,,ii  #aacth ,,congress  #b;d ,session  
,s4 #bdbe  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #d1 #bjad
 ,mr4 ,begich 7for himself and ,mr4     
,pryor7 introduced the following bill2  
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 psychiatrists1 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 clinics1 and for other     
purposes4  #a4  ,short title  ,this ,act
 may be cited as the ,ensuring          
,veterans' ,resiliency ,act4  #b4       
,pilot program on repayment of          
educational loans for certain           
psychiatrists of ,veterans ,health      

,administration  7a7 ,in general  ,the  
,secretary of ,veterans ,affairs shall  
carry out a pilot program to repay loans
 of individuals described in subsection 
7b7 that--  7#a7 were used by such      
individuals to finance the educational  
expenses of such individuals relating to
 psychiatric medicine1 including        
education leading to-- 7,a7 an          
undergraduate degree2  7,b7 a degree of 
doctor of medicine2 or  7,c7 a degree of
 doctor of osteopathy2 and  7#b7 were   
obtained from any of the following3 7,a7
 ,a governmental entity4  7,b7 ,a       
private financial institution4  7,c7 ,an
 institution of higher education4  7,d7 
,any other entity as specified the      
,secretary for purposes of the pilot    
program4  7b7  ,eligible individuals    
7#a7 ,in general ,subject to paragraph  
7#b71 an individual eligible for        
participation in the pilot program is an
 individual who--  7,a7 either--  7i7 is
 licensed or eligible for licensure to  
practice psychiatric medicine in the    

,veterans ,health ,administration of the
 ,department of ,veterans ,affairs2 or  
7ii7 is enrolled in the final year of a 
residency program leading to a specialty
 qualification in psychiatric medicine  
that is approved by the ,accreditation  
,council for ,graduate ,medical         
,education2 and  7,b7 demonstrates a    
commitment to a long-term career as a   
psychiatrist in the ,veterans ,health   
,administration1 as determined by the   
,secretary4  7#b7 ,prohibition on       
simultaneous eligibility ,an individual 
who is participating in any other       
program of the ,federal ,government that
 repays the educational loans of the    
individual is not eligible to           
participate in the pilot program4  7c7  
,selection  7#a7 ,in general ,the       
,secretary shall select not less than   
#aj individuals described in subsection 
7b7 to participate in the pilot program 
for each year in which the ,secretary   
carries out the pilot program4  7#b7    
,rural or highly rural areas ,of the    

individuals selected under paragraph    
7#a71 not less than five shall be       
individuals who practice psychiatric    
medicine in a rural area or highly rural
 area or demonstrate a commitment to    
practice psychiatric medicine in such an
 area4  7d7 ,period of obligated service
 ,the ,secretary shall enter into an    
agreement with each individual selected 
under subsection 7c7 in which such      
individual agrees to serve a period of  
obligated service for the ,veterans     
,health ,administration in the field of 
psychiatric medicine1 as determined by  
the ,secretary for purposes of the pilot
 program1 in exchange for the repayment 
of the loan or loans of such individual 
under the pilot program4  7e7  ,loan    
,repayments  7#a7 ,in general  ,subject 
to paragraph 7#b71 a loan repayment     
under this section may consist of       
payment of the principal1 interest1 and 
related expenses of a loan obtained by  
an individual who is participating in   
the pilot program for all educational   

expenses 7including tuition1 fees1      
books1 and laboratory expenses7 of such 
individual relating to education        
described in subsection 7a77#a74  7#b7  
,limit  ,the amount paid by the         
,secretary under the pilot program for  
each year of obligated service agreed to
 by an individual under subsection 7d7  
may not exceed #fj1jjj4  7f7 ,breach    
7#a7 ,liability ,an individual who      
participates in the pilot program and   
fails to satisfy the period of obligated
 service under subsection 7d7 shall be  
liable to the ,united ,states1 in lieu  
of such obligated service1 for the      
amount that has been paid to or on      
behalf of the individual under the pilot
 program1 reduced by the proportion that
 the number of days served for          
completion of the period of obligated   
service bears to the total number of    
days in the period of obligated service 
of such individual4  7#b7 ,repayment    
period ,any amount of damages that the  
,united ,states is entitled to recover  

