59–006 

114TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 2d Session 114–710 

GROW OUR OWN DIRECTIVE: PHYSICIAN ASSISTANT 

EMPLOYMENT AND EDUCATION ACT OF 2016 

SEPTEMBER 6, 2016.—Committed to the Committee of the Whole House on the State 

of the Union and ordered to be printed 

Mr. MILLER of Florida, from the Committee on Veterans’ Affairs, 

submitted the following 

R E P O R T 

[To accompany H.R. 3974] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on Veterans’ Affairs, to whom was referred the 

bill (H.R. 3974) to require the Secretary of Veterans Affairs to 

carry out a pilot program to provide educational assistance to certain former members of the Armed Forces for education and training as physician assistants of the Department of Veterans Affairs, 

to establish pay grades and require competitive pay for physician 

assistants of the Department, and for other purposes, having considered the same, report favorably thereon with amendment and 

recommend that the bill as amended do pass. 

CONTENTS 

Page 

Amendment .............................................................................................................. 2 

Purpose and Summary ............................................................................................ 4 

Background and Need for Legislation .................................................................... 5 

Hearings ................................................................................................................... 6 

Subcommittee Consideration .................................................................................. 6 

Committee Consideration ........................................................................................ 6 

Committee Votes ...................................................................................................... 7 

Committee Oversight Findings ............................................................................... 7 

Statement of General Performance Goals and Objectives .................................... 7 

New Budget Authority, Entitlement Authority, and Tax Expenditures ............. 7 

Earmarks and Tax and Tariff Benefits .................................................................. 7 

Committee Cost Estimate ....................................................................................... 7 

Congressional Budget Office Estimate ................................................................... 7 

Federal Mandates Statement ................................................................................. 9 

Advisory Committee Statement .............................................................................. 9 

Constitutional Authority Statement ...................................................................... 9 

Applicability to Legislative Branch ........................................................................ 10 


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Statement on Duplication of Federal Programs .................................................... 10 

Disclosure of Directed Rulemaking ........................................................................ 10 

Section-by-Section Analysis of the Legislation ...................................................... 10 

Changes in Existing Law Made by the Bill as Reported ...................................... 13 

AMENDMENT

The amendments are as follows: 

Strike all after the enacting clause and insert the following: 

SECTION 1. SHORT TITLE. 

This Act may be cited as the ‘‘Grow Our Own Directive: Physician Assistant Employment and Education Act of 2016’’. 

SEC. 2. PILOT PROGRAM TO PROVIDE EDUCATIONAL ASSISTANCE TO PHYSICIAN ASSISTANTS 

TO BE EMPLOYED AT THE DEPARTMENT OF VETERANS AFFAIRS. 

(a) PILOT PROGRAM.— 

(1) IN GENERAL.—The Secretary of Veterans Affairs shall carry out a pilot program to be known as the ‘‘Grow Our Own Directive’’ or ‘‘G.O.O.D.’’ pilot program (in this section referred to as the ‘‘pilot program’’) to provide educational 

assistance to certain former members of the Armed Forces for education and 

training as physician assistants of the Department of Veterans Affairs. 

(2) INFORMATION ON PILOT PROGRAM.—The Secretary shall provide information on the pilot program to eligible individuals under subsection (b), including 

information on application requirements and a list of entities with which the 

Secretary has partnered under subsection (g). 

(b) ELIGIBLE INDIVIDUALS.—An individual is eligible to participate in the pilot program if the individual— 

(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 postbaccalaureate training in a science relating to health care; 

(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 diseases and disorders; and 

(4) does not have a degree of doctor of medicine, doctor of osteopathy, or doctor of dentistry. 

(c) DURATION.—The pilot program shall be carried out during the five-year period 

beginning on the date that is 180 days after the date of the enactment of this Act. 

(d) SELECTION.— 

(1) IN GENERAL.—The Secretary shall select not less than 250 eligible individuals under subsection (b) to participate in the pilot program. 

