174 
(5) The term ‘‘infrastructure’’ means improve-
ments to land other than buildings or structures. 
(6) The term ‘‘modernization’’ includes— 
(A) any action, including closure, required 
to align the form and function of a facility of 
the Veterans Health Administration to the pro-
vision of modern day health care, including util-
ities and environmental control systems; 
(B) the construction, purchase, lease, or 
sharing of a facility of the Veterans Health Ad-
ministration; and 
(C) realignments, disposals, exchanges, col-
laborations between the Department of Vet-
erans Affairs and other Federal entities, and 
strategic collaborations between the Depart-
ment and non-Federal entities, including tribal 
organizations. 
(7) The term ‘‘realignment’’, with respect to a 
facility of the Veterans Health Administration, in-
cludes— 
(A) any action that changes the numbers 
of or relocates services, functions, and per-
sonnel positions; 
(B) disposals or exchanges between the 
Department of Veterans Affairs and other Fed-
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175 
eral entities, including the Department of De-
fense; and 
(C) strategic collaborations between the 
Department of Veterans Affairs and non-Fed-
eral entities, including tribal organizations. 
(8) The term ‘‘redevelopment authority’’, in the 
case of a facility of the Veterans Health Administra-
tion closed or modernized under this subtitle, means 
any entity (including an entity established by a 
State or local government) recognized by the Sec-
retary of Veterans Affairs as the entity responsible 
for developing the redevelopment plan with respect 
to the facility or for directing the implementation of 
such plan. 
(9) The term ‘‘redevelopment plan’’ in the case 
of a facility of the Veterans Health Administration 
to be closed or realigned under this subtitle, means 
a plan that— 
(A) is agreed to by the local redevelopment 
authority with respect to the facility; and 
(B) provides for the reuse or redevelop-
ment of the real property and personal property 
of the facility that is available for such reuse 
and redevelopment as a result of the closure or 
realignment of the facility. 
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(10) The term ‘‘Secretary’’ means the Secretary 
of Veterans Affairs. 
(11) The term ‘‘tribal organization’’ has the 
meaning given such term in section 3765 of title 38, 
United States Code. 
Subtitle B—Other Infrastructure 
Matters 
SEC. 211. IMPROVEMENT TO TRAINING OF CONSTRUCTION 
PERSONNEL. 
Subsection (g) of section 8103 of title 38, United 
States Code, is amended to read as follows: 
‘‘(g)(1)(A) Not later than September 30 of the fiscal 
year following the fiscal year during which the VA Asset 
and Infrastructure Review Act of 2018 is enacted, the Sec-
retary shall implement the covered training curriculum 
and the covered certification program. 
‘‘(B) In designing and implementing the covered 
training curriculum and the covered certification program 
under paragraph (1), the Secretary shall use as models 
existing training curricula and certification programs that 
have been established under chapter 87 of title 10, United 
States Code, as determined relevant by the Secretary. 
‘‘(2) The Secretary may develop the training cur-
riculum under paragraph (1)(A) in a manner that provides 
such training in any combination of— 
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‘‘(A) training provided in person; 
‘‘(B) training provided over an internet website; 
or 
‘‘(C) training provided by another department 
or agency of the Federal Government. 
‘‘(3) The Secretary may develop the certification pro-
gram under paragraph (1)(A) in a manner that uses— 
‘‘(A) one level of certification; or 
‘‘(B) more than one level of certification, as de-
termined appropriate by the Secretary with respect 
to the level of certification for different grades of the 
General Schedule. 
‘‘(4) The Secretary may enter into a contract with 
an appropriate entity to provide the covered training cur-
riculum and the covered certification program under para-
graph (1)(A). 
‘‘(5)(A) Not later than September 30 of the second 
fiscal year following the fiscal year during which the VA 
Asset and Infrastructure Review Act of 2018 is enacted, 
the Secretary shall ensure that the majority of employees 
subject to the covered certification program achieve the 
certification or the appropriate level of certification pursu-
ant to paragraph (3), as the case may be. 
‘‘(B) After carrying out subparagraph (A), the Sec-
retary shall ensure that each employee subject to the cov-
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178 
ered certification program achieves the certification or the 
appropriate level of certification pursuant to paragraph 
(3), as the case may be, as quickly as practicable. 
‘‘(6) In this subsection: 
‘‘(A) The term ‘covered certification program’ 
means, with respect to employees of the Department 
of Veterans Affairs who are members of occupational 
series relating to construction or facilities manage-
ment, or employees of the Department who award or 
administer contracts for major construction, minor 
construction, or nonrecurring maintenance, including 
as contract specialists or contracting officers’ rep-
resentatives, a program to certify knowledge and 
skills relating to construction or facilities manage-
ment and to ensure that such employees maintain 
adequate expertise relating to industry standards 
and best practices for the acquisition of design and 
construction services. 
‘‘(B) The term ‘covered training curriculum’ 
means, with respect to employees specified in sub-
paragraph (A), a training curriculum relating to 
construction or facilities management.’’. 
SEC. 212. REVIEW OF ENHANCED USE LEASES. 
Section 8162(b)(6) is amended to read as follows: 
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179 
‘‘(6) The Office of Management and Budget shall re-
view each enhanced-use lease before the lease goes into 
effect to determine whether the lease is in compliance with 
paragraph (5).’’. 
SEC. 213. ASSESSMENT OF HEALTH CARE FURNISHED BY 
THE DEPARTMENT TO VETERANS WHO LIVE 
IN THE PACIFIC TERRITORIES. 
(a) IN GENERAL.—Not later than 180 days after the 
date of the enactment of this Act, the Secretary of Vet-
erans Affairs shall submit to the Committees on Veterans’ 
Affairs of the Senate and the House of Representatives 
a report regarding health care furnished by the Depart-
ment of Veterans Affairs to veterans who live in the Pa-
cific territories. 
(b) ELEMENTS.—The report under subsection (a) 
shall include assessments of the following: 
(1) The ability of the Department to furnish to 
veterans who live in the Pacific territories the fol-
lowing: 
(A) Hospital care. 
(B) Medical services. 
(C) Mental health services. 
(D) Geriatric services. 
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(2) The feasibility of establishing a community- 
based outpatient clinic of the Department in any Pa-
cific territory that does not contain such a facility. 
