H. R. 3447
One Hundred Seventh Congress
of the
United States of America
AT THE FIRST SESSION
Begun and held at the City of Washington on Wednesday,
the third day of January, two thousand and one
An Act
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, to provide an additional basis for establishing the inability of
veterans to defray expenses of necessary medical care, to enhance certain health
care programs of the Department of Veterans Affairs, 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; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the ‘‘Department
of Veterans Affairs Health Care Programs Enhancement Act of
2001’’.
(b) TABLE OF CONTENTS.—The table of contents for 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
Subtitle A—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 annu-
itants to fill nurse positions.
Subtitle B—Retention Authorities
Sec. 121. Additional pay for Saturday tours of duty for additional health care pro-
fessionals in the Veterans Health Administration.
Sec. 122. Unused sick leave included in annuity computation of registered nurses
within 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 nursing assistants in De-
partment 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.
Sec. 133. Modification of nurse locality pay authorities.
Subtitle D—National Commission on VA Nursing
Sec. 141. Establishment of Commission.
Sec. 142. Duties of Commission.
Sec. 143. Reports.
Sec. 144. Powers.
Sec. 145. Personnel matters.
H. R. 3447—2
Sec. 146. Termination of Commission.
TITLE II—OTHER MATTERS
Sec. 201. Authority for Secretary of Veterans Affairs to provide service dogs for vet-
erans with certain disabilities.
Sec. 202. gement of health care for certain low-income veterans.
Sec. 203. Maintenance of capacity for specialized treatment and rehabilitative
needs of disabled veterans.
Sec. 204. Program for provision of chiropractic care and services to veterans.
Sec. 205. nds for field offices of the Office of Research Compliance and Assurance.
Sec. 206. Major medical facility construction.
Sec. 207. Sense of Congress on special telephone services for veterans.
Sec. 208. Recodification of bereavement counseling authority and certain other
health-related authorities.
Sec. 209. Extension of expiring collections authorities.
Sec. 210. Personal emergency response system for veterans with service-connected
disabilities.
Sec. 211. One-year extension of eligibility for health care of veterans who served in
Southwest Asia during the Persian Gulf War.
SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.
Except as otherwise expressly provided, whenever in this Act
an amendment or repeal is expressed in terms of an amendment
to, or repeal of, a section or other provision, the reference shall
be considered to be made to a section or other provision of title
38, United States Code.
TITLE I—ENHANCEMENT OF NURSE RE-
CRUITMENT 
AND 
RETENTION 
AU-
THORITIES
Subtitle A—Recruitment Authorities
SEC. 101. ENHANCEMENT OF EMPLOYEE INCENTIVE SCHOLARSHIP
PROGRAM.
(a) PERMANENT AUTHORITY.—(1) Section 7676 is repealed.
(2) The table of sections at the beginning of chapter 76 is
amended by striking the item relating to section 7676.
(b) MINIMUM PERIOD OF DEPARTMENT EMPLOYMENT FOR ELIGI-
BILITY.—Section 7672(b) is amended by striking ‘‘2 years’’ and
inserting ‘‘one year’’.
(c) SCHOLARSHIP AMOUNT.—Subsection (b) of section 7673 is
amended—
(1) in paragraph (1), by striking ‘‘for any 1 year’’ and
inserting ‘‘for the equivalent of one year of full-time
coursework’’; and
(2) by striking paragraph (2) and inserting the following
new paragraph (2):
‘‘(2) in the case of a participant in the Program who is
a part-time student, shall bear the same ratio to the amount
that would be paid under paragraph (1) if the participant
were a full-time student in the course of education or training
being pursued by the participant as the coursework carried
by the participant to full-time coursework in that course of
education or training.’’.
(d) LIMITATION ON PAYMENT.—Subsection (c) of section 7673
is amended to read as follows:
‘‘(c) LIMITATIONS ON PERIOD OF PAYMENT.—(1) The maximum
number of school years for which a scholarship may be paid under
H. R. 3447—3
subsection (a) to a participant in the Program shall be six school
years.
‘‘(2) A participant in the Program may not receive a scholarship
under subsection (a) for more than the equivalent of three years
of full-time coursework.’’.
(e) FULL-TIME COURSEWORK.—Section 7673 is further amended
by adding at the end the following new subsection:
‘‘(e) FULL-TIME COURSEWORK.—For purposes of this section,
full-time coursework shall consist of the following:
‘‘(1) In the case of undergraduate coursework, 30 semester
hours per undergraduate school year.
‘‘(2) In the case of graduate coursework, 18 semester hours
per graduate school year.’’.
(f) ANNUAL ADJUSTMENT OF MAXIMUM SCHOLARSHIP AMOUNT.—
Section 7631 is amended—
(1) in subsection (a)(1), by striking ‘‘and the maximum
Selected Reserve member stipend amount’’ and inserting ‘‘the
maximum Selected Reserve member stipend amount, the max-
imum employee incentive scholarship amount,’’; and
(2) in subsection (b)—
(A) by redesignating paragraph (4) as paragraph (6);
and
(B) by inserting after paragraph (3) the following new
paragraph (4):
‘‘(4) The term ‘maximum employee incentive scholarship
amount’ means the maximum amount of the scholarship pay-
able to a participant in the Department of Veterans Affairs
Employee Incentive Scholarship Program under subchapter VI
of this chapter, as specified in section 7673(b)(1) of this title
and as previously adjusted (if at all) in accordance with this
section.’’.
(g) TECHNICAL
AMENDMENTS.—Section 7631(b) is further
amended by striking ‘‘this subsection’’ each place it appears and
inserting ‘‘this section’’.
SEC. 102. ENHANCEMENT OF EDUCATION DEBT REDUCTION PROGRAM.
(a) PERMANENT AUTHORITY.—(1) Section 7684 is repealed.
(2) The table of sections at the beginning of chapter 76 is
amended by striking the item relating to section 7684.