(2) PRIORITY FOR SELECTION.—In selecting individuals to participate in the 

pilot program under paragraph (1), the Secretary shall give priority to the following individuals: 

(A) Individuals who participated in the Intermediate Care Technician 

Pilot Program of the Department that was carried out by the Secretary between January 2011 and February 2015. 

(B) Individuals who agree to be employed as a physician assistant for the 

Veterans Health Administration at a medical facility of the Department located in a community that— 

(i) is designated as a medically underserved population under section 

330(b)(3)(A) of the Public Health Service Act (42 U.S.C. 254b(b)(3)(A)); 

and 

(ii) is in a State with a per capita population of veterans of more than 

9 percent according to the National Center for Veterans Analysis and 

Statistics and the United States Census Bureau. 

(e) EDUCATIONAL ASSISTANCE.— 

(1) IN GENERAL.—In carrying out the pilot program, the Secretary shall provide educational assistance to individuals participating in the pilot program, including through the use of scholarships, to cover the costs to such individuals 

of obtaining a master’s degree in physician assistant studies or a similar master’s degree. 

(2) USE OF EXISTING PROGRAMS.—In providing educational assistance under 

paragraph (1), the Secretary shall use the Department of Veterans Affairs 

Health Professionals Educational Assistance Program under chapter 76 of title 

38, United States Code, and such other educational assistance programs of the 

Department as the Secretary considers appropriate. 


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(3) USE OF SCHOLARSHIPS.—The Secretary shall provide not less than 35 

scholarships under the pilot program to individuals participating in the pilot 

program during each year in which the pilot program is carried out. 

(f) PERIOD OF OBLIGATED SERVICE.— 

(1) IN GENERAL.—The Secretary shall enter into an agreement with each individual participating in the pilot program in which such individual agrees to be 

employed as a physician assistant for the Veterans Health Administration for 

a period of obligated service specified in paragraph (2). 

(2) PERIOD SPECIFIED.—With respect to each individual participating in the 

pilot program, the period of obligated service specified in this paragraph for the 

individual is— 

(A) if the individual is participating in the pilot program through a program described in subsection (e)(2) that specifies a period of obligated service, the period specified with respect to such program; or 

(B) if the individual is participating in the pilot program other than 

through a program described in such subsection, or if such program does 

not specify a period of obligated service, a period of three years or such 

other period as the Secretary considers appropriate for purposes of the pilot 

program. 

(g) BREACH.— 

(1) LIABILITY.—Except as provided in paragraph (2), an individual who participates in the pilot program and fails to satisfy the period of obligated service 

under subsection (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. 

(2) EXCEPTION.—If an individual is participating in the pilot program through 

a program described in subsection (e)(2) that specifies a period of obligated service, the liability of the individual for failing to satisfy the period of obligated 

service under subsection (f) shall be determined as specified with respect to 

such program. 

(h) MENTORS.—The Secretary shall ensure that a physician assistant mentor or 

mentors are available for individuals participating in the pilot program at each facility of the Veterans Health Administration at which a participant in the pilot program is employed. 

(i) PARTNERSHIPS.—In carrying out the pilot program, the Secretary shall seek to 

partner with the following: 

(1) Not less than 15 institutions of higher education that— 

(A) offer a master’s degree program in physician assistant studies or a 

similar area of study that is accredited by the Accreditation Review Commission on Education for the Physician Assistant; and 

(B) agree— 

(i) to guarantee seats in such master’s degree program for individuals 

participating in the pilot program who meet the entrance requirements 

for such master’s degree program; and 

(ii) to provide individuals participating in the pilot program with information on admissions criteria and the admissions process. 

(2) Other institutions of higher education that offer programs in physician assistant studies or other similar areas of studies that are accredited by the Accreditation Review Commission on Education for the Physician Assistant. 

(3) The Transition Assistance Program of the Department of Defense. 

(4) The Veterans’ Employment and Training Service of the Department of 

Labor. 

(5) Programs carried out under chapter 41 of title 38, United States Code, for 

the purpose of marketing and advertising the pilot program to veterans and 

members of the Armed Forces who may be interested in the pilot program. 