(c) DEFINITION.—In this section, the term ‘‘Pacific 
territories’’ means American Samoa, Guam, and the 
Northern Mariana Islands. 
TITLE III—IMPROVEMENTS TO 
RECRUITMENT 
OF 
HEALTH 
CARE PROFESSIONALS 
SEC. 301. DESIGNATED SCHOLARSHIPS FOR PHYSICIANS 
AND DENTISTS UNDER DEPARTMENT OF VET-
ERANS 
AFFAIRS 
HEALTH 
PROFESSIONAL 
SCHOLARSHIP PROGRAM. 
(a) SCHOLARSHIPS
FOR PHYSICIANS
AND DEN-
TISTS.—Section 7612(b) of title 38, United States Code, 
is amended by adding at the end the following new para-
graph: 
‘‘(6)(A) Of the scholarships awarded under this sub-
chapter, the Secretary shall ensure that not less than 50 
scholarships are awarded each year to individuals who are 
accepted for enrollment or enrolled (as described in section 
7602 of this title) in a program of education or training 
leading to employment as a physician or dentist until such 
date as the Secretary determines that the staffing short-
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181 
age of physicians and dentists in the Department is less 
than 500. 
‘‘(B) After such date, the Secretary shall ensure that 
of the scholarships awarded under this subchapter, a num-
ber of scholarships is awarded each year to individuals re-
ferred to in subparagraph (A) in an amount equal to not 
less than ten percent of the staffing shortage of physicians 
and dentists in the Department, as determined by the Sec-
retary. 
‘‘(C) Notwithstanding subsection (c)(1), the agree-
ment between the Secretary and a participant in the 
Scholarship Program who receives a scholarship pursuant 
to this paragraph shall provide the following: 
‘‘(i) The Secretary’s agreement to provide the 
participant with a scholarship under this subchapter 
for a specified number (from two to four) of school 
years during which the participant is pursuing a 
course of education or training leading to employ-
ment as a physician or dentist. 
‘‘(ii) The participant’s agreement to serve as a 
full-time employee in the Veterans Health Adminis-
tration for a period of time (hereinafter in this sub-
chapter referred to as the ‘period of obligated serv-
ice’) of 18 months for each school year or part 
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thereof for which the participant was provided a 
scholarship under the Scholarship Program. 
‘‘(D) In providing scholarships pursuant to this para-
graph, the Secretary may provide a preference for appli-
cants who are veterans. 
‘‘(E) On an annual basis, the Secretary shall provide 
to appropriate educational institutions informational ma-
terial about the availability of scholarships under this 
paragraph.’’. 
(b) BREACH OF AGREEMENT.—Section 7617 of such 
title is amended— 
(1) by redesignating paragraphs (4) and (5) as 
paragraphs (5) and (6), respectively; and 
(2) by inserting after paragraph (3) the fol-
lowing new paragraph (4): 
‘‘(4) In the case of a participant who is enrolled 
in a program or education or training leading to em-
ployment as a physician, the participant fails to suc-
cessfully complete post-graduate training leading to 
eligibility for board certification in a specialty.’’. 
(c) EXTENSION OF PROGRAM.—Section 7619 of such 
title is amended by striking ‘‘December 31, 2019’’ and in-
serting ‘‘December 31, 2033’’. 
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183 
SEC. 302. INCREASE IN MAXIMUM AMOUNT OF DEBT THAT 
MAY BE REDUCED UNDER EDUCATION DEBT 
REDUCTION PROGRAM OF DEPARTMENT OF 
VETERANS AFFAIRS. 
(a) INCREASE IN AMOUNT.—Section 7683(d)(1) is 
amended— 
(1) by striking ‘‘$120,000’’ and inserting 
‘‘$200,000’’; and 
(2) by striking ‘‘$24,000’’ and inserting 
‘‘$40,000’’. 
(b) STUDY.— 
(1) IN
GENERAL.—Not later than one year 
after the date of the enactment of this Act, the Sec-
retary of Veterans Affairs shall— 
(A) conduct a study on the demand for 
education debt reduction under subchapter VII 
of chapter 76 of title 38, United States Code; 
and 
(B) submit to the Committee on Veterans’ 
Affairs of the Senate and the Committee on 
Veterans’ Affairs of the House of Representa-
tives a report on the findings of the Secretary 
with respect to the study carried out under sub-
paragraph (A). 
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(2) CONSIDERATIONS.—In carrying out the 
study required by paragraph (1)(A), the Secretary 
shall consider the following: 
(A) The total number of vacancies within 
the Veterans Health Administration whose ap-
plicants are eligible to participate in the Edu-
cation Debt Reduction Program pursuant to 
section 7682(a) of such title. 
(B) The types of medical professionals in 
greatest demand in the United States. 
(C) Projections by the Secretary of the 
numbers and types of medical professions that 
meet the needs of veterans. 
SEC. 303. ESTABLISHING THE DEPARTMENT OF VETERANS 
AFFAIRS SPECIALTY EDUCATION LOAN RE-
PAYMENT PROGRAM. 
(a) IN GENERAL.—Chapter 76 of title 38, United 
States Code, is amended by inserting after subchapter VII 
the following new subchapter: 
‘‘SUBCHAPTER VIII—SPECIALTY EDUCATION 
LOAN REPAYMENT PROGRAM 
‘‘§ 7691. Establishment 
‘‘As part of the Educational Assistance Program, the 
Secretary may carry out a student loan repayment pro-
gram under section 5379 of title 5. The program shall be 
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known as the Department of Veterans Affairs Specialty 
Education Loan Repayment Program (in this chapter re-
ferred to as the ‘Specialty Education Loan Repayment 
Program’). 
‘‘§ 7692. Purpose 
‘‘The purpose of the Specialty Education Loan Re-
payment Program is to assist, through the establishment 
of an incentive program for certain individuals employed 
in the Veterans Health Administration, in meeting the 
staffing needs of the Veterans Health Administration for 
physicians in medical specialties for which the Secretary 
determines recruitment or retention of qualified personnel 
is difficult. 
