108TH CONGRESS

2D SESSION S. 2484

AN ACT

To amend title 38, United States Code, to simplify and

improve pay provisions for physicians and dentists and

to authorize alternate work schedules and executive pay

for nurses, 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,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Department of Vet5 erans Affairs Health Care Personnel Enhancement Act of

6 2004’’.
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1 SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.

2 Except as otherwise expressly provided, whenever in

3 this Act an amendment is expressed in terms of an amend4 ment to a section or other provision, the reference shall

5 be considered to be made to a section or other provision

6 of title 38, United States Code.

7 SEC. 3. SIMPLIFICATION AND IMPROVEMENT OF GRADE

8 AND PAY PROVISIONS FOR PHYSICIANS AND

9 DENTISTS.

10 (a) SIMPLIFICATION OF GRADES AND GRADE RE11 QUIREMENTS.—(1) Subsection (b) of section 7404 is

12 amended—

13 (A) by striking ‘‘(1)’’ after ‘‘(b)’’;

14 (B) in the Physician and Dentist Schedule, by

15 striking the items relating to the grades and insert16 ing the following:

17 ‘‘Physician grade.

18 ‘‘Dentist grade.’’; and

19 (C) by striking paragraph (2).

20 (2) Subsection (a) of such section is amended by add21 ing at the end the following: ‘‘The pay of physicians and

22 dentists serving in positions to which an Executive order

23 applies under the preceding sentence shall be determined

24 under subchapter III of this chapter instead of such Exec25 utive order.’’.
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1 (b) SIMPLIFICATION AND IMPROVEMENT OF PAY AU2 THORITIES.—Subchapter III of chapter 74 is amended to

3 read as follows:

4 ‘‘SUBCHAPTER III—PAY FOR PHYSICIANS AND

5 DENTISTS

6 ‘‘§ 7431. Pay

7 ‘‘(a) ELEMENTS OF PAY.—Pay of physicians and

8 dentists in the Veterans Health Administration shall con9 sist of three elements as follows:

10 ‘‘(1) Base pay as provided for under subsection

11 (b).

12 ‘‘(2) Market pay as provided for under sub13 section (c).

14 ‘‘(3) Performance pay as provided under sub15 section (d).

16 ‘‘(b) BASE PAY.—One element of pay for physicians

17 and dentists shall be base pay. Base pay shall meet the

18 following requirements:

19 ‘‘(1) Each physician and dentist is entitled to

20 base pay determined under the Physician and Den21 tist Base and Longevity Pay Schedule.

22 ‘‘(2) The Physician and Dentist Base and Lon23 gevity Pay Schedule is composed of 15 rates of base

24 pay designated, from the lowest rate of pay to the

25 highest rate of pay, as base pay steps 1 through 15.
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1 ‘‘(3) The rate of base pay payable to a physi2 cian or dentist is based on the total number of the

3 years of the service of the physician or dentist in the

4 Veterans Health Administration as follows:

‘‘For a physician or dentist The rate of base pay is

with total service of: the rate payable for:

two years or less ...................................................................... step 1

more than 2 years and not more than 4 years ........................ step 2

more than 4 years and not more than 6 years ........................ step 3

more than 6 years and not more than 8 years ........................ step 4

more than 8 years and not more than 10 years ...................... step 5

more than 10 years and not more than 12 years .................... step 6

more than 12 years and not more than 14 years .................... step 7

more than 14 years and not more than 16 years .................... step 8

more than 16 years and not more than 18 years .................... step 9

more than 18 years and not more than 20 years .................... step 10

more than 20 years and not more than 22 years .................... step 11

more than 22 years and not more than 24 years .................... step 12

more than 24 years and not more than 26 years .................... step 13

more than 26 years and not more than 28 years .................... step 14

more than 28 years .................................................................. step 15.

5 ‘‘(4) At the same time as rates of basic pay are

6 increased for a year under section 5303 of title 5,

7 the Secretary shall increase the amount of base pay

8 payable under this subsection for that year by a per9 centage equal to the percentage by which rates of

10 basic pay are increased under such section for that

11 year.