(j) ADMINISTRATION OF PILOT PROGRAM.—For purposes of carrying out the pilot 

program, the Secretary shall appoint or select within the Office of Physician Assistant Services of the Veterans Health Administration the following: 

(1) A Deputy Director for Education and Career Development of Physician Assistants who— 

(A) is a physician assistant, a veteran, and employed by the Department 

as of the date of the enactment of this Act; 

(B) is responsible for— 

(i) overseeing the pilot program; 

(ii) recruiting candidates to participate in the pilot program; 


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(iii) coordinating with individuals participating in the pilot program 

and assisting those individuals in applying and being admitted to a 

master’s degree program under the pilot program; and 

(iv) providing information to eligible individuals under subsection (b) 

with respect to the pilot program; and 

(C) may be employed in the field at a medical center of the Department. 

(2) A Deputy Director of Recruitment and Retention who— 

(A) is a physician assistant, a veteran, and employed by the Department 

as of the date of the enactment of this Act; 

(B) is responsible for— 

(i) identifying and coordinating the needs of the pilot program and 

assist the Secretary in providing mentors under subsection (h) to participants in the pilot program; and 

(ii) coordinating the staff of facilities of the Veterans Health Administration with respect to identifying employment positions and mentors 

under subsection (h) for participants in the pilot program; and 

(C) may be employed in the field at a medical center of the Department. 

(3) A recruiter who— 

(A) reports directly to the Deputy Director of Recruitment and Retention; 

and 

(B) works with the Workforce Management and Consulting Office and the 

Healthcare Talent Management Office of the Veterans Health Administration to develop and implement national recruiting strategic plans for the recruitment and retention of physician assistants within the Department. 

(4) An administrative assistant, compensated at a rate not less than level 

GS–6 of the General Schedule, or equivalent, who assists with administrative 

duties relating to the pilot program in the Office of Physician Assistant Services 

and such other duties as determined by the Secretary to ensure that the Office 

runs effectively and efficiently. 

(k) REPORT.— 

(1) IN GENERAL.—Not later than one year after the date of the enactment of 

this Act, the Secretary of Veterans Affairs, in collaboration with the Secretary 

of Labor, the Secretary of Defense, and the Secretary of Health and Human 

Services, shall submit to Congress a report on the pilot program. 

(2) ELEMENTS.—The report required by paragraph (1) shall include the following: 

(A) The extent to which the pilot program is effective in improving the 

ability of eligible individuals under subsection (b) to become physician assistants; 

(B) An examination of whether the pilot program is achieving the goals 

of— 

(i) enabling individuals to build on medical skills gained as members 

of the Armed Forces by entering into the physician assistant workforce 

of the Department; and 

(ii) helping to meet the shortage of physician assistants employed by 

the Department. 

(C) An identification of such modifications to the pilot program as the 

Secretary of Veterans Affairs, the Secretary of Labor, the Secretary of Defense, and the Secretary of Health and Human Services consider necessary 

to meet the goals described in subparagraph (B). 

(D) An assessment of whether the pilot program could serve as a model 

for other programs of the Department to assist individuals in obtaining certification and employment in other health care fields. 

Amend the title so as to read: 

A bill to require the Secretary of Veterans Affairs to carry out 

a pilot program to provide educational assistance to certain former 

members of the Armed Forces for education and training as physician assistants of the Department of Veterans Affairs. 

PURPOSE AND SUMMARY

H.R. 3974, the ‘‘Grow Our Own Directive: Physician Assistant 

Employment and Education Act of 2015,’’ was introduced by Representative Ann McLane Kuster of New Hampshire on November 

5, 2015. The bill, as amended, was ordered to be favorably reported 

to the full House on May 18, 2016, by voice vote. H.R. 3974, as 


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1May 15, 2015, Subcommittee on Health hearing, ‘‘Overcoming Barriers to More Efficient and 

Effective VA Staffing,’’ http://veterans.house.gov/hearing/overcoming-barriers-to-more-efficientand-effective-va-staffing. 2 January 30, 2015, VA Inspector General report, ‘‘Determination of VHA Occupational Staffing Shortages,’’ http://www.va.gov/oig/pubs/VAOIG–15–00430–103.pdf. 

amended, would direct the Department of Veterans Affairs (VA) to 

carry out the Grow Our Own Directive—or, G.O.O.D.—pilot program to provide educational assistance to certain former members 

of the Armed Forces for education and training as VA physician assistants (PAs). 