(b) ELIGIBLE INDIVIDUALS.—Subsection (a)(1) of section 7682
is amended—
(1) by striking ‘‘under an appointment under section
7402(b) of this title in a position’’ and inserting ‘‘in a position
(as determined by the Secretary) providing direct-patient care
services or services incident to direct-patient care services’’;
and
(2) by striking ‘‘(as determined by the Secretary)’’ and
inserting ‘‘(as so determined)’’.
(c) MAXIMUM DEBT REDUCTION AMOUNT.—Section 7683(d)(1)
is amended—
(1) by striking ‘‘for a year’’; and
(2) by striking ‘‘exceed—’’ and all that follows through
the end of the paragraph and inserting ‘‘exceed $44,000 over
a total of five years of participation in the Program, of which
not more than $10,000 of such payments may be made in
each of the fourth and fifth years of participation in the Pro-
gram.’’.
H. R. 3447—4
(d) ANNUAL ADJUSTMENT OF MAXIMUM DEBT REDUCTION PAY-
MENTS AMOUNT.—(1) Section 7631, as amended by section 101(f)
of this Act, is further amended—
(A) in subsection (a)(1), by inserting before the period at
the end of the first sentence the following: ‘‘and the maximum
education debt reduction payments amount’’; and
(B) in subsection (b), by inserting after paragraph (4) the
following new paragraph (5):
‘‘(5) The term ‘maximum education debt reduction pay-
ments amount’ means the maximum amount of education debt
reduction payments payable to a participant in the Department
of Veterans Affairs Education Debt Reduction Program under
subchapter VII of this chapter, as specified in section 7683(d)(1)
of this title and as previously adjusted (if at all) in accordance
with this section.’’.
(2) Notwithstanding section 7631(a)(1) of title 38, United States
Code, as amended by paragraph (1), the Secretary of Veterans
Affairs shall not increase the maximum education debt reduction
payments amount under that section in calendar year 2002.
(e) TEMPORARY
EXPANSION
OF
INDIVIDUALS
ELIGIBLE
FOR
PARTICIPATION IN PROGRAM.—(1) Notwithstanding section 7682(c)
of title 38, United States Code, the Secretary of Veterans Affairs
may treat a covered individual as being a recently appointed
employee in the Veterans Health Administration under section
7682(a) of that title for purposes of eligibility in the Education
Debt Reduction Program if the Secretary determines that the
participation of the individual in the Program under this subsection
would further the purposes of the Program.
(2) For purposes of this subsection, a covered individual is
any individual otherwise described by section 7682(a) of title 38,
United States Code, as in effect on the day before the date of
the enactment of this Act, who—
(A) was appointed as an employee in a position described
in paragraph (1) of that section, as so in effect, between January
1, 1999, and December 31, 2001; and
(B) is an employee in such position, or in another position
described in paragraph (1) of that section, as so in effect,
at the time of application for treatment as a covered individual
under this subsection.
(3) The Secretary shall make determinations regarding the
exercise of the authority in this subsection on a case-by-case basis.
(4) The Secretary may not exercise the authority in this sub-
section after June 30, 2002. The expiration of the authority in
this subsection shall not affect the treatment of an individual under
this subsection before that date as a covered individual for purposes
of eligibility in the Education Debt Reduction Program.
(5) In this subsection, the term ‘‘Education Debt Reduction
Program’’ means the Department of Veterans Affairs Education
Debt Reduction Program under subchapter VII of chapter 76 of
title 38, United States Code.
H. R. 3447—5
SEC. 103. REPORT ON REQUESTS FOR WAIVERS OF PAY REDUCTIONS
FOR REEMPLOYED ANNUITANTS TO FILL NURSE POSI-
TIONS.
(a) REPORT.—Not later than March 28 of each of 2002 and
2003, the Secretary of Veterans Affairs shall submit to the Commit-
tees on Veterans’ Affairs of the Senate and the House of Representa-
tives and to the National Commission on VA Nursing established
under subtitle D a report describing each request of the Secretary,
during the fiscal year preceding such report, to the Director of
the Office of Personnel Management for the following:
(1) A waiver under subsection (i)(1)(A) of section 8344
of title 5, United States Code, of the provisions of such section
in order to meet requirements of the Department of Veterans
Affairs for appointments to nurse positions in the Veterans
Health Administration.
(2) A waiver under subsection (f)(1)(A) of section 8468
of title 5, United States Code, of the provisions of such section
in order to meet requirements of the Department for appoint-
ments to such positions.
(3) A grant of authority under subsection (i)(1)(B) of section
8344 of title 5, United States Code, for the waiver of the
provisions of such section in order to meet requirements of
the Department for appointments to such positions.
(4) A grant of authority under subsection (f)(1)(B) of section
8468 of title 5, United States Code, for the waiver of the
provisions of such section in order to meet requirements of
the Department for appointments to such positions.
(b) INFORMATION
ON RESPONSES
TO REQUESTS.—The report
under subsection (a) shall specify for each request covered by the
report—
(1) the response of the Director to such request; and
(2) if such request was granted, whether or not the waiver
or authority, as the case may be, assisted the Secretary in
meeting requirements of the Department for appointments to
nurse positions in the Veterans Health Administration.
Subtitle B—Retention Authorities
SEC. 121. ADDITIONAL PAY FOR SATURDAY TOURS OF DUTY FOR ADDI-
TIONAL HEALTH CARE PROFESSIONALS IN THE VET-
ERANS HEALTH ADMINISTRATION.
(a) IN GENERAL.—Section 7454(b) is amended—
(1) by inserting ‘‘(1)’’ after ‘‘(b)’’; and
(2) by adding at the end the following new paragraph:
‘‘(2) Health care professionals employed in positions referred
to in paragraph (1) shall be entitled to additional pay on the
same basis as provided for nurses in section 7453(c) of this title.’’.