12 ‘‘(c) MARKET PAY.—One element of pay for physi13 cians and dentists shall be market pay. Market pay shall

14 meet the following requirements:

15 ‘‘(1) Each physician and dentist is eligible for

16 market pay.
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1 ‘‘(2) Market pay shall consist of pay intended

2 to reflect the recruitment and retention needs for

3 the specialty or assignment (as defined by the Sec4 retary) of a particular physician or dentist in a facil5 ity of the Department of Veterans Affairs.

6 ‘‘(3) The annual amount of the market pay

7 payable to a physician or dentist shall be determined

8 by the Secretary on a case-by-case basis.

9 ‘‘(4)(A) In determining the amount of market

10 pay for physicians or dentists, the Secretary shall

11 consult two or more national surveys of pay for phy12 sicians or dentists, as applicable, whether prepared

13 by private, public, or quasi-public entities in order to

14 make a general assessment of the range of pays pay15 able to physicians or dentists, as applicable.

16 ‘‘(B)(i) In determining the amount of the mar17 ket pay for a particular physician or dentist under

18 this subsection, and in determining a tier (if any) to

19 apply to a physician or dentist under subsection

20 (e)(1)(B), the Secretary shall consult with and con21 sider the recommendations of an appropriate panel

22 or board composed of physicians or dentists (as ap23 plicable).

24 ‘‘(ii) A physician or dentist may not be a mem25 ber of the panel or board that makes recommenda-
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1 tions under clause (i) with respect to the market pay

2 of such physician or dentist, as the case may be.

3 ‘‘(iii) The Secretary should, to the extent prac4 ticable, ensure that a panel or board consulted under

5 this subparagraph includes physicians or dentists (as

6 applicable) who are practicing clinicians and who do

7 not hold management positions in the medical facil8 ity of the Department at which the physician or den9 tist subject to the consultation is employed.

10 ‘‘(5) The determination of the amount of mar11 ket pay of a physician or dentist shall take into

12 account—

13 ‘‘(A) the level of experience of the physi14 cian or dentist in the specialty or assignment of

15 the physician or dentist;

16 ‘‘(B) the need for the specialty or assign17 ment of the physician or dentist at the medical

18 facility of the Department concerned;

19 ‘‘(C) the health care labor market for the

20 specialty or assignment of the physician or den21 tist, which may cover any geographic area the

22 Secretary considers appropriate for the spe23 cialty or assignment;

24 ‘‘(D) the board certifications, if any, of the

25 physician or dentist;
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1 ‘‘(E) the prior experience, if any, of the

2 physician or dentist as an employee of the Vet3 erans Health Administration; and

4 ‘‘(F) such other considerations as the Sec5 retary considers appropriate.

6 ‘‘(6) The amount of market pay of a physician

7 or dentist shall be evaluated by the Secretary not

8 less often than once every 24 months. The amount

9 of market pay may be adjusted as the result of an

10 evaluation under this paragraph. A physician or den11 tist whose market pay is evaluated under this para12 graph shall receive written notice of the results of

13 such evaluation in accordance with procedures pre14 scribed under section 7433 of this title.

15 ‘‘(7) No adjustment of the amount of market

16 pay of a physician or dentist under paragraph (6)

17 may result in a reduction of the amount of market

18 pay of the physician or dentist while in the same po19 sition or assignment at the medical facility of the

20 Department concerned.

21 ‘‘(d) PERFORMANCE PAY.—(1) One element of pay

22 for physicians and dentists shall be performance pay.

23 ‘‘(2) Performance pay shall be paid to a physician

24 or dentist on the basis of the physician’s or dentist’s
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1 achievement of specific goals and performance objectives

2 prescribed by the Secretary.

3 ‘‘(3) The Secretary shall ensure that each physician

4 and dentist of the Department is advised of the specific

5 goals or objectives that are to be measured by the Sec6 retary in determining the eligibility of that physician or

7 dentist for performance pay.

8 ‘‘(4) The amount of the performance pay payable to

9 a physician or dentist may vary annually on the basis of

10 individual achievement or attainment of the goals or objec11 tives applicable to the physician or dentist under para12 graph (2).

13 ‘‘(5) The amount of performance pay payable to a

14 physician or dentist in a fiscal year shall be determined

15 in accordance with regulations prescribed by the Sec16 retary, but may not exceed the lower of—

17 ‘‘(A) $15,000; or

18 ‘‘(B) the amount equal to 7.5 percent of the

19 sum of the base pay and the market pay payable to

20 such physician or dentist in that fiscal year.

