II

Calendar No. 190

107TH CONGRESS

1ST SESSION S. 1188

[Report No. 107–80]

To amend title 38, United States Code, to enhance the authority of the

Secretary of Veterans Affairs to recruit and retain qualified nurses

for the Veterans Health Administration, and for other purposes.

IN THE SENATE OF THE UNITED STATES

JULY 17, 2001

Mr. ROCKEFELLER (for himself, Mr. CLELAND, and Mr. SPECTER) introduced

the following bill; which was read twice and referred to the Committee

on Veterans’ Affairs

OCTOBER 10, 2001

Reported by Mr. ROCKEFELLER, with an amendment and an amendment to

the title

[Strike out all after the enacting clause and insert the part printed in italic]

A BILL

To amend title 38, United States Code, to enhance the

authority of the Secretary of Veterans Affairs to recruit

and retain qualified nurses for the Veterans Health Administration, and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

2 (a) SHORT TITLE.—This Act may be cited as the

3 ‘‘Department of Veterans Affairs Nurse Recruitment and

4 Retention Enhancement Act of 2001’’.

5 (b) TABLE OF CONTENTS.—The table of contents for

6 this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. References to title 38, United States Code.

TITLE I—ENHANCEMENT OF RECRUITMENT AUTHORITIES

Sec. 101. Enhancement of employee incentive scholarship program.

Sec. 102. Enhancement of education debt reduction program.

Sec. 103. Report on requests for waivers of pay reductions for reemployed annuitants to fill nurse positions.

TITLE II—ENHANCEMENT OF RETENTION AUTHORITIES

Sec. 201. Additional pay for Saturday tours of duty for additional health care

professional in the Veterans Health Administration.

Sec. 202. Unused sick leave included in annuity computation of registered

nurses with the Veterans Health Administration.

Sec. 203. Evaluation of Department of Veterans Affairs nurse managed clinics.

Sec. 204. Staffing levels for operations of medical facilities.

Sec. 205. Annual report on use of authorities to enhance retention of experienced nurses.

Sec. 206. Report on mandatory overtime for nurses and nurse assistants in Department of Veterans Affairs facilities.

TITLE III—OTHER MATTERS

Sec. 301. Organizational responsibility of the Director of the Nursing Service.

Sec. 302. Computation of annuity for part-time service performed by certain

health-care professionals before April 7, 1986.

Sec. 303. Modification of nurse locality pay authorities.

Sec. 304. Technical amendments.

7 SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.

8 Except as otherwise expressly provided, whenever in

9 this Act an amendment or repeal is expressed in terms

10 of an amendment to, or repeal of, a section or other provi11 sion, the reference shall be considered to be made to a

12 section or other provision of title 38, United States Code.
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1 TITLE I—ENHANCEMENT OF

2 RECRUITMENT AUTHORITIES

3 SEC. 101. ENHANCEMENT OF EMPLOYEE INCENTIVE

4 SCHOLARSHIP PROGRAM.

5 (a) PERMANENT AUTHORITY.—(1) Section 7676 is

6 repealed.

7 (2) The table of sections at the beginning of chapter

8 76 is amended by striking the item relating to section

9 7676.

10 (b) MINIMUM PERIOD OF DEPARTMENT EMPLOY11 MENT FOR ELIGIBILITY.—Section 7672(b) is amended by

12 striking ‘‘2 years’’ and inserting ‘‘one year’’.

13 (c) SCHOLARSHIP AMOUNT.—Subsection (b) of sec14 tion 7673 is amended—

15 (1) in paragraph (1), by striking ‘‘for any one

16 year’’ and inserting ‘‘for the equivalent of one year

17 of full-time coursework’’; and

18 (2) by striking paragraph (2) and inserting the

19 following new paragraph (2):

20 ‘‘(2) in the case of a participant in the Program

21 who is a part-time student, shall bear the same ratio

22 to the amount that would be paid under paragraph

23 (1) if the participant were a full-time student in the

24 course of education or training being pursued by the

25 participant as the coursework carried by the student
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1 bears to full-time coursework in that course of edu2 cation or training.’’.

3 (d) LIMITATION ON PAYMENT.—Subsection (c) of

4 section 7673 is amended to read as follows:

5 ‘‘(c) LIMITATIONS ON PERIOD OF PAYMENT.—(1)

6 The maximum number of school years for which a scholar7 ship may be paid under subsection (a) to a participant

8 in the Program shall be six school years.

9 ‘‘(2) A participant in the Program may not receive

10 a scholarship under subsection (a) for more than the

11 equivalent of three years of full-time coursework.’’.

12 (e) FULL-TIME COURSEWORK.—Section 7673 is fur13 ther amended by adding at the end the following new sub14 section:

15 ‘‘(e) FULL-TIME COURSEWORK.—For purposes of

16 this section, full-time coursework shall consist of the fol17 lowing:

18 ‘‘(1) In the case of undergraduate coursework,

19 30 semester hours per undergraduate school year.

20 ‘‘(2) In the case of graduate coursework, 18 se21 mester hours per graduate school year.’’.

22 (f) ANNUAL ADJUSTMENT OF MAXIMUM SCHOLAR23 SHIP AMOUNT.—Section 7631 is amended—

24 (1) in subsection (a)(1), by striking ‘‘and the

25 maximum Selected Reserve member stipend
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1 amount’’ and inserting ‘‘the maximum Selected Re2 serve member stipend amount, the maximum em3 ployee incentive scholarship amount,’’; and

4 (2) in subsection (b)—

5 (A) by redesignating paragraph (4) as

6 paragraph (6); and

7 (B) by inserting after paragraph (3) the

8 following new paragraph (4):

9 ‘‘(4) The term ‘maximum employee incentive

10 scholarship amount’ means the maximum amount of

11 the scholarship payable to a participant in the De12 partment of Veterans Affairs Employee Incentive

13 Scholarship Program under subchapter VI of this

14 chapter, as specified in section 7673(b)(1) of this

15 title and as previously adjusted (if at all) in accord16 ance with this section.’’.

17 SEC. 102. ENHANCEMENT OF EDUCATION DEBT REDUC18 TION PROGRAM.

19 (a) PERMANENT AUTHORITY.—(1) Section 7684 is

20 repealed.

21 (2) The table of sections at the beginning of chapter

22 76 is amended by striking the item relating to section

23 7684.

24 (b) ELIGIBLE INDIVIDUALS.—Subsection (a)(1) of

25 section 7682 is amended—
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1 (1) by striking ‘‘under an appointment under

2 section 7402(b) of this title in a position’’ and in3 serting ‘‘in a position (as determined by the Sec4 retary) providing direct-patient care services or serv5 ices incident to direct-patient care services’’; and

6 (2) by striking ‘‘(as determined by the Sec7 retary)’’ and inserting ‘‘(as so determined)’’.