BACKGROUND AND NEED FOR LEGISLATION

The PA profession started in the mid-1960s in response to a nationwide shortage of primary care physicians. The first class of PAs 

were primarily composed of Army medics and Navy corpsman who 

had served in the Vietnam War. The significant number of veterans working as PAs has continued since that time and is illustrative of the unique relationship veterans and the VA health care 

system have historically had with the PA profession. According to 

testimony from the VA Physician Assistants Association (VAPAA), 

VA is the largest single federal employer of PAs, and a quarter of 

all primary care patients in the VA health care system are seen by 

PAs.1 However, VA has experienced recent difficulties recruiting 

and retaining PAs within the VA health care system, and as such, 

PAs are a top 5 mission-critical occupation for VA, ranking fourth 

according to a January 2015 VA Office of Inspector General (OIG) 

report.2

The Committee believes that PAs are critical to VA’s ability to 

provide access to timely, high-quality care to veteran patients and 

encourages VA to prioritize recruitment and retention of PAs within the VA health care system. As such, the bill would require VA 

to carry out the G.O.O.D. pilot for five years to assist certain veterans in obtaining education and training as PAs. Individuals eligible to participate in the G.O.O.D. pilot would include those with 

medical or military health experience who have received a certificate, associate degree, baccalaureate degree, master’s degree, or 

post-baccalaureate training in a science relating to health care and 

that have participated in the delivery of health care services or related medical services but do not have a doctor of medicine, doctor 

of osteopathy, or doctor of dentistry degree. VA would be required 

to select not less than 250 eligible individuals to participate in the 

pilot and give priority to those who participated in the VA Intermediate Care Technician pilot program and who agree to work as 

a PA at VA medical facilities in medically underserved communities or in states with a per capita population of veterans of more 

than nine percent. The bill would also require VA to provide educational assistance—to include not less than 35 scholarships—to individuals participating in the pilot program through the VA Health 

Professionals Educational Assistance program, to enter into an 

agreement for a period of obligated service with each individual 

participating in the pilot program who agrees to work as a VA PA, 

and to ensure PA mentors are available for pilot program participants. Finally, the bill would require VA to appoint a Deputy Director for PA Education and Career Development and a Deputy Director for Recruitment and Retention from within the VA Office of 


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PAs and to submit a report to Congress on the pilot program one 

year after enactment. 

HEARINGS

There were no full Committee hearings held on H.R. 3974, as 

amended. 

On April 20, 2016, the Subcommittee on Health held a legislative 

hearing on various bills introduced in the 114th Congress, including H.R. 3974. The following witnesses testified: 

The Honorable Lee Zeldin, U.S House of Representatives, 1st Congressional District, New York; The Honorable 

Mike Bost, U.S. House of Representatives, 12th Congressional District, Illinois; The Honorable Ann McLane 

Kuster; U.S. House of Representatives, 2nd Congressional 

District, New Hampshire; The Honorable Elise Stefanik, 

U.S. House of Representatives, 21st Congressional District, 

New York; The Honorable Jackie Walorski, U.S. House of 

Representatives, 2nd Congressional District, Indiana; 

Diane M. Zumatto, National Legislative Director, 

AMVETS; Shurhonda Y. Love, Assistant National Legislative Director, Disabled American Veterans; Fred S. 

Sganga, Legislative Officer, National Association of State 

Veteran Homes; Maureen McCarthy M.D., Assistant Deputy Under Secretary for Health for Patient Care Services, 

Veterans Health Administration, U.S. Department of Veterans Affairs; Accompanied by: Susan Blauert, Chief Counsel, Health Care Law Group, Office of General Counsel, 

U.S. Department of Veterans Affairs. 