21 ‘‘(6) A failure to meet goals or objectives applicable

22 to a physician or dentist under paragraph (2) may not

23 be the sole basis for an adverse personnel action against

24 that physician or dentist.
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1 ‘‘(e) REQUIREMENTS AND LIMITATIONS ON TOTAL

2 PAY.—(1)(A) Not less often than once every two years,

3 the Secretary shall prescribe for Department-wide applica4 bility the minimum and maximum amounts of annual pay

5 that may be paid under this section to physicians and the

6 minimum and maximum amounts of annual pay that may

7 be paid under this section to dentists.

8 ‘‘(B) The Secretary may prescribe for Department9 wide applicability under this paragraph separate minimum

10 and maximum amounts of pay for a specialty or assign11 ment. If the Secretary prescribes separate minimum and

12 maximum amounts for a specialty or assignment, the Sec13 retary may establish up to four tiers of minimum and

14 maximum amounts for such specialty or assignment and

15 prescribe for each tier a minimum amount and a max16 imum amount that the Secretary determines appropriate

17 for the professional responsibilities, professional achieve18 ments, and administrative duties of the physicians or den19 tists (as the case may be) whose pay is set within that

20 tier.

21 ‘‘(C) Amounts prescribed under this paragraph shall

22 be published in the Federal Register, and shall not take

23 effect until at least 60 days after the date of publication.

24 ‘‘(2) Except as provided in paragraph (3) and subject

25 to paragraph (4), the sum of the total amount of the an-
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1 nual rate of base pay payable to a physician or dentist

2 under subsection (b) and the market pay determined for

3 the physician or dentist under subsection (c) may not be

4 less than the minimum amount, nor more than the max5 imum amount, applicable to specialty or assignment of the

6 physician or dentist under paragraph (1).

7 ‘‘(3) The sum of the total amount of the annual rate

8 of base pay payable to a physician or dentist under sub9 section (b) and the market pay determined for the physi10 cian or dentist under subsection (c) may exceed the max11 imum amount applicable to the specialty or assignment

12 of the physician or dentist under paragraph (1) as a result

13 of an adjustment under paragraph (3) or (4) of subsection

14 (b).

15 ‘‘(4) In no case may the total amount of compensa16 tion paid to a physician or dentist under this title in any

17 year exceed the amount of annual compensation (exclud18 ing expenses) specified in section 102 of title 3.

19 ‘‘(f) TREATMENT OF PAY.—Pay under subsections

20 (b) and (c) of this section shall be considered pay for all

21 purposes, including retirement benefits under chapters 83

22 and 84 of title 5 and other benefits.

23 ‘‘(g) ANCILLARY EFFECTS OF DECREASES IN PAY.—

24 (1) A decrease in pay of a physician or dentist resulting

25 from an adjustment in the amount of market pay of the
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1 physician or dentist under subsection (c) shall not be

2 treated as an adverse action.

3 ‘‘(2) If the pay of a physician or dentist is reduced

4 under this subchapter as a result of an involuntary reas5 signment in connection with a disciplinary action taken

6 against the physician or dentist, the involuntary reassign7 ment shall be subject to appeal under subchapter V of this

8 chapter.

9 ‘‘(h) DELEGATION OF RESPONSIBILITIES.—The Sec10 retary may delegate to an appropriate officer or employee

11 of the Department any responsibility of the Secretary

12 under subsection (c), (d), or (e) except for the responsibil13 ities of the Secretary under subsection (e)(1).

14 ‘‘§ 7432. Pay of Under Secretary for Health

15 ‘‘(a) BASE PAY.—The base pay of the Under Sec16 retary for Health shall be the annual rate of basic pay

17 for positions at Level III of the Executive Schedule under

18 section 5314 of title 5.

19 ‘‘(b) MARKET PAY.—(1) In the case of an Under Sec20 retary for Health who is also a physician or dentist, in

21 addition to the base pay specified in subsection (a) the

22 Under Secretary for Health may also be paid the market

23 pay element of pay of physicians and dentists under sec24 tion 7431(c) of this title.
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1 ‘‘(2) The amount of market pay of the Under Sec2 retary for Health under this subsection shall be estab3 lished by the Secretary.

4 ‘‘(3) In establishing the amount of market pay of the

5 Under Secretary for Health under this subsection, the

6 Secretary shall utilize an appropriate health care labor

7 market selected by the Secretary for purposes of this sub8 section.

