An act to authorize appropriations and to appropriate amounts for the Veterans Choice Program of the Department of Veterans Affairs, to improve hiring authorities of the Department, to authorize major medical facility leases, and for other purposes
PL 115-46 (S.114), enacted 08/12/2017

131 STAT. 958 
PUBLIC LAW 115–46—AUG. 12, 2017 
Public Law 115–46 
115th Congress 
An Act 
To authorize appropriations and to appropriate amounts for the Veterans Choice 
Program of the Department of Veterans Affairs, to improve hiring authorities 
of the Department, to authorize major medical facility leases, and for other 
purposes. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the ‘‘VA Choice 
and Quality Employment Act of 2017’’. 
(b) TABLE OF CONTENTS.—The table of contents for this Act 
is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—APPROPRIATION OF AMOUNTS FOR VETERANS CHOICE 
PROGRAM 
Sec. 101. Appropriation of amounts for Veterans Choice Program. 
TITLE II—PERSONNEL MATTERS 
Sec. 201. Modification to annual determination of staffing shortages in Veterans 
Health Administration. 
Sec. 202. Establishment of Department of Veterans Affairs Executive Management 
Fellowship Program. 
Sec. 203. Accountability of leaders for managing the Department of Veterans Af-
fairs. 
Sec. 204. Reemployment of former employees at Department of Veterans Affairs. 
Sec. 205. Promotional opportunities for technical experts at Department of Vet-
erans Affairs. 
Sec. 206. Employment of students and recent graduates by Department of Veterans 
Affairs. 
Sec. 207. Encouragement of transition of military medical professionals into em-
ployment with Veterans Health Administration. 
Sec. 208. Recruiting database at Department of Veterans Affairs. 
Sec. 209. Training for human resources professionals of Veterans Health Adminis-
tration on recruitment and retention. 
Sec. 210. Plan to hire directors of medical centers of Department of Veterans Af-
fairs. 
Sec. 211. Exit surveys at Department of Veterans Affairs. 
Sec. 212. Requirement that physician assistants employed by the Department of 
Veterans Affairs receive competitive pay. 
Sec. 213. Expansion of direct-hiring authority for Department of Veterans Affairs 
in case of shortage of highly qualified candidates. 
Sec. 214. Comptroller General of the United States assessment of succession plan-
ning at Department of Veterans Affairs. 
TITLE III—MAJOR MEDICAL FACILITY LEASES 
Sec. 301. Authorization of certain major medical facility leases of the Department 
of Veterans Affairs. 
Sec. 302. Authorization of appropriations for medical facility leases. 
VA Choice 
and Quality 
Employment 
Act of 2017. 
38 USC 101 note. 
Aug. 12, 2017 
[S. 114] 
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131 STAT. 959 
PUBLIC LAW 115–46—AUG. 12, 2017 
TITLE IV—OTHER MATTERS 
Sec. 401. Extension of reduction in amount of pension furnished by Department of 
Veterans Affairs for certain veterans covered by medicaid plans for serv-
ices furnished by nursing facilities. 
Sec. 402. Extension of requirement for collection of fees for housing loans guaran-
teed by Secretary of Veterans Affairs. 
Sec. 403. Extension of authority to use income information. 
TITLE I—APPROPRIATION OF AMOUNTS 
FOR VETERANS CHOICE PROGRAM 
SEC. 101. APPROPRIATION OF AMOUNTS FOR VETERANS CHOICE PRO-
GRAM. 
(a) IN GENERAL.—There is authorized to be appropriated, and 
is appropriated, to the Secretary of Veterans Affairs, out of any 
funds in the Treasury not otherwise appropriated, $2,100,000,000 
to be deposited in the Veterans Choice Fund under section 802 
of the Veterans Access, Choice, and Accountability Act of 2014 
(Public Law 113–146; 38 U.S.C. 1701 note). 
(b) AVAILABILITY.—The amount appropriated under subsection 
(a) shall remain available until expended. 
TITLE II—PERSONNEL MATTERS 
SEC. 201. MODIFICATION TO ANNUAL DETERMINATION OF STAFFING 
SHORTAGES IN VETERANS HEALTH ADMINISTRATION. 
Section 7412(a) of title 38, United States Code, is amended— 
(1) by striking ‘‘the five occupations’’ and inserting ‘‘at 
a minimum, the five clinical occupations and the five nonclinical 
occupations’’; and 
(2) by striking ‘‘throughout the Department’’ and inserting 
‘‘with respect to each medical center of the Department,’’. 