‘‘§ 7693. Eligibility; preferences; covered costs 
‘‘(a) ELIGIBILITY.—An individual is eligible to par-
ticipate in the Specialty Education Loan Repayment Pro-
gram if the individual— 
‘‘(1) is hired under section 7401 of this title to 
work in an occupation described in section 7692 of 
this title; 
‘‘(2) owes any amount of principal or interest 
under a loan, the proceeds of which were used by or 
on behalf of that individual to pay costs relating to 
a course of education or training which led to a de-
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186 
gree that qualified the individual for the position re-
ferred to in paragraph (1); and 
‘‘(3) is— 
‘‘(A) recently graduated from an accredited 
medical or osteopathic school and matched to 
an accredited residency program in a medical 
specialty described in section 7692 of this title; 
or 
‘‘(B) a physician in training in a medical 
specialty described in section 7692 of this title 
with more than two years remaining in such 
training. 
‘‘(b) PREFERENCES.—In selecting individuals for 
participation in the Specialty Education Loan Repayment 
Program under this subchapter, the Secretary may give 
preference to the following: 
‘‘(1) Individuals who are, or will be, partici-
pating in residency programs in health care facili-
ties— 
‘‘(A) located in rural areas; 
‘‘(B) operated by Indian tribes, tribal orga-
nizations, or the Indian Health Service; or 
‘‘(C) affiliated with underserved health 
care facilities of the Department. 
‘‘(2) Veterans. 
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‘‘(c) COVERED COSTS.—For purposes of subsection 
(a)(2), costs relating to a course of education or training 
include— 
‘‘(1) tuition expenses; 
‘‘(2) all other reasonable educational expenses, 
including expenses for fees, books, equipment, and 
laboratory expenses; and 
‘‘(3) reasonable living expenses. 
‘‘§ 7694. Specialty education loan repayment 
‘‘(a) IN GENERAL.—Payments under the Specialty 
Education Loan Repayment Program shall consist of pay-
ments for the principal and interest on loans described in 
section 7682(a)(2) of this title for individuals selected to 
participate in the Program to the holders of such loans. 
‘‘(b) FREQUENCY
OF
PAYMENT.—The Secretary 
shall make payments for any given participant in the Spe-
cialty Education Loan Repayment Program on a schedule 
determined appropriate by the Secretary. 
‘‘(c) MAXIMUM AMOUNT; WAIVER.—(1) The amount 
of payments made for a participant under the Specialty 
Education Loan Repayment Program may not exceed 
$160,000 over a total of four years of participation in the 
Program, of which not more than $40,000 of such pay-
ments may be made in each year of participation in the 
Program. 
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‘‘(2)(A) The Secretary may waive the limitations 
under paragraph (1) in the case of a participant described 
in subparagraph (B). In the case of such a waiver, the 
total amount of payments payable to or for that partici-
pant is the total amount of the principal and the interest 
on the participant’s loans referred to in subsection (a). 
‘‘(B) A participant described in this subparagraph is 
a participant in the Program who the Secretary deter-
mines serves in a position for which there is a shortage 
of qualified employees by reason of either the location or 
the requirements of the position. 
‘‘§ 7695. Choice of location 
‘‘Each participant in the Specialty Education Loan 
Repayment Program who completes residency may select, 
from a list of medical facilities of the Veterans Health Ad-
ministration provided by the Secretary, at which such fa-
cility the participant will work in a medical specialty de-
scribed in section 7692 of this title. 
‘‘§ 7696. Term of obligated service 
‘‘(a) IN GENERAL.—In addition to any requirements 
under section 5379(c) of title 5, a participant in the Spe-
cialty Education Loan Repayment Program must agree, 
in writing and before the Secretary may make any pay-
ment to or for the participant, to— 
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‘‘(1) obtain a license to practice medicine in a 
State; 
‘‘(2) successfully complete post-graduate train-
ing leading to eligibility for board certification in a 
specialty; 
‘‘(3) serve as a full-time clinical practice em-
ployee of the Veterans Health Administration for 12 
months for every $40,000 in such benefits that the 
employee receives, but in no case for fewer than 24 
months; and 
‘‘(4) except as provided in subsection (b), to 
begin such service as a full-time practice employee 
by not later than 60 days after completing a resi-
dency. 
‘‘(b) FELLOWSHIP.—In the case of a participant who 
receives an accredited fellowship in a medical specialty 
other than a medical specialty described in section 7692 
of this title, the Secretary, on written request of the par-
ticipant, may delay the term of obligated service under 
subsection (a) for the participant until after the partici-
pant completes the fellowship, but in no case later than 
60 days after completion of such fellowship. 
‘‘(c) PENALTY.—(1) An employee who does not com-
plete a period of obligated service under this section shall 
owe the Federal Government an amount determined in ac-
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cordance with the following formula: A = B × ((T ¥ S) 
÷ T)). 
‘‘(2) In the formula in paragraph (1): 
‘‘(A) ‘A’ is the amount the employee owes the 
Federal Government. 
‘‘(B) ‘B’ is the sum of all payments to or for 
the participant under the Specialty Education Loan 
Repayment Program. 
‘‘(C) ‘T’ is the number of months in the period 
of obligated service of the employee. 
‘‘(D) ‘S’ is the number of whole months of such 
period of obligated service served by the employee. 
‘‘§ 7697. Relationship to Educational Assistance Pro-
gram 
‘‘Assistance under the Specialty Education Loan Re-
payment Program may be in addition to other assistance 
available to individuals under the Educational Assistance 
Program.’’. 
(b) CONFORMING AND TECHNICAL AMENDMENTS.— 
(1) CONFORMING AMENDMENTS.— 
(A) Section 7601(a) of title 38, United 
States Code, is amended— 
(i) in paragraph (4), by striking 
‘‘and’’; 
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(ii) in paragraph (5), by striking the 
period and inserting ‘‘; and’’; and 
(iii) by adding at the end the fol-
lowing new paragraph: 
‘‘(6) the specialty education loan repayment 
program provided for in subchapter VIII of this 
chapter.’’. 
(B) Section 7603(a)(1) of title 38, United 
States Code, is amended by striking ‘‘or VI’’ 
and inserting ‘‘VI, or VIII’’. 
(C) Section 7604 of title 38, United States 
Code, is amended by striking ‘‘or VI’’ each 
place it appears and inserting ‘‘VI, or VIII’’. 