Statements for the record were submitted by: 

The American Legion, American Psychiatric Association, 

Easter Seals, National Association of Mental Illness, Veterans Affairs Physician Assistant Association, Veterans of 

Foreign Wars of the United States. 

SUBCOMMITTEE CONSIDERATION

On April 29, 2016, the Subcommittee on Health met in open 

markup session, a quorum being present, and ordered H.R. 3974, 

as amended, favorably forwarded to the full Committee by voice 

vote. During consideration of the bill, the following amendment in 

the nature of a substitute was considered and agreed to by voice 

vote: 

An Amendment in the Nature of a Substitute to H.R. 

3974 offered by Representative Ann McLane Kuster of 

New Hampshire. 

COMMITTEE CONSIDERATION

On May 18, 2016, the full Committee met in open markup session, a quorum being present, and ordered H.R. 3974, as amended, 

reported favorably to the House of Representatives by voice vote. 

During consideration of the bill, the following amendment in the 

nature of a substitute was considered and agreed to by voice vote: 


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An Amendment in the Nature of a Substitute to H.R. 

3974, as amended, offered by Representative Ann McLane 

Kuster of New Hampshire. 

A motion by Representative Corrine Brown of Florida to favorably report H.R. 3974, as amended, to the House of Representatives was agreed to by voice vote. 

COMMITTEE VOTES

In compliance with clause 3(b) of rule XIII of the Rules of the 

House of Representatives, there were no recorded votes taken on 

amendments or in connection with ordering H.R. 3974, as amended, reported to the House. 

COMMITTEE OVERSIGHT FINDINGS

In compliance with clause 3(c)(1) of rule XIII and clause (2)(b)(1) 

of rule X of the Rules of the House of Representatives, the Committee’s oversight findings and recommendations are reflected in the 

descriptive portions of this report. 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

In accordance with clause 3(c)(4) of rule XIII of the Rules of the 

House of Representatives, the Committee’s performance goals and 

objectives are to ensure VA provides educational assistance to certain former members of the Armed Forces for education and training as VA physician assistants and increases access to care for veteran patients through the increased availability of VA physician assistants. 

NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX

EXPENDITURES

In compliance with clause 3(c)(2) of rule XIII of the Rules of the 

House of Representatives, the Committee adopts as its own the estimate of new budget authority, entitlement authority, or tax expenditures or revenues contained in the cost estimate prepared by 

the Director of the Congressional Budget Office pursuant to section 

402 of the Congressional Budget Act of 1974. 

EARMARKS AND TAX AND TARIFF BENEFITS

H.R. 3974, as amended, does not contain any Congressional earmarks, limited tax benefits, or limited tariff benefits as defined in 

clause 9 of rule XXI of the Rules of the House of Representatives. 

COMMITTEE COST ESTIMATE

The Committee adopts as its own the cost estimate on H.R. 3974, 

as amended, prepared by the Director of the Congressional Budget 

Office pursuant to section 402 of the Congressional Budget Act of 

1974. 

CONGRESSIONAL BUDGET OFFICE COST ESTIMATE

Pursuant to clause 3(c)(3) of rule XIII of the Rules of the House 

of Representatives, the following is the cost estimate for H.R. 3974, 

as amended, provided by the Congressional Budget Office pursuant 

to section 402 of the Congressional Budget Act of 1974: 


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U.S. CONGRESS, CONGRESSIONAL BUDGET OFFICE, Washington, DC, June 28, 2016. 

Hon. JEFF MILLER

Chairman, Committee on Veterans’ Affairs, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 3974, the Grow Our Own 

Directive: Physician Assistant Employment and Education Act of 

2016. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Ann E. Futrell. 

Sincerely, 

KEITH HALL. 

Enclosure. 