SEC. 202. ESTABLISHMENT OF DEPARTMENT OF VETERANS AFFAIRS 
EXECUTIVE MANAGEMENT FELLOWSHIP PROGRAM. 
(a) FELLOWSHIP PROGRAM.—Chapter 7 of title 38, United States 
Code, is amended by adding at the end the following new sub-
chapter: 
‘‘SUBCHAPTER III—EXECUTIVE MANAGEMENT 
FELLOWSHIP PROGRAM 
‘‘§ 741. Executive Management Fellowship Program 
‘‘(a) FELLOWSHIP PROGRAM.—There is in the Department an 
Executive Management Fellowship Program. The purpose of the 
program shall be to provide— 
‘‘(1) eligible employees of the Veterans Benefits Administra-
tion and the Veterans Health Administration with training 
and experience in the private sector; and 
‘‘(2) eligible employees of a private-sector entity with 
training and experience in the Department of Veterans Affairs. 
‘‘(b) FELLOWSHIP.—(1) A fellowship provided under this section 
is a 1-year fellowship during which— 
‘‘(A) with respect to a Department participant, the partici-
pant receives training and experience at a private-sector entity 
that is engaged in the administration and delivery of health 
38 USC 741. 
38 USC 
prec. 741. 
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131 STAT. 960 
PUBLIC LAW 115–46—AUG. 12, 2017 
care or other services similar to the benefits administered by 
the Secretary; and 
‘‘(B) with respect to a private-sector participant, the partici-
pant receives training and experience at the Veterans Benefits 
Administration or the Veterans Health Administration. 
‘‘(2) The Secretary shall enter into such agreements with pri-
vate-sector entities as are necessary to carry out this section. 
‘‘(c) SELECTION OF RECIPIENTS.—(1) In August of each year, 
the Secretary shall select— 
‘‘(A) not fewer than 18 and not more than 30 eligible 
employees of the Veterans Benefits Administration and the 
Veterans Health Administration to receive a fellowship under 
this section; and 
‘‘(B) not fewer than 18 and not more than 30 eligible 
employees of private-sector entities to receive a fellowship under 
this section. 
‘‘(2) To the extent practicable, the Secretary shall select eligible 
employees under subparagraphs (A) and (B) of paragraph (1) from 
among eligible employees who are veterans in a manner that is 
reflective of the demographics of the veteran population of the 
United States and that whenever practicable provides a preference 
to such employees who represent or service rural areas. 
‘‘(d) ELIGIBLE EMPLOYEES.—For the purposes of this section, 
an eligible employee is— 
‘‘(1) with respect to an employee of the Veterans Benefits 
Administration or the Veterans Health Administration, an 
employee who— 
‘‘(A) is compensated at a rate of basic pay not less 
than the minimum rate of basic pay payable for grade 
GS–14 of the General Schedule and not more than either 
the minimum rate of basic pay payable to a member of 
the Senior Executive Service under section 5382 of title 
5 or the minimum rate of basic pay payable pursuant 
to chapter 74 of this title, as the case may be; 
‘‘(B) enters into an agreement with the Secretary under 
subsection (e); and 
‘‘(C) submits to the Secretary an application containing 
such information and assurances as the Secretary may 
require; and 
‘‘(2) with respect to an employee of a private-sector entity, 
an employee who— 
‘‘(A) is employed in a position whose duties and respon-
sibilities are commensurate with an employee of the 
Department described in paragraph (1); 
‘‘(B) enters into an agreement with the Secretary under 
subsection (e); and 
‘‘(C) submits to the Secretary an application containing 
such information and assurances as the Secretary may 
require. 
‘‘(e) AGREEMENTS.—(1) An agreement between the Secretary 
and a Department participant shall be in writing, shall be signed 
by the participant, and shall include the following provisions: 
‘‘(A) The Secretary’s agreement to provide the participant 
with a fellowship under this section; 
‘‘(B) The participant’s agreement— 
‘‘(i) to accept the fellowship; 
Contracts. 
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131 STAT. 961 
PUBLIC LAW 115–46—AUG. 12, 2017 
‘‘(ii) after completion of the fellowship, to serve as 
a full-time employee in the Veterans Benefits Administra-
tion or the Veterans Health Administration for at least 
2 years as specified in the agreement; and 
‘‘(iii) that, during the 2-year period beginning on the 
last day of the fellowship, the participant will not accept 
employment in the same industry as the industry of the 
private-sector entity at which the participant accepts the 
fellowship. 