(D) Section 7631 of title 38, United States 
Code, is amended— 
(i) in subsection (a)(1)— 
(I) 
by 
striking 
‘‘and’’ 
after 
‘‘scholarship amount’’; and 
(II) by inserting ‘‘, and the max-
imum specialty education loan repay-
ment amount’’ after ‘‘reduction pay-
ments amount’’; and 
(ii) in subsection (b) by adding at the 
end the following new paragraph: 
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‘‘(7) The term ‘specialty education loan repayment 
amount’ means the maximum amount of specialty edu-
cation loan repayment payments payable to or for a partic-
ipant in the Department of Veterans Affairs Specialty 
Education Loan Repayment Program under subchapter 
VIII of this chapter, as specified in section 7694(c)(1) of 
this title and as previously adjusted (if at all) in accord-
ance with this section.’’. 
(E) Section 7632 of title 38, United States 
Code, is amended— 
(i) in paragraph (1), by striking ‘‘and 
the Education Debt Reduction Program’’ 
and inserting ‘‘the Education Debt Reduc-
tion Program, and the Specialty Education 
Loan Repayment Program’’; and 
(ii) in paragraph (4), by striking ‘‘and 
per participant in the Education Debt Re-
duction Program’’ and inserting ‘‘per par-
ticipant in the Education Debt Reduction 
Program, and per participant in the Spe-
cialty Education Loan Repayment Pro-
gram’’. 
(2) TABLE OF SECTIONS.—The table of sections 
at the beginning of chapter 76 of such title is 
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amended by inserting after the items relating to sub-
chapter VII the following: 
‘‘SUBCHAPTER VIII—SPECIALTY EDUCATION LOAN REPAYMENT PROGRAM 
‘‘Sec. 
‘‘7691. Establishment. 
‘‘7692. Purpose. 
‘‘7693. Eligibility; preferences; covered costs. 
‘‘7694. Specialty education loan repayment. 
‘‘7695. Choice of location. 
‘‘7696. Term of obligated service. 
‘‘7697. Relationship to Educational Assistance Program.’’. 
(c) NEEDS OF THE VHA.—In making determinations 
each year under section 7692 of title 38, United States 
Code, as enacted by subsection (a), the Secretary of Vet-
erans Affairs shall consider the anticipated needs of the 
Veterans Health Administration during the period two to 
six years in the future. 
(d) PREFERENCE.—In granting preference under 
section 7693 of title 38, United States Code, as enacted 
by subsection (a), the Secretary of Veterans Affairs shall 
determine whether a facility of the Department is under-
served based on the criteria developed under section 401 
of this Act. 
(e) OFFER DEADLINE.—In the case of an applicant 
who applies before receiving a residency match and whom 
the Secretary of Veterans Affairs selects for participation 
in the Specialty Education Loan Repayment Program es-
tablished by subsection (a), the Secretary shall offer par-
ticipation to the applicant not later than 28 days after— 
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(1) the applicant matches with a residency in a 
medical specialty described in section 7692 of title 
38, United States Code, as enacted by subsection 
(a); and 
(2) such match is published. 
(f) PUBLICITY.—The Secretary of Veterans Affairs 
shall take such steps as the Secretary determines are ap-
propriate to publicize the Specialty Education Loan Re-
payment Program established under subchapter VIII of 
chapter 76 of title 38, United States Code, as enacted by 
subsection (a). 
SEC. 304. VETERANS HEALING VETERANS MEDICAL ACCESS 
AND SCHOLARSHIP PROGRAM. 
(a) ESTABLISHMENT.—The Secretary of Veterans 
Affairs, acting through the Office of Academic Affiliations 
of the Department of Veterans Affairs, shall carry out a 
pilot program under which the Secretary shall provide 
funding for the medical education of a total of 18 eligible 
veterans. Such funding shall be provided for two veterans 
enrolled in each covered medical schools in accordance 
with this section. 
(b) ELIGIBLE VETERANS.—To be eligible to receive 
funding for medical education under this section, a vet-
eran shall— 
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(1) have been discharged from the Armed 
Forces not more than ten years before the date of 
application for admission to a covered medical 
school; 
(2) not be entitled to educational assistance 
under chapter 30, 31, 32, 33, 34, or 35 of title 38, 
United States Code, or chapter 1606 or 1607 of title 
10, United States Code; 
(3) apply for admission to a covered medical 
school for the entering class of 2019; 
(4) indicate on such application for admission 
that the veteran would like to be considered for an 
award of funding under this section; 
(5) meet the minimum admissions criteria for 
the covered medical school to which the veteran ap-
plies; and 
(6) enter into an agreement described in sub-
section (e). 
(c) AWARD OF FUNDING.— 
(1) IN GENERAL.—Each covered medical school 
that opts to participate in the program under this 
section shall reserve two seats in the entering class 
of 2019 for eligible veterans who receive funding 
under such program. Such funding shall be awarded 
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to the two eligible veterans with the highest admis-
sions rankings for such class at such school. 
(2) AMOUNT OF FUNDING.—Each eligible vet-
eran who receives funding under this section shall 
receive an amount equal to the actual cost of— 
(A) tuition at the covered medical school at 
which the veteran enrolls for four years; 
(B) books, fees, and technical equipment; 
(C) fees associated with the National Resi-
dency Match Program; 
(D) two away rotations performed during 
the fourth year at a Department of Veterans 
Affairs medical facility; and 
(E) a monthly stipend for the four-year pe-
riod during which the veteran is enrolled in 
medical school in an amount to be determined 
by the Secretary. 
(3) DISTRIBUTION OF FUNDING.—In the event 
that two or more eligible veterans do not apply for 
admission at one of the covered medical schools for 
the entering class of 2019, the Secretary shall dis-
tribute the available funding to eligible veterans who 
applied for admission at other covered medical 
schools. 
(d) AGREEMENT.— 
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(1) TERMS OF AGREEMENT.—Each eligible vet-
eran who accepts funding for medical education 
under this section shall enter into an agreement with 
the Secretary that provides that the veteran 
agrees— 
(A) to maintain enrollment and attendance 
in the medical school; 
(B) while enrolled in such medical school, 
to maintain an acceptable level of academic 
standing (as determined by the medical school 
under regulations prescribed by the Secretary); 
(C) to complete post-graduate training 
leading to eligibility for board certification in a 
speciality applicable to the Department of Vet-
erans Affairs, as determined by the Secretary; 
(D) after completion of medical school, to 
obtain a license to practice medicine in a State; 
and 
(E) after completion of medical school and 
post-graduate training, to serve as a full-time 
clinical practice employee in the Veterans 
Health Administration for a period of four 
years. 
