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Federal Register / Vol. 86, No. 194 / Tuesday, October 12, 2021 / Rules and Regulations a certificate, undergraduate degree, or post baccalaureate training in a science relating to health care; or participated in the delivery of health care services or related medical services, to further their medical education and become a physician assistant PA providing medical care to fellow veterans. The EACFMAF would increase access to VA
health care by utilizing a veteran workforce that has received training as a PA in the Armed Forces. Section 246
of Public Law 115141 sets forth the eligibility criteria, the types of available funding, established an agreement to be met by the participants, as well as the consequences for a breach in such agreement. This final rule establishes the regulations needed to carry out the EACFMAF. Immediately following title 38 of the Code of Federal Regulations CFR 17.531, we are adding a new undesignated center heading titled Educational Assistance for Certain Former Members of the Armed Forces and new 17.535 through 17.539.
General Comments in Support of the Proposed Rule Several commenters who were in favor of the rule stated that the EACFMAF is an excellent way to support our veterans and it would provide jobs for veterans with medical or military health experience and would also become vested stakeholders as contributing employees. Several commenters similarly stated that they strongly supported the promoting of opportunities for veterans to transition into the PA profession by providing educational assistance. A commenter also added that the program is critical in maintaining a strong health care workforce for the VA, staffed with people that are not only highly trained, but that have had the experience of serving in the military. Several commenters stated that having veteran PAs would increase patient satisfaction as well as patient health care and will benefit VA as the participants would have intimate knowledge of veteran issues and understand better what the veteran patient is going through. A
commenter similarly stated that PAs with former military service gave the best quality of care, explained the care the veteran would receive in terms the veterans could readily understand, and had the needed insight of what the veteran was going through to help such veterans make an informed decision about their medical care. Another commenter stated that this program is a great way to provide additional training to already highly qualified individuals which will lead to a degree and a VA
career as a physician assistant.

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Another commenter was in favor of the rule and stated that the EACFMAF
will offer participants peace of mind in not having to worry about tuition, books, and other expenses while in school and allow the participants to concentrate their efforts in finishing their studies. A commenter similarly stated that the EACFMAF will help reduce the number of homeless veterans by ensuring that they maintain a steady cash flow for their necessities. The commenter added that the concept of paying back all the money that participants receive in the EACFMAF in case they fail the classes sounds fair and will make the participants more responsible in completing their studies.
Another commenter agrees in that the proposed rule specified up front the repayment requirements.
One commenter stated that the EACFMAF would be a perfect fit for a veteran who served as a medic in a war zone. The commenter added that they would love to be part of the program.
Another commenter added that this is a much-needed scholarship program and that it would improve access to care for veterans. Lastly, the commenter stated that if the EACFMAF should become permanent it would be a direct line of PAs to seek employment in VA.
A commenter stated that other Federal agencies have recently waived requirements for doctors to perform certain intake, vaccination, or other medical procedures under the COVID
19 pandemic and having increased numbers of PAs would save doctors time as well as increase the availability of health care services, which include examinations, interviewing, and telemedicine procedures. The commenter added that they are aware that veterans often have to travel long distances because of the lack of available physicians in the VA medical facility nearest them, and having PAs available could provide a benefit to these veterans seeking medical care from VA, including through telemedicine. We are not making any changes based on these comments.
17.536 Eligibility Military and training requirements.
Several commenters suggested that VA
not limit the eligibility for the EACFMAF to individuals who have medical or military health experience gained while serving in the military.
The commenters stated that there are many servicemembers who decide to pursue a PA degree after leaving the military and should not be limited to what their jobs were in the service. The commenter suggested that the eligibility criteria for the EACFMAF be that the
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servicemember gets accepted into PA
school and not be limited to what their previous job was in the service. Another commenter stated that medical experience as a corpsman or medic may provide priority, but not exclusivity for application to the EACFMAF.
We note that the eligibility criteria for the EACFMAF is set forth in section 246b of the Consolidated Appropriations Act, 2018. The applicant has to meet one of these criteria by law in order to qualify for the EACFMAF;
VA does not have any flexibility on amending the criteria in the regulation.
The second criteria in proposed 17.536a is that the individual has received a certificate, associate degree, baccalaureate degree, masters degree, or post baccalaureate training in a science relating to health care. The veteran does not have to meet this criteria while in military service. This criteria can be met once the veteran is discharged from service. As we have stated in this rulemaking, the purpose EACFMAF is to provide an opportunity to veterans to further their medical education and become a PA providing medical care to fellow veterans. Based on the comments in the previous paragraph, we are clarifying the regulation text to state that in order to qualify for the EACFMAF, a claimant must meet one of the eligibility criteria.
Several commenters were in favor of the rule, but suggested that VA remove the stipulation that the applicants must have a science related degree. A
commenter added that PA schools require prerequisite science and math courses to be completed prior to the application process and this requirement is not needed in this proposal, and that the applicants do not need a science degree to enter PA
school, but are required to demonstrate the ability to handle science related courses. The commenter indicated that the proposed rule has the potential of removing worthy veteran applicants from consideration because they do not have a science related degree. The commenter also stated that science majors are not the only individuals who make excellent clinical providers.
Another commenter similarly stated that the requirement for a degree in health care, biology, physiology, etc. is also not required if the individual has been accepted into a PA education program, and that this requirement should merely give priority to individuals with a health care related degree and not exclude other individuals with other types of degrees.
VA notes that the second eligibility requirement in section 246 of the Consolidated Appropriations Act, 2018

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