II 

113TH CONGRESS 

2D SESSION S. 2425 

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

to reduce the shortage of psychiatrists in the Veterans Health Administration of the Department of Veterans Affairs by repaying loans for 

certain psychiatrists, to carry out a pilot program to provide housing 

allowances to health care providers of the Veterans Health Administration who accept assignment at rural and highly rural clinics, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 4, 2014 

Mr. BEGICH (for himself and Mr. PRYOR) introduced the following bill; which 

was read twice and referred to the Committee on Veterans’ Affairs 

A BILL 

To require the Secretary of Veterans Affairs to carry out 

a pilot program to reduce the shortage of psychiatrists 

in the Veterans Health Administration of the Department of Veterans Affairs by repaying loans for certain 

psychiatrists, to carry out a pilot program to provide 

housing allowances to health care providers of the Veterans Health Administration who accept assignment at 

rural and highly rural clinics, 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 ‘‘Ensuring Veterans’ 

3 Resiliency Act’’. 

4 SEC. 2. PILOT PROGRAM ON REPAYMENT OF EDUCATIONAL 

5 LOANS FOR CERTAIN PSYCHIATRISTS OF 

6 VETERANS HEALTH ADMINISTRATION. 

7 (a) IN GENERAL.—The Secretary of Veterans Affairs 

8 shall carry out a pilot program to repay loans of individ9 uals described in subsection (b) that— 

10 (1) were used by such individuals to finance the 

11 educational expenses of such individuals relating to 

12 psychiatric medicine, including education leading 

13 to— 

14 (A) an undergraduate degree; 

15 (B) a degree of doctor of medicine; or 

16 (C) a degree of doctor of osteopathy; and 

17 (2) were obtained from any of the following: 

18 (A) A governmental entity. 

19 (B) A private financial institution. 

20 (C) An institution of higher education. 

21 (D) Any other entity as specified the Sec22 retary for purposes of the pilot program. 

23 (b) ELIGIBLE INDIVIDUALS.— 

24 (1) IN GENERAL.—Subject to paragraph (2), an 

25 individual eligible for participation in the pilot pro26 gram is an individual who— 


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1 (A) either— 

2 (i) is licensed or eligible for licensure 

3 to practice psychiatric medicine in the Vet4 erans Health Administration of the De5 partment of Veterans Affairs; or 

6 (ii) is enrolled in the final year of a 

7 residency program leading to a specialty 

8 qualification in psychiatric medicine that is 

9 approved by the Accreditation Council for 

10 Graduate Medical Education; and 

11 (B) demonstrates a commitment to a long12 term career as a psychiatrist in the Veterans 

13 Health Administration, as determined by the 

14 Secretary. 

15 (2) PROHIBITION ON SIMULTANEOUS ELIGI16 BILITY.—An individual who is participating in any 

17 other program of the Federal Government that re18 pays the educational loans of the individual is not el19 igible to participate in the pilot program. 

20 (c) SELECTION.— 

21 (1) IN GENERAL.—The Secretary shall select 

22 not less than 10 individuals described in subsection 

23 (b) to participate in the pilot program for each year 

24 in which the Secretary carries out the pilot program. 


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1 (2) RURAL OR HIGHLY RURAL AREAS.—Of the 

2 individuals selected under paragraph (1), not less 

3 than five shall be individuals who practice psy4 chiatric medicine in a rural area or highly rural area 

5 or demonstrate a commitment to practice psychiatric 

6 medicine in such an area. 

7 (d) PERIOD OF OBLIGATED SERVICE.—The Sec8 retary shall enter into an agreement with each individual 

9 selected under subsection (c) in which such individual 

10 agrees to serve a period of obligated service for the Vet11 erans Health Administration in the field of psychiatric 

12 medicine, as determined by the Secretary for purposes of 

13 the pilot program, in exchange for the repayment of the 

14 loan or loans of such individual under the pilot program. 