9 ‘‘(c) TREATMENT OF PAY.—Pay under this section

10 shall be considered pay for all purposes, including retire11 ment benefits under chapters 83 and 84 of title 5 and

12 other benefits.

13 ‘‘§ 7433. Administrative matters

14 ‘‘(a) REGULATIONS.—(1) The Secretary shall pre15 scribe regulations relating to the pay of physicians and

16 dentists in the Veterans Health Administration under this

17 subchapter.

18 ‘‘(2) In prescribing the regulations, the Secretary

19 shall take into account the recommendations of the Under

20 Secretary for Health on the administration of this sub21 chapter. In formulating recommendations for the purpose

22 of this paragraph, the Under Secretary shall request the

23 views of representatives of labor organizations that are ex24 clusive representatives of physicians and dentists of the

25 Department and the views of representatives of profes-
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1 sional organizations of physicians and dentists of the De2 partment.

3 ‘‘(b) REPORTS.—(1) Not later than 18 months after

4 the Secretary prescribes the regulations required by sub5 section (a), and annually thereafter for the next 5 years,

6 the Secretary shall submit to the Committees on Veterans’

7 Affairs of the Senate and House of Representatives a re8 port on the pay of physicians and dentists in the Veterans

9 Health Administration under this subchapter.

10 ‘‘(2) Each report under this subsection shall include

11 the following:

12 ‘‘(A) A description of the rates of pay in effect

13 during the current fiscal year with a comparison to

14 the rates in effect during the fiscal year preceding

15 the current fiscal year, set forth by facility and by

16 specialty.

17 ‘‘(B) The number of physicians and dentists

18 who left the Veterans Health Administration during

19 the preceding fiscal year.

20 ‘‘(C) The number of unfilled physician positions

21 and dentist positions in each specialty in the Vet22 erans Health Administration, the average and max23 imum lengths of time that such positions have been

24 unfilled, and an assessment of the reasons that such

25 positions remain unfilled.
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1 ‘‘(D) An assessment of the impact of implemen2 tation of this subchapter on efforts to recruit and re3 tain physicians and dentists in the Veterans Health

4 Administration.

5 ‘‘(3) The first two annual reports under this sub6 section shall also include a comparison of staffing levels,

7 contract expenditures, and average salaries of physicians

8 and dentists in the Veterans Health Administration for

9 the current fiscal year and for the fiscal year preceding

10 the current fiscal year, set forth by facility and by spe11 cialty.’’.

12 (c) INITIAL RATES OF BASE PAY FOR PHYSICIANS

13 AND DENTISTS.—The initial rates of base pay established

14 for the base pay steps under the Physician and Dentist

15 Base and Longevity Pay Schedule provided in section

16 7431(b) of title 38, United States Code (as added by sub17 section (b)), are as follows:

Base Pay Step: Rate of Pay:

1 ............................................................................................... $90,000

2 ............................................................................................... $93,000

3 ............................................................................................... $96,000

4 ............................................................................................... $99,000

5 ............................................................................................... $102,000

6 ............................................................................................... $105,000

7 ............................................................................................... $108,000

8 ............................................................................................... $111,000

9 ............................................................................................... $114,000

10 ............................................................................................. $117,000

11 ............................................................................................. $120,000

12 ............................................................................................. $123,000

13 ............................................................................................. $126,000

14 ............................................................................................. $129,000

15 ............................................................................................. $132,000.
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1 (d) EFFECTIVE DATE.—(1) Notwithstanding the 60-

2 day waiting requirement in section 7431(e)(1)(C) of title

3 38, United States Code (as amended by subsection (b)),

4 pay provided for a physician or dentist under subchapter

5 III of chapter 74 of such title, as amended by subsection

6 (b), shall take effect on the first day of the first pay period

7 applicable to such physician or dentist that begins on or

8 after January 1, 2006.