8 (c) MAXIMUM DEBT REDUCTION AMOUNT.—Section

9 7683(d)(1) is amended—

10 (1) by striking ‘‘for a year’’; and

11 (2) by striking ‘‘exceed—’’ and all that follows

12 through the end of the paragraph and inserting ‘‘ex13 ceed $44,000 over a total of five years of participa14 tion in the Program, of which not more than

15 $10,000 of such payments may be made in each of

16 the fourth and fifth years of participation in the

17 Program.’’.

18 (d) ANNUAL ADJUSTMENT OF MAXIMUM DEBT RE19 DUCTION PAYMENTS AMOUNT.—(1) Section 7631, as

20 amended by section 101(f) of this Act, is further

21 amended—

22 (A) in subsection (a)(1), by inserting before the

23 period at the end of the first sentence the following:

24 ‘‘and the maximum education debt reduction pay25 ments amount’’; and
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1 (B) in subsection (b), by inserting after para2 graph (4) the following new paragraph (5):

3 ‘‘(5) The term ‘maximum education debt reduc4 tion payments amount’ means the maximum amount

5 of education debt reduction payments payable to a

6 participant in the Department of Veterans Affairs

7 Education Debt Reduction Program under sub8 chapter VII of this chapter, as specified in section

9 7683(d)(1) of this title and as previously adjusted

10 (if at all) in accordance with this section.’’.

11 (2) Notwithstanding section 7631(a)(1) of title 38,

12 United States Code, as amended by paragraph (1), the

13 Secretary of Veterans Affairs shall not increase the max14 imum education debt reduction payments amount under

15 that section in calendar year 2002.

16 (e) TEMPORARY EXPANSION OF INDIVIDUALS ELIGI17 BLE FOR PARTICIPATION IN PROGRAM.—(1) Notwith18 standing section 7682(c) of title 38, United States Code,

19 the Secretary of Veterans Affairs may treat a covered indi20 vidual as being a recently appointed employee in the Vet21 erans Health Administration under section 7682(a) of

22 that title for purposes of eligibility in the Education Debt

23 Reduction Program if the Secretary determines that the

24 participation of the individual in the Program under this

25 subsection would further the purposes of the Program.
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1 (2) For purposes of this subsection, a covered indi2 vidual is any individual otherwise described by section

3 7682(a) of title 38, United States Code, as in effect on

4 the day before the date of the enactment of this Act,

5 who—

6 (A) was appointed as an employee in a position

7 described in paragraph (1) of that section, as so in

8 effect, between January 1, 1999, and September 30,

9 2000; and

10 (B) is an employee in such position, or in an11 other position described in paragraph (1) of that

12 section, as so in effect, at the time of application for

13 treatment as a covered individual under this sub14 section.

15 (3) The Secretary shall make determinations regard16 ing the exercise of the authority in this subsection on a

17 case-by-case basis.

18 (4) The Secretary may not exercise the authority in

19 this subsection after December 31, 2001. The expiration

20 of the authority in this subsection shall not affect the

21 treatment of an individual under this subsection before

22 that date as a covered individual for purposes of eligibility

23 in the Education Debt Reduction Program.

24 (5) In this subsection, the term ‘‘Education Debt Re25 duction Program’’ means the Department of Veterans Af-
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1 fairs Education Debt Reduction Program under sub2 chapter VII of chapter 76 of title 38, United States Code.

3 SEC. 103. REPORT ON REQUESTS FOR WAIVERS OF PAY RE4 DUCTIONS FOR REEMPLOYED ANNUITANTS

5 TO FILL NURSE POSITIONS.

6 (a) REPORT.—Not later than November 30 of each

7 of 2001 and 2002, the Secretary of Veterans Affairs shall

8 submit to the Committees on Veterans’ Affairs of the Sen9 ate and the House of Representatives a report describing

10 each request of the Secretary, during the fiscal year pre11 ceding such report, to the Director of the Office of Per12 sonnel Management for the following:

13 (1) A waiver under subsection (i)(1)(A) of sec14 tion 8344 of title 5, United States Code, of the pro15 visions of such section in order to meet requirements

16 of the Department of Veterans Affairs for appoint17 ments to nurse positions in the Veterans Health Ad18 ministration.

19 (2) A waiver under subsection (f)(1)(A) of sec20 tion 8468 of title 5, United States Code, of the pro21 visions of such section in order to meet requirements

22 of the Department for appointments to such posi23 tions.

24 (3) A grant of authority under subsection

25 (i)(1)(B) of section 8344 of title 5, United States
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1 Code, for the waiver of the provisions of such section

2 in order to meet requirements of the Department for

3 appointments to such positions.

4 (4) A grant of authority under subsection

5 (f)(1)(B) of section 8468 of title 5, United States

6 Code, for the waiver of the provisions of such section

7 in order to meet requirements of the Department for

8 appointments to such positions.

9 (b) INFORMATION ON RESPONSES TO REQUESTS.—

10 The report under subsection (a) shall specify for each re11 quest covered by the report—

12 (1) the response of the Director to such re13 quest; and

14 (2) if such request was granted, whether or not

15 the waiver or authority, as the case may be, assisted

16 the Secretary in meeting requirements of the De17 partment for appointments to nurse positions in the

18 Veterans Health Administration.

19 TITLE II—ENHANCEMENT OF

20 RETENTION AUTHORITIES

21 SEC. 201. ADDITIONAL PAY FOR SATURDAY TOURS OF DUTY

22 FOR ADDITIONAL HEALTH CARE PROFES23 SIONAL IN THE VETERANS HEALTH ADMINIS24 TRATION.

25 (a) IN GENERAL.—Section 7454(b) is amended—
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1 (1) by inserting ‘‘(1)’’ after ‘‘(b)’’; and

2 (2) by adding at the end the following new

3 paragraph:

4 ‘‘(2) Health care professionals employed in positions

5 referred to in paragraph (1) shall be entitled to additional

6 pay on the same basis as provided for nurses in section

7 7453(c) of this title.’’.

8 (b) APPLICABILITY.—The amendments made by sub9 section (a) shall take effect on the date of the enactment

10 of this Act, and shall apply with respect to pay periods

11 beginning on or after that date.