(2) BREACH
OF
AGREEMENT.—If an eligible 
veteran who accepts funding under this section 
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breaches the terms of the agreement described in 
paragraph (1), the United States shall be entitled to 
recover damages in an amount equal to the total 
amount of such funding received by the veteran. 
(e) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to prevent any covered medical 
school from accepting more than two eligible veterans for 
the entering class of 2019. 
(f) REPORT TO CONGRESS.—Not later than Decem-
ber 31, 2020, and annually thereafter for the subsequent 
three years, the Secretary shall submit to Congress a re-
port on the pilot program under this section. Such report 
shall include the evaluation of the Secretary of the success 
of the pilot program, including the number of veterans 
who received funding under the program who matriculated 
and an evaluation of the academic progress of such vet-
erans. 
(g) COVERED MEDICAL SCHOOLS.—In this section, 
the term ‘‘covered medical school’’ means any of the fol-
lowing. 
(1) The Teague-Cranston medical schools, con-
sisting of— 
(A) Texas A&M College of Medicine; 
(B) Quillen College of Medicine at East 
Tennessee State University; 
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(C) Boonshoft School of Medicine at 
Wright State University; 
(D) Joan C. Edwards School of Medicine 
at Marshall University; and 
(E) University of South Carolina School of 
Medicine. 
(2) Charles R Drew University of Medicine and 
Science. 
(3) Howard University College of Medicine. 
(4) Meharry Medical College. 
(5) Morehouse School of Medicine. 
SEC. 305. BONUSES FOR RECRUITMENT, RELOCATION, AND 
RETENTION. 
Section 705(a) of the Veterans Access, Choice, and 
Accountability Act of 2014 (Public Law 113–146; 38 
U.S.C. 703 note) is amended— 
(1) 
in 
paragraph 
(1), 
by 
striking 
‘‘$230,000,000’’ and inserting ‘‘$250,000,000, of 
which not less than $20,000,000 shall be for recruit-
ment, relocation, and retention bonuses’’; and 
(2) 
in 
paragraph 
(2), 
by 
striking 
‘‘$225,000,000’’ and inserting ‘‘$290,000,000, of 
which not less than $20,000,000 shall be for recruit-
ment, relocation, and retention bonuses’’. 
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SEC. 306. INCLUSION OF VET CENTER EMPLOYEES IN EDU-
CATION DEBT REDUCTION PROGRAM OF DE-
PARTMENT OF VETERANS AFFAIRS. 
(a) IN GENERAL.—The Secretary of Veterans Affairs 
shall ensure that clinical staff working at Vet Centers are 
eligible to participate in the Education Debt Reduction 
Program of the Department of Veterans Affairs under 
subchapter VII of chapter 76 of title 38, United States 
Code. 
(b) REPORT.—Not later than one year after the date 
of the enactment of this Act, the Secretary shall submit 
to the Committee on Veterans’ Affairs of the Senate and 
the Committee on Veterans’ Affairs of the House of Rep-
resentatives a report on the number of participants in the 
Education Debt Reduction Program of the Department 
under such subchapter who work at Vet Centers. 
(c) VET CENTER DEFINED.—In this section, the 
term ‘‘Vet Center’’ has the meaning given that term in 
section 1712A(h) of title 38, United States Code. 
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201 
TITLE IV—HEALTH CARE IN 
UNDERSERVED AREAS 
SEC. 401. DEVELOPMENT OF CRITERIA FOR DESIGNATION 
OF CERTAIN MEDICAL FACILITIES OF THE 
DEPARTMENT OF VETERANS AFFAIRS AS UN-
DERSERVED FACILITIES AND PLAN TO AD-
DRESS PROBLEM OF UNDERSERVED FACILI-
TIES. 
(a) IN GENERAL.—Not later than 180 days after the 
date of the enactment of this Act, the Secretary of Vet-
erans Affairs shall develop criteria to designate medical 
centers, ambulatory care facilities, and community based 
outpatient clinics of the Department of Veterans Affairs 
as underserved facilities. 
(b) CONSIDERATION.—Criteria developed under sub-
section (a) shall include consideration of the following with 
respect to a facility: 
(1) The ratio of veterans to health care pro-
viders of the Department of Veterans Affairs for a 
standardized geographic area surrounding the facil-
ity, including a separate ratio for general practi-
tioners and specialists. 
(2) The range of clinical specialties covered by 
such providers in such area. 
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(3) Whether the local community is medically 
underserved. 
(4) The type, number, and age of open consults. 
(5) Whether the facility is meeting the wait- 
time goals of the Department. 
(6) Such other criteria as the Secretary con-
siders important in determining which facilities are 
not adequately serving area veterans. 
(c) ANALYSIS OF FACILITIES.—Not less frequently 
than annually, directors of Veterans Integrated Service 
Networks of the Department shall perform an analysis to 
determine which facilities within that Veterans Integrated 
Service Network qualify as underserved facilities pursuant 
to criteria developed under subsection (a). 
(d) ANNUAL PLAN TO ADDRESS UNDERSERVED FA-
CILITIES.— 
(1) PLAN REQUIRED.—Not later than one year 
after the date of the enactment of this Act and not 
less frequently than once each year, the Secretary 
shall submit to Congress a plan to address the prob-
lem of underserved facilities of the Department, as 
designated pursuant to criteria developed under sub-
section (a). 
(2) CONTENTS.—Each plan submitted under 
paragraph (1) shall address the following: 
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(A) Increasing personnel or temporary per-
sonnel assistance, including mobile deployment 
teams furnished under section 407 of this Act. 
(B) Providing special hiring incentives, in-
cluding under the Education Debt Reduction 
Program under subchapter VII of chapter 76 of 
title 38, United States Code, and recruitment, 
relocation, and retention incentives. 
(C) Using direct hiring authority. 
(D) Improving training opportunities for 
staff. 
(E) Such other actions as the Secretary 
considers appropriate. 
SEC. 402. PILOT PROGRAM TO FURNISH MOBILE DEPLOY-
MENT TEAMS TO UNDERSERVED FACILITIES. 
(a) IN GENERAL.—The Secretary of Veterans Affairs 
shall carry out a pilot program to furnish mobile deploy-
ment teams of medical personnel to underserved facilities. 
(b) ELEMENTS.—In furnishing mobile deployment 
teams under subsection (a), the Secretary shall consider 
the following elements: 
(1) The medical positions of greatest need at 
underserved facilities. 