15 (e) LOAN REPAYMENTS.— 

16 (1) IN GENERAL.—Subject to paragraph (2), a 

17 loan repayment under this section may consist of 

18 payment of the principal, interest, and related ex19 penses of a loan obtained by an individual who is 

20 participating in the pilot program for all educational 

21 expenses (including tuition, fees, books, and labora22 tory expenses) of such individual relating to edu23 cation described in subsection (a)(1). 

24 (2) LIMIT.—The amount paid by the Secretary 

25 under the pilot program for each year of obligated 


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1 service agreed to by an individual under subsection 

2 (d) may not exceed $60,000. 

3 (f) BREACH.— 

4 (1) LIABILITY.—An individual who participates 

5 in the pilot program and fails to satisfy the period 

6 of obligated service under subsection (d) shall be lia7 ble to the United States, in lieu of such obligated 

8 service, for the amount that has been paid to or on 

9 behalf of the individual under the pilot program, re10 duced by the proportion that the number of days 

11 served for completion of the period of obligated serv12 ice bears to the total number of days in the period 

13 of obligated service of such individual. 

14 (2) REPAYMENT PERIOD.—Any amount of dam15 ages that the United States is entitled to recover 

16 under this subsection shall be paid to the United 

17 States not later than one year after the date of the 

18 breach of the agreement. 

19 (g) REPORT.— 

20 (1) IN GENERAL.—Not later than 90 days after 

21 the date on which the pilot program terminates 

22 under subsection (i), the Secretary shall submit to 

23 the Committee on Veterans’ Affairs of the Senate 

24 and the Committee on Veterans’ Affairs of the 


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1 House of Representatives a report on the pilot pro2 gram. 

3 (2) ELEMENTS.—The report required by para4 graph (1) shall include the following: 

5 (A) An assessment of the overall effect of 

6 the pilot program on the psychiatric workforce 

7 shortage of the Veterans Health Administra8 tion. 

9 (B) A current assessment of the long-term 

10 stability of the psychiatric workforce of the Vet11 erans Health Administration. 

12 (C) Strategies of the Veterans Health Ad13 ministration to improve and increase the ability 

14 of the Administration to promote the physical 

15 and mental resiliency of all veterans. 

16 (h) REGULATIONS.—The Secretary shall prescribe 

17 regulations to carry out this section, including standards 

18 for qualified loans and authorized payees and other terms 

19 and conditions for the making of loan repayments. 

20 (i) TERMINATION.—The authority to carry out the 

21 pilot program shall expire on the date that is three years 

22 after the date on which the Secretary commences the pilot 

23 program. 


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1 SEC. 3. COMPTROLLER GENERAL OF THE UNITED STATES 

2 STUDY ON PAY DISPARITIES OF PSYCHIA3 TRISTS OF VETERANS HEALTH ADMINISTRA4 TION. 

5 (a) STUDY.— 

6 (1) IN GENERAL.—Not later than one year 

7 after the date of the enactment of this Act, the 

8 Comptroller General of the United States shall con9 duct a study of pay disparities among psychiatrists 

10 of the Veterans Health Administration of the De11 partment of Veterans Affairs. 

12 (2) ELEMENTS.—The study conducted under 

13 paragraph (1) shall include— 

14 (A) an examination of laws, regulations, 

15 practices, and policies, including salary flexibili16 ties, that contribute to pay disparities described 

17 in paragraph (1); and 

18 (B) recommendations with respect to legis19 lative or administrative actions to improve eq20 uity in pay among psychiatrists of the Veterans 

21 Health Administration. 

22 (b) REPORT.—Not later than one year after the date 

23 on which the Comptroller General completes the study 

24 under subsection (a), the Comptroller General shall sub25 mit to the Committee on Veterans’ Affairs of the Senate 


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1 and the Committee on Veterans’ Affairs of the House of 

