Informed Consent and Advance Directives
The Department of Veterans Affairs (VA) published an interim final rule amending its regulation regarding informed consent and advance directives. In that rulemaking, we amended the regulation by reorganizing it and amending language where necessary to enhance clarity. We also made changes to facilitate the informed consent process, the ability to communicate with patients or surrogates through available modalities of communication, and the execution and witness requirements for a VA Advance Directive. Before adopting that interim final rule as final, VA revises the provision related to which personnel may be delegated the responsibility for providing a patient with information needed for the patient to make a fully informed consent decision. Upon further review, VA has determined that this provision requires a further change to better clarify roles in the team-based delivery of care model. We are providing the public an opportunity to submit comments solely on this amendment.
Clarification Concerning Tuition and Fees Payment Plans for Standard Terms and 85/15 Calculations
The Department of Veterans Affairs (VA) provides notice of a policy advisory issued on August 31, 2021, by VA's Education Service. The policy advisory clarifies and amends VA's previous regulatory interpretation of tuition and fees (T&F) payment plans to differentiate between types of payment plans. Some payment plans should no longer be categorized as institutional support to a student when calculating the ratio of ``supported'' to ``non-supported'' students in a program pursuant to the 85/15 Rule. While VA is retaining the general rule that a student who has a payment plan with an Educational Training Institute (ETI) should be considered supported, a student participating in a payment plan that meets the criteria set forth in this notice should not be considered supported and, instead, should be counted on the non- supported side of the 85/15 ratio.
VA Pilot Program on Graduate Medical Education and Residency
The Department of Veterans Affairs proposes to revise its medical regulations to establish a new pilot program on graduate medical education and residency, as required by section 403 of the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Network Act of 2018.