12 SEC. 202. UNUSED SICK LEAVE INCLUDED IN ANNUITY

13 COMPUTATION OF REGISTERED NURSES

14 WITH THE VETERANS HEALTH ADMINISTRA15 TION.

16 (a) ANNUITY COMPUTATION.—Section 8415 of title

17 5, United States Code, is amended by adding at the end

18 the following:

19 ‘‘(i) In computing an annuity under this subchapter,

20 the total service of an employee who retires from the posi21 tion of a registered nurse with the Veterans Health Ad22 ministration on an immediate annuity, or dies while em23 ployed in that position leaving any survivor entitled to an

24 annuity, includes the days of unused sick leave to the cred25 it of that employee under a formal leave system, except
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1 that such days shall not be counted in determining average

2 pay or annuity eligibility under this subchapter.’’.

3 (b) DEPOSIT NOT REQUIRED.—Section 8422(d) of

4 title 5, United States Code, is amended—

5 (1) by inserting ‘‘(1)’’ before ‘‘Under such regu6 lations’’; and

7 (2) by adding at the end the following:

8 ‘‘(2) Deposit may not be required for days of unused

9 sick leave credited under section 8415(i).’’.

10 (c) EFFECTIVE DATE.—The amendments made by

11 this section shall take effect 60 days after the date of the

12 enactment of this Act, and shall apply to individuals who

13 separate from service on or after that effective date.

14 SEC. 203. EVALUATION OF DEPARTMENT OF VETERANS AF15 FAIRS NURSE MANAGED CLINICS.

16 (a) EVALUATION.—The Secretary of Veterans Affairs

17 shall carry out an evaluation of the efficacy of the nurse

18 managed health care clinics of the Department of Vet19 erans Affairs. The Secretary shall complete the evaluation

20 not later than 18 months after the date of the enactment

21 of this Act.

22 (b) CLINICS TO BE EVALUATED.—(1) In carrying

23 out the evaluation under subsection (a), the Secretary con24 sider nurse managed health care clinics, including primary

25 care clinics and geriatric care clinics, located in three dif-
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1 ferent Veterans Integrated Service Networks (VISNs) of

2 the Department.

3 (2) If there are not nurse managed health care clinics

4 located in three different Veterans Integrated Service Net5 works as of the commencement of the evaluation, the Sec6 retary shall—

7 (A) establish nurse managed health care clinics

8 in additional Veterans Integrated Services Networks

9 such that there are nurse managed health care clin10 ics in three different Veterans Integrated Service

11 Networks for purposes of the evaluation; and

12 (B) include such clinics, as so established, in

13 the evaluation.

14 (c) MATTERS TO BE EVALUATED.—In carrying out

15 the evaluation under subsection (a), the Secretary shall

16 address the following:

17 (1) Patient satisfaction.

18 (2) Provider experiences.

19 (3) Cost of care.

20 (4) Access to care, including waiting time for

21 care.

22 (5) The functional status of patients receiving

23 care.

24 (6) Any other matters the Secretary considers

25 appropriate.
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1 (d) REPORT.—Not later than 18 months after the

2 date of the enactment of this Act, the Secretary shall sub3 mit to the Committees on Veterans’ Affairs of the Senate

4 and the House of Representatives a report on the evalua5 tion carried out under subsection (a). The report shall ad6 dress the matters specified in subsection (c) and include

7 any other information, and any recommendations, that the

8 Secretary considers appropriate.

9 SEC. 204. STAFFING LEVELS FOR OPERATIONS OF MEDICAL

10 FACILITIES.

11 (a) IN GENERAL.—Section 8110(a) is amended—

12 (1) in paragraph (1), by inserting after ‘‘com13 plete care of patients,’’ in the fifth sentence the fol14 lowing: ‘‘and in a manner consistent with the poli15 cies of the Secretary on overtime,’’; and

16 (2) in paragraph (2)—

17 (A) by inserting ‘‘, including the staffing

18 required to maintain such capacities,’’ after ‘‘all

19 Department medical facilities’’;

20 (B) by striking ‘‘and to minimize’’ and in21 serting ‘‘, to minimize’’; and

22 (C) by inserting before the period the fol23 lowing: ‘‘, and to ensure that eligible veterans

24 are provided such care and services in an ap25 propriate manner’’.
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1 (b) NATIONWIDE POLICY ON STAFFING.—Paragraph

2 (3) of that section is amended—

3 (1) in subparagraph (A), by inserting ‘‘the ade4 quacy of staff levels for compliance with the policy

5 established under subparagraph (C),’’ after ‘‘regard6 ing’’; and

7 (2) by inserting after subparagraph (B) the fol8 lowing new subparagraph:

9 ‘‘(C) The Secretary shall, in consultation with the

10 Under Secretary for Health, establish a nationwide policy

11 on the staffing of Department medical facilities in order

12 to ensure that such facilities have adequate staff for the

13 provision to veterans of appropriate, high-quality care and

14 services. The policy shall take into account the staffing

15 levels and mixture of staff skills required for the range

16 of care and services provided veterans in Department fa17 cilities.’’.

18 SEC. 205. ANNUAL REPORT ON USE OF AUTHORITIES TO

19 ENHANCE RETENTION OF EXPERIENCED

20 NURSES.

21 (a) ANNUAL REPORT.—(1) Subchapter II of chapter

22 73 is amended by adding at the end the following new

23 section:
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1 ‘‘§ 7324. Annual report on use of authorities to en2 hance retention of experienced nurses

3 ‘‘(a) ANNUAL REPORT.—Not later than January 31

4 each year, the Secretary, acting through the Under Sec5 retary for Health, shall submit to Congress a report on

6 the use during the preceding year of authorities for pur7 poses of retaining experienced nurses in the Veterans

8 Health Administration, as follows:

9 ‘‘(1) The authorities under chapter 76 of this

10 title.

11 ‘‘(2) The authority under VA Directive 5102.1,

12 relating to the Department of Veterans Affairs

13 nurse qualification standard, dated November 10,

14 1999, or any successor directive.

15 ‘‘(3) Any other authorities available to the Sec16 retary for those purposes.

17 ‘‘(b) REPORT ELEMENTS.—Each report under sub18 section (a) shall specify for the period covered by such re19 port, for each Department medical facility and for each

20 Veterans Integrated Service Network, the following:

21 ‘‘(1) The number of waivers requested under

22 the authority referred to in subsection (a)(2), and

23 the number of waivers granted under that authority,

24 to promote to the Nurse II grade or Nurse III grade

25 under the Nurse Schedule under section 7404(b)(1)

26 of this title any nurse who has not completed a
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1 bachelors of science in nursing in a recognized

2 school of nursing, set forth by age, race, and years

3 of experience of the individuals subject to such waiv4 er requests and waivers, as the case may be.

5 ‘‘(2) The programs carried out to facilitate the

6 use of nursing education programs by experienced

7 nurses, including programs for flexible scheduling,

8 scholarships, salary replacement pay, and on-site

9 classes.’’.

