```

[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 919 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 919

 To amend title 38, United States Code, to enhance the capacity of the 
 Department of Veterans Affairs to recruit and retain nurses and other 
      critical health care professionals, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                            February 9, 2009

Ms. Eddie Bernice Johnson of Texas introduced the following bill; which 
           was referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL

 
 To amend title 38, United States Code, to enhance the capacity of the 
 Department of Veterans Affairs to recruit and retain nurses and other 
      critical health care professionals, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Veterans' Medical Personnel 
Recruitment and Retention Act of 2009''.

SEC. 2. ENHANCEMENT OF AUTHORITIES FOR RETENTION OF MEDICAL 
              PROFESSIONALS.

    (a) Secretarial Authority To Extend Title 38 Status to Additional 
Positions.--
            (1) In general.--Paragraph (3) of section 7401 of title 38, 
        United States Code, is amended by striking ``and blind 
        rehabilitation outpatient specialists.'' and inserting the 
        following: ``blind rehabilitation outpatient specialists, and 
        such other classes of health care occupations as the Secretary 
        considers necessary for the recruitment and retention needs of 
        the Department subject to the following requirements:
                    ``(A) Not later than 45 days before the Secretary 
                appoints any personnel for a class of health care 
                occupations that is not specifically listed in this 
                paragraph, the Secretary shall submit to the Committee 
                on Veterans' Affairs of the Senate, the Committee on 
                Veterans' Affairs of the House of Representatives, and 
                the Office of Management and Budget notice of such 
                appointment.
                    ``(B) Before submitting notice under subparagraph 
                (A), the Secretary shall solicit comments from any 
                labor organization representing employees in such class 
                and include such comments in such notice.''.
            (2) Appointment of nurse assistants.--Such paragraph is 
        further amended by inserting ``nurse assistants,'' after 
        ``licensed practical or vocational nurses,''.
    (b) Probationary Periods for Nurses.--Section 7403(b) of such title 
is amended--
            (1) in paragraph (1), by striking ``Appointments'' and 
        inserting ``Except as otherwise provided in this subsection, 
        appointments'';
            (2) by redesignating paragraph (2) as paragraph (4); and
            (3) by inserting after paragraph (1) the following new 
        paragraphs:
    ``(2) An appointment of a nurse under this chapter, whether on a 
full-time basis or a part-time basis, shall be for a probationary 
period ending upon the completion by the person so appointed of 4,180 
hours of work pursuant to such appointment.
    ``(3) An appointment described in subsection (a) on a part-time 
basis of a person who has previously served on a full-time basis for 
the probationary period for the position concerned shall be without a 
probationary period.''.
    (c) Prohibition on Temporary Part-Time Nurse Appointments in Excess 
of 4,180 Hours.--Section 7405(f)(2) of such title is amended by 
inserting after ``year'' the following: ``, except that a part-time 
appointment of a nurse shall be for a period that does not exceed 4,180 
hours''.
    (d) Waiver of Offset From Pay for Certain Reemployed Annuitants.--
            (1) In general.--Section 7405 of such title is amended by 
        adding at the end the following:
    ``(g)(1) The Secretary may waive the application of sections 8344 
and 8468 of title 5 (relating to annuities and pay on reemployment) or 
any other similar provision of law under a Government retirement system 
on a case-by-case basis for an annuitant reemployed on a temporary 
basis under the authority of subsection (a) in a position described 
under paragraph (1) of that subsection.
    ``(2) An annuitant for whom a waiver under paragraph (1) is in 
effect shall not be considered an employee for purposes of any 
Government retirement system.
    ``(3) An annuitant for whom a waiver under paragraph (1) is in 
effect shall be subject to the provisions of chapter 71 of title 5 
(including all labor authority and labor representative collective 
bargaining agreements) applicable to the position to which appointed.
    ``(4) In this subsection:
            ``(A) The term `annuitant' means an annuitant under a 
        Government retirement system.
            ``(B) The term `employee' has the meaning under section 
        2105 of title 5.
            ``(C) The term `Government retirement system' means a 
        retirement system established by law for employees of the 
        Government of the United States.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall take effect on the date that is six months after the date 
        of the enactment of this Act, and shall apply to pay periods 
        beginning on or after such effective date.