‘‘(C) A provision that any financial obligation of the United 
States arising out of an agreement entered into under this 
subchapter, and any obligation of the participant which is condi-
tioned on such agreement, is contingent upon funds being 
appropriated. 
‘‘(D) A statement of the damages to which the United 
States is entitled under this subchapter for the participant’s 
breach of the agreement. 
‘‘(E) Such other terms as the Secretary determines are 
required to be included in the agreement. 
‘‘(2) An agreement between the Secretary and a private-sector 
participant shall be in writing, shall be signed by the participant, 
and shall include the following provisions: 
‘‘(A) The Secretary’s agreement to provide the participant 
with a fellowship under this section. 
‘‘(B) The participant’s agreement to accept the fellowship. 
‘‘(C) Such other terms as the Secretary determines are 
required to be included in the agreement. 
‘‘(f) TREATMENT OF RECIPIENTS.—(1) A Department participant 
shall be considered an employee of the Department for all purposes, 
including for purposes of receiving a salary and benefits, and shall 
remain eligible for all promotion and incentive programs otherwise 
available to such an employee. 
‘‘(2) A private-sector participant shall be considered an 
employee of the private-sector entity that employs the participant 
for all purposes, including for purposes of receiving a salary and 
benefits, and during the fellowship shall be treated as a contractor 
of the Department. 
‘‘(g) REPORTS.—(1) Not later than 60 days after completing 
a fellowship under this section, a recipient of the fellowship shall 
submit to the Secretary a report on the fellowship. 
‘‘(2) Each such report shall describe the duties of the recipient 
during the fellowship and any recommendations of the recipient 
for the application by the Secretary of industry processes, tech-
nologies, and best practices. 
‘‘(3) Not later than 7 days after receiving each such report, 
the Secretary shall submit to the Committees on Veterans’ Affairs 
of the Senate and House of Representatives such report without 
change. 
‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) The term ‘Department participant’ means an employee 
of the Veterans Benefits Administration or the Veterans Health 
Administration who is participating in the fellowship under 
this section. 
‘‘(2) The term ‘private-sector entity’ includes an entity oper-
ating under a public-private partnership. 
Determination. 
Time period. 
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131 STAT. 962 
PUBLIC LAW 115–46—AUG. 12, 2017 
‘‘(3) The term ‘private-sector participant’ means an 
employee of a private-sector entity who is participating in the 
fellowship under this section.’’. 
(b) DEADLINE FOR IMPLEMENTATION.—Not later than 1 year 
after the date of the enactment of this Act, the Secretary of Veterans 
Affairs shall implement the Executive Management Fellowship Pro-
gram required under section 741 of title 38, United States Code, 
as added by subsection (a). 
(c) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of chapter 7 of title 38, United States Code, is amended 
by adding at the end the following new items: 
‘‘SUBCHAPTER III—EXECUTIVE MANAGEMENT FELLOWSHIP PROGRAM 
‘‘741. Executive Management Fellowship Program.’’. 
SEC. 203. ACCOUNTABILITY OF LEADERS FOR MANAGING THE DEPART-
MENT OF VETERANS AFFAIRS. 
(a) IN GENERAL.—Subchapter I of chapter 7 of title 38, United 
States Code, is amended by adding at the end the following new 
section: 
‘‘§ 725. Annual performance plan for political appointees 
‘‘(a) IN GENERAL.—The Secretary shall conduct an annual 
performance plan for each political appointee of the Department 
that is similar to the annual performance plan conducted for an 
employee of the Department who is appointed as a career appointee 
(as that term is defined in section 3132(a) of title 5) within the 
Senior Executive Service at the Department. 
‘‘(b) ELEMENTS OF PLAN.—Each annual performance plan con-
ducted under subsection (a) with respect to a political appointee 
of the Department shall include an assessment of whether the 
appointee is meeting the following goals: 
‘‘(1) Recruiting, selecting, and retaining well-qualified 
individuals for employment at the Department. 
‘‘(2) Engaging and motivating employees. 
‘‘(3) Training and developing employees and preparing 
those employees for future leadership roles within the Depart-
ment. 
‘‘(4) Holding each employee of the Department that is a 
manager accountable for addressing issues relating to perform-
ance, in particular issues relating to the performance of 
employees that report to the manager. 