(b) APPLICABILITY.—The amendments made by subsection (a)
shall apply with respect to pay periods beginning on or after the
date of the enactment of this Act.
H. R. 3447—6
SEC. 122. UNUSED SICK LEAVE INCLUDED IN ANNUITY COMPUTATION
OF 
REGISTERED 
NURSES 
WITHIN 
THE 
VETERANS
HEALTH ADMINISTRATION.
(a) ANNUITY COMPUTATION.—Section 8415 of title 5, United
States Code, is amended by adding at the end the following new
subsection:
‘‘(i) In computing an annuity under this subchapter, the total
service of an employee who retires from the position of a registered
nurse with the Veterans Health Administration on an immediate
annuity, or dies while employed in that position leaving any sur-
vivor entitled to an annuity, includes the days of unused sick
leave to the credit of that employee under a formal leave system,
except that such days shall not be counted in determining average
pay or annuity eligibility under this subchapter.’’.
(b) DEPOSIT NOT REQUIRED.—Section 8422(d) of such title is
amended—
(1) by inserting ‘‘(1)’’ before ‘‘Under such regulations’’; and
(2) by adding at the end the following:
‘‘(2) Deposit may not be required for days of unused sick leave
credited under section 8415(i).’’.
(c) EFFECTIVE DATE.—The amendments made by this section
shall take effect 60 days after the date of the enactment of this
Act and shall apply to individuals who separate from service on
or after that effective date.
SEC. 123. EVALUATION OF DEPARTMENT OF VETERANS AFFAIRS
NURSE MANAGED CLINICS.
(a) EVALUATION.—The Secretary of Veterans Affairs shall carry
out an evaluation of the efficacy of the nurse managed health
care clinics of the Department of Veterans Affairs. The Secretary
shall complete the evaluation not later than 18 months after the
date of the enactment of this Act.
(b) CLINICS TO BE EVALUATED.—(1) In carrying out the evalua-
tion under subsection (a), the Secretary shall consider nurse man-
aged health care clinics, including primary care clinics and geriatric
care clinics, located in three different geographic service areas of
the Department.
(2) If there are not nurse managed health care clinics located
in three different geographic service areas as of the commencement
of the evaluation, the Secretary shall—
(A) establish nurse managed health care clinics in addi-
tional geographic service areas such that there are nurse man-
aged health care clinics in three different geographic service
areas for purposes of the evaluation; and
(B) include such clinics, as so established, in the evaluation.
(c) MATTERS TO BE EVALUATED.—In carrying out the evaluation
under subsection (a), the Secretary shall address the following:
(1) Patient satisfaction.
(2) Provider experiences.
(3) Cost of care.
(4) Access to care, including waiting time for care.
(5) The functional status of patients receiving care.
(6) Any other matters the Secretary considers appropriate.
(d) REPORT.—Not later than 18 months after the date of the
enactment of this Act, the Secretary shall submit to the Committees
on Veterans’ Affairs of the Senate and the House of Representatives
a report on the evaluation carried out under subsection (a). The
H. R. 3447—7
report shall address the matters specified in subsection (c) and
include any other information, and any recommendations, that the
Secretary considers appropriate. The Secretary shall provide a copy
of the report to the National Commission on VA Nursing established
under subtitle D.
SEC. 124. STAFFING LEVELS FOR OPERATIONS OF MEDICAL FACILI-
TIES.
(a) IN GENERAL.—Section 8110(a) is amended—
(1) in paragraph (1), by inserting after ‘‘complete care of
patients,’’ in the fifth sentence the following: ‘‘and in a manner
consistent with the policies of the Secretary on overtime,’’;
and
(2) in paragraph (2)—
(A) by inserting ‘‘, including the staffing required to
maintain such capacities,’’ after ‘‘all Department medical
facilities’’;
(B) by striking ‘‘and to minimize’’ and inserting ‘‘, to
minimize’’; and
(C) by inserting before the period the following: ‘‘,
and to ensure that eligible veterans are provided such
care and services in an appropriate manner’’.
(b) NATIONWIDE POLICY ON STAFFING.—Paragraph (3) of that
section is amended—
(1) in subparagraph (A), by inserting ‘‘the adequacy of
staff levels for compliance with the policy established under
subparagraph (C),’’ after ‘‘regarding’’; and
(2) by inserting after subparagraph (B) the following new
subparagraph:
‘‘(C) The Secretary shall, in consultation with the Under Sec-
retary for Health, establish a nationwide policy on the staffing
of Department medical facilities in order to ensure that such facili-
ties have adequate staff for the provision to veterans of appropriate,
high-quality care and services. The policy shall take into account
the staffing levels and mixture of staff skills required for the range
of care and services provided veterans in Department facilities.’’.
SEC. 125. ANNUAL REPORT ON USE OF AUTHORITIES TO ENHANCE
RETENTION OF EXPERIENCED NURSES.
(a) ANNUAL REPORT.—(1) Subchapter II of chapter 73 is
amended by adding at the end the following new section:
‘‘§ 7324. Annual report on use of authorities to enhance reten-
tion of experienced nurses
‘‘(a) ANNUAL REPORT.—Not later than January 31 each year,
the Secretary, acting through the Under Secretary for Health, shall
submit to Congress a report on the use during the preceding year
of authorities for purposes of retaining experienced nurses in the
Veterans Health Administration, as follows:
‘‘(1) The authorities under chapter 76 of this title.
‘‘(2) The authority under VA Directive 5102.1, relating to
the Department of Veterans Affairs nurse qualification
standard, dated November 10, 1999, or any successor directive.
‘‘(3) Any other authorities available to the Secretary for
those purposes.