2 Representatives a report on the results of the study. 

3 SEC. 4. PILOT PROGRAM ON HOUSING ALLOWANCES FOR 

4 HEALTH CARE PROVIDERS OF VETERANS 

5 HEALTH ADMINISTRATION ACCEPTING AS6 SIGNMENT AT RURAL AND HIGHLY RURAL 

7 COMMUNITY-BASED OUTPATIENT CLINICS. 

8 (a) PILOT PROGRAM AUTHORIZED.—The Secretary 

9 of Veterans Affairs may carry out a pilot program to as10 sess the feasibility and advisability of providing a housing 

11 allowance to health care providers of the Veterans Health 

12 Administration of the Department of Veterans Affairs who 

13 accept assignment at rural or highly rural community14 based outpatient clinics as a means of encouraging such 

15 health care providers to accept assignment to such clinics. 

16 (b) ELIGIBILITY.—An individual is eligible for par17 ticipation in the pilot program if the individual— 

18 (1) is a health care provider; 

19 (2) is, or agrees to become, an employee of the 

20 Veterans Health Administration on a full-time basis 

21 in a health care position designated by the Secretary 

22 for purposes of the pilot program; and 

23 (3) accepts an assignment in such position for 

24 a term of not less than 36 months at a rural or 

25 highly rural community-based outpatient clinic seVerDate Mar 15 2010 05:38 Jun 06, 2014 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2425.IS S2425

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1 lected by the Secretary for purposes of the pilot pro2 gram. 

3 (c) CONDITIONS ON PAYMENT OF HOUSING ALLOW4 ANCE.—Except as provided in subsection (d)(3), an indi5 vidual may be provided a housing allowance under the 

6 pilot program only while— 

7 (1) in good standing as a health care provider 

8 within the Veterans Health Administration; and 

9 (2) assigned as a health care provider at a rural 

10 or highly rural community-based outpatient clinic. 

11 (d) AMOUNT OF HOUSING ALLOWANCE.— 

12 (1) MONTHLY AMOUNT DURING INITIAL

13 TERM.—During the first 36 months of participation 

14 in the pilot program, the housing allowance provided 

15 a health care provider participating in the pilot pro16 gram shall be provided on a monthly basis at a rate 

17 that is equivalent to the monthly rate of basic allow18 ance for housing (BAH) payable under section 403 

19 of title 37, United States Code, to members of the 

20 uniformed services whose grade, dependency status, 

21 and geographic location most closely equals, as de22 termined by the Secretary, the grade of such pro23 vider under section 7404 of title 38, United States 

24 Code, and the dependency status and geographic lo25 cation of such provider. 


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1 (2) MONTHLY AMOUNT FOR CERTAIN PRO2 VIDERS FOR ADDITIONAL TERM.—If upon comple3 tion of the first 36 months in the pilot program a 

4 health care provider accepts continuing participation 

5 in the pilot program at a rural or highly rural com6 munity-based outpatient clinic for a term of not less 

7 than 12 additional months, the housing allowance 

8 provided the health care provider under the pilot 

9 program shall be provided on a monthly basis for 

10 such additional months at a rate determined in ac11 cordance with paragraph (1). 

12 (3) BONUS AMOUNT.— 

13 (A) COMPLETION OF INITIAL TERM.—Any 

14 health care provider who successfully completes 

15 36 months of participation in the pilot program 

16 shall be paid upon completion of participation 

17 in the pilot program an amount equal to three 

18 months of the monthly rate of housing allow19 ance provided the health care provider under 

20 paragraph (1) during the last month before the 

21 provider’s completion of participation in the 

22 pilot program. 

23 (B) COMPLETION OF ADDITIONAL ONE24 YEAR TERM.—Any health care provider who 

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1 tion in the pilot program shall be paid upon 

2 completion of participation in the pilot program 

3 an amount equal to 12 months of the monthly 

4 rate of housing allowance provided the health 

5 care provider under paragraph (2) during the 

6 last month before the provider’s completion of 

7 participation in the pilot program. 