10 (2) The table of sections at the beginning of chapter

11 73 is amended by inserting after the item relating to sec12 tion 7323 the following new item:

‘‘7324. Annual report on use of authorities to enhance retention of experienced

nurses.’’.

13 (b) INITIAL REPORT.—The initial report required

14 under section 7324 of title 38, United States Code, as

15 added by subsection (a), shall be submitted in 2002.

16 SEC. 206. REPORT ON MANDATORY OVERTIME FOR NURSES

17 AND NURSE ASSISTANTS IN DEPARTMENT OF

18 VETERANS AFFAIRS FACILITIES.

19 (a) REPORT.—Not later than 180 days after the date

20 of the enactment of this Act, the Secretary of Veterans

21 Affairs shall submit to the Committees on Veterans’ Af22 fairs of the Senate and the House of Representatives a

23 report on the mandatory overtime required of licensed

24 nurses and nurse assistants providing direct patient care
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1 at Department of Veterans Affairs medical facilities dur2 ing 2001.

3 (b) MANDATORY OVERTIME.—For purposes of the

4 report under subsection (a), mandatory overtime shall con5 sist of any period in which a nurse or nurse assistant is

6 mandated or otherwise required, whether directly or indi7 rectly, to work or be in on-duty status in excess of—

8 (1) a scheduled workshift or duty period;

9 (2) 12 hours in any 24-hour period; or

10 (3) 80 hours in any period of 14 consecutive

11 days.

12 (c) ELEMENTS.—The report under subsection (a)

13 shall include the following:

14 (1) A description of the amount of mandatory

15 overtime described in that subsection at each De16 partment medical facility during the period covered

17 by the report.

18 (2) A description of the mechanisms employed

19 by the Secretary to monitor overtime of the nurses

20 and nurse assistants referred to in that subsection.

21 (3) An assessment of the effects of the manda22 tory overtime of such nurses and nurse assistants on

23 patient care, including its contribution to medical er24 rors.
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1 (4) Recommendations regarding mechanisms

2 for preventing requirements for amounts of manda3 tory overtime in other than emergency situations by

4 such nurses and nurse assistants.

5 (5) Any other matters that the Secretary con6 siders appropriate.

7 TITLE III—OTHER MATTERS

8 SEC. 301. ORGANIZATIONAL RESPONSIBILITY OF THE DI9 RECTOR OF THE NURSING SERVICE.

10 Section 7306(a)(5) is amended by inserting ‘‘, and

11 report directly to,’’ after ‘‘responsible to’’.

12 SEC. 302. COMPUTATION OF ANNUITY FOR PART-TIME

13 SERVICE PERFORMED BY CERTAIN HEALTH14 CARE PROFESSIONALS BEFORE APRIL 7, 1986.

15 Section 7426 is amended—

16 (1) by redesignating subsection (c) as sub17 section (d); and

18 (2) by inserting after subsection (b) the fol19 lowing new subsection (c):

20 ‘‘(c) The provisions of subsection (b) shall not apply

21 to the part-time service before April 7, 1986, of a reg22 istered nurse, physician assistant, or expanded-function

23 dental auxiliary. In computing the annuity under the ap24 plicable provision of law specified in that subsection of an

25 individual covered by the preceding sentence, the service
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1 described in that sentence shall be credited as full-time

2 service.’’.

3 SEC. 303. MODIFICATION OF NURSE LOCALITY PAY AU4 THORITIES.

5 Section 7451 is amended—

6 (1) in subsection (d)(3)—

7 (A) in subparagraph (A), by striking ‘‘be8 ginning rates of’’ each time it appears;

9 (B) in subparagraph (B), by striking ‘‘be10 ginning rates of’’; and

11 (C) in subparagraph (C)(i), by striking

12 ‘‘beginning rates of’’ each time it appears;

13 (2) in subsection (d)(4)—

14 (A) by striking ‘‘or at any other time that

15 an adjustment in rates of pay is scheduled to

16 take place under this subsection’’ in the first

17 sentence; and

18 (B) by striking the second sentence; and

19 (3) in subsection (e)(4)—

20 (A) in subparagraph (A), by striking

21 ‘‘grade in a’’;

22 (B) in subparagraph (B)—

23 (i) by striking ‘‘grade of a’’; and

24 (ii) by striking ‘‘that grade’’ and in25 serting ‘‘that position’’; and
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1 (C) in subparagraph (D), by striking

2 ‘‘grade of a’’.

3 SEC. 304. TECHNICAL AMENDMENTS.

4 Section 7631(b) is amended by striking ‘‘this sub5 section’’ each place it appears and inserting ‘‘this section’’.

6 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

7 (a) SHORT TITLE.—This Act may be cited as the ‘‘De8 partment of Veterans Affairs Medical Programs Enhance9 ment Act of 2001’’.

10 (b) TABLE OF CONTENTS.—The table of contents for

11 this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. References to title 38, United States Code.

TITLE I—ENHANCEMENT OF NURSE RECRUITMENT AND

RETENTION AUTHORITIES

Sec. 101. Short title.

Subtitle A—Recruitment Authorities

Sec. 111. Enhancement of employee incentive scholarship program.

Sec. 112. Enhancement of education debt reduction program.

Sec. 113. Report on requests for waivers of pay reductions for reemployed annuitants to fill nurse positions.

Subtitle B—Retention Authorities

Sec. 121. Additional pay for Saturday tours of duty for additional health care

professional in the Veterans Health Administration.

Sec. 122. Unused sick leave included in annuity computation of registered nurses

with the Veterans Health Administration.

Sec. 123. Evaluation of Department of Veterans Affairs nurse managed clinics.

Sec. 124. Staffing levels for operations of medical facilities.

Sec. 125. Annual report on use of authorities to enhance retention of experienced

nurses.

Sec. 126. Report on mandatory overtime for nurses and nurse assistants in Department of Veterans Affairs facilities.

Subtitle C—Other Authorities

Sec. 131. Organizational responsibility of the Director of the Nursing Service.

Sec. 132. Computation of annuity for part-time service performed by certain

health-care professionals before April 7, 1986.
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Sec. 133. Modification of nurse locality pay authorities.

TITLE II—OTHER MATTERS

Sec. 201. Modification and enhancement of authority to provide dog-guides and

service dogs to veterans with disabilities.

Sec. 202. Additional basis for establishment of inability to defray expenses of necessary care.

Sec. 203. Funds for field offices of the Office of Research Compliance and Assurance.

Sec. 204. Technical amendments.