‘‘(b) REPORT ELEMENTS.—Each report under subsection (a) shall
specify for the period covered by such report, for each Department
H. R. 3447—8
medical facility and for each geographic service area of the Depart-
ment, the following:
‘‘(1) The number of waivers requested under the authority
referred to in subsection (a)(2), and the number of waivers
granted under that authority, to promote to the Nurse II grade
or Nurse III grade under the Nurse Schedule under section
7404(b)(1) of this title any nurse who has not completed a
baccalaureate degree in nursing in a recognized school of
nursing, set forth by age, race, and years of experience of
the individuals subject to such waiver requests and waivers,
as the case may be.
‘‘(2) The programs carried out to facilitate the use of
nursing education programs by experienced nurses, including
programs for flexible scheduling, scholarships, salary replace-
ment pay, and on-site classes.’’.
(2) The table of sections at the beginning of chapter 73 is
amended by inserting after the item relating to section 7323 the
following new item:
‘‘7324. Annual report on use of authorities to enhance retention of experienced
nurses.’’.
(b) INITIAL REPORT.—The initial report required under section
7324 of title 38, United States Code, as added by subsection (a),
shall be submitted to the National Commission on VA Nursing
established under subtitle D as well as to Congress.
SEC. 126. REPORT ON MANDATORY OVERTIME FOR NURSES AND
NURSING ASSISTANTS IN DEPARTMENT OF VETERANS
AFFAIRS FACILITIES.
(a) REPORT.—Not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall submit
to the Committees on Veterans’ Affairs of the Senate and the
House of Representatives and to the National Commission on VA
Nursing established under subtitle D a report on the mandatory
overtime required of licensed nurses and nursing assistants pro-
viding direct patient care at Department of Veterans Affairs medical
facilities during 2001.
(b) MANDATORY OVERTIME.—For purposes of the report under
subsection (a), mandatory overtime shall consist of any period in
which a nurse or nursing assistant is mandated or otherwise
required, whether directly or indirectly, to work or be in on-duty
status in excess of—
(1) a scheduled workshift or duty period;
(2) 12 hours in any 24-hour period; or
(3) 80 hours in any period of 14 consecutive days.
(c) ELEMENTS.—The report under subsection (a) shall include
the following:
(1) A description of the amount of mandatory overtime
described in that subsection at each Department medical facility
during the period covered by the report.
(2) A description of the mechanisms employed by the Sec-
retary to monitor overtime of the nurses and nursing assistants
referred to in that subsection.
(3) An assessment of the effects of the mandatory overtime
of such nurses and nursing assistants on patient care, including
any reported association with medical errors.
H. R. 3447—9
(4) Recommendations regarding mechanisms for preventing
mandatory overtime in other than emergency situations by
such nurses and nursing assistants.
(5) Any other matters that the Secretary considers appro-
priate.
Subtitle C—Other Authorities
SEC. 131. ORGANIZATIONAL RESPONSIBILITY OF THE DIRECTOR OF
THE NURSING SERVICE.
Section 7306(a)(5) is amended by inserting ‘‘, and report directly
to,’’ after ‘‘responsible to’’.
SEC. 132. COMPUTATION OF ANNUITY FOR PART-TIME SERVICE PER-
FORMED BY CERTAIN HEALTH-CARE PROFESSIONALS
BEFORE APRIL 7, 1986.
Section 7426 is amended by adding at the end the following
new subsection:
‘‘(c) The provisions of subsection (b) shall not apply to the
part-time service before April 7, 1986, of a registered nurse, physi-
cian assistant, or expanded-function dental auxiliary. In computing
the annuity under the applicable provision of law specified in that
subsection of an individual covered by the preceding sentence, the
service described in that sentence shall be credited as full-time
service.’’.
SEC. 133. MODIFICATION OF NURSE LOCALITY PAY AUTHORITIES.
Section 7451 is amended—
(1) in subsection (d)(3)—
(A) in subparagraph (A), by striking ‘‘beginning rates
of’’ each place it appears;
(B) in subparagraph (B), by striking ‘‘beginning rates
of’’ the first place it appears; and
(C) in subparagraph (C)(i), by striking ‘‘beginning rates
of’’ each place it appears;
(2) in subsection (d)(4)—
(A) by striking ‘‘or at any other time that an adjust-
ment in rates of pay is scheduled to take place under
this subsection’’ in the first sentence; and
(B) by striking the second sentence; and
(3) in subsection (e)(4)—
(A) in subparagraph (A), by striking ‘‘grade in a’’;
(B) in subparagraph (B)—
(i) by striking ‘‘grade of a’’; and
(ii) by striking ‘‘that grade’’ and inserting ‘‘that
position’’; and
(C) in subparagraph (D), by striking ‘‘grade of a’’.
Subtitle D—National Commission on VA
Nursing
SEC. 141. ESTABLISHMENT OF COMMISSION.
(a) ESTABLISHMENT.—There is hereby established in the Depart-
ment of Veterans Affairs a commission to be known as the ‘‘National
H. R. 3447—10
Commission on VA Nursing’’ (hereinafter in this subtitle referred
to as the ‘‘Commission’’).
(b) COMPOSITION.—The Commission shall be composed of 12
members appointed by the Secretary of Veterans Affairs as follows:
(1) At least two shall be recognized representatives of
employees (including nurses) of the Department of Veterans
Affairs.
(2) At least one shall be a representative of professional
associations of nurses of the Department or similar organiza-
tions affiliated with the Department’s health care practitioners.
(3) At least one shall be a nurse from a nursing school
affiliated with the Department of Veterans Affairs.
(4) At least two shall be representatives of veterans.
(5) At least one shall be an economist.
(6) The remainder shall be appointed in such manner as
the Secretary considers appropriate.
(c) CHAIR OF COMMISSION.—The Secretary of Veterans Affairs
shall designate one of the members of the Commission to chair
the Commission.
(d) PERIOD OF APPOINTMENT; VACANCIES.—Members shall be
appointed for the life of the Commission. Any vacancy in the
Commission shall be filled in the same manner as the original
appointment.
