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Office of Academic Affiliations

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Educational Activity Records


Affiliates work with the VA to establish disbursement agreements (DA) and rate schedules, which are required to reimburse the salaries and benefits of Health Professions Trainees (HPT) employed by the affiliates for the time HPTs spend performing duties at the VA facility.

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VHA Directive 1400.05 provides the policy for the use of disbursement agreements to reimburse affiliates for the salaries and benefits for HPTs appointed under 38 U.S.C. § 7406. DAs are agreements between the VA medical center (VAMC) and a disbursing agent; the disbursing agent may be the affiliate/sponsoring institution or another entity created for the purpose of managing disbursements. The DA covers the financial provisions for graduate medical, dental and other HPTs during the time spent at VA for purposes of clinical education and training. The directive includes a companion standard operating procedures (SOP) document. The disbursing agent/sponsoring institution provides their affiliated VAMC with an invoice specifying the resident educational activity at the VA facility for the billable period. The VAMC reconciles and pays the invoice. Alternatively, VA may provide the disbursing agent with a payable document, based on VA’s records of HPT educational activity, for reconciliation by the disbursing agent.

All VAMCs are required to have a process in place to ensure that HPTs being reimbursed through a disbursement agreement are tracked for accuracy of time/attendance, reconciliation, billing and payment. The following are reimbursable activities:

  • Care for Veterans on VA property
  • Approved educational details
  • Holidays
  • In-Service exam time/travel time
  • Local, regional, national meeting time
  • Orientation
  • ACGME off-duty days
  • Post-call days after VA call
  • Approved telework
  • Sick leave
  • On-site didactics
  • Off-site approved didactics
  • On-site/off-site research