8 (C) COMPLETION OF ADDITIONAL TWO9 YEAR TERM.—Any health care provider who 

10 successfully completes 60 months of participa11 tion in the pilot program shall be paid upon 

12 completion of participation in the pilot program 

13 an amount equal to 13 months of the monthly 

14 rate of housing allowance provided the health 

15 care provider under paragraph (2) during the 

16 last month before the provider’s completion of 

17 participation in the pilot program. 

18 (D) NO REQUIREMENT TO REMAIN ON AS19 SIGNMENT.—An amount payable under this 

20 paragraph shall be paid whether or not the 

21 health care provider concerned remains in an 

22 assignment at a rural or highly rural commu23 nity-based outpatient clinic. 

24 (e) SUPPLEMENTAL NATURE OF ALLOWANCE.—Any 

25 housing allowance provided under the pilot program shall 


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1 be in addition to any pay (including basic pay, special pay, 

2 and retirement or other bonus pay) payable to personnel 

3 of the Veterans Health Administration personnel under 

4 chapter 74 of title 38, United States Code, or any other 

5 provision of law. 

6 (f) ANNUAL REPORTS.— 

7 (1) IN GENERAL.—Not later than one year 

8 after the date of the enactment of this Act and not 

9 less frequently than once each year thereafter while 

10 the pilot program is in effect, the Secretary shall 

11 submit to the Committee on Veterans’ Affairs of the 

12 Senate and the Committee on Veterans’ Affairs of 

13 the House of Representatives a report on the pilot 

14 program. 

15 (2) ELEMENTS.—Each report submitted under 

16 paragraph (1) shall include the following: 

17 (A) A current description of the pilot pro18 gram, including the current number of partici19 pants in the pilot program and the amounts of 

20 housing allowance being provided such partici21 pants. 

22 (B) A current assessment of the value of 

23 the housing allowance under the pilot program 

24 in encouraging health care providers in acceptVerDate Mar 15 2010 05:38 Jun 06, 2014 Jkt 039200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S2425.IS S2425

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1 ing assignment to rural and highly rural com2 munity-based outpatient clinics. 

3 (g) FUNDING.—Amounts for housing allowances 

4 under the pilot program shall be derived from amounts 

5 available for the Veterans Health Administration for Med6 ical Services. 

7 (h) SUNSET.— 

8 (1) IN GENERAL.—No individual may com9 mence participation in the pilot program on or after 

10 the date that is five years after the date of the en11 actment of this Act. 

12 (2) CONTINUATION OF ON-GOING PROVISION OF

13 ALLOWANCE.—Nothing in paragraph (1) shall be 

14 construed to prohibit the Secretary from providing 

15 housing allowances under the pilot program to indi16 viduals who commence participation in the pilot pro17 gram before the date that is five years after the date 

18 of the enactment of this Act. 

19 (i) RURAL OR HIGHLY RURAL COMMUNITY-BASED

20 OUTPATIENT CLINIC DEFINED.—In this section, the term 

21 ‘‘rural or highly rural community-based outpatient clinic’’ 

22 means a community-based outpatient clinic of the Vet23 erans Health Administration that predominantly serves 

24 veterans who live in rural areas and highly rural areas. 


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1 SEC. 5. DEFINITIONS. 

2 In this Act: 

3 (1) HIGHLY RURAL AREA.—The term ‘‘highly 

4 rural area’’ means an area located in a county or 

5 similar community that has less than seven individ6 uals residing in that county or community per 

7 square mile. 

8 (2) RURAL AREA.—The term ‘‘rural area’’ 

9 means an area that is not an urbanized area or a 

10 highly rural area. 

11 (3) URBANIZED AREA.—The term ‘‘urbanized 

12 area’’ has the meaning given that term by the Direc13 tor of the Bureau of the Census. 

Æ 


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