under this subsection shall be paid to  
the ,united ,states not later than one  
year after the date of the breach of the
 agreement4  7g7 ,report  7#a7 ,in      
general ,not later than #ij days after  
the date on which the pilot program     
terminates under subsection 7i71 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 pilot  
program4  7#b7 ,elements ,the report    
required by paragraph 7#a7 shall include
 the following3 7,a7 ,an assessment of  
the overall effect of the pilot program 
on the psychiatric workforce shortage of
 the ,veterans ,health ,administration4 
7,b7 ,a current assessment of the       
long-term stability of the psychiatric  
workforce of the ,veterans ,health      
,administration4  7,c7 ,strategies of   
the ,veterans ,health ,administration to
 improve and increase the ability of the
 ,administration to promote the physical

 and mental resiliency of all veterans4 
7h7  ,regulations  ,the ,secretary shall
 prescribe regulations to carry out this
 section1 including standards for       
qualified loans and authorized payees   
and other terms and conditions for the  
making of loan repayments4  7i7         
,termination ,the authority to carry out
 the pilot program shall expire on the  
date that is three years after the date 
on which the ,secretary commences the   
pilot program4  #c4  ,comptroller       
,general of the ,united ,states study on
 pay disparities of psychiatrists of    
,veterans ,health ,administration  7a7  
,study  7#a7 ,in general ,not later than
 one year after the date of the         
enactment of this ,act1 the ,comptroller
 ,general of the ,united ,states shall  
conduct a study of pay disparities among
 psychiatrists of the ,veterans ,health 
,administration of the ,department of   
,veterans ,affairs4  7#b7 ,elements ,the
 study conducted under paragraph 7#a7   
shall include--  7,a7 an examination of 

laws1 regulations1 practices1 and       
policies1 including salary              
flexibilities1 that contribute to pay   
disparities described in paragraph 7#a72
 and  7,b7 recommendations with respect 
to legislative or administrative actions
 to improve equity in pay among         
psychiatrists of the ,veterans ,health  
,administration4  7b7 ,report ,not later
 than one year after the date on which  
the ,comptroller ,general completes the 
study under subsection 7a71 the         
,comptroller ,general 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 results
 of the study4  #d4 ,pilot program on   
housing allowances for health care      
providers of ,veterans ,health          
,administration accepting assignment at 
rural and highly rural community-based  
outpatient clinics  7a7 ,pilot program  
authorized ,the ,secretary of ,veterans 
,affairs may carry out a pilot program  

to assess the feasibility and           
advisability of providing a housing     
allowance to health care providers of   
the ,veterans ,health ,administration of
 the ,department of ,veterans ,affairs  
who accept assignment at rural or highly
 rural community-based outpatient       
clinics as a means of encouraging such  
health care providers to accept         
assignment to such clinics4  7b7        
,eligibility ,an individual is eligible 
for participation in the pilot program  
if the individual-- 7#a7 is a health    
care provider2  7#b7 is1 or agrees to   
become1 an employee of the ,veterans    
,health ,administration on a full-time  
basis in a health care position         
designated by the ,secretary for        
purposes of the pilot program2 and  7#c7
 accepts an assignment in such position 
for a term of not less than #cf months  
at a rural or highly rural              
community-based outpatient clinic       
selected by the ,secretary for purposes 
of the pilot program4  7c7 ,conditions  

on payment of housing allowance ,except 
as provided in subsection 7d77#c71 an   
individual may be provided a housing    
allowance under the pilot program only  
while-- 7#a7 in good standing as a      
health care provider within the         
,veterans ,health ,administration2 and  
7#b7 assigned as a health care provider 
at a rural or highly rural              
community-based outpatient clinic4  7d7 
,amount of housing allowance  7#a7      
,monthly amount during initial term     
,during the first #cf months of         
participation in the pilot program1 the 
housing allowance provided a health care
 provider participating in the pilot    
program shall be provided on a monthly  
basis at a rate that is equivalent to   
the monthly rate of basic allowance for 
housing 7,,bah7 payable under section   
#djc of title #cg1 ,united ,states      
,code1 to members of the uniformed      
services whose grade1 dependency status1
 and geographic location most closely   
equals1 as determined by the ,secretary1

