I 
108TH CONGRESS 
2D SESSION 
H. R. 4231
To provide for a pilot program in the Department of Veterans Affairs to 
improve recruitment and retention of nurses, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 28, 2004
Mr. SIMMONS introduced the following bill; which was referred to the 
Committee on Veterans’ Affairs 
A BILL 
To provide for a pilot program in the Department of Vet-
erans Affairs to improve recruitment and retention of 
nurses, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Department of Vet-
erans Affairs Nurse Recruitment and Retention Act of 
2004’’.
SEC. 2. PILOT PROGRAM TO STUDY INNOVATIVE RECRUIT-
MENT TOOLS TO ADDRESS NURSING SHORT-
AGES AT DEPARTMENT OF VETERANS AF-
FAIRS HEALTH-CARE FACILITIES. 
(a) PILOT PROGRAM.—(1) Not later than 90 days 
after the date of the enactment of this Act, the Secretary 
of Veterans Affairs shall designate a health-care service 
region, or a section within such a region, in which health 
care facilities of the Department of Veterans Affairs are 
adversely affected by a shortage of qualified nurses. 
(2) The Secretary shall conduct a pilot program in 
the region or section designated under paragraph (1) to 
determine the effectiveness of the use of innovative 
human-capital tools and techniques in the recruitment of 
qualified nurses for positions at Department health care 
facilities and for the retention of nurses at such facilities. 
In carrying out the pilot program, the Secretary shall 
enter into a contract with a private-sector entity for serv-
ices under the pilot program for recruitment of qualified 
nurses. 
(b) PRIVATE-SECTOR RECRUITMENT PRACTICES.—
For purposes of the pilot program under this section, the 
Secretary shall identify and use recruitment practices that 
have proven effective for placing qualified individuals in 
positions that are difficult to fill due to shortages of quali-
fied individuals or other factors. Recruitment practices to
be reviewed by the Secretary for use in the pilot program 
shall include—
(1) employer branding and interactive adver-
tising strategies; 
(2) internet technologies and automated staff-
ing systems; and 
(3) the use of recruitment, advertising, and 
communication agencies. 
(c) STREAMLINED HIRING PROCESS.—In carrying 
out the pilot program under this section, the Secretary 
shall, at health care facilities of the Department in the 
region or section in which the pilot program is conducted, 
revise procedures and systems for selecting and hiring 
qualified nurses to reduce the length of the hiring process. 
If the Secretary identifies measures to streamline and 
automate the hiring process that can only be implemented 
if authorized by law, the Secretary shall submit to the 
Committees on Veterans’ Affairs of the Senate and House 
of Representatives recommendations for such changes in 
law as may be necessary to enable such measure to be 
implemented. 
(d) REPORT.—Not later than one year after the date 
of the enactment of this Act, the Secretary shall submit 
to the Committees on Veterans’ Affairs of the Senate and 
House of Representatives a report on the extent to which
the pilot program achieved the goal of improving the re-
cruitment and retention of nurses in Department of Vet-
erans Affairs health care facilities. 
SEC. 3. ALTERNATE WORK SCHEDULES FOR NURSES. 
(a) ENHANCED SHIFT FLEXIBILITY.—Chapter 74 of 
title 38, United States Code, is amended by inserting after 
section 7456 the following new section: 
‘‘§ 7456a. Alternate work schedules 
‘‘(a) APPLICABILITY.—This section applies to reg-
istered nurses appointed under this chapter. 
‘‘(b) 36/40 WORK SCHEDULE.—(1) Subject to para-
graph (2), if the Secretary determines it to be necessary 
in order to obtain or retain the services of registered 
nurses at a Department health-care facility, the Secretary 
may provide, in the case of registered nurses employed at 
that facility, that such a nurse who works three regularly 
scheduled 12-hour tours of duty within a workweek shall 
be considered for all purposes (except computation of full-
time equivalent employees for the purposes of determining 
compliance with personnel ceilings) to have worked a full 
40-hour basic workweek. Such a schedule may be referred 
to as a ‘36/40 work schedule’. 
‘‘(2)(A) Basic and additional pay for a registered 
nurse who is considered under paragraph (1) to have
worked a full 40-hour basic workweek is subject to sub-
paragraphs (B) and (C). 
‘‘(B) The hourly rate of basic pay for such a nurse 
for service performed as part of a regularly scheduled 36-
hour tour of duty within the workweek shall be derived 
by dividing the nurse’s annual rate of basic pay by 1,872. 
‘‘(C)(i) Such a nurse who performs a period of service 
in excess of such nurse’s regularly scheduled 36-hour tour 
of duty within a workweek is entitled to overtime pay 
under section 7453(e) of this title, or other applicable law, 
for officially ordered or approved service performed in ex-
cess of—
‘‘(I) eight hours on a day other than a day on 
which such nurse’s regularly scheduled 12-hour tour 
falls; 
‘‘(II) 12 hours for any day included in the regu-
larly scheduled 36-hour tour of duty; and 
‘‘(III) 40 hours during an administrative work-
week. 