H.R. 3974—Grow Our Own Directive: Physician Assistant Employment and Education Act of 2016 

Summary: H.R. 3974 would require the Department of Veterans 

Affairs (VA) to carry out a five-year pilot program that would provide educational assistance to veterans training to be physician assistants (PAs) for the department. CBO estimates that implementing the bill would cost $36 million over the 2017–2021 period, 

subject to appropriation of the necessary amounts. 

Pay-as-you-go procedures do not apply because enacting the legislation would not affect direct spending or revenues. CBO estimates that enacting H.R. 3974 would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2027. 

H.R. 3974 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act (UMRA) 

and would impose no costs on state, local, or tribal governments. 

Estimated cost to the Federal Government: The estimated budgetary effect of H.R. 3974 is shown in the following table. The costs 

of this legislation fall within budget function 700 (veterans benefits 

and services). 

By fiscal year, in millions of dollars— 

2017 2018 2019 2020 2021 2017– 

2021 

INCREASE IN SPENDING SUBJECT TO APPROPRIATION 

Estimated Authorization Level ............................................................................. 3 7 10 11 6 37 

Estimated Outlays ............................................................................................... 2 7 10 11 6 36 

Basis of estimate: For this estimate, CBO assumes that H.R. 

3974 will be enacted near the start of fiscal year 2017, that the 

necessary amounts will be provided, and that outlays will follow 

historical spending patterns for affected programs. 

Within 180 days of enactment, the bill would require VA to establish a five-year pilot program that would pay for certain veterans to obtain master’s degrees in physician assistant studies. 

Participants in the pilot program would be required to work as PAs 

for VA for at least three years. The bill would require VA to offer 

educational assistance to at least 250 candidates and to provide no 

fewer than 35 scholarships each year. 


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A master’s degree program in physician assistant studies takes 

two years to complete. Based on a review of various graduate programs for PA studies, CBO estimates that the average annual cost 

for tuition was $36,000 in 2015 and, after accounting for projected 

inflation, would average about $44,000 over the 2017–2021 period. 

Based on the assistance provided by VA under the existing Health 

Professional Educational Assistance Program, CBO expects that 

VA would cover the full costs of tuition and provide an annual stipend that would average $22,000. CBO expects that those benefits 

would be provided to 35 people in 2017 and a total of 250 people 

through 2021. On that basis, CBO estimates that providing benefits under this program would cost $32 million over the 2017–2021 

period. 

To administer the pilot program, H.R. 3974 would require VA to 

establish two new deputy director positions and two supporting positions. On the basis of information from VA on compensation for 

deputy directors, we estimate that the salary and other benefits for 

that position would amount to roughly $190,000 a year. Including 

the costs of compensation for a recruiter, an administrative assistant, and the necessary office space, CBO estimates that administering the program would cost $4 million over the 2017–2021 period. 

In total, CBO estimates that implementing the pilot program 

would cost $36 million over the 2017–2021 period, assuming appropriation of the necessary amounts. 

Pay-As-You-Go considerations: None. 

Increase in long-term direct spending and deficits: CBO estimates that enacting H.R. 3974 would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2027. 

Intergovernmental and private-sector impact: H.R. 3974 contains 

no intergovernmental or private-sector mandates as defined in 

UMRA and would impose no costs on state, local, or tribal governments. 

Estimate prepared by: Federal Costs: Ann E. Futrell; Impact on 

State, Local, and Tribal Governments: Jon Sperl; Impact on the 

Private Sector: Paige Piper/Bach . 

Estimate approved by: H. Samuel Papenfuss, Deputy Assistant 

Director for Budget Analysis. 

FEDERAL MANDATES STATEMENT

The Committee adopts as its own the estimate of Federal mandates regarding H.R. 3974, as amended, prepared by the Director 

of the Congressional Budget Office pursuant to section 423 of the 

Unfunded Mandates Reform Act. 

ADVISORY COMMITTEE STATEMENT

No advisory committees within the meaning of section 5(b) of the 

Federal Advisory Committee Act would be created by H.R. 3974, as 

amended. 

