A bipartisan bill from the Senate Veterans Affairs Committee is targeting several longstanding challenges within the VA’s health care workforce, including higher pay for VA doctors and other health care providers.

The VA CAREERS Act, introduced on Tuesday by Chairman Jon Tester (D-Mont.) and Sen. John Boozman (R-Ark.) would set higher base pay caps for VA physicians, podiatrists, optometrists and dentists.

VA’s pay tables for 2022 show the base pay for physicians, dentists and podiatrists in several specialties currently max out at $400,000 — the current annual salary of the President.

The VA CAREERS Act would also allow the VA secretary to authorize recruitment, retention or relocation bonuses for Veterans Health Administration employees.

The bill allows the VA to waive any pay limitation for VHA employees who are “performing mission-critical work,” or if the VA secretary “determines it is necessary for the recruitment or retention of critical health care personnel.”

Tester and Boozman say the bill will help the VA recruit and retain health care workers, especially in rural areas, as the agency expects to bring millions more veterans into its care under the PACT Act.

“We need VA to hire providers faster and be able to retain high-quality talent in rural areas,” Tester said in a statement, adding that the VA CAREERS Act would allow the agency to “recruit the best and brightest clinicians to help deliver veterans.”

The PACT Act and the RAISE Act, both passed by Congress last year, gave the VA new pay and bonus authority to recruit in-demand health care workers. VA Secretary Denis McDonough said last August that the RAISE Act resulted in 10,000 VA nurses — about one out of every nine VA nurses — receiving higher salaries.

Boozman said VA personnel in Arkansas frequently describe “persistent challenges” filling health care positions.

“Our legislation expands the VA workforce in communities nationwide and creates a sustainable pipeline, strengthening its ability to attract expert physicians,” Boozman said. “Ensuring the VA is properly staffed is key to fulfilling our promise to the men and women who served in uniform.”

The VA CAREERS Act would require the VA to provide an annual report to Congress on the steps VA is taking to achieve full staffing capacity. The report must include a list of VHA and Veterans Benefits Administration regional facilities not meeting time-to-hire goals.

VA Undersecretary for Health Shereef Elnahal told Federal News Network in an interview last November, that the agency’s top legislative priorities for this fiscal year included higher pay for these health care positions.

Elnahal said VHA is seeking to not just raise salaries, but provide financial incentives “that are more creative and help incentivize both quality patient safety and productivity.”

The bill also includes retroactive pay authority for physicians, podiatrists, optometrists and dentists whose net pay exceeded previous pay caps between January 2006 and December 2017.

“The Secretary of Veterans Affairs is retroactively authorized to pay to a covered employee the amount of compensation that was authorized to be paid to the employee … but was deferred and paid to the employee in the calendar year following the calendar year in which it was authorized to be paid because it exceeded $400,000 in a calendar year,” the draft bill states.

The bill increases the maximum amount of incentive pay for VA pharmacist executives from $40,000 to $100,000. It also allows VHA to grant special pay authority to nurse executives.

The VA CAREERS Act also sets up a new “market rate” pay system for VA medical center directors.

The VA under the legislation will determine the market rate on a “case by case basis,” and will take into account “the level of experience of the individual in managing facilities or programs of the department or other similar agencies or companies.”

The pay for VA medical center directors will also be determined by the labor market for individuals holding similar health care positions in the same geographic areas.

The VA under the legislation will reevaluate these market rates no less than once every two years. The agency, as part of this review, will publish the minimum and maximum market rates of pay in the Federal Register.

The VA CAREERS Act would also limit the VA’s ability to detail its medical center directors to different positions.

The bill requires the VA to notify the House and Senate VA committees within 90 days of reassigning a medical center director to a different position. The agency would also have to inform lawmakers what positions those medical center directors have been detailed to, and how long they’d be detailed away from their permanent roles.

The bill would require a medical center’s permanent director to return to their position within 180 days of their detail, except for ongoing investigations or administrative actions.

The VA CAREERS Act would expand eligibility for more health care staff to be reimbursed for professional education costs. It would also require the VA to fine-tune its workforce data to better inform its long-term hiring plans.

The legislation also mandates several reports from VA watchdogs.

The bill requires the VA inspector general’s office to review the agency’s use of its direct hire authority and its overall hiring flexibility. It also mandates the Government Accountability Office to issue a report within 18 months on the status of human resources modernization efforts at the VA.

The VA CAREERS Act also seeks to prepare the VA workforce for caring for an aging veteran population. This requires the VA to provide clinical staff with continuing professional education on how to care for veterans with Alzheimer’s disease and dementia.

The VA, within two years of the bill passing, would be required to report on the status of hiring and retention efforts at its community centers. The report should identify top barriers to hiring, and best practices for bringing in-demand talent. Including nurses on board.

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