‘‘(c) DEFINITION OF POLITICAL APPOINTEE.—In this section, the 
term ‘political appointee’ means an employee of the Department 
who holds— 
‘‘(1) a position which has been excepted from the competi-
tive service by reason of its confidential, policy-determining, 
policy-making, or policy-advocating character; or 
‘‘(2) a position in the Senior Executive Service as a non-
career appointee (as such term is defined in section 3132(a) 
of title 5).’’. 
(b) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of chapter 7 of such title is amended by inserting after the 
item relating to section 723 the following new item: 
‘‘725. Annual performance plan for political appointees.’’. 
38 USC 
prec. 701. 
Assessment. 
38 USC 725. 
38 USC 
prec. 701. 
38 USC 741 note. 
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131 STAT. 963 
PUBLIC LAW 115–46—AUG. 12, 2017 
SEC. 204. REEMPLOYMENT OF FORMER EMPLOYEES AT DEPARTMENT 
OF VETERANS AFFAIRS. 
(a) IN GENERAL.—Notwithstanding sections 3309 through 3318 
of title 5, United States Code, the Secretary of Veterans Affairs 
may noncompetitively appoint a qualified former career or career 
conditional employee to any position within the competitive service 
at the Department of Veterans Affairs that is one grade or equiva-
lent higher than the grade or equivalent of the position at the 
Department most recently occupied by the employee. 
(b) LIMITATION.—The Secretary may not appoint a qualified 
former employee to a position that is more than one grade (or 
equivalent) higher than the position at the Department most 
recently occupied by the employee. 
(c) DEFINITION
OF QUALIFIED FORMER EMPLOYEE.—For pur-
poses of this section, the term ‘‘qualified former employee’’ means 
any individual who— 
(1) formerly occupied any career or career conditional posi-
tion at the Department of Veterans Affairs within 2 years 
before applying for reemployment at the Department; 
(2) voluntarily left such position, or was subject to a reduc-
tion in force, and had a satisfactory performance record while 
occupying such position; and 
(3) since leaving such position has maintained licensing 
requirements, related to the position, if any, and gained skill, 
knowledge, or other factors related to the position. 
SEC. 205. PROMOTIONAL OPPORTUNITIES FOR TECHNICAL EXPERTS 
AT DEPARTMENT OF VETERANS AFFAIRS. 
Not later than one year after the date of the enactment of 
this Act, the Secretary of Veterans Affairs shall establish a pro-
motional track system for employees of the Department of Veterans 
Affairs that the Secretary determines are technical experts pursuant 
to regulations prescribed by the Secretary for purposes of carrying 
out this section. Such system shall— 
(1) provide any such employee the opportunity to advance 
within the Department without being required to transition 
to a management position; and 
(2) for purposes of achieving career advancement— 
(A) provide for the establishment of new positions 
within the Department; and 
(B) notwithstanding any other provision of law, provide 
for increases in pay for any such employee. 
SEC. 206. EMPLOYMENT OF STUDENTS AND RECENT GRADUATES BY 
DEPARTMENT OF VETERANS AFFAIRS. 
(a) IN GENERAL.—The Secretary of Veterans Affairs shall pre-
scribe regulations to allow for excepted service appointments of 
students and recent graduates leading to conversion to career or 
career conditional employment of a student or recent graduate 
of a qualifying educational institution, as defined by the Depart-
ment. 
(b) APPLICABILITY.—The conversion authority described in sub-
section (a) shall be applicable to individuals in good standing who— 
(1) are employed in a qualifying internship or fellowship 
program at the Department; 
(2) are employed in the Department in a volunteer capacity 
and performing substantive duties comparable to those of 
Regulations. 
38 USC 701 note. 
Deadline. 
38 USC 701 note. 
38 USC 701 note. 
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131 STAT. 964 
PUBLIC LAW 115–46—AUG. 12, 2017 
individuals in internship or fellowship programs and meet the 
required number of hours for conversion; 
(3) are employed in the Department under a contract or 
agreement with an external nonprofit organization and per-
forming substantive duties comparable to those of individuals 
in internship or fellowship programs; 
(4) have received educational assistance under chapter 33 
of title 38, United States Code; or 
(5) graduated from a qualifying educational institution, 
as defined by the Department, and have not reached 30 years 
of age. 
(c) UNIFORMITY.—For the purposes of paragraphs (2) and (3) 
of subsection (b), hours of work performed by an individual 
employed shall be considered equal to those performed by an indi-
vidual employed in a qualifying internship or fellowship program 
by the Department. 
