Title 38 employees are what are deemed "professional employees," the doctors, nurses and PhD psychologists. Title 5 employees are basically everyone else: the nurses aides, the dosimetrists, and similar. A number of my family members have worked for the VA for years, in various places; I was just talking to my father, and he said that they plan to build small professional teams, led by psychologists and including a psychiatrist to prescribe medication and lower level mental health professionals, although he doesn't know if they would hire LCSWs and similar as Title 5 or Title 38 employees. The psychologists heading up the teams would be Title 38.