(2) The size and composition of teams to be de-
ployed. 
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(3) Such other elements as the Secretary con-
siders necessary for effective oversight of the pro-
gram established under subsection (a). 
(c) USE OF ANNUAL ANALYSIS.—The Secretary shall 
use the results of the annual analysis conducted under sec-
tion 401(c) of this Act to form mobile deployment teams 
under subsection (a) that are composed of the most needed 
medical personnel for underserved facilities. 
(d) REPORTING.— 
(1) PROGRESS
REPORT.—Not later than one 
year after the date of the enactment of this Act, the 
Secretary shall submit a report to Congress on the 
implementation of the pilot program under this sec-
tion. 
(2) FINAL REPORT.—Not later than the termi-
nation of the pilot program under this section, the 
Secretary shall submit a final report to Congress 
that contains the recommendations of the Secretary 
regarding the feasibility and advisability of— 
(A) extending or expanding the pilot pro-
gram; and 
(B) making the pilot program (or any as-
pect thereof) permanent. 
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(e) DURATION.—The pilot program under this sec-
tion shall terminate three years after the date of the enact-
ment of this Act. 
(f) UNDERSERVED FACILITY DEFINED.—In this sec-
tion, the term ‘‘underserved facility’’ means a medical cen-
ter, ambulatory care facility, or community based out-
patient clinic of the Department of Veterans Affairs des-
ignated by the Secretary of Veterans Affairs as under-
served pursuant to criteria developed under section 401 
of this Act. 
SEC. 403. PILOT PROGRAM ON GRADUATE MEDICAL EDU-
CATION AND RESIDENCY. 
(a) ESTABLISHMENT.— 
(1) IN GENERAL.—Subject to paragraph (5), 
the Secretary of Veterans Affairs shall establish a 
pilot program to establish medical residency posi-
tions authorized under section 301(b)(2) of the Vet-
erans Access, Choice, and Accountability Act of 
2014 (Public Law 113–146; 38 U.S.C. 7302 note) 
at covered facilities. 
(2) COVERED
FACILITIES.—For purposes of 
this section, a covered facility is any of the following: 
(A) A health care facility of the Depart-
ment of Veterans Affairs. 
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(B) A health care facility operated by an 
Indian tribe or a tribal organization, as those 
terms are defined in section 4 of the Indian 
Self-Determination and Education Assistance 
Act (25 U.S.C. 5304). 
(C) A health care facility operated by the 
Indian Health Service. 
(D) A Federally-qualified health center, as 
defined in section 1905(l)(2)(B) of the Social 
Security Act (42 U.S.C. 1396d(l)(2)(B)). 
(E) A health care facility operated by the 
Department of Defense. 
(F) Such other health care facility as the 
Secretary considers appropriate for purposes of 
this section. 
(3) AGREEMENTS.—To carry out the pilot pro-
gram under this section, the Secretary may enter 
into agreements with entities that operate covered 
facilities in which the Secretary places residents 
under paragraph (1). 
(4) PARAMETERS
FOR
LOCATION, AFFILIATE 
SPONSOR, AND
DURATION.—When determining in 
which covered facilities to place residents under 
paragraph (1), the Secretary shall consider the ex-
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tent to which there is a clinical need for providers 
in an area, as determined by the following: 
(A) The ratio of veterans to health care 
providers of the Department for a standardized 
geographic area surrounding a facility, includ-
ing a separate ratio for general practitioners 
and specialists. 
(B) The range of clinical specialties of pro-
viders in standardized geographic areas sur-
rounding a facility. 
(C) Whether the specialty of a provider is 
included in the most recent staffing shortage 
determination of the Department under section 
7412 of title 38, United States Code. 
(D) Whether the local community is des-
ignated by the Secretary of Veterans Affairs as 
underserved pursuant to criteria developed 
under section 401 of this Act. 
(E) Whether the facility is located in a 
community that is designated by the Secretary 
of Health and Human Services as a health pro-
fessional shortage area under section 332 of the 
Public Health Service Act (42 U.S.C. 254e). 
(F) Whether the facility is located in a 
rural or remote area. 
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(G) Such other criteria as the Secretary 
considers important in determining which facili-
ties are not adequately serving area veterans. 
(5) PRIORITY
IN
PLACEMENTS.—During the 
pilot program under this section, the Secretary shall 
place no fewer than 100 residents in covered facili-
ties— 
(A) operated by the Indian Health Service; 
(B) operated by an Indian tribe; 
(C) operated by a tribal organization; or 
(D) located in communities designated by 
the Secretary as underserved pursuant to cri-
teria developed under section 401 of this Act. 
(6) STIPENDS AND BENEFITS.—The Secretary 
may pay stipends and provide benefits for residents 
in positions under paragraph (1), regardless of 
whether they have been assigned in a Department 
facility. 
(b) REIMBURSEMENT.—If a covered facility estab-
lishes a new residency program in which the Secretary 
places a resident under the pilot program, the Secretary 
shall reimburse that covered facility for costs of the fol-
lowing: 
(1) Curriculum development. 
(2) Recruitment and retention of faculty. 
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(3) Accreditation of the program by the Accred-
itation Council for Graduate Medical Education. 
(4) The portion of faculty salaries attributable 
to duties under an agreement subsection (a)(3). 
(5) Expenses relating to educating a resident 
under the pilot program. 
(c) REPORTING.— 
(1) IN
GENERAL.—Not later than one year 
after the date of the enactment of this Act and not 
less frequently than once each year thereafter until 
the termination of the pilot program, the Secretary 
shall submit to Congress a report on the implemen-
tation of the pilot program. 
(2) ELEMENTS.—Each report submitted under 
paragraph (1) shall include the following with regard 
to the immediately preceding year, and in compari-
son to the year immediately preceding that year: 
(A) The number of veterans who received 
care from residents under the pilot program. 
(B) The number of veterans who received 
care from each resident per position described 
in subsection (a)(1) under the pilot program. 
(C) The number of veterans who received 
care from residents under the pilot program ex-
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pressed as a percentage of all individuals who 
received care from such residents. 
(D) The number of clinical appointments 
for veterans conducted by each resident under 
the pilot program. 
(E) The number of clinical appointments 
for veterans conducted by residents per position 
described in subsection (a)(1) under the pilot 
program. 