(e) INITIAL ORGANIZATION REQUIREMENTS.—All appointments
to the Commission shall be made not later than 60 days after
the date of the enactment of this Act. The Commission shall convene
its first meeting not later than 60 days after the date as of which
all members of the Commission have been appointed.
SEC. 142. DUTIES OF COMMISSION.
(a) ASSESSMENT.—The Commission shall—
(1) consider legislative and organizational policy changes
to enhance the recruitment and retention of nurses and other
nursing personnel by the Department of Veterans Affairs; and
(2) assess the future of the nursing profession within the
Department.
(b) RECOMMENDATIONS.—The Commission shall recommend
legislative and organizational policy changes to enhance the recruit-
ment and retention of nurses and other nursing personnel in the
Department.
SEC. 143. REPORTS.
(a) COMMISSION REPORT.—The Commission shall, not later than
two years after the date of its first meeting, submit to Congress
and the Secretary of Veterans Affairs a report on the Commission’s
findings and recommendations.
(b) SECRETARY OF VETERANS AFFAIRS REPORT.—Not later than
60 days after the date of the Commission’s report under subsection
(a), the Secretary shall submit to Congress a report—
(1) providing the Secretary’s views on the Commission’s
findings and recommendations; and
(2) explaining what actions, if any, the Secretary intends
to take to implement the recommendations of the Commission
and the Secretary’s reasons for doing so.
SEC. 144. POWERS.
(a) HEARINGS.—The Commission or, at its direction, any panel
or member of the Commission, may, for the purpose of carrying
H. R. 3447—11
out the provisions of this subtitle, hold hearings and take testimony
to the extent that the Commission or any member considers advis-
able.
(b) INFORMATION.—The Commission may secure directly from
any Federal department or agency information that the Commission
considers necessary to enable the Commission to carry out its
responsibilities under this subtitle.
SEC. 145. PERSONNEL MATTERS.
(a) PAY OF MEMBERS.—Members of the Commission shall serve
without pay by reason of their work on the Commission.
(b) TRAVEL EXPENSES.—The members of the Commission shall
be allowed travel expenses, including per diem in lieu of subsistence,
at rates authorized for employees of agencies under subchapter
I of chapter 57 of title 5, United States Code, while away from
their homes or regular places of business in the performance of
services for the Commission.
(c) STAFF.—(1) The Secretary may, without regard to the provi-
sions of title 5, United States Code, governing appointments in
the competitive service, appoint a staff director and such additional
personnel as may be necessary to enable the Commission to perform
its duties.
(2) The Secretary may fix the pay of the staff director and
other personnel appointed under paragraph (1) without regard to
the provisions of chapter 51 and subchapter III of chapter 53
of title 5, United States Code, relating to classification of positions
and General Schedule pay rates, except that the rate of pay fixed
under this paragraph for the staff director may not exceed the
rate payable for level V of the Executive Schedule under section
5316 of such title and the rate of pay for other personnel may
not exceed the maximum rate payable for grade GS–15 of the
General Schedule.
(d) DETAIL OF GOVERNMENT EMPLOYEES.—Upon request of the
Secretary, the head of any Federal department or agency may
detail, on a nonreimbursable basis, any personnel of that depart-
ment or agency to the Commission to assist it in carrying out
its duties.
SEC. 146. TERMINATION OF COMMISSION.
The Commission shall terminate 90 days after the date of
the submission of its report under section 143(a).
TITLE II—OTHER MATTERS
SEC. 201. AUTHORITY FOR SECRETARY OF VETERANS AFFAIRS TO PRO-
VIDE SERVICE DOGS FOR VETERANS WITH CERTAIN
DISABILITIES.
(a) AUTHORITY.—Section 1714 is amended—
(1) in subsection (b)—
(A) by striking ‘‘seeing-eye or’’ the first place it appears;
(B) by striking ‘‘who are entitled to disability com-
pensation’’ and inserting ‘‘who are enrolled under section
1705 of this title’’;
(C) by striking ‘‘, and may pay’’ and all that follows
through ‘‘such seeing-eye or guide dogs’’; and
(D) by striking ‘‘handicap’’ and inserting ‘‘disability’’;
and
H. R. 3447—12
(2) by adding at the end the following new subsections:
‘‘(c) The Secretary may, in accordance with the priority specified
in section 1705 of this title, provide—
‘‘(1) service dogs trained for the aid of the hearing impaired
to veterans who are hearing impaired and are enrolled under
section 1705 of this title; and
‘‘(2) service dogs trained for the aid of persons with spinal
cord injury or dysfunction or other chronic impairment that
substantially limits mobility to veterans with such injury,
dysfunction, or impairment who are enrolled under section
1705 of this title.
‘‘(d) In the case of a veteran provided a dog under subsection
(b) or (c), the Secretary may pay travel and incidental expenses
for that veteran under the terms and conditions set forth in section
111 of this title to and from the veteran’s home for expenses
incurred in becoming adjusted to the dog.’’.
(b) CLERICAL AMENDMENTS.—(1) The heading for such section
is amended to read as follows:
‘‘§ 1714. Fitting and training in use of prosthetic appliances;
guide dogs; service dogs’’.
(2) The item relating to such section in the table of sections
at the beginning of chapter 17 is amended to read as follows:
‘‘1714. Fitting and training in use of prosthetic appliances; guide dogs; service
dogs.’’.
SEC. 202. MANAGEMENT OF HEALTH CARE FOR CERTAIN LOW-INCOME
VETERANS.
(a) PRIORITY
OF
ENROLLMENT
IN
PATIENT
ENROLLMENT
SYSTEM.—Section 1705(a) is amended by striking paragraph (7)
and inserting the following new paragraphs:
‘‘(7) Veterans described in section 1710(a)(3) of this title
who are eligible for treatment as a low-income family under
section 3(b) of the United States Housing Act of 1937 (42
U.S.C. 1437a(b)) for the area in which such veterans reside,
regardless of whether such veterans are treated as single person
families under paragraph (3)(A) of such section 3(b) or as fami-
lies under paragraph (3)(B) of such section 3(b).