    (e) Minimum Rate of Basic Pay for Appointees to the Office of the 
Under Secretary for Health Set to Lowest Rate of Basic Pay Payable for 
a Senior Executive Service Position.--
            (1) In general.--Section 7404(a) of such title is amended--
                    (A) by striking ``The annual'' and inserting ``(1) 
                The annual'';
                    (B) by striking ``The pay'' and inserting the 
                following:
    ``(2) The pay'';
                    (C) by striking ``under the preceding sentence'' 
                and inserting ``under paragraph (1)''; and
                    (D) by adding at the end the following:
    ``(3) The minimum rate of basic pay for a position to which an 
Executive order applies under paragraph (1) and is not described by 
paragraph (2) may not be less than the lowest rate of basic pay payable 
for a Senior Executive Service position under section 5382 of title 
5.''.
            (2) Effective date.--The amendments made by paragraph (1) 
        shall take effect on the first day of the first pay period 
        beginning after the day that is 180 days after the date of the 
        enactment of this Act.
    (f) Comparability Pay Program for Appointees to the Office of the 
Under Secretary for Health.--Section 7410 of such title is amended--
            (1) by striking ``The Secretary may'' and inserting ``(a) 
        In General.--The Secretary may''; and
            (2) by adding at the end the following new subsection:
    ``(b) Comparability Pay for Appointees to the Office of the Under 
Secretary for Health.--(1) The Secretary may authorize the Under 
Secretary for Health to provide comparability pay of not more than 
$100,000 per year to individuals of the Veterans Health Administration 
appointed under section 7306 of this title who are not physicians or 
dentists to achieve annual pay levels for such individuals that are 
comparable with annual pay levels of individuals with similar positions 
in the private sector.
    ``(2) Comparability pay under paragraph (1) for an individual is in 
addition to all other pay, awards, and performance bonuses paid to such 
individual under this title.
    ``(3) Except as provided in paragraph (4), comparability pay under 
paragraph (1) for an individual shall be considered basic pay for all 
purposes, including retirement benefits under chapters 83 and 84 of 
title 5, and other benefits.
    ``(4) Comparability pay under paragraph (1) for an individual shall 
not be considered basic pay for purposes of adverse actions under 
subchapter V of this chapter.
    ``(5) Comparability pay under paragraph (1) may not be awarded to 
an individual in an amount that would result in an aggregate amount of 
pay (including bonuses and awards) received by such individual in a 
year under this title that is greater than the annual pay of the 
President.''.
    (g) Special Incentive Pay for Department Pharmacist Executives.--
Section 7410 of such title, as amended by subsection (f), is further 
amended by adding at the end the following new subsection:
    ``(c) Special Incentive Pay for Department Pharmacist Executives.--
(1) In order to recruit and retain highly qualified Department 
pharmacist executives, the Secretary may authorize the Under Secretary 
for Health to pay special incentive pay of not more than $40,000 per 
year to an individual of the Veterans Health Administration who is a 
pharmacist executive.
    ``(2) In determining whether and how much special pay to provide to 
such individual, the Under Secretary shall consider the following:
            ``(A) The grade and step of the position of the individual.
            ``(B) The scope and complexity of the position of the 
        individual.
            ``(C) The personal qualifications of the individual.
            ``(D) The characteristics of the labor market concerned.
            ``(E) Such other factors as the Secretary considers 
        appropriate.
    ``(3) Special incentive pay under paragraph (1) for an individual 
is in addition to all other pay (including basic pay) and allowances to 
which the individual is entitled.
    ``(4) Except as provided in paragraph (5), special incentive pay 
under paragraph (1) for an individual shall be considered basic pay for 
all purposes, including retirement benefits under chapters 83 and 84 of 
title 5, and other benefits.
    ``(5) Special incentive pay under paragraph (1) for an individual 
shall not be considered basic pay for purposes of adverse actions under 
subchapter V of this chapter.
    ``(6) Special incentive pay under paragraph (1) may not be awarded 
to an individual in an amount that would result in an aggregate amount 
of pay (including bonuses and awards) received by such individual in a 
year under this title that is greater than the annual pay of the 
President.''.
    (h) Pay for Physicians and Dentists.--
            (1) Non-foreign cost of living adjustment allowance.--
        Section 7431(b) of such title is amended by adding at the end 
        the following:
            ``(5) The non-foreign cost of living adjustment allowance 
        authorized under section 5941 of title 5 for physicians and 
        dentists whose pay is set under this section shall be 
        determined as a percentage of base pay only.''.