(F) The number of clinical appointments 
for veterans expressed as a percentage of all 
clinical appointments conducted by residents 
under the pilot program. 
(G) The number of positions described in 
subsection (a)(1) at each covered facility under 
the pilot program. 
(H) For each position described in sub-
section (a)(1) in a residency program affiliated 
with a health care facility of the Department, 
the time a resident under the pilot program 
spent training at that facility of the Depart-
ment, expressed as a percentage of the total 
training time for that resident position. 
(I) For each residency program affiliated 
with a health care facility of the Department, 
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the time all residents under the pilot program 
spent training at that facility of the Depart-
ment, expressed as a percentage of the total 
training time for those residents. 
(J) The time that all residents under the 
pilot program who are assigned to programs af-
filiated with health care facilities of the Depart-
ment spent training at facilities of the Depart-
ment, expressed as a percentage of the total 
training time for those residents. 
(K) The cost to the Department of Vet-
erans Affairs under the pilot program in the 
year immediately preceding the report and since 
the beginning of the pilot program. 
(L) The cost to the Department of Vet-
erans Affairs per resident placed under the pilot 
program at each covered facility. 
(M) The number of residents under the 
pilot program hired by the Secretary to work in 
the Veterans Health Administration after com-
pletion of residency in the year immediately 
preceding the report and since the beginning of 
the pilot program. 
(N) The medical specialties pursued by 
residents under the pilot program. 
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(d) DURATION.—The pilot program under this sec-
tion shall terminate on August 7, 2024. 
TITLE V—OTHER MATTERS 
SEC. 501. ANNUAL REPORT ON PERFORMANCE AWARDS 
AND BONUSES AWARDED TO CERTAIN HIGH- 
LEVEL EMPLOYEES OF THE DEPARTMENT. 
(a) IN GENERAL.—Chapter 7 of title 38, United 
States Code, is amended by adding at the end the fol-
lowing new section: 
‘‘§ 726. Annual report on performance awards and bo-
nuses awarded to certain high-level em-
ployees 
‘‘(a) IN GENERAL.—Not later than 100 days after 
the end of each fiscal year, the Secretary shall submit to 
the appropriate committees of Congress a report that con-
tains, for the most recent fiscal year ending before the 
submittal of the report, a description of all performance 
awards or bonuses awarded to each of the following: 
‘‘(1) Regional Office Director of the Depart-
ment. 
‘‘(2) Director of a Medical Center of the De-
partment. 
‘‘(3) Director of a Veterans Integrated Service 
Network. 
‘‘(4) Senior executive of the Department. 
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‘‘(b) ELEMENTS.—Each report submitted under sub-
section (a) shall include the following with respect to each 
performance award or bonus awarded to an individual de-
scribed in such subsection: 
‘‘(1) The amount of each award or bonus. 
‘‘(2) The job title of the individual awarded the 
award or bonus. 
‘‘(3) The location where the individual awarded 
the award or bonus works. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) The term ‘appropriate committees of Con-
gress’ means the Committees on Veterans’ Affairs 
and Appropriations of the Senate and House of Rep-
resentatives. 
‘‘(2) The term ‘senior executive’ means— 
‘‘(A) a career appointee; or 
‘‘(B) an individual— 
‘‘(i) in an administrative or executive 
position; and 
‘‘(ii) appointed under section 7306(a) 
or section 7401(1) of this title. 
‘‘(3) The term ‘career appointee’ has the mean-
ing given that term in section 3132(a) of title 5, 
United States Code.’’. 
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(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of such chapter is amended by inserting 
after the item relating to section 725 the following new 
item: 
‘‘726. Annual report on performance awards and bonuses awarded to certain 
high-level employees.’’. 
SEC. 502. ROLE OF PODIATRISTS IN DEPARTMENT OF VET-
ERANS AFFAIRS. 
(a) INCLUSION AS PHYSICIAN.— 
(1) IN GENERAL.—Subchapter I of chapter 74 
is amended by adding at the end the following new 
section: 
‘‘§ 7413. Treatment of podiatrists; clinical oversight 
standards 
‘‘(a) PODIATRISTS.—Except as provided by sub-
section (b), a doctor of podiatric medicine who is ap-
pointed as a podiatrist under section 7401(1) of this title 
is eligible for any supervisory position in the Veterans 
Health Administration to the same degree that a physician 
appointed under such section is eligible for the position. 
‘‘(b) ESTABLISHMENT
OF
CLINICAL
OVERSIGHT 
STANDARDS.—The Secretary, in consultation with appro-
priate stakeholders, shall establish standards to ensure 
that specialists appointed in the Veterans Health Adminis-
tration to supervisory positions do not provide direct clin-
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215 
ical oversight for purposes of peer review or practice eval-
uation for providers of other clinical specialties.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of chapter 74 is amended by 
inserting after the item relating to section 7412 the 
following new item: 
‘‘7413. Treatment of podiatrists; clinical oversight standards.’’. 
(b) MODIFICATION
AND CLARIFICATION
OF PAY 
GRADE.— 
(1) GRADE.—The list in section 7404(b) of 
such title is amended— 
(A) by striking ‘‘PHYSICIAN AND DEN-
TIST SCHEDULE’’ and inserting ‘‘PHYSI-
CIAN 
AND 
SURGEON 
(MD/DO), 
PODIATRIC SURGEON (DPM), AND DEN-
TIST AND ORAL SURGEON (DDS, DMD) 
SCHEDULE’’; 
(B) by striking, ‘‘Physician grade’’ and in-
serting ‘‘Physician and surgeon grade’’; and 
(C) by striking ‘‘PODIATRIST, CHIRO-
PRACTOR, AND’’ and inserting ‘‘CHIRO-
PRACTOR AND’’. 
(2) APPLICATION.—The amendments made by 
paragraph (1) shall apply with respect to a pay pe-
riod of the Department of Veterans Affairs begin-
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ning on or after the date that is 30 days after the 
date of the enactment of this Act. 
SEC. 503. DEFINITION OF MAJOR MEDICAL FACILITY 
PROJECT. 
(a) MODIFICATION OF DEFINITION OF MEDICAL FA-
CILITY.—Section 8101(3) is amended by striking ‘‘Sec-
retary’’ and all that follows through ‘‘nursing home,’’ and 
inserting ‘‘Secretary, or as otherwise authorized by law, 
for the provision of health-care services (including hos-
pital, outpatient clinic, nursing home,’’. 
