section: 

7 ‘‘§ 7423A. Personnel administration: uniform creden8 tialing process. 

9 ‘‘(a) UNIFORM PROCESS.—The Secretary shall imple10 ment a uniform credentialing process for employees of the 

11 Veterans Health Administration for each position specified 

12 in section 7421(b) of this title. 

13 ‘‘(b) RECOGNITION THROUGHOUT ADMINISTRA14 TION.—If an employee of the Administration in a position 

15 specified in section 7421(b) of this title is credentialed 

16 under this section for purposes of practicing in a location 

17 within the Administration, such credential shall be deemed 

18 to be sufficient for the employee to practice in any location 

19 within the Administration. 

20 ‘‘(c) RENEWAL.—(1) Except as provided in para21 graph (2), the Secretary may provide for the renewal of 

22 credentials under this section pursuant to such regulations 

23 as the Secretary may prescribe for such purpose. 

24 ‘‘(2) Renewal of credentials under this section may 

25 not be required solely because an employee moves from 

26 one facility of the Department to another.’’. 


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1 (b) CLERICAL AMENDMENT.—The table of sections 

2 at the beginning of chapter 74 of such title is amended 

3 by inserting after the item relating to section 7423 the 

4 following new item: 

‘‘7423A. Personnel administration: uniform credentialing process.’’. 

5 (c) EFFECTIVE DATE.—The Secretary of Veterans 

6 Affairs shall implement the uniform credentialing process 

7 required under section 7423A of such title, as added by 

8 subsection (a), not later than one year after the date of 

9 the enactment of this Act. 

10 SEC. 4. PROVISION OF FULL PRACTICE AUTHORITY FOR 

11 ADVANCED PRACTICE REGISTERED NURSES, 

12 PHYSICIAN ASSISTANTS, AND OTHER HEALTH 

13 CARE PROFESSIONALS OF THE DEPARTMENT 

14 OF VETERANS AFFAIRS. 

15 (a) FULL PRACTICE AUTHORITY.—The Secretary of 

16 Veterans Affairs shall provide full practice authority to ad17 vanced practice registered nurses, physician assistants, 

18 and such other licensed health care professionals of the 

19 Department of Veterans Affairs as the Secretary considers 

20 appropriate consistent with the education, training, and 

21 certification of such health care professionals. 

22 (b) INAPPLICABILITY OF STATE LIMITATIONS.—Full 

23 practice authority shall be provided by the Secretary under 

24 subsection (a) to health care professionals described in 

25 that subsection without regard to any limitation that 


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1 would otherwise be imposed on the health care practice 

2 of such professionals by a licensing or credentialing body 

3 of a State or otherwise under State law. 

4 (c) DEFINITIONS.—In this section: 

5 (1) ADVANCED PRACTICE REGISTERED

6 NURSE.—The term ‘‘advanced practice registered 

7 nurse’’ has the meaning given that term in section 

8 5509(e)(1) of Public Law 111–148 (42 U.S.C. 

9 1395ww note). 

10 (2) FULL PRACTICE AUTHORITY.—The term 

11 ‘‘full practice authority’’ means— 

12 (A) with respect to an advanced practice 

13 registered nurse, the full scope of practice for 

14 the area of nursing practiced by the advanced 

15 practice registered nurse as determined by the 

16 national professional association or organiza17 tion, a successor association or organization, or 

18 any other appropriate entity as determined by 

19 the Secretary for such area of nursing; 

20 (B) with respect to a physician assistant, 

21 the full scope of practice for the area of medi22 cine practiced by the physician assistant as de23 termined by the national professional associa24 tion or organization, a successor association or 

25 organization, or any other appropriate entity as 


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1 determined by the Secretary for such area of 

2 medicine; and 

3 (C) with respect to any other licensed 

4 health care professional not specified in sub5 paragraph (A) or (B), the full scope of practice 

6 for the area of medicine practiced by the li7 censed health care professional as determined 

8 by the national professional association or orga9 nization, a successor association or organiza10 tion, or any other appropriate entity as deter11 mined by the Secretary for such area of medi12 cine. 

13 (3) PHYSICIAN ASSISTANT.—The term ‘‘physi14 cian assistant’’ has the meaning given that term in 

15 section 1861(aa)(5)(A) of the Social Security Act 

16 (42 U.S.C. 1395x(aa)(5)(A)). 

Æ 


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