‘‘(ii) Except as provided in clause (i), a registered 
nurse to whom this subsection is applicable is not entitled 
to additional pay under section 7453 of this title, or other 
applicable law, for any period included in a regularly 
scheduled 12-hour tour of duty.
‘‘(3) A nurse who works a 36/40 work schedule de-
scribed in this subsection who is absent on approved sick 
leave or annual leave during a regularly scheduled 12-hour 
tour of duty shall be charged for such leave at a rate of 
ten hours of leave for nine hours of absence. 
‘‘(c) 7/7 WORK SCHEDULE.—(1) Subject to para-
graph (2), if the Secretary determines it to be necessary 
in order to obtain or retain the services of registered 
nurses at a Department health-care facility, the Secretary 
may provide, in the case of registered nurses employed at 
such facility, that such a nurse who works seven regularly 
scheduled 10-hour tours of duty, with seven days off duty, 
within a two-week pay period, shall be considered for all 
purposes (except computation of full-time equivalent em-
ployees for the purposes of determining compliance with 
personnel ceilings) to have worked a full 80 hours for the 
pay period. Such a schedule may be referred to as a ‘7/
7 work schedule’. 
‘‘(2)(A) Basic and additional pay for a registered 
nurse who is considered under paragraph (1) to have 
worked a full 80-hour pay period is subject to subpara-
graphs (B) and (C). 
‘‘(B) The hourly rate of basic pay for such a nurse 
for service performed as part of a regularly scheduled 70-
hour tour of duty within the pay period shall be derived 
by dividing the nurse’s annual rate of basic pay by 1,820. 
‘‘(C)(i) Such a nurse who performs a period of service 
in excess of such nurse’s regularly scheduled 70-hour tour 
of duty within a pay period is entitled to overtime pay 
under section 7453(e) of this title, or other applicable law, 
for officially ordered or approved service performed in ex-
cess of—
‘‘(I) eight hours on a day other than a day on 
which such nurse’s regularly scheduled 10-hour tour 
falls; 
‘‘(II) 10 hours for any day included in the regu-
larly scheduled 70-hour tour of duty; and 
‘‘(III) 80 hours during a pay period. 
‘‘(ii) Except as provided in subparagraph (i), a reg-
istered nurse to whom this subsection is applicable is not 
entitled to additional pay under section 7453 of this title, 
or other applicable law, for any period included in a regu-
larly scheduled 10-hour tour of duty. 
‘‘(3) A nurse who works a 7/7 work schedule de-
scribed in this subsection who is absent on approved sick 
leave or annual leave during a regularly scheduled 12-hour 
tour of duty shall be charged for such leave at a rate of 
eight hours of leave for seven hours of absence.
‘‘(d) 9-MONTH WORK SCHEDULE.—The Secretary 
may authorize a registered nurse appointed under section 
7405 of this title, with the nurse’s written consent, to 
work full-time for nine months with three months off duty, 
within a fiscal year, and be paid at 75 percent of the full-
time rate for such nurse’s grade for each pay period of 
that fiscal year. A nurse working on such a schedule for 
any fiscal year shall be considered a 3⁄4 full-time equivalent 
employee for that fiscal year in computing full-time equiv-
alent employees for the purposes of determining compli-
ance with personnel ceilings. Service on such a schedule 
shall be considered to be part-time service for purposes 
of computing benefits under chapters 83 and 84 of title 
5. 
‘‘(e) REGULATIONS.—The Secretary shall prescribe 
regulations for the implementation of this section.’’. 
(b) 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 7456 the 
following new item:
‘‘7456a. Alternate work schedules.’’.
SEC. 4. APPOINTMENT OF NURSES WHO DO NOT HAVE BAC-
CALAUREATE DEGREES. 
Section 7403 of title 38, United States Code, is 
amended by adding at the end the following new sub-
section:
‘‘(h) In a case in which a registered nurse applying 
for an appointment under this chapter as a registered 
nurse has presented the qualifications established under 
subsection (a) for such an appointment, the lack of a bac-
calaureate degree in nursing shall not be a bar to appoint-
ment, and in such a case the registered nurse shall not 
be denied appointment on that basis.’’. 
SEC. 5. TECHNICAL CORRECTION TO LISTING OF CERTAIN 
HYBRID POSITIONS IN VETERANS HEALTH 
ADMINISTRATION. 
Section 7401(3) of title 38, United States Code, is 
amended—
(1) by striking ‘‘and dental technologists’’ and 
inserting ‘‘technologists, dental hygienists, dental as-
sistants,’’; and 
(2) 
by 
striking 
‘‘technicians, 
therapeutic 
radiologic technicians, and social workers’’ and in-
serting ‘‘technologists, therapeutic radiologic tech-
nologists, social workers, blind rehabilitation special-
ists, and blind rehabilitation outpatient specialists’’.
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