‘‘(8) Veterans described in section 1710(a)(3) of this title
who are not covered by paragraph (7).’’.
(b) REDUCED COPAYMENTS FOR CARE.—Subsection (f) of section
1710 is amended—
(1) in paragraph (1), by inserting ‘‘or (4)’’ after ‘‘paragraph
(2)’’;
(2) by redesignating paragraph (4) as paragraph (5); and
(3) by inserting after paragraph (3) the following new para-
graph (4):
‘‘(4) In the case of a veteran covered by this subsection who
is also described by section 1705(a)(7) of this title, the amount
for which the veteran shall be liable to the United States for
hospital care under this subsection shall be an amount equal to
20 percent of the total amount for which the veteran would other-
wise be liable for such care under subparagraphs (2)(B) and (3)(A)
but for this paragraph.’’.
(c) EFFECTIVE DATE.—The amendments made by this section
shall take effect on October 1, 2002.
H. R. 3447—13
SEC. 203. MAINTENANCE OF CAPACITY FOR SPECIALIZED TREATMENT
AND REHABILITATIVE NEEDS OF DISABLED VETERANS.
(a) MAINTENANCE OF CAPACITY ON A GEOGRAPHIC SERVICE AREA
BASIS.—Section 1706(b) is amended—
(1) in paragraph (1)—
(A) in the first sentence, by inserting ‘‘(and each
geographic service area of the Veterans Health Administra-
tion)’’ after ‘‘ensure that the Department’’; and
(B) in clause (B), by inserting ‘‘(and each geographic
service area of the Veterans Health Administration)’’ after
‘‘overall capacity of the Department’’;
(2) by redesignating paragraphs (2) and (3) as paragraphs
(5) and (6), respectively; and
(3) by inserting after paragraph (1) the following new para-
graphs;
‘‘(2) For purposes of paragraph (1), the capacity of the Depart-
ment (and each geographic service area of the Veterans Health
Administration) to provide for the specialized treatment and
rehabilitative needs of disabled veterans (including veterans with
spinal cord dysfunction, traumatic brain injury, blindness, pros-
thetics and sensory aids, and mental illness) within distinct pro-
grams or facilities shall be measured for seriously mentally ill
veterans as follows (with all such data to be provided by geographic
service area and totaled nationally):
‘‘(A) For mental health intensive community-based care,
the number of discrete intensive care teams constituted to
provide such intensive services to seriously mentally ill veterans
and the number of veterans provided such care.
‘‘(B) For opioid substitution programs, the number of
patients treated annually and the amounts expended.
‘‘(C) For dual-diagnosis patients, the number treated
annually and the amounts expended.
‘‘(D) For substance-use disorder programs—
‘‘(i) the number of beds (whether hospital, nursing
home, or other designated beds) employed and the average
bed occupancy of such beds;
‘‘(ii) the percentage of unique patients admitted directly
to outpatient care during the fiscal year who had two
or more additional visits to specialized outpatient care
within 30 days of their first visit, with a comparison from
1996 until the date of the report;
‘‘(iii) the percentage of unique inpatients with sub-
stance-use disorder diagnoses treated during the fiscal year
who had one or more specialized clinic visits within three
days of their index discharge, with a comparison from
1996 until the date of the report;
‘‘(iv) the percentage of unique outpatients seen in a
facility or geographic service area during the fiscal year
who had one or more specialized clinic visits, with a
comparison from 1996 until the date of the report; and
‘‘(v) the rate of recidivism of patients at each special-
ized clinic in each geographic service area of the Veterans
Health Administration.
‘‘(E) For mental health programs, the number and type
of staff that are available at each facility to provide specialized
mental health treatment, including satellite clinics, outpatient
H. R. 3447—14
programs, and community-based outpatient clinics, with a
comparison from 1996 to the date of the report.
‘‘(F) The number of such clinics providing mental health
care, the number and type of mental health staff at each
such clinic, and the type of mental health programs at each
such clinic.
‘‘(G) The total amounts expended for mental health during
the fiscal year.
‘‘(3) For purposes of paragraph (1), the capacity of the Depart-
ment (and each geographic service area of the Veterans Health
Administration) to provide for the specialized treatment and
rehabilitative needs of disabled veterans within distinct programs
or facilities shall be measured for veterans with spinal cord dysfunc-
tion, traumatic brain injury, blindness, or prosthetics and sensory
aids as follows (with all such data to be provided by geographic
service area and totaled nationally):
‘‘(A) For spinal cord injury and dysfunction specialized
centers and for blind rehabilitation specialized centers, the
number of staffed beds and the number of full-time equivalent
employees assigned to provide care at such centers.
‘‘(B) For prosthetics and sensory aids, the annual amount
expended.
‘‘(C) For traumatic brain injury, the number of patients
treated annually and the amounts expended.
‘‘(4) In carrying out paragraph (1), the Secretary may not use
patient outcome data as a substitute for, or the equivalent of,
compliance with the requirement under that paragraph for mainte-
nance of capacity.’’.
(b) EXTENSION OF ANNUAL REPORT REQUIREMENT.—Paragraph
(5) of such section, as so redesignated, is amended—
(1) by inserting ‘‘(A)’’ before ‘‘Not later than’’;
(2) by striking ‘‘April 1, 1999, April 1, 2000, and April
1, 2001’’ and inserting ‘‘April 1 of each year through 2004’’;
(3) by adding at the end of subparagraph (A), as designated
by paragraph (1), the following new sentence: ‘‘Each such report
shall include information on recidivism rates associated with
substance-use disorder treatment.’’; and
(4) by adding at the end of such paragraph the following
new subparagraphs:
‘‘(B) In preparing each report under subparagraph (A), the
Secretary shall use standardized data and data definitions.