9 (2) Pay provided for the Under Secretary for Health

10 under subchapter III of chapter 74 of title 38, United

11 States Code, as amended by this section shall take effect

12 on the first day of the first pay period applicable to the

13 Under Secretary that begins on or after January 1, 2006.

14 (e) TRANSITION PROVISIONS.—

15 (1) PHYSICIANS AND DENTISTS.—

16 (A) PAY.—(i) The amount of the pay pay17 able on and after the date of the enactment of

18 this Act to a physician or dentist in receipt of

19 pay under section 7404 or 7405 of title 38,

20 United States Code, as of the day before such

21 date shall continue to be determined under such

22 section (as in effect on the day before such

23 date) until the effective date that is applicable

24 under subsection (d) to such physician or den25 tist, as the case may be.
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1 (ii) A physician or dentist appointed or re2 assigned on or after the date of the enactment

3 of this Act, but before the effective date appli4 cable under subsection (d) to such physician or

5 dentist, shall be compensated in accordance

6 with applicable provisions of section 7404 or

7 7405 of title 38, United States Code (as in ef8 fect on the day before date of the enactment of

9 this Act), until such effective date.

10 (B) SPECIAL PAY.—(i) A special pay

11 agreement entered into by a physician or den12 tist under subchapter III of chapter 74 of title

13 38, United States Code, before the date of the

14 enactment of this Act shall terminate on the

15 date of the enactment of this Act. However, a

16 physician or dentist in receipt of special pay

17 pursuant to such an agreement on that date

18 shall continue to receive special pay under the

19 terms of such agreement until the effective date

20 that is applicable under subsection (d) to such

21 physician or dentist.

22 (ii) A physician or dentist described in sub23 paragraph (A)(ii) may be paid special pay

24 under applicable provisions of section 7433,

25 7434, 7435, or 7436 of title 38, United States
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1 Code (as in effect on the day before the date of

2 the enactment of this Act), during the period

3 beginning on the date of the appointment or re4 assignment of such physician or dentist, as the

5 case may be, and ending on the effective date

6 applicable under subsection (d) to such physi7 cian or dentist. However, no special pay agree8 ment shall be required for the payment of spe9 cial pay under this clause.

10 (C) TREATMENT OF SPECIAL PAY.—(i)

11 Special pay paid under subparagraph (B) to a

12 physician or dentist during the period beginning

13 on the date of the enactment of this Act and

14 ending on the effective date applicable under

15 subsection (d) to such physician or dentist shall

16 be subject to the provisions of paragraphs (1),

17 (2), (4), (5), and (6) of section 7438(b) of title

18 38, United States Code (as in effect on the day

19 before the date of the enactment of this Act).

20 (ii) Special pay paid to a physician or den21 tist under section 7438 of title 38, United

22 States Code (as in effect on the day before the

23 date of the enactment of this Act), shall be fully

24 creditable for purposes of computing benefits
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1 under chapters 83 and 84 of title 5, United

2 States Code.

3 (D) PRESERVATION OF PAY.—The amount

4 of pay paid to a physician or dentist after the

5 effective date of this Act shall not be less than

6 the amount of pay paid to such physician or

7 dentist on the day before the effective date of

8 this Act while such physician or dentist remains

9 in the same position or assignment.

10 (2) UNDER SECRETARY FOR HEALTH.—

11 (A) SPECIAL PAY.—(i) The current special

12 pay agreement entered into by the Under Sec13 retary for Health under subchapters I and III

14 of chapter 74 of title 38, United States Code,

15 before the date of the enactment of this Act

16 shall terminate on the date of the enactment of

17 this Act. However, the Under Secretary shall

18 continue to receive special pay under the terms

19 of such agreement until the effective date that

20 is applicable under subsection (d) to the Under

21 Secretary.

22 (ii) An individual appointed as Under Sec23 retary for Health on or after the date of the en24 actment of this Act and before the effective

25 date applicable under subsection (d) to the
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1 Under Secretary shall be paid special pay in ac2 cordance with the provisions of sections

3 7432(d)(2) and 7433 of title 38, United States

4 Code (as in effect on the day before the date of

5 the enactment of this Act), during the period

6 beginning on the date of appointment and end7 ing on such effective date. However, no special

8 pay agreement shall be required for the pay9 ment of special pay under this clause.

10 (B) TREATMENT OF SPECIAL PAY.—Spe11 cial pay paid under subparagraph (A) during

12 the period beginning on the date of the enact13 ment of this Act and ending on the effective

14 date applicable under subsection (d) to the

15 Under Secretary—

16 (i) shall be subject to the provisions of

17 paragraphs (1), (2), (4), (5), and (6) of

18 section 7438(b) of title 38, United States

19 Code (as in effect on the day before the

20 date of the enactment of this Act); and

21 (ii) shall be fully creditable for pur22 poses of computing benefits under chapters

23 83 and 84 of title 5, United States Code.