1 SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.

2 Except as otherwise expressly provided, whenever in

3 this Act an amendment or repeal is expressed in terms of

4 an amendment to, or repeal of, a section or other provision,

5 the reference shall be considered to be made to a section or

6 other provision of title 38, United States Code.

7 TITLE I—ENHANCEMENT OF

8 NURSE RECRUITMENT AND

9 RETENTION AUTHORITIES

10 SEC. 101. SHORT TITLE.

11 This title may be cited as the ‘‘Department of Veterans

12 Affairs Nurse Recruitment and Retention Enhancement Act

13 of 2001’’.

14 Subtitle A—Recruitment

15 Authorities

16 SEC. 111. ENHANCEMENT OF EMPLOYEE INCENTIVE SCHOL17 ARSHIP PROGRAM.

18 (a) PERMANENT AUTHORITY.—(1) Section 7676 is re19 pealed.
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1 (2) The table of sections at the beginning of chapter

2 76 is amended by striking the item relating to section 7676.

3 (b) MINIMUM PERIOD OF DEPARTMENT EMPLOYMENT

4 FOR ELIGIBILITY.—Section 7672(b) is amended by striking

5 ‘‘2 years’’ and inserting ‘‘one year’’.

6 (c) SCHOLARSHIP AMOUNT.—Subsection (b) of section

7 7673 is amended—

8 (1) in paragraph (1), by striking ‘‘for any one

9 year’’ and inserting ‘‘for the equivalent of one year of

10 full-time coursework’’; and

11 (2) by striking paragraph (2) and inserting the

12 following new paragraph (2):

13 ‘‘(2) in the case of a participant in the Program

14 who is a part-time student, shall bear the same ratio

15 to the amount that would be paid under paragraph

16 (1) if the participant were a full-time student in the

17 course of education or training being pursued by the

18 participant as the coursework carried by the student

19 bears to full-time coursework in that course of edu20 cation or training.’’.

21 (d) LIMITATION ON PAYMENT.—Subsection (c) of sec22 tion 7673 is amended to read as follows:

23 ‘‘(c) LIMITATIONS ON PERIOD OF PAYMENT.—(1) The

24 maximum number of school years for which a scholarship
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1 may be paid under subsection (a) to a participant in the

2 Program shall be six school years.

3 ‘‘(2) A participant in the Program may not receive

4 a scholarship under subsection (a) for more than the equiva5 lent of three years of full-time coursework.’’.

6 (e) FULL-TIME COURSEWORK.—Section 7673 is fur7 ther amended by adding at the end the following new sub8 section:

9 ‘‘(e) FULL-TIME COURSEWORK.—For purposes of this

10 section, full-time coursework shall consist of the following:

11 ‘‘(1) In the case of undergraduate coursework, 30

12 semester hours per undergraduate school year.

13 ‘‘(2) In the case of graduate coursework, 18 se14 mester hours per graduate school year.’’.

15 (f) ANNUAL ADJUSTMENT OF MAXIMUM SCHOLARSHIP

16 AMOUNT.—Section 7631 is amended—

17 (1) in subsection (a)(1), by striking ‘‘and the

18 maximum Selected Reserve member stipend amount’’

19 and inserting ‘‘the maximum Selected Reserve mem20 ber stipend amount, the maximum employee incentive

21 scholarship amount,’’; and

22 (2) in subsection (b)—

23 (A) by redesignating paragraph (4) as

24 paragraph (6); and
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1 (B) by inserting after paragraph (3) the fol2 lowing new paragraph (4):

3 ‘‘(4) The term ‘maximum employee incentive

4 scholarship amount’ means the maximum amount of

5 the scholarship payable to a participant in the De6 partment of Veterans Affairs Employee Incentive

7 Scholarship Program under subchapter VI of this

8 chapter, as specified in section 7673(b)(1) of this title

9 and as previously adjusted (if at all) in accordance

10 with this section.’’.

11 SEC. 112. ENHANCEMENT OF EDUCATION DEBT REDUCTION

12 PROGRAM.

13 (a) PERMANENT AUTHORITY.—(1) Section 7684 is re14 pealed.

15 (2) The table of sections at the beginning of chapter

16 76 is amended by striking the item relating to section 7684.

17 (b) ELIGIBLE INDIVIDUALS.—Subsection (a)(1) of sec18 tion 7682 is amended—

19 (1) by striking ‘‘under an appointment under

20 section 7402(b) of this title in a position’’ and insert21 ing ‘‘in a position (as determined by the Secretary)

22 providing direct-patient care services or services inci23 dent to direct-patient care services’’; and

24 (2) by striking ‘‘(as determined by the Sec25 retary)’’ and inserting ‘‘(as so determined)’’.
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1 (c) MAXIMUM DEBT REDUCTION AMOUNT.—Section

2 7683(d)(1) is amended—

3 (1) by striking ‘‘for a year’’; and

4 (2) by striking ‘‘exceed—’’ and all that follows

5 through the end of the paragraph and inserting ‘‘ex6 ceed $44,000 over a total of five years of participation

7 in the Program, of which not more than $10,000 of

8 such payments may be made in each of the fourth and

9 fifth years of participation in the Program.’’.

10 (d) ANNUAL ADJUSTMENT OF MAXIMUM DEBT REDUC11 TION PAYMENTS AMOUNT.—(1) Section 7631, as amended

12 by section 101(f) of this Act, is further amended—

13 (A) in subsection (a)(1), by inserting before the

14 period at the end of the first sentence the following:

15 ‘‘and the maximum education debt reduction pay16 ments amount’’; and

17 (B) in subsection (b), by inserting after para18 graph (4) the following new paragraph (5):

19 ‘‘(5) The term ‘maximum education debt reduc20 tion payments amount’ means the maximum amount

21 of education debt reduction payments payable to a

22 participant in the Department of Veterans Affairs

23 Education Debt Reduction Program under subchapter

24 VII of this chapter, as specified in section 7683(d)(1)
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1 of this title and as previously adjusted (if at all) in

2 accordance with this section.’’.

3 (2) Notwithstanding section 7631(a)(1) of title 38,

4 United States Code, as amended by paragraph (1), the Sec5 retary of Veterans Affairs shall not increase the maximum

6 education debt reduction payments amount under that sec7 tion in calendar year 2002.

8 (e) TEMPORARY EXPANSION OF INDIVIDUALS ELIGI9 BLE FOR PARTICIPATION IN PROGRAM.—(1) Notwith10 standing section 7682(c) of title 38, United States Code, the

11 Secretary of Veterans Affairs may treat a covered indi12 vidual as being a recently appointed employee in the Vet13 erans Health Administration under section 7682(a) of that

14 title for purposes of eligibility in the Education Debt Re15 duction Program if the Secretary determines that the par16 ticipation of the individual in the Program under this sub17 section would further the purposes of the Program.