SEC. 207. ENCOURAGEMENT OF TRANSITION OF MILITARY MEDICAL 
PROFESSIONALS INTO EMPLOYMENT WITH VETERANS 
HEALTH ADMINISTRATION. 
The Secretary of Veterans Affairs shall establish a program 
to encourage an individual who serves in the Armed Forces with 
a military occupational specialty relating to the provision of health 
care to seek employment with the Veterans Health Administration 
when the individual has been discharged or released from service 
in the Armed Forces or is contemplating separating from such 
service. 
SEC. 208. RECRUITING DATABASE AT DEPARTMENT OF VETERANS 
AFFAIRS. 
(a) ESTABLISHMENT.—The Secretary of Veterans Affairs shall 
establish a single database that lists— 
(1) each vacant position in the Department of Veterans 
Affairs that the Secretary determines is critical to the mission 
of the Department, difficult to fill, or both; and 
(2) each vacant position in the Department of Veterans 
Affairs for a mental health professional. 
(b) QUALIFIED APPLICANT.—If the Secretary determines that 
an applicant for a vacant position listed in the database established 
under subsection (a) is qualified for such position but does not 
select the applicant for such position, the Secretary, at the election 
of the applicant, may consider the applicant for other similar vacant 
positions listed in the database for which the applicant is qualified. 
(c) PROLONGED VACANCIES.—If the Secretary does not fill a 
vacant position listed in the database established under subsection 
(a) after a period determined appropriate by the Secretary, the 
Secretary— 
(1) may ensure that applicants described in subsection 
(b) are considered for such position; and 
(2) may use the database established under subsection 
(a) to assist in filling such position. 
(d) REPORT.—Not later than one year after the date of the 
enactment of this Act, the Secretary shall submit to Congress 
a report on the use and efficacy of the database established under 
subsection (a). 
Determinations. 
38 USC 701 note. 
38 USC 7401 
note. 
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131 STAT. 965 
PUBLIC LAW 115–46—AUG. 12, 2017 
SEC. 209. TRAINING FOR HUMAN RESOURCES PROFESSIONALS OF VET-
ERANS HEALTH ADMINISTRATION ON RECRUITMENT AND 
RETENTION. 
(a) IN GENERAL.—The Secretary of Veterans Affairs shall pro-
vide to human resources professionals of the Veterans Health 
Administration training on how to best recruit and retain employees 
of the Veterans Health Administration, including with respect to 
any recruitment and retention matters that are unique to the 
Veterans Health Administration pursuant to chapter 74 of title 
38, United States Code, or other provisions of law. 
(b) VIRTUAL TRAINING.—Training provided under this section 
shall be provided virtually. 
(c) AMOUNT OF TRAINING.—The Secretary shall ensure that 
each human resources professional of the Veterans Health Adminis-
tration receives the training described in subsection (a)— 
(1) as soon as practicable after being hired by the Secretary 
as a human resources professional; and 
(2) annually thereafter. 
(d) CERTIFICATION.—The Secretary shall require that each 
human resources professional of the Veterans Health Administra-
tion, upon the completion of the training described in subsection 
(a), certifies that the professional received the training and under-
stands the information provided by the training. 
(e) ANNUAL REPORT.—Not less frequently than annually, the 
Secretary shall submit to the Committee on Veterans’ Affairs of 
the Senate and the Committee on Veterans’ Affairs of the House 
of Representatives a report on the training described in subsection 
(a), including the cost of providing such training and the number 
of human resources professionals who received such training during 
the year covered by the report. 
SEC. 210. PLAN TO HIRE DIRECTORS OF MEDICAL CENTERS OF 
DEPARTMENT OF VETERANS AFFAIRS. 
(a) PLAN.—Not later than 120 days after the date of the enact-
ment of this Act, the Secretary of Veterans Affairs shall develop 
and implement a plan to hire highly qualified directors for each 
medical center of the Department of Veterans Affairs that lacks 
a permanent director as of the date of the plan. 
(b) PRIORITY.—The Secretary shall prioritize under the plan 
developed under subsection (a) the hiring of directors for medical 
centers that have not had a permanent director for the longest 
periods. 
(c) MATTERS INCLUDED.—The plan developed under subsection 
(a) shall include the following: 
(1) A deadline to hire directors of medical centers of the 
Department as described in such subsection. 
(2) Identification of the possible impediments to such 
hiring. 
(3) Identification of opportunities to promote and train 
candidates from within the Department to senior executive 
positions in the Department, including as directors of medical 
centers. 