24 (f) CONFORMING AMENDMENTS.—Section 7404 is

25 amended—
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1 (1) in subsection (c), by striking ‘‘special pay’’

2 and inserting ‘‘pay’’; and

3 (2) in subsection (d), by striking ‘‘pay may not

4 be paid’’ and all that follows and inserting ‘‘pay for

5 positions for which basic pay is paid under this sec6 tion may not be paid at a rate in excess of the rate

7 of basic pay authorized by section 5316 of title 5 for

8 positions in Level V of the Executive Schedule.’’.

9 (g) CLERICAL AMENDMENT.—The table of sections

10 at the beginning of chapter 74 is amended by striking the

11 items relating to subchapter III and inserting the fol12 lowing new items:

‘‘SUBCHAPTER III—PAY FOR PHYSICIANS AND DENTISTS

‘‘Sec. 7431. Pay.

‘‘Sec. 7432. Pay of Under Secretary for Health.

‘‘Sec. 7433. Administrative matters.’’.

13 SEC. 4. ALTERNATE WORK SCHEDULES FOR REGISTERED

14 NURSES.

15 (a) IN GENERAL.—(1) Chapter 74 is amended by in16 serting after section 7456 the following new section:

17 ‘‘§ 7456A. Nurses: alternate work schedules

18 ‘‘(a) APPLICABILITY.—This section applies to reg19 istered nurses appointed under this chapter.

20 ‘‘(b) 36/40 WORK SCHEDULE.—(1)(A) Subject to

21 paragraph (2), if the Secretary determines it to be nec22 essary in order to obtain or retain the services of reg23 istered nurses at any Department health-care facility, the
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1 Secretary may provide, in the case of nurses employed at

2 such facility, that such nurses who work three regularly

3 scheduled 12-hour tours of duty within a work week shall

4 be considered for all purposes to have worked a full 40-

5 hour basic work week.

6 ‘‘(B) A nurse who works under the authority in sub7 paragraph (A) shall be considered a 0.90 full-time equiva8 lent employee in computing full-time equivalent employees

9 for the purposes of determining compliance with personnel

10 ceilings.

11 ‘‘(2)(A) Basic and additional pay for a nurse who is

12 considered under paragraph (1) to have worked a full 40-

13 hour basic work week shall be subject to subparagraphs

14 (B) and (C).

15 ‘‘(B) The hourly rate of basic pay for a nurse covered

16 by this paragraph for service performed as part of a regu17 larly scheduled 36-hour tour of duty within the work week

18 shall be derived by dividing the nurse’s annual rate of

19 basic pay by 1,872.

20 ‘‘(C) The Secretary shall pay overtime pay to a nurse

21 covered by this paragraph who—

22 ‘‘(i) performs a period of service in excess of

23 such nurse’s regularly scheduled 36-hour tour of

24 duty within an administrative work week;
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1 ‘‘(ii) for officially ordered or approved service,

2 performs a period of service in excess of 8 hours on

3 a day other than a day on which such nurse’s regu4 larly scheduled 12-hour tour of duty falls;

5 ‘‘(iii) performs a period of service in excess of

6 12 hours for any day included in the regularly

7 scheduled 36-hour tour of duty work week; or

8 ‘‘(iv) performs a period of service in excess of

9 40 hours during an administrative work week.

10 ‘‘(D) The Secretary may provide a nurse to whom

11 this subsection applies with additional pay under section

12 7453 of this title for any period included in a regularly

13 scheduled 12-hour tour of duty.

14 ‘‘(3) A nurse who works a work schedule described

15 in this subsection who is absent on approved sick leave

16 or annual leave during a regularly scheduled 12-hour tour

17 of duty shall be charged for such leave at a rate of ten

18 hours of leave for every nine hours of absence.

19 ‘‘(c) HOLIDAY PAY.—A nurse working a work sched20 ule under subsection (b) that includes a holiday designated

21 by law or Executive order shall be eligible for holiday pay

22 under section 7453(d) of this title for any service per23 formed by the nurse on such holiday under such section.