18 (2) For purposes of this subsection, a covered indi19 vidual is any individual otherwise described by section

20 7682(a) of title 38, United States Code, as in effect on the

21 day before the date of the enactment of this Act, who—

22 (A) was appointed as an employee in a position

23 described in paragraph (1) of that section, as so in

24 effect, between January 1, 1999, and September 30,

25 2000; and
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1 (B) is an employee in such position, or in an2 other position described in paragraph (1) of that sec3 tion, as so in effect, at the time of application for

4 treatment as a covered individual under this sub5 section.

6 (3) The Secretary shall make determinations regarding

7 the exercise of the authority in this subsection on a case8 by-case basis.

9 (4) The Secretary may not exercise the authority in

10 this subsection after December 31, 2001. The expiration of

11 the authority in this subsection shall not affect the treat12 ment of an individual under this subsection before that date

13 as a covered individual for purposes of eligibility in the

14 Education Debt Reduction Program.

15 (5) In this subsection, the term ‘‘Education Debt Re16 duction Program’’ means the Department of Veterans Af17 fairs Education Debt Reduction Program under subchapter

18 VII of chapter 76 of title 38, United States Code.

19 SEC. 113. REPORT ON REQUESTS FOR WAIVERS OF PAY RE20 DUCTIONS FOR REEMPLOYED ANNUITANTS

21 TO FILL NURSE POSITIONS.

22 (a) REPORT.—Not later than November 30 of each of

23 2001 and 2002, the Secretary of Veterans Affairs shall sub24 mit to the Committees on Veterans’ Affairs of the Senate

25 and the House of Representatives a report describing each
29

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1 request of the Secretary, during the fiscal year preceding

2 such report, to the Director of the Office of Personnel Man3 agement for the following:

4 (1) A waiver under subsection (i)(1)(A) of sec5 tion 8344 of title 5, United States Code, of the provi6 sions of such section in order to meet requirements of

7 the Department of Veterans Affairs for appointments

8 to nurse positions in the Veterans Health Administra9 tion.

10 (2) A waiver under subsection (f)(1)(A) of sec11 tion 8468 of title 5, United States Code, of the provi12 sions of such section in order to meet requirements of

13 the Department for appointments to such positions.

14 (3) A grant of authority under subsection

15 (i)(1)(B) of section 8344 of title 5, United States

16 Code, for the waiver of the provisions of such section

17 in order to meet requirements of the Department for

18 appointments to such positions.

19 (4) A grant of authority under subsection

20 (f)(1)(B) of section 8468 of title 5, United States

21 Code, for the waiver of the provisions of such section

22 in order to meet requirements of the Department for

23 appointments to such positions.
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1 (b) INFORMATION ON RESPONSES TO REQUESTS.—The

2 report under subsection (a) shall specify for each request

3 covered by the report—

4 (1) the response of the Director to such request;

5 and

6 (2) if such request was granted, whether or not

7 the waiver or authority, as the case may be, assisted

8 the Secretary in meeting requirements of the Depart9 ment for appointments to nurse positions in the Vet10 erans Health Administration.

11 Subtitle B—Retention Authorities

12 SEC. 121. ADDITIONAL PAY FOR SATURDAY TOURS OF DUTY

13 FOR ADDITIONAL HEALTH CARE PROFES14 SIONAL IN THE VETERANS HEALTH ADMINIS15 TRATION.

16 (a) IN GENERAL.—Section 7454(b) is amended—

17 (1) by inserting ‘‘(1)’’ after ‘‘(b)’’; and

18 (2) by adding at the end the following new para19 graph:

20 ‘‘(2) Health care professionals employed in positions

21 referred to in paragraph (1) shall be entitled to additional

22 pay on the same basis as provided for nurses in section

23 7453(c) of this title.’’.

24 (b) APPLICABILITY.—The amendments made by sub25 section (a) shall take effect on the date of the enactment
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1 of this Act, and shall apply with respect to pay periods

2 beginning on or after that date.

3 SEC. 122. UNUSED SICK LEAVE INCLUDED IN ANNUITY COM4 PUTATION OF REGISTERED NURSES WITH

5 THE VETERANS HEALTH ADMINISTRATION.

6 (a) ANNUITY COMPUTATION.—Section 8415 of title 5,

7 United States Code, is amended by adding at the end the

8 following:

9 ‘‘(i) In computing an annuity under this subchapter,

10 the total service of an employee who retires from the posi11 tion of a registered nurse with the Veterans Health Admin12 istration on an immediate annuity, or dies while employed

13 in that position leaving any survivor entitled to an annu14 ity, includes the days of unused sick leave to the credit of

15 that employee under a formal leave system, except that such

16 days shall not be counted in determining average pay or

17 annuity eligibility under this subchapter.’’.

18 (b) DEPOSIT NOT REQUIRED.—Section 8422(d) of title

19 5, United States Code, is amended—

20 (1) by inserting ‘‘(1)’’ before ‘‘Under such regula21 tions’’; and

22 (2) by adding at the end the following:

23 ‘‘(2) Deposit may not be required for days of unused

24 sick leave credited under section 8415(i).’’.
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1 (c) EFFECTIVE DATE.—The amendments made by this

2 section shall take effect 60 days after the date of the enact3 ment of this Act, and shall apply to individuals who sepa4 rate from service on or after that effective date.

5 SEC. 123. EVALUATION OF DEPARTMENT OF VETERANS AF6 FAIRS NURSE MANAGED CLINICS.

7 (a) EVALUATION.—The Secretary of Veterans Affairs

8 shall carry out an evaluation of the efficacy of the nurse

9 managed health care clinics of the Department of Veterans

10 Affairs. The Secretary shall complete the evaluation not

11 later than 18 months after the date of the enactment of this

12 Act.

13 (b) CLINICS TO BE EVALUATED.—(1) In carrying out

14 the evaluation under subsection (a), the Secretary consider

15 nurse managed health care clinics, including primary care

16 clinics and geriatric care clinics, located in three different

17 Veterans Integrated Service Networks (VISNs) of the De18 partment.

19 (2) If there are not nurse managed health care clinics

20 located in three different Veterans Integrated Service Net21 works as of the commencement of the evaluation, the Sec22 retary shall—

23 (A) establish nurse managed health care clinics

24 in additional Veterans Integrated Services Networks

25 such that there are nurse managed health care clinics
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1 in three different Veterans Integrated Service Net2 works for purposes of the evaluation; and

3 (B) include such clinics, as so established, in the

4 evaluation.