 the grade of such provider under       
section #gdjd of title #ch1 ,united     
,states ,code1 and the dependency status
 and geographic location of such        
provider4  7#b7 ,monthly amount for     
certain providers for additional term   
,if upon completion of the first #cf    
months in the pilot program a health    
care provider accepts continuing        
participation in the pilot program at a 
rural or highly rural community-based   
outpatient clinic for a term of not less
 than #ab additional months1 the housing
 allowance provided the health care     
provider under the pilot program shall  
be provided on a monthly basis for such 
additional months at a rate determined  
in accordance with paragraph 7#a74  7#c7
 ,bonus amount  7,a7 ,completion of     
initial term ,any health care provider  
who successfully completes #cf months of
 participation in the pilot program     
shall be paid upon completion of        
participation in the pilot program an   
amount equal to three months of the     

monthly rate of housing allowance       
provided the health care provider under 
paragraph 7#a7 during the last month    
before the provider's completion of     
participation in the pilot program4     
7,b7 ,completion of additional one-year 
term ,any health care provider who      
successfully completes #dh months of    
participation in the pilot program shall
 be paid upon completion of             
participation in the pilot program an   
amount equal to #ab months of the       
monthly rate of housing allowance       
provided the health care provider under 
paragraph 7#b7 during the last month    
before the provider's completion of     
participation in the pilot program4     
7,c7 ,completion of additional two-year 
term ,any health care provider who      
successfully completes #fj months of    
participation in the pilot program shall
 be paid upon completion of             
participation in the pilot program an   
amount equal to #ac months of the       
monthly rate of housing allowance       

provided the health care provider under 
paragraph 7#b7 during the last month    
before the provider's completion of     
participation in the pilot program4     
7,d7 ,no requirement to remain on       
assignment ,an amount payable under this
 paragraph shall be paid whether or not 
the health care provider concerned      
remains in an assignment at a rural or  
highly rural community-based outpatient 
clinic4  7e7 ,supplemental nature of    
allowance ,any housing allowance        
provided under the pilot program shall  
be in addition to any pay 7including    
basic pay1 special pay1 and retirement  
or other bonus pay7 payable to personnel
 of the ,veterans ,health               
,administration personnel under chapter 
#gd of title #ch1 ,united ,states ,code1
 or any other provision of law4  7f7    
,annual reports  7#a7 ,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 while the pilot program is in

 effect1 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 pilot  
program4  7#b7 ,elements ,each report   
submitted under paragraph 7#a7 shall    
include the following3 7,a7 ,a current  
description of the pilot program1       
including the current number of         
participants in the pilot program and   
the amounts of housing allowance being  
provided such participants4  7,b7 ,a    
current assessment of the value of the  
housing allowance under the pilot       
program in encouraging health care      
providers in accepting assignment to    
rural and highly rural community-based  
outpatient clinics4  7g7 ,funding       
,amounts for housing allowances under   
the pilot program shall be derived from 
amounts available for the ,veterans     
,health ,administration for ,medical    
,services4  7h7 ,sunset  7#a7 ,in       
general ,no individual may commence     

participation in the pilot program on or
 after the date that is five years after
 the date of the enactment of this ,act4
  7#b7 ,continuation of on-going        
provision of allowance ,nothing in      
paragraph 7#a7 shall be construed to    
prohibit the ,secretary from providing  
housing allowances under the pilot      
program to individuals who commence     
participation in the pilot program      
before the date that is five years after
 the date of the enactment of this ,act4
  7i7 ,rural or highly rural            
community-,based outpatient clinic      
defined ,in this section1 the term rural
 or highly rural community-based        
outpatient clinic means a               
community-based outpatient clinic of the
 ,veterans ,health ,administration that 
predominantly serves veterans who live  
in rural areas and highly rural areas4  
#e4 ,definitions ,in this ,act3 7#a7    
,highly rural area ,the term highly     
rural area means an area located in a   
county or similar community that has    

less than seven individuals residing in 
that county or community per square     
mile4  7#b7 ,rural area ,the term rural 
area means an area that is not an       
urbanized area or a highly rural area4  
7#c7 ,urbanized area ,the term urbanized
 area has the meaning given that term by
 the ,director of the ,bureau of the    
,census4