(d) SUBMITTAL OF PLAN.—Not later than 120 days after the 
date of the enactment of this Act, the Secretary shall submit to 
the Committee on Veterans’ Affairs of the Senate and the Com-
mittee on Veterans’ Affairs of the House of Representatives the 
plan developed under subsection (a). 
Deadlines. 
38 USC 7401 
note. 
38 USC 7401 
note. 
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131 STAT. 966 
PUBLIC LAW 115–46—AUG. 12, 2017 
(e) SEMIANNUAL REPORTS.—Not later than 180 days after the 
date of the enactment of this Act, and not later than 180 days 
thereafter, the Secretary shall submit to the Committee on Vet-
erans’ Affairs of the Senate and the Committee on Veterans’ Affairs 
of the House of Representatives a report containing a list of each 
medical center of the Department that lacks a permanent director 
as of the date of the report. 
SEC. 211. EXIT SURVEYS AT DEPARTMENT OF VETERANS AFFAIRS. 
(a) EXIT SURVEYS REQUIRED.— 
(1) IN GENERAL.—The Secretary of Veterans Affairs shall 
develop and carry out a standardized exit survey to be volun-
tarily completed by career and noncareer employees and execu-
tives of the Department of Veterans Affairs who voluntarily 
separate from the Department. 
(2) CONSULTATION.—Such exit survey shall be developed 
in consultation with an appropriate non-Department entity with 
experience developing such surveys. 
(b) SURVEY CONTENT.—The survey shall include, at a minimum, 
the following: 
(1) Reasons for leaving the Department. 
(2) Efforts made by the supervisor of the employee to 
retain the individual. 
(3) The extent of job satisfaction and engagement during 
the employment. 
(4) The intent of employee to either remain employed within 
the Federal Government or to leave employment with the Fed-
eral Government. 
(5) Such other matters as the Secretary determines appro-
priate. 
(c) ANONYMITY
OF SURVEY CONTENT.—The Secretary shall 
ensure that data collected under subsection (a)— 
(1) is anonymized, including through the use of a location 
that allows for privacy; 
(2) is not directly visible by another employee; and 
(3) does not require the departing employee to input any 
personally identifiable data. 
(d) SHARING
OF SURVEY DATA.—The Secretary shall ensure 
that the results of the survey required by subsection (a) are— 
(1) aggregated at the Veterans Integrated Service Network 
level; and 
(2) shared on an annual basis with directors and managers 
of facilities of the Department and the Veterans Integrated 
Service Networks. 
(e) ANNUAL REPORT.— 
(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, the Secretary shall submit to the 
Committee on Veterans’ Affairs of the Senate and the Com-
mittee on Veterans’ Affairs of the House of Representatives 
a report containing the aggregate results of the exit survey 
under subsection (a) covering the year prior to the report. 
(2) CONTENTS.—Each report submitted under paragraph 
(1) shall include, for the period covered by the report, the 
following: 
(A) An analysis of the most common reasons employees 
choose to leave the Department. 
Analysis. 
38 USC 701 note. 
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131 STAT. 967 
PUBLIC LAW 115–46—AUG. 12, 2017 
(B) The steps the Secretary is taking to improve reten-
tion, particularly for mission-critical occupations. 
(C) The demographic characteristics of employees 
choosing to leave the Department. 
(D) Any legislative barriers to improving employee 
retention. 
(E) The total number of employees who voluntarily 
separated from the Department and the number and 
percentage of whom took the exit survey under subsection 
(a). 
SEC. 212. REQUIREMENT THAT PHYSICIAN ASSISTANTS EMPLOYED BY 
THE DEPARTMENT OF VETERANS AFFAIRS RECEIVE 
COMPETITIVE PAY. 
Section 7451(a)(2) of title 38, United States Code, is amended— 
(1) by redesignating subparagraph (B) as subparagraph 
(C); 
(2) by inserting after subparagraph (A) the following new 
subparagraph (B): 
‘‘(B) Physician assistant.’’; and 
(3) in subparagraph (C), as redesignated by paragraph 
(1), by striking ‘‘and registered nurse’’ and inserting ‘‘registered 
nurse, and physician assistant’’. 
SEC. 213. EXPANSION OF DIRECT-HIRING AUTHORITY FOR DEPART-
MENT OF VETERANS AFFAIRS IN CASE OF SHORTAGE OF 
HIGHLY QUALIFIED CANDIDATES. 