STATEMENT OF CONSTITUTIONAL AUTHORITY

Pursuant to Article I, section 8 of the United States Constitution, 

H.R. 3974, as amended, is authorized by Congress’ power to ‘‘proVerDate Sep 11 2014 05:37 Sep 08, 2016 Jkt 059006 PO 00000 Frm 00009 Fmt 6659 Sfmt 6602 E:\HR\OC\HR710.XXX HR710

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vide for the common Defense and general Welfare of the United 

States.’’ 

APPLICABILITY TO LEGISLATIVE BRANCH

The Committee finds that H.R. 3974, as amended, does not relate 

to the terms and conditions of employment or access to public services or accommodations within the meaning of section 102(b)(3) of 

the Congressional Accountability Act. 

STATEMENT ON DUPLICATION OF FEDERAL PROGRAMS

Pursuant to section 3(g) of H. Res. 5, 114th Cong. (2015), the 

Committee finds that no provision of H.R. 3974, as amended, establishes or reauthorizes a program of the Federal Government known 

to be duplicative of another Federal program, a program that was 

included in any report from the Government Accountability Office 

to Congress pursuant to section 21 of Public Law 111–139, or a 

program related to a program identified in the most recent Catalog 

of Federal Domestic Assistance. 

DISCLOSURE OF DIRECTED RULEMAKING

Pursuant to section 3(i) of H. Res. 5, 114th Cong. (2015), the 

Committee estimates that H.R. 3974, as amended, contains no directed rule making that would require the Secretary to prescribe 

regulations. 

SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title 

Section 1 of the bill would provide the short title of the ‘‘Grow 

Our Own Directive: Physician Assistant Employment and Education Act of 2016.’’ 

Section 2. Pilot program to provide educational assistance to physician assistants to be employed at the Department of Veterans 

Affairs 

Section 2(a) of the bill would require VA to carry out a pilot program called the ‘‘Grow Our Own Directive’’ (or, ‘‘G.O.O.D.’’) to provide assistance to veterans for education and training as VA physician assistants. Section 2(a) would also require VA to provide relevant information—to include information regarding the application process and a list of entities with which VA has partnered— 

to individuals eligible for the G.O.O.D. pilot. 

Section 2(b) of the bill would require that the eligibility criteria 

for the G.O.O.D. pilot be defined as follows: (1) possession of medical or military health experience gained while serving as a member of the Armed Forces; (2) possession of a certificate, associate 

degree, baccalaureate degree, master’s degree, or post baccalaureate training in a science relating to health care; (3) participation in the delivery of health care services or related medical services, including military training relating to identification, evaluation, treatment, and prevention of diseases and disorders; and, (4) 

lack of a doctor of medicine, doctor of osteopathy, or doctor of dentistry degree. 


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Section 2(c) of the bill would require that the G.O.O.D. pilot be 

carried out for five years, beginning 180 days after the date of enactment. 

Section 2(d) of the bill would require VA to select at least 250 

eligible individuals to participate in the G.O.O.D. pilot. In selecting 

eligible individuals, VA would give priority to those who participated in the Intermediate Care Technician pilot program and those 

who agree to be employed as a physician assistant at a VA facility 

in a community that is designated as serving a medically underserved population in a state with a per capita veteran population 

of more than nine percent. 

Section 2(e) of the bill would require VA to provide assistance, 

including through scholarships, to individuals participating in the 

G.O.O.D. pilot to cover the costs of obtaining a master’s degree in 

physician assistant studies or a similar master’s degree. VA would 

also be required to use the VA Health Professionals Education Assistance Program and such other educational assistance programs 

as considered appropriate to individuals participating in the 

G.O.O.D. pilot. Additionally, VA would be required to provide at 

least 35 scholarships to individuals participating in the G.O.O.D. 

pilot during each year in which the pilot is carried out. 

Section 2(f) of the bill would require VA to enter into agreements 

with each G.O.O.D. pilot participant stipulating that the participant will be employed as a VA physician assistant for a period of 

three years, unless a participating individual is in a program described in subsection (e)(2) of the bill and that program specified 

a period of time during which that individual agreed to work for 

VA. 