‘‘(C) Each report under subparagraph (A) shall be audited by
the Inspector General of the Department, who shall submit to
Congress a certification as to the accuracy of each such report.’’.
SEC. 204. PROGRAM FOR PROVISION OF CHIROPRACTIC CARE AND
SERVICES TO VETERANS.
(a) REQUIREMENT FOR PROGRAM.—Subject to the provisions of
this section, the Secretary of Veterans Affairs shall carry out a
program to provide chiropractic care and services to veterans
through Department of Veterans Affairs medical centers and clinics.
(b) ELIGIBLE VETERANS.—Veterans eligible to receive chiro-
practic care and services under the program are veterans who
are enrolled in the system of patient enrollment under section
1705 of title 38, United States Code.
(c) LOCATION OF PROGRAM.—The program shall be carried out
at sites designated by the Secretary for purposes of the program.
H. R. 3447—15
The Secretary shall designate at least one site for such program
in each geographic service area of the Veterans Health Administra-
tion. The sites so designated shall be medical centers and clinics
located in urban areas and in rural areas.
(d) CARE AND SERVICES AVAILABLE.—The chiropractic care and
services available under the program shall include a variety of
chiropractic care and services for neuro-musculoskeletal conditions,
including subluxation complex.
(e) OTHER ADMINISTRATIVE MATTERS.—(1) The Secretary shall
carry out the program through personal service contracts and by
appointment of licensed chiropractors in Department medical cen-
ters and clinics.
(2) As part of the program, the Secretary shall provide training
and materials relating to chiropractic care and services to Depart-
ment health care providers assigned to primary care teams for
the purpose of familiarizing such providers with the benefits of
chiropractic care and services.
(f) REGULATIONS.—The Secretary shall prescribe regulations
to carry out this section.
(g) CHIROPRACTIC ADVISORY COMMITTEE.—(1) The Secretary
shall establish an advisory committee to provide direct assistance
and advice to the Secretary in the development and implementation
of the chiropractic health program.
(2) The membership of the advisory committee shall include
members of the chiropractic care profession and such other members
as the Secretary considers appropriate.
(3) Matters on which the advisory committee shall assist and
advise the Secretary shall include the following:
(A) Protocols governing referral to chiropractors.
(B) Protocols governing direct access to chiropractic care.
(C) Protocols governing scope of practice of chiropractic
practitioners.
(D) Definition of services to be provided.
(E) Such other matters the Secretary determines to be
appropriate.
(4) The advisory committee shall cease to exist on December
31, 2004.
SEC. 205. FUNDS FOR FIELD OFFICES OF THE OFFICE OF RESEARCH
COMPLIANCE AND ASSURANCE.
(a) IN GENERAL.—Section 7303 is amended by adding at the
end the following new subsection:
‘‘(e) Amounts for the activities of the field offices of the Office
of Research Compliance and Assurance of the Department shall
be derived from amounts appropriated for the Veterans Health
Administration for Medical Care (rather than from amounts appro-
priated for the Veterans Health Administration for Medical and
Prosthetic Research).’’.
(b) APPLICABILITY TO FISCAL YEAR 2002.—In order to carry
out subsection (e) of section 7303 of title 38, United States Code,
as added by subsection (a), for fiscal year 2002, the Secretary
of Veterans Affairs shall transfer such sums as necessary for that
purpose from amounts appropriated for the Veterans Health
Administration for Medical and Prosthetic Research for fiscal year
2002 to amounts appropriated for the Veterans Health Administra-
tion for Medical Care for that fiscal year.
H. R. 3447—16
SEC. 206. MAJOR MEDICAL FACILITY CONSTRUCTION.
(a) PROJECT AUTHORIZED.—The Secretary of Veterans Affairs
may carry out a major medical facility project for the renovation
from electrical fire of the Department of Veterans Affairs Medical
Center, Miami, Florida, in an amount not to exceed $28,300,000.
(b) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to the Secretary of Veterans Affairs for the
Construction, Major Projects Account, for fiscal year 2002,
$28,300,000 for the project authorized by subsection (a).
(c) LIMITATION.—The project authorized by subsection (a) may
only be carried out using—
(1) funds appropriated for fiscal year 2002 pursuant to
the authorization of appropriations in subsection (b);
(2) funds appropriated for Construction, Major Projects,
for a fiscal year before fiscal year 2002 that remain available
for obligation; and
(3) funds appropriated for Construction, Major Projects,
for fiscal year 2002 for a category of activity not specific to
a project.
SEC. 207. SENSE OF CONGRESS ON SPECIAL TELEPHONE SERVICES
FOR VETERANS.
It is the sense of Congress that the Secretary of Veterans
Affairs should conduct an assessment of all special telephone serv-
ices for veterans (such as help lines and hotlines) that are provided
by the Department of Veterans Affairs and that any such assess-
ment, if conducted, should include assessment of the geographical
coverage, 
availability, 
utilization, 
effectiveness, 
management,
coordination, staffing, and cost of those services and should include
a survey of veterans to measure their satisfaction with current
special telephone services and the demand for additional services.
SEC. 
208. 
RECODIFICATION 
OF 
BEREAVEMENT 
COUNSELING
AUTHORITY AND CERTAIN OTHER HEALTH-RELATED
AUTHORITIES.
(a) STATUTORY REORGANIZATION.—Subchapter I of chapter 17
is amended—
(1) in section 1701(6)—
(A) by striking subparagraph (B) and the sentence
following that subparagraph;
(B) by striking ‘‘services—’’ in the matter preceding
subparagraph (A) and inserting ‘‘services, the following:’’;
and
(C) by striking subparagraph (A) and inserting the
following:
‘‘(A) Surgical services.
‘‘(B) Dental services and appliances as described in sections
1710 and 1712 of this title.
‘‘(C) Optometric and podiatric services.
‘‘(D) Preventive health services.