Section 3304(a)(3)(B) of title 5, United States Code, is amended 
by inserting ‘‘(or, with respect to the Department of Veterans 
Affairs, that there exists a severe shortage of highly qualified can-
didates)’’ after ‘‘severe shortage of candidates’’. 
SEC. 214. COMPTROLLER GENERAL OF THE UNITED STATES ASSESS-
MENT OF SUCCESSION PLANNING AT DEPARTMENT OF 
VETERANS AFFAIRS. 
(a) ASSESSMENT.— 
(1) IN GENERAL.—The Comptroller General of the United 
States shall assess the extent to which key succession planning 
policies and guidance at the Department of Veterans Affairs, 
including the Veterans Health Administration, the Veterans 
Benefits Administration, and the National Cemetery Adminis-
tration, are consistent with leading practices for succession 
and workforce planning identified by Comptroller General. 
(2) ADDITIONAL MATTERS.—In carrying out the assessment 
required by paragraph (1), the Comptroller General may assess 
such other matters as the Comptroller General considers appro-
priate. 
(b) REPORT.—Not later than two years after the date of the 
enactment of this Act, the Comptroller General shall submit to 
the Committee on Veterans’ Affairs of the Senate and the Com-
mittee on Veterans’ Affairs of the House of Representatives a report 
on the assessment carried out under subsection (a). 
(c) SENSE OF CONGRESS ON STUDY ON COMPLIANCE WITH POLI-
CIES AND GUIDANCE.—It is the sense of Congress that— 
(1) the Comptroller General should conduct a study to 
examine the extent to which a sampling of installations of 
the Department of Veterans Affairs are complying with policies 
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131 STAT. 968 
PUBLIC LAW 115–46—AUG. 12, 2017 
and guidance of the Department, as well as applicable leading 
practices; and 
(2) the scope and timeframe of a study conducted as 
described in paragraph (1) may be dependent upon the findings 
of the Comptroller General with respect to the assessment 
carried out under subsection (a). 
TITLE III—MAJOR MEDICAL FACILITY 
LEASES 
SEC. 301. AUTHORIZATION OF CERTAIN MAJOR MEDICAL FACILITY 
LEASES OF THE DEPARTMENT OF VETERANS AFFAIRS. 
The Secretary of Veterans Affairs may carry out the following 
major medical facility leases at the locations specified and in an 
amount for each lease not to exceed the amount specified for such 
location (not including any estimated cancellation costs): 
(1) For a replacement outpatient clinic, Ann Arbor, 
Michigan, an amount not to exceed $4,247,000. 
(2) For a new outpatient mental health clinic, Birmingham, 
Alabama, an amount not to exceed $6,649,000. 
(3) For new research space, Boston, Massachusetts, an 
amount not to exceed $6,224,000. 
(4) For a replacement research space, Charleston, South 
Carolina, an amount not to exceed $7,274,000. 
(5) For a replacement outpatient clinic, Corpus Christi, 
Texas, an amount not to exceed $6,556,000. 
(6) For a replacement outpatient clinic, Daytona Beach, 
Florida, an amount not to exceed $12,198,000. 
(7) For a replacement Chief Business Office Purchased 
Care office space, Denver, Colorado, an amount not to exceed 
$14,784,000. 
(8) For a replacement outpatient clinic, Fredericksburg, 
Virginia, an amount not to exceed $45,015,000. 
(9) For a new outpatient clinic, Gainesville, Florida, an 
amount not to exceed $7,891,000. 
(10) For an outpatient mental health clinic, Gainesville, 
Florida, an amount not to exceed $4,320,000. 
(11) For a replacement outpatient clinic, Hampton Roads, 
Virginia, an amount not to exceed $18,141,000. 
(12) For a replacement outpatient clinic, Indianapolis, 
Indiana, an amount not to exceed $7,876,000. 
(13) For a replacement outpatient clinic, Jacksonville, 
Florida, an amount not to exceed $18,623,000. 
(14) For a replacement outpatient clinic, Missoula, Mon-
tana, an amount not to exceed $6,942,000. 
(15) For a replacement outpatient mental health clinic, 
Northern Colorado, Colorado, an amount not to exceed 
$8,904,000. 
(16) For a replacement outpatient clinic, Ocala, Florida, 
an amount not to exceed $5,026,000. 
(17) For a new outpatient clinic, Oxnard, California, an 
amount not to exceed $5,274,000. 
(18) For a new outpatient clinic, Pike County, Georgia, 
an amount not to exceed $5,565,000. 