            (2) Market pay determinations for physicians and dentists 
        in administrative or executive leadership positions.--Section 
        7431(c)(4)(B)(i) of such title is amended by adding at the end 
        the following: ``The Secretary may exempt physicians and 
        dentists occupying administrative or executive leadership 
        positions from the requirements of the previous sentence.''.
            (3) Exception to prohibition on reduction of market pay.--
        Section 7431(c)(7) of such title is amended by striking 
        ``concerned.'' and inserting ``concerned, unless there is a 
        change in board certification or reduction of privileges.''.
    (i) Adjustment of Pay Cap for Nurses.--Section 7451(c)(2) of such 
title is amended by striking ``title 5'' and inserting ``title 5 or in 
level of GS-15 as prescribed under section 5332 of such title, 
whichever is greater''.
    (j) Exemption for Certified Registered Nurse Anesthetists From 
Limitation on Authorized Competitive Pay.--Section 7451(c)(2) of such 
title is further amended by adding at the end the following new 
sentence: ``The maximum rate of basic pay for a grade for the position 
of certified registered nurse anesthetist pursuant to an adjustment 
under subsection (d) may exceed the maximum rate otherwise provided in 
the preceding sentence.''.
    (k) Locality Pay Scale Computations.--
            (1) Education, training, and support for facility directors 
        in wage surveys.--Section 7451(d)(3) of such title is amended 
        by adding at the end the following new subparagraph:
    ``(F) The Under Secretary for Health shall provide appropriate 
education, training, and support to directors of Department health-care 
facilities in the conduct and use of surveys under this paragraph.''.
            (2) Information on methodology used in wage surveys.--
        Section 7451(e)(4) of such title is amended--
                    (A) by redesignating subparagraph (D) as 
                subparagraph (E); and
                    (B) by inserting after subparagraph (C) the 
                following new subparagraph (D):
            ``(D) In any case in which the director conducts such a 
        wage survey during the period covered by the report and makes 
        adjustment in rates of basic pay applicable to one or more 
        covered positions at the facility, information on the 
        methodology used in making such adjustment or adjustments.''.
            (3) Disclosure of information to persons in covered 
        positions.--Section 7451(e) of such title is further amended by 
        adding at the end the following new paragraph:
    ``(6)(A) Upon the request of an individual described in 
subparagraph (B) for a report provided under paragraph (4) with respect 
to a Department health care facility, the Under Secretary for Health or 
the director of such facility shall provide to the individual the most 
current report for such facility provided under such paragraph.
    ``(B) An individual described in this subparagraph is--
            ``(i) an individual in a covered position at a Department 
        health care facility; or
            ``(ii) a representative of the labor organization 
        representing that individual who is designated by that 
        individual to make the request.''.
    (l) Increased Limitation on Special Pay for Nurse Executives.--
Section 7452(g)(2) of such title is amended by striking ``$25,000'' and 
inserting ``$100,000''.
    (m) Eligibility of Part-Time Nurses for Additional Nurse Pay.--
            (1) In general.--Section 7453 of such title is amended--
                    (A) in subsection (a), by striking ``a nurse'' and 
                inserting ``a full-time nurse or part-time nurse'';
                    (B) in subsection (b)--
                            (i) in the first sentence--
                                    (I) by striking ``on a tour of 
                                duty'';
                                    (II) by striking ``on such tour''; 
                                and
                                    (III) by striking ``of such tour'' 
                                and inserting ``of such service''; and
                            (ii) in the second sentence, by striking 
                        ``of such tour'' and inserting ``of such 
                        service'';
                    (C) in subsection (c)--
                            (i) by striking ``on a tour of duty''; and
                            (ii) by striking ``on such tour''; and
                    (D) in subsection (e)--
                            (i) in paragraph (1), by striking ``eight 
                        hours in a day'' and inserting ``eight 
                        consecutive hours''; and
                            (ii) in paragraph (5)(A), by striking 
                        ``tour of duty'' and inserting ``period of 
                        service''.