(b) MODIFICATION OF DEFINITION OF MAJOR MED-
ICAL FACILITY PROJECT.—Paragraph (3) of section 
8104(a) is amended to read as follows: 
‘‘(3) For purposes of this subsection, the term ‘major 
medical facility project’ means a project for the construc-
tion, alteration, or acquisition of a medical facility involv-
ing a total expenditure of more than $20,000,000, but 
such term does not include an acquisition by exchange, 
nonrecurring maintenance projects of the Department, or 
the construction, alteration, or acquisition of a shared 
Federal medical facility for which the Department’s esti-
mated share of the project costs does not exceed 
$20,000,000.’’. 
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SEC. 504. AUTHORIZATION OF CERTAIN MAJOR MEDICAL 
FACILITY PROJECTS OF THE DEPARTMENT 
OF VETERANS AFFAIRS. 
(a) AUTHORIZATION.—The Secretary of Veterans Af-
fairs may carry out the following major medical facility 
project, to be carried out in an amount not to exceed the 
amount specified for that project: Construction of the new 
East Bay Community Based Outpatient Clinic and all as-
sociated site work, utilities, parking, and landscaping, con-
struction of the Central Valley Engineering and Logistics 
support facility, and enhanced flood plain mitigation at the 
Central Valley and East Bay Community Based Out-
patient Clinics as part of the realignment of medical facili-
ties in Livermore, California, in an amount not to exceed 
$117,300,000. 
(b) AUTHORIZATION OF APPROPRIATIONS FOR CON-
STRUCTION.—There is authorized to be appropriated to 
the Secretary of Veterans Affairs for fiscal year 2018 or 
the year in which funds are appropriated for the Construc-
tion, Major Projects account, $117,300,000 for the project 
authorized in subsection (a). 
(c) SUBMITTAL OF INFORMATION.—Not later than 
90 days after the date of the enactment of this Act, for 
the project authorized in subsection (a), the Secretary of 
Veterans Affairs shall submit to the Committee on Vet-
erans’ Affairs of the Senate and the Committee on Vet-
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erans’ Affairs of the House of Representatives the fol-
lowing information: 
(1) A line item accounting of expenditures re-
lating to construction management carried out by 
the Department of Veterans Affairs for such project. 
(2) The future amounts that are budgeted to be 
obligated for construction management carried out 
by the Department for such project. 
(3) A justification for the expenditures de-
scribed in paragraph (1) and the future amounts de-
scribed in paragraph (2). 
(4) Any agreement entered into by the Sec-
retary regarding a non-Department of Veterans Af-
fairs Federal entity providing management services 
relating to such project, including reimbursement 
agreements and the costs to the Department for 
such services. 
SEC. 505. DEPARTMENT OF VETERANS AFFAIRS PER-
SONNEL TRANSPARENCY. 
(a) PUBLICATION OF STAFFING AND VACANCIES.— 
(1) WEBSITE
REQUIRED.—Subject to para-
graph (2) and not later than 90 days after the date 
of the enactment of this Act, the Secretary of Vet-
erans Affairs shall make publicly available on an 
Internet website of the Department of Veterans Af-
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fairs the following information, which shall, subject 
to subparagraph (D), be displayed by departmental 
component or, in the case of information relating to 
Veterans Health Administration positions, by med-
ical facility: 
(A) The number of personnel encumbering 
positions. 
(B) The number of accessions and separa-
tion actions processed during the quarter pre-
ceding the date of the publication of the infor-
mation. 
(C) The number of vacancies, by occupa-
tion. 
(D) The percentage of new hires for the 
Department who were hired within the time-to- 
hire target of the Office of Personnel Manage-
ment, disaggregated by administration. 
(2) EXCEPTIONS.—The Secretary may withhold 
from publication under paragraph (1) information 
relating to law enforcement, information security, or 
such positions in the Department that the Secretary 
determines to be sensitive. 
(3) UPDATE OF INFORMATION.—The Secretary 
shall update the information on the website required 
under paragraph (1) on a quarterly basis. 
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(4) TREATMENT OF CONTRACTOR POSITIONS.— 
Any Department of Veterans Affairs position that is 
filled with a contractor may not be treated as a De-
partment position for purposes of the information 
required to be published under paragraph (1). 
(5) INSPECTOR GENERAL REVIEW.—On a semi- 
annual basis, the Inspector General of the Depart-
ment shall review the administration of the website 
required under paragraph (1) and make rec-
ommendations relating to the improvement of such 
administration. 
(b) REPORT TO CONGRESS.—The Secretary of Vet-
erans Affairs shall submit to Congress an annual report 
on the steps the Department is taking to achieve full staff-
ing capacity. Each such report shall include the amount 
of additional funds necessary to enable the Department 
to reach full staffing capacity. 
SEC. 506. PROGRAM ON ESTABLISHMENT OF PEER SPE-
CIALISTS IN PATIENT ALIGNED CARE TEAM 
SETTINGS WITHIN MEDICAL CENTERS OF DE-
PARTMENT OF VETERANS AFFAIRS. 
(a) PROGRAM REQUIRED.—The Secretary of Vet-
erans Affairs shall carry out a program to establish not 
fewer than two peer specialists in patient aligned care 
teams at medical centers of the Department of Veterans 
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Affairs to promote the use and integration of services for 
mental health, substance use disorder, and behavioral 
health in a primary care setting. 
(b) TIMEFRAME
FOR ESTABLISHMENT
OF PRO-
GRAM.—The Secretary shall carry out the program at 
medical centers of the Department as follows: 
(1) Not later than May 31, 2019, at not fewer 
than 15 medical centers of the Department. 
(2) Not later than May 31, 2020, at not fewer 
than 30 medical centers of the Department. 
(c) SELECTION OF LOCATIONS.— 
(1) IN GENERAL.—The Secretary shall select 
medical centers for the program as follows: 
(A) Not fewer than five shall be medical 
centers of the Department that are designated 
by the Secretary as polytrauma centers. 
(B) Not fewer than ten shall be medical 
centers of the Department that are not des-
ignated by the Secretary as polytrauma centers. 
(2) CONSIDERATIONS.—In selecting medical 
centers for the program under paragraph (1), the 
Secretary shall consider the feasibility and advis-
ability of selecting medical centers in the following 
areas: 
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