(19) For a new outpatient clinic, Pittsburgh, Pennsylvania, 
an amount not to exceed $6,247,000. 
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131 STAT. 969 
PUBLIC LAW 115–46—AUG. 12, 2017 
(20) For a replacement outpatient clinic, Portland, Maine, 
an amount not to exceed $6,808,000. 
(21) For a replacement outpatient clinic, Raleigh, North 
Carolina, an amount not to exceed $21,870,000. 
(22) For a replacement outpatient clinic, phase II, Roch-
ester, New York, an amount not to exceed $3,645,000. 
(23) For a replacement research space, San Diego, Cali-
fornia, an amount not to exceed $4,852,000. 
(24) For a new outpatient clinic, Santa Rosa, California, 
an amount not to exceed $6,922,000. 
(25) For a replacement mental health clinic, Tampa, 
Florida, an amount not to exceed $13,387,000. 
(26) For a replacement outpatient clinic, Lakeland, Tampa, 
Florida, an amount not to exceed $10,760,000. 
(27) For a replacement outpatient clinic, Terre Haute, 
Indiana, an amount not to exceed $4,102,000. 
(28) For a replacement outpatient clinic, Rapid City, South 
Dakota, an amount not to exceed $4,532,000. 
SEC. 302. AUTHORIZATION OF APPROPRIATIONS FOR MEDICAL 
FACILITY LEASES. 
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 Medical Facilities account $274,634,000 
for the major medical facility leases authorized in section 301. 
TITLE IV—OTHER MATTERS 
SEC. 401. EXTENSION OF REDUCTION IN AMOUNT OF PENSION FUR-
NISHED BY DEPARTMENT OF VETERANS AFFAIRS FOR 
CERTAIN VETERANS COVERED BY MEDICAID PLANS FOR 
SERVICES FURNISHED BY NURSING FACILITIES. 
Section 5503(d)(7) of title 38, United States Code, is amended 
by striking ‘‘September 30, 2024’’ and inserting ‘‘September 30, 
2027’’. 
SEC. 402. EXTENSION OF REQUIREMENT FOR COLLECTION OF FEES 
FOR HOUSING LOANS GUARANTEED BY SECRETARY OF 
VETERANS AFFAIRS. 
Section 3729(b)(2) of title 38, United States Code, is amended— 
(1) in subparagraph (A)— 
(A) in clause (iii), by striking ‘‘September 30, 2024’’ 
and inserting ‘‘September 30, 2027’’; and 
(B) in clause (iv), by striking ‘‘September 30, 2024’’ 
and inserting ‘‘September 30, 2027’’; 
(2) in subparagraph (B)— 
(A) in clause (i), by striking ‘‘September 30, 2024’’ 
and inserting ‘‘September 30, 2027’’; and 
(B) in clause (ii), by striking ‘‘September 30, 2024’’ 
and inserting ‘‘September 30, 2027’’; 
(3) in subparagraph (C)— 
(A) in clause (i), by striking ‘‘September 30, 2024’’ 
and inserting ‘‘September 30, 2027’’; and 
(B) in clause (ii), by striking ‘‘September 30, 2024’’ 
and inserting ‘‘September 30, 2027’’; and 
(4) in subparagraph (D)— 
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131 STAT. 970 
PUBLIC LAW 115–46—AUG. 12, 2017 
LEGISLATIVE HISTORY—S. 114 (H.R. 1690): 
HOUSE REPORTS: No. 115–249 (Comm. on Veterans’ Affairs) accompanying 
H.R. 1690. 
CONGRESSIONAL RECORD, Vol. 163 (2017): 
May 25, considered and passed Senate. 
July 24, considered and failed House. 
July 28, considered and passed House, amended. 
Aug. 1, Senate concurred in House amendments. 
DAILY COMPILATION OF PRESIDENTIAL DOCUMENTS (2017): 
Aug. 12, Presidential remarks. 
(A) in clause (i), by striking ‘‘September 30, 2024’’ 
and inserting ‘‘September 30, 2027’’; and 
(B) in clause (ii), by striking ‘‘September 30, 2024’’ 
and inserting ‘‘September 30, 2027’’. 
SEC. 403. EXTENSION OF AUTHORITY TO USE INCOME INFORMATION. 
Section 5317(g) of title 38, United States Code, is amended 
by striking ‘‘September 30, 2024’’ and inserting ‘‘September 30, 
2027’’. 
Approved August 12, 2017. 
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