5 (c) MATTERS TO BE EVALUATED.—In carrying out

6 the evaluation under subsection (a), the Secretary shall ad7 dress the following:

8 (1) Patient satisfaction.

9 (2) Provider experiences.

10 (3) Cost of care.

11 (4) Access to care, including waiting time for

12 care.

13 (5) The functional status of patients receiving

14 care.

15 (6) Any other matters the Secretary considers

16 appropriate.

17 (d) REPORT.—Not later than 18 months after the date

18 of the enactment of this Act, the Secretary shall submit to

19 the Committees on Veterans’ Affairs of the Senate and the

20 House of Representatives a report on the evaluation carried

21 out under subsection (a). The report shall address the mat22 ters specified in subsection (c) and include any other infor23 mation, and any recommendations, that the Secretary con24 siders appropriate.
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1 SEC. 124. STAFFING LEVELS FOR OPERATIONS OF MEDICAL

2 FACILITIES.

3 (a) IN GENERAL.—Section 8110(a) is amended—

4 (1) in paragraph (1), by inserting after ‘‘com5 plete care of patients,’’ in the fifth sentence the fol6 lowing: ‘‘and in a manner consistent with the policies

7 of the Secretary on overtime,’’; and

8 (2) in paragraph (2)—

9 (A) by inserting ‘‘, including the staffing re10 quired to maintain such capacities,’’ after ‘‘all

11 Department medical facilities’’;

12 (B) by striking ‘‘and to minimize’’ and in13 serting ‘‘, to minimize’’; and

14 (C) by inserting before the period the fol15 lowing: ‘‘, and to ensure that eligible veterans

16 are provided such care and services in an appro17 priate manner’’.

18 (b) NATIONWIDE POLICY ON STAFFING.—Paragraph

19 (3) of that section is amended—

20 (1) in subparagraph (A), by inserting ‘‘the ade21 quacy of staff levels for compliance with the policy es22 tablished under subparagraph (C),’’ after ‘‘regard23 ing’’; and

24 (2) by inserting after subparagraph (B) the fol25 lowing new subparagraph:
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1 ‘‘(C) The Secretary shall, in consultation with the

2 Under Secretary for Health, establish a nationwide policy

3 on the staffing of Department medical facilities in order

4 to ensure that such facilities have adequate staff for the pro5 vision to veterans of appropriate, high-quality care and

6 services. The policy shall take into account the staffing levels

7 and mixture of staff skills required for the range of care

8 and services provided veterans in Department facilities.’’.

9 SEC. 125. ANNUAL REPORT ON USE OF AUTHORITIES TO EN10 HANCE RETENTION OF EXPERIENCED

11 NURSES.

12 (a) ANNUAL REPORT.—(1) Subchapter II of chapter

13 73 is amended by adding at the end the following new sec14 tion:

15 ‘‘§ 7324. Annual report on use of authorities to en16 hance retention of experienced nurses

17 ‘‘(a) ANNUAL REPORT.—Not later than January 31

18 each year, the Secretary, acting through the Under Sec19 retary for Health, shall submit to Congress a report on the

20 use during the preceding year of authorities for purposes

21 of retaining experienced nurses in the Veterans Health Ad22 ministration, as follows:

23 ‘‘(1) The authorities under chapter 76 of this

24 title.
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1 ‘‘(2) The authority under VA Directive 5102.1,

2 relating to the Department of Veterans Affairs nurse

3 qualification standard, dated November 10, 1999, or

4 any successor directive.

5 ‘‘(3) Any other authorities available to the Sec6 retary for those purposes.

7 ‘‘(b) REPORT ELEMENTS.—Each report under sub8 section (a) shall specify for the period covered by such re9 port, for each Department medical facility and for each Vet10 erans Integrated Service Network, the following:

11 ‘‘(1) The number of waivers requested under the

12 authority referred to in subsection (a)(2), and the

13 number of waivers granted under that authority, to

14 promote to the Nurse II grade or Nurse III grade

15 under the Nurse Schedule under section 7404(b)(1) of

16 this title any nurse who has not completed a bachelors

17 of science in nursing in a recognized school of nurs18 ing, set forth by age, race, and years of experience of

19 the individuals subject to such waiver requests and

20 waivers, as the case may be.

21 ‘‘(2) The programs carried out to facilitate the

22 use of nursing education programs by experienced

23 nurses, including programs for flexible scheduling,

24 scholarships, salary replacement pay, and on-site

25 classes.’’.
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1 (2) The table of sections at the beginning of chapter

2 73 is amended by inserting after the item relating to section

3 7323 the following new item:

‘‘7324. Annual report on use of authorities to enhance retention of experienced

nurses.’’.

4 (b) INITIAL REPORT.—The initial report required

5 under section 7324 of title 38, United States Code, as added

6 by subsection (a), shall be submitted in 2002.

7 SEC. 126. REPORT ON MANDATORY OVERTIME FOR NURSES

8 AND NURSE ASSISTANTS IN DEPARTMENT OF

9 VETERANS AFFAIRS FACILITIES.

10 (a) REPORT.—Not later than 180 days after the date

11 of the enactment of this Act, the Secretary of Veterans Af12 fairs shall submit to the Committees on Veterans’ Affairs

13 of the Senate and the House of Representatives a report on

14 the mandatory overtime required of licensed nurses and

15 nurse assistants providing direct patient care at Depart16 ment of Veterans Affairs medical facilities during 2001.

17 (b) MANDATORY OVERTIME.—For purposes of the re18 port under subsection (a), mandatory overtime shall consist

19 of any period in which a nurse or nurse assistant is man20 dated or otherwise required, whether directly or indirectly,

21 to work or be in on-duty status in excess of—

22 (1) a scheduled workshift or duty period;

23 (2) 12 hours in any 24-hour period; or
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1 (3) 80 hours in any period of 14 consecutive

2 days.

3 (c) ELEMENTS.—The report under subsection (a) shall

4 include the following:

5 (1) A description of the amount of mandatory

6 overtime described in that subsection at each Depart7 ment medical facility during the period covered by

8 the report.

9 (2) A description of the mechanisms employed by

10 the Secretary to monitor overtime of the nurses and

11 nurse assistants referred to in that subsection.

12 (3) An assessment of the effects of the mandatory

13 overtime of such nurses and nurse assistants on pa14 tient care, including its contribution to medical er15 rors.

16 (4) Recommendations regarding mechanisms for

17 preventing mandatory overtime in other than emer18 gency situations by such nurses and nurse assistants.

19 (5) Any other matters that the Secretary con20 siders appropriate.