Section 2(g) of the bill would require that an individual who participated in the G.O.O.D. pilot and who fails to satisfy the period 

of obligated service described in subsection (f)(2) of the bill is liable 

for the amount that has been paid or is payable to or on behalf of 

the individual reduced by the number of days served for completion 

of the period of obligated service. If an individual is participating 

in the G.O.O.D. pilot through a program described in subsection 

(e)(2) that specifies a period of obligated service, the liability of the 

individual for failing to satisfy the period of obligated service under 

subsection (f)(1) would be determined as specified with respect to 

such program. 

Section 2(h) of the bill would require VA to ensure physician assistant mentors are available for individuals participating in the 

G.O.O.D. pilot at each VA facility at which pilot participants are 

working. 

Section 2(i) of the bill would require that, in carrying out the 

G.O.O.D. pilot, VA seek to partner with: (1) at least 15 institutions 

of higher education that offer a master’s degree program in physician assistant studies or a similar area of study that is accredited 

by the Accreditation Review Commission on Education for the Physician Assistant and that agree to guarantee seats in such programs for individuals participating in the G.O.O.D. pilot who meet 

the entrance requirements and to provide pilot participants with 

information on admissions; (2) other institutions of higher education that offer programs in physician assistant studies or other 

similar areas of studies that are accredited by the Accreditation Review Commission on Education for the Physician Assistant; (3) the 


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Department of Defense Transition Assistance Program; (4) the Department of Labor Veterans’ Employment and Training Service; 

and (5) programs carried out under chapter 41 of title 38, U.S.C., 

for the purpose of marketing and advertising the G.O.O.D. pilot to 

veterans and members of the Armed Forces who may be interested. 

Section 2(j) of the bill would require that, for the purposes of carrying out the G.O.O.D. pilot, VA appoint from within the Office of 

Physician Assistants, a Deputy Director for Education and Career 

Development of Physician Assistants who is a physician assistant, 

a veteran, and a VA employee to be responsible for the following: 

(1) overseeing the G.O.O.D. pilot; (2) recruiting candidates to participate in the G.O.O.D. pilot; (3) coordinating with individuals participating in the G.O.O.D. pilot; and (4) assisting individuals participating in the G.O.O.D. pilot in applying to master’s programs. 

VA would also be required to select a Deputy Director of Recruitment and Retention who is a physician assistant employed by VA 

to be responsible for: (1) identifying and coordinating the needs of 

the pilot program; (2) assisting VA in providing mentors to 

G.O.O.D. pilot participants; and (3) coordinating VA facility staff 

with respect to identifying employment positions and mentors. This 

Section would also require VA require to select a recruiter to report 

directly to the Deputy Director of Recruitment and Retention and 

work with the Workforce Management and Consulting Office and 

the Healthcare Talent Management Office to develop and implement national recruiting strategic plans for the recruitment and retention of VA physician assistants. Further, Section 2(j) of the bill 

would require VA to select an administrative assistant, compensated at a rate not less than level GS–6 or equivalent, to assist 

with administrative duties relating to the G.O.O.D. pilot in the Office of Physician Assistant Services and such other duties as determined by the Secretary to ensure that the Office runs effectively 

and efficiently. 

Section 2(k) of the bill would require that, within one year of enactment, VA submit to Congress a report on the pilot program, in 

collaboration with the Department of Labor, the Department of Defense, and the Department of Health and Human Services. The report must include: (1) the extent to which the G.O.O.D. pilot is effective in improving the ability of participants to become physician 

assistants; (2) an examination of whether the G.O.O.D. pilot is 

achieving the goal of enabling individuals to build on medical skills 

gained as members of the Armed Forces by entering into the VA 

physician assistant workforce and helping to meet the shortage of 

physician assistants employed by VA; (3) an identification of such 

modifications to the pilot program as considered necessary; and (4) 

an assessment of whether the G.O.O.D. pilot could serve as a 

model for other VA programs. 


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CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

If enacted, this bill would make no changes in existing law. 

Æ 


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