            (2) Exclusion of application of additional nurse pay 
        provisions to certain additional employees.--Section 7454(b)(3) 
        of such title is amended to read as follows:
    ``(3) Employees appointed under section 7408 of this title 
performing service on a tour of duty, any part of which is within the 
period commencing at midnight Friday and ending at midnight Sunday, 
shall receive additional pay in addition to the rate of basic pay 
provided such employees for each hour of service on such tour at a rate 
equal to 25 percent of such employee's hourly rate of basic pay.''.
    (n) Exemption of Additional Nurse Positions From Limitation on 
Increase in Rates of Basic Pay.--Section 7455(c)(1) of such title is 
amended by inserting after ``nurse anesthetists,'' the following: 
``licensed practical nurses, licensed vocational nurses, and nursing 
positions otherwise covered by title 5,''.

SEC. 3. LIMITATIONS ON OVERTIME DUTY, WEEKEND DUTY, AND ALTERNATIVE 
              WORK SCHEDULES FOR NURSES.

    (a) Overtime Duty.--
            (1) In general.--Subchapter IV of chapter 74 of title 38, 
        United States Code, is amended by adding at the end the 
        following new section:
``Sec. 7459. Nurses: special rules for overtime duty
    ``(a) Limitation.--Except as provided in subsection (c), the 
Secretary may not require a nurse to work more than 40 hours (or 24 
hours if such nurse is covered under section 7456) in an administrative 
work week or more than eight consecutive hours (or 12 hours if such 
nurse is covered under section 7456 or 7456A).
    ``(b) Voluntary Overtime.--(1) A nurse may on a voluntary basis 
elect to work hours otherwise prohibited by subsection (a).
    ``(2) The refusal of a nurse to work hours prohibited by subsection 
(a) shall not be grounds to discriminate (within the meaning of section 
704(a) of the Civil Rights Act of 1964 (42 U.S.C. 2000e-3(a))) against 
the nurse, to dismiss or discharge the nurse, or to take any other 
adverse personnel action against the nurse.
    ``(c) Overtime Under Emergency Circumstances.--(1) Subject to 
paragraph (2), the Secretary may require a nurse to work hours 
otherwise prohibited by subsection (a) if--
            ``(A) the work is a consequence of an emergency that could 
        not have been reasonably anticipated;
            ``(B) the emergency is non-recurring and is not caused by 
        or aggravated by the inattention of the Secretary or lack of 
        reasonable contingency planning by the Secretary;
            ``(C) the Secretary has exhausted all good faith, 
        reasonable attempts to obtain voluntary workers;
            ``(D) the nurse has critical skills and expertise that are 
        required for the work; and
            ``(E) the work involves work for which the standard of care 
        for a patient assignment requires continuity of care through 
        completion of a case, treatment, or procedure.
    ``(2) A nurse may not be required to work hours under this 
subsection after the requirement for a direct role by the nurse in 
responding to medical needs resulting from the emergency ends.
    ``(d) Nurse Defined.--In this section, the term `nurse' includes 
the following:
            ``(1) A registered nurse.
            ``(2) A licensed practical or vocational nurse.
            ``(3) A nurse assistant appointed under this chapter or 
        title 5.
            ``(4) Any other nurse position designated by the Secretary 
        for purposes of this section.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 74 of such title is amended by inserting 
        after the item relating to section 7458 the following new item:

``7459. Nurses: special rules for overtime duty.''.
    (b) Weekend Duty.--Section 7456 of such title is amended--
            (1) in subsection (a) by striking ``regularly scheduled 12-
        hour tour of duty'' and inserting ``scheduled 12-hour periods 
        of service'';
            (2) in subsection (b)--
                    (A) in paragraph (2), by striking ``service 
                performed as part of a regularly scheduled 12-hour tour 
                of duty'' and inserting ``any service performed''; and
                    (B) in paragraph (3)--
                            (i) in subparagraph (A), by striking 
                        ``regularly scheduled two 12-hour tours of 
                        duty'' and inserting ``scheduled 12-hour period 
                        of service'';
                            (ii) in subparagraph (B), by striking 
                        ``regularly scheduled two 12-hour tour of 
                        duty'' and inserting ``scheduled 12-hour period 
                        of service''; and
                            (iii) in subparagraph (C), by striking 
                        ``regularly scheduled two 12-hour tours of 
                        duty'' and inserting ``scheduled two 12-hour 
                        periods of service'';
            (3) by striking subsection (c); and
            (4) by redesignating subsection (d) as subsection (c).