21 Subtitle C—Other Authorities

22 SEC. 131. ORGANIZATIONAL RESPONSIBILITY OF THE DI23 RECTOR OF THE NURSING SERVICE.

24 Section 7306(a)(5) is amended by inserting ‘‘, and re25 port directly to,’’ after ‘‘responsible to’’.
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1 SEC. 132. COMPUTATION OF ANNUITY FOR PART-TIME

2 SERVICE PERFORMED BY CERTAIN HEALTH3 CARE PROFESSIONALS BEFORE APRIL 7, 1986.

4 Section 7426 is amended by adding at the end the fol5 lowing new subsection:

6 ‘‘(c) The provisions of subsection (b) shall not apply

7 to the part-time service before April 7, 1986, of a registered

8 nurse, physician assistant, or expanded-function dental

9 auxiliary. In computing the annuity under the applicable

10 provision of law specified in that subsection of an indi11 vidual covered by the preceding sentence, the service de12 scribed in that sentence shall be credited as full-time serv13 ice.’’.

14 SEC. 133. MODIFICATION OF NURSE LOCALITY PAY AU15 THORITIES.

16 Section 7451 is amended—

17 (1) in subsection (d)(3)—

18 (A) in subparagraph (A), by striking ‘‘be19 ginning rates of’’ each place it appears;

20 (B) in subparagraph (B), by striking ‘‘be21 ginning rates of’’ the first place it appears; and

22 (C) in subparagraph (C)(i), by striking ‘‘be23 ginning rates of’’ each place it appears;

24 (2) in subsection (d)(4)—

25 (A) by striking ‘‘or at any other time that

26 an adjustment in rates of pay is scheduled to
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1 take place under this subsection’’ in the first sen2 tence; and

3 (B) by striking the second sentence; and

4 (3) in subsection (e)(4)—

5 (A) in subparagraph (A), by striking

6 ‘‘grade in a’’;

7 (B) in subparagraph (B)—

8 (i) by striking ‘‘grade of a’’; and

9 (ii) by striking ‘‘that grade’’ and in10 serting ‘‘that position’’; and

11 (C) in subparagraph (D), by striking

12 ‘‘grade of a’’.

13 TITLE II—OTHER MATTERS

14 SEC. 201. MODIFICATION AND ENHANCEMENT OF AUTHOR15 ITY TO PROVIDE DOG-GUIDES AND SERVICE

16 DOGS TO VETERANS WITH DISABILITIES.

17 (a) ENHANCEMENT OF AUTHORITY.—Subsection (b) of

18 section 1714 is amended to read as follows:

19 ‘‘(b)(1) The Secretary may provide any blind veteran

20 who is entitled to disability compensation with—

21 ‘‘(A) a dog-guide trained for the aid of the blind;

22 and

23 ‘‘(B) mechanical or electronic equipment for aid

24 in overcoming the disability of blindness.
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1 ‘‘(2) The Secretary may provide a service dog to the

2 following:

3 ‘‘(A) Any hearing-impaired veteran who is enti4 tled to disability compensation.

5 ‘‘(B) Any veteran with a spinal cord injury or

6 dysfunction who is entitled to disability compensa7 tion.

8 ‘‘(C) Any veteran entitled to disability com9 pensation who has any other chronic physical or men10 tal impairment that substantially limits mobility,

11 hearing, or activities of daily living in order to assist

12 such veteran in overcoming such physical or mental

13 impairment.

14 ‘‘(3) In providing a dog-guide or service dog to a vet15 eran under this subsection, the Secretary may pay travel

16 and incidental expenses (under the terms and conditions

17 set forth in section 111 of this title) of the veteran to and

18 from the veteran’s home and incurred in becoming adjusted

19 to the dog-guide or service dog, as the case may be.’’.

20 (b) CONFORMING AND CLERICAL AMENDMENTS.—(1)

21 The section heading of that section is amended to read as

22 follows:
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1 ‘‘§ 1714. Fitting and training in use of prosthetic ap2 pliances; dog-guides and service dogs’’

3 (2) The table of section at the beginning of chapter 17

4 is amended by striking the item relating to section 1714

5 and inserting the following new item:

‘‘1714. Fitting and training in use of prosthetic appliances; dog-guides and service

dogs.’’.

6 SEC. 202. ADDITIONAL BASIS FOR ESTABLISHMENT OF IN7 ABILITY TO DEFRAY EXPENSES OF NEC8 ESSARY CARE.

9 (a) ADDITIONAL BASIS.—Section 1722(a) is

10 amended—

11 (1) in paragraph (2), by striking ‘‘or’’ at the

12 end;

13 (2) in paragraph (3), by striking the period at

14 the end and inserting ‘‘; or’’; and

15 (3) by adding at the end the following new para16 graph:

17 ‘‘(4) the veteran (including any applicable part

18 of the veteran’s family) is eligible for treatment as a

19 low-income family under section 3 of the United

20 States Housing Act of 1937 (42 U.S.C. 1437a) for the

21 area in which the veteran resides.’’.

22 (b) APPLICABILITY.—The amendments made by sub23 section (a) shall take effect on January 1, 2002, and shall
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1 apply with respect to years beginning after December 31,

2 2001.

3 SEC. 203. FUNDS FOR FIELD OFFICES OF THE OFFICE OF

4 RESEARCH COMPLIANCE AND ASSURANCE.

5 (a) IN GENERAL.—Amounts for the activities of the

6 field offices of the Office of Research Compliance and Assur7 ance of the Department of Veterans Affairs shall be derived

8 from amounts appropriated for the Department of Veterans

9 Affairs for the Veterans Health Administration for Medical

10 Care, rather than from amounts appropriated for the Vet11 erans Health Administration for Medical and Prosthetic

12 Research.

13 (b) APPLICABILITY.—Subsection (a) shall apply with

14 respect to fiscal years after fiscal year 2001.

15 SEC. 204. TECHNICAL AMENDMENTS.

16 Section 7631(b) is amended by striking ‘‘this sub17 section’’ each place it appears and inserting ‘‘this section’’.

18 Amend the title to read: ‘‘A Bill to amend title 38,

19 United States Code, to enhance the authority of the Sec20 retary of Veterans Affairs to recruit and retain qualified

21 nurses for the Veterans Health Administration, to provide

22 an additional basis for establishing the inability of vet23 erans to defray expenses of necessary medical care, to

24 modify other authorities relating to health care for vet25 erans, and for other purposes.’’.
Calendar No. 190

107TH CONGRESS

1ST SESSION S. 1188

[Report No. 107–80]

A BILL

To amend title 38, United States Code, to enhance

the authority of the Secretary of Veterans Affairsto recruit and retain qualified nurses for the Veterans Health Administration, and for other purposes.

OCTOBER 10, 2001

Reported with an amendment and an amendment to the

title