24 ‘‘(d) 9-MONTH WORK SCHEDULE FOR CERTAIN

25 NURSES.—(1) The Secretary may authorize a registered
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1 nurse appointed under section 7405 of this title, with the

2 nurse’s written consent, to work full time for nine months

3 with 3 months off duty, within a fiscal year, and be paid

4 at 75 percent of the full-time rate for such nurse’s grade

5 for each pay period of such fiscal year.

6 ‘‘(2) A nurse who works under the authority in para7 graph (1) shall be considered a 0.75 full-time equivalent

8 employee in computing full-time equivalent employees for

9 the purposes of determining compliance with personnel

10 ceilings.

11 ‘‘(3) Work under this subsection shall be considered

12 part-time service for purposes of computing benefits under

13 chapters 83 and 84 of title 5.

14 ‘‘(4) A nurse who works under the authority in para15 graph (1) shall be considered a full-time employee for pur16 poses of chapter 89 of title 5.

17 ‘‘(e) NOTIFICATION OF MODIFICATION OF BENE18 FITS.—The Secretary shall provide each employee with re19 spect to whom an alternate work schedule under this sec20 tion may apply written notice of the effect, if any, that

21 the alternate work schedule will have on the employee’s

22 health care premium, retirement, life insurance premium,

23 probationary status, or other benefit or condition of em24 ployment. The notice shall be provided not later than 14
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1 days before the employee consents to the alternate work

2 schedule.

3 ‘‘(f) REGULATIONS.—The Secretary shall prescribe

4 regulations to carry out this section.’’.

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

6 74 is amended by inserting after the item relating to sec7 tion 7456 the following new item:

‘‘Sec. 7456A. Nurses: alternate work schedules.’’.

8 (b) POLICY AGAINST CERTAIN WORK HOURS.—(1)

9 It is the sense of Congress to encourage the Secretary of

10 Veterans Affairs to prevent work hours by nurses pro11 viding direct patient care in excess of 12 consecutive hours

12 or in excess of 60 hours in any 7-day period, except in

13 the case of nurses providing emergency care.

14 (2) Not later than one year after the date of the en15 actment of this Act and every year thereafter for the next

16 two years, the Secretary shall certify to Congress whether

17 or not each Veterans Health Administration facility has

18 in place, as of the date of such certification, a policy de19 signed to prevent work hours by nurses providing direct

20 patient care (other than nurses providing emergency care)

21 in excess of 12 consecutive hours or in excess of 60 hours

22 in any 7-day period.

23 SEC. 5. NURSE EXECUTIVE SPECIAL PAY.

24 Section 7452 is amended by adding at the end the

25 following new subsection:
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1 ‘‘(g)(1) In order to recruit and retain highly qualified

2 Department nurse executives, the Secretary may, in ac3 cordance with regulations prescribed by the Secretary, pay

4 special pay to the nurse executive at each location as fol5 lows:

6 ‘‘(A) Each Department health care facility.

7 ‘‘(B) The Central Office.

8 ‘‘(2) The amount of special pay paid to a nurse execu9 tive under paragraph (1) shall be not less than $10,000

10 or more than $25,000.

11 ‘‘(3) The amount of special pay paid to a nurse execu12 tive under paragraph (1) shall be based on factors such

13 as the grade of the nurse executive position, the scope and

14 complexity of the nurse executive position, the personal

15 qualifications of the nurse executive, the characteristics of

16 the health care facility concerned, the nature and number

17 of specialty care units at the health care facility concerned,

18 demonstrated difficulties in recruitment and retention of

19 nurse executives at the health care facility concerned, and

20 such other factors as the Secretary considers appropriate.

21 ‘‘(4) Special pay paid to a nurse executive under

22 paragraph (1) shall be in addition to any other pay (in23 cluding basic pay) and allowances to which the nurse exec24 utive is entitled, and shall be considered pay for all pur25 poses, including retirement benefits under chapters 83 and
†

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S 2484 ES

1 84 of title 5, and other benefits, but shall not be consid2 ered basic pay for purposes of adverse actions under sub3 chapter V of this chapter.’’.

Passed the Senate October 5, 2004.

Attest:

Secretary.
108TH CONGRESS

2D SESSION S. 2484

AN ACT

To amend title 38, United States Code, to simplify

purposes.ules and executive pay for nurses, and for otherdentists and to authorize alternate work schedand improve pay provisions for physicians and