    (c) Alternate Work Schedules.--
            (1) In general.--Section 7456A(b)(1)(A) of such title is 
        amended by striking ``three regularly scheduled'' and all that 
        follows through the period at the end and inserting ``six 
        regularly scheduled 12-hour periods of service within a pay 
        period shall be considered for all purposes to have worked a 
        full 80-hour pay period.''.
            (2) Conforming amendments.--Section 7456A(b) of such title 
        is amended--
                    (A) in the subsection heading, by striking ``36/
                40'' and inserting ``72/80'';
                    (B) in paragraph (2)--
                            (i) in subparagraph (A), by striking ``40-
                        hour basic work week'' and inserting ``80-hour 
                        pay period'';
                            (ii) in subparagraph (B), by striking 
                        ``regularly scheduled 36-hour tour of duty 
                        within the work week'' and inserting 
                        ``scheduled 72-hour period of service within 
                        the bi-weekly pay period'';
                            (iii) in subparagraph (C)--
                                    (I) in clause (i), by striking 
                                ``regularly scheduled 36-hour tour of 
                                duty within an administrative work 
                                week'' and inserting ``scheduled 72-
                                hour period of service within an 
                                administrative pay period'';
                                    (II) in clause (ii), by striking 
                                ``regularly scheduled 12-hour tour of 
                                duty'' and inserting ``scheduled 12-
                                hour period of service''; and
                                    (III) in clause (iii), by striking 
                                ``regularly scheduled 36-hour tour of 
                                duty work week'' and inserting 
                                ``scheduled 72-hour period of service 
                                pay period''; and
                            (iv) in subparagraph (D), by striking 
                        ``regularly scheduled 12-hour tour of duty'' 
                        and inserting ``scheduled 12-hour period of 
                        service''; and
                    (C) in paragraph (3), by striking ``regularly 
                scheduled 12-hour tour of duty'' and inserting 
                ``scheduled 12-hour period of service''.

SEC. 4. IMPROVEMENTS TO CERTAIN EDUCATIONAL ASSISTANCE PROGRAMS.

    (a) Reinstatement of Health Professionals Educational Assistance 
Scholarship Program.--
            (1) In general.--Section 7618 of title 38, United States 
        Code, is amended by striking ``December 31, 1998'' and 
        inserting ``December 31, 2013''.
            (2) Expansion of eligibility requirements.--Paragraph (2) 
        of section 7612(b) of such title is amended by striking 
        ``(under section'' and all that follows through the period at 
        the end and inserting the following: ``as an appointee under 
        paragraph (1) or (3) of section 7401 of this title.''.
    (b) Improvements to Education Debt Reduction Program.--
            (1) Inclusion of employee retention as purpose of 
        program.--Section 7681(a)(2) of such title is amended by 
        inserting ``and retention'' after ``recruitment'' the first 
        time it appears.
            (2) Eligibility.--Section 7682 of such title is amended--
                    (A) in subsection (a)(1), by striking ``a recently 
                appointed'' and inserting ``an''; and
                    (B) by striking subsection (c).
            (3) Maximum amounts of assistance.--Section 7683(d)(1) of 
        such title is amended--
                    (A) by striking ``$44,000'' and inserting 
                ``$60,000''; and
                    (B) by striking ``$10,000'' and inserting 
                ``$12,000''.
    (c) Loan Repayment Program for Clinical Researchers From 
Disadvantaged Backgrounds.--
            (1) In general.--The Secretary of Veterans Affairs, in 
        consultation with the Secretary of Health and Human Services, 
        may utilize the authorities available in section 487E of the 
        Public Health Service Act (42 U.S.C. 288-5) for the repayment 
        of the principal and interest of educational loans of 
        appropriately qualified health professionals who are from 
        disadvantaged backgrounds in order to secure clinical research 
        by such professionals for the Veterans Health Administration.
            (2) Limitations.--The exercise by the Secretary of Veterans 
        Affairs of the authorities referred to in paragraph (1) shall 
        be subject to the conditions and limitations specified in 
        paragraphs (2) and (3) of section 487E(a) of the Public Health 
        Service Act (42 U.S.C. 288-5(2) and (3)).
            (3) Funding.--Amounts for the repayment of principal and 
        interest of educational loans under this subsection shall be 
        derived from amounts available to the Secretary of Veterans for 
        the Veterans Health Administration for Medical Services.
                                 <all>
```