‘‘(E) In the case of a person otherwise receiving care or
services under this chapter—
‘‘(i) wheelchairs, artificial limbs, trusses, and similar
appliances;
‘‘(ii) special clothing made necessary by the wearing
of prosthetic appliances; and
H. R. 3447—17
‘‘(iii) such other supplies or services as the Secretary
determines to be reasonable and necessary.
‘‘(F) Travel and incidental expenses pursuant to section
111 of this title.’’; and
(2) in section 1707—
(A) by inserting ‘‘(a)’’ at the beginning of the text
of the section; and
(B) by adding at the end the following:
‘‘(b) The Secretary may furnish sensori-neural aids only in
accordance with guidelines prescribed by the Secretary.’’.
(b) CONSOLIDATION
OF
PROVISIONS
RELATING
TO
PERSONS
OTHER THAN VETERANS.—Such chapter is further amended by
adding at the end the following new subchapter:
‘‘SUBCHAPTER VIII—HEALTH CARE OF PERSONS OTHER
THAN VETERANS
‘‘§ 1782. Counseling, training, and mental health services for
immediate family members
‘‘(a) 
COUNSELING
FOR
FAMILY
MEMBERS
OF
VETERANS
RECEIVING SERVICE-CONNECTED TREATMENT.—In the case of a vet-
eran who is receiving treatment for a service-connected disability
pursuant to paragraph (1) or (2) of section 1710(a) of this title,
the Secretary shall provide to individuals described in subsection
(c) such consultation, professional counseling, training, and mental
health services as are necessary in connection with that treatment.
‘‘(b) 
COUNSELING
FOR
FAMILY
MEMBERS
OF
VETERANS
RECEIVING NON-SERVICE-CONNECTED TREATMENT.—In the case of
a veteran who is eligible to receive treatment for a non-service-
connected disability under the conditions described in paragraph
(1), (2), or (3) of section 1710(a) of this title, the Secretary may,
in the discretion of the Secretary, provide to individuals described
in subsection (c) such consultation, professional counseling, training,
and mental health services as are necessary in connection with
that treatment if—
‘‘(1) those services were initiated during the veteran’s hos-
pitalization; and
‘‘(2) the continued provision of those services on an out-
patient basis is essential to permit the discharge of the veteran
from the hospital.
‘‘(c) ELIGIBLE INDIVIDUALS.—Individuals who may be provided
services under this subsection are—
‘‘(1) the members of the immediate family or the legal
guardian of a veteran; or
‘‘(2) the individual in whose household such veteran cer-
tifies an intention to live.
‘‘(d) TRAVEL AND TRANSPORTATION AUTHORIZED.—Services pro-
vided under subsections (a) and (b) may include, under the terms
and conditions set forth in section 111 of this title, travel and
incidental expenses of individuals described in subsection (c) in
the case of any of the following:
‘‘(1) A veteran who is receiving care for a service-connected
disability.
‘‘(2) A dependent or survivor receiving care under the last
sentence of section 1783(b) of this title.
H. R. 3447—18
‘‘§ 1783. Bereavement counseling
‘‘(a) DEATHS OF VETERANS.—In the case of an individual who
was a recipient of services under section 1782 of this title at
the time of the death of the veteran, the Secretary may provide
bereavement counseling to that individual in the case of a death—
‘‘(1) that was unexpected; or
‘‘(2) that occurred while the veteran was participating in
a hospice program (or a similar program) conducted by the
Secretary.
‘‘(b) DEATHS IN ACTIVE SERVICE.—The Secretary may provide
bereavement counseling to an individual who is a member of the
immediate family of a member of the Armed Forces who dies
in the active military, naval, or air service in the line of duty
and under circumstances not due to the person’s own misconduct.
‘‘(c) BEREAVEMENT COUNSELING DEFINED.—For purposes of this
section, the term ‘bereavement counseling’ means such counseling
services, for a limited period, as the Secretary determines to be
reasonable and necessary to assist an individual with the emotional
and psychological stress accompanying the death of another indi-
vidual.
‘‘§ 1784. Humanitarian care
‘‘The Secretary may furnish hospital care or medical services
as a humanitarian service in emergency cases, but the Secretary
shall charge for such care and services at rates prescribed by
the Secretary.’’.
(c) TRANSFER OF CHAMPVA SECTION.—Section 1713 is—
(1) transferred to subchapter VIII of chapter 17 of title
38, United States Code, as added by subsection (b), and inserted
after the subchapter heading;
(2) redesignated as section 1781; and
(3) amended by adding at the end of subsection (b) the
following new sentence: ‘‘A dependent or survivor receiving
care under the preceding sentence shall be eligible for the
same medical services as a veteran, including services under
sections 1782 and 1783 of this title.’’.
(d) REPEAL
OF
RECODIFIED
AUTHORITY.—Section 1711 is
amended by striking subsection (b).
(e) CROSS REFERENCE AMENDMENTS.—Title 38, United States
Code, is further amended as follows:
(1) Section 103(d)(5)(B) is amended by striking ‘‘1713’’ and
inserting ‘‘1781’’.
(2) Section 1701(5) is amended by striking ‘‘1713(b)’’ in
subparagraphs (B) and (C)(i) and inserting ‘‘1781(b)’’.
(3) Section 1712A(b) is amended—
(A) in the last sentence of paragraph (1), by striking
‘‘section 1711(b)’’ and inserting ‘‘section 1784’’; and
(A) in paragraph (2), by striking ‘‘section 1701(6)(B)’’
and inserting ‘‘sections 1782 and 1783’’.
(4) Section 1729(f) is amended by striking ‘‘section 1711(b)’’
and inserting ‘‘section 1784’’.
(5) Section 1729A(b) is amended—
(A) by redesignating paragraph (7) as paragraph (8);
and
(B) by inserting after paragraph (6) the following new
paragraph (7):
‘‘(7) Section 1784 of this title.’’.