I 
108TH CONGRESS 
2D SESSION 
H. R. 4020
To amend title 38, United States Code, to establish within the Department 
of Veterans Affairs a program to assist the States in hiring and retaining 
nurses at State veterans homes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 24, 2004
Mr. SMITH of New Jersey (for himself and Mr. EVANS) introduced the 
following bill; which was referred to the Committee on Veterans’ Affairs 
A BILL 
To amend title 38, United States Code, to establish within 
the Department of Veterans Affairs a program to assist 
the States in hiring and retaining nurses at State vet-
erans homes.
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 ‘‘State Veterans Home 
Nurse Recruitment Act of 2004’’.
SEC. 2. ASSISTANCE FOR HIRING AND RETENTION OF 
NURSES AT STATE VETERANS HOMES. 
(a) IN GENERAL.—(1) Chapter 17 of title 38, United 
States Code, is amended by inserting after section 1743 
the following new section: 
‘‘§ 1744. Hiring and retention of nurses: payments to 
assist States 
‘‘(a) PAYMENT PROGRAM.—The Secretary shall make 
payments to States under this section for the purpose of 
assisting State homes in the hiring and retention of nurses 
and the reduction of nursing shortages at State homes. 
‘‘(b) ELIGIBLE RECIPIENTS.—Payments to a State 
for a fiscal year under this section shall, subject to submis-
sion of an application, be made to any State that during 
that year—
‘‘(1) receives per diem payments under this 
subchapter for that fiscal year; and 
‘‘(2) has in effect an employee incentive schol-
arship program or other employee incentive program 
at a State home designed to promote the hiring and 
retention of nursing staff and to reduce nursing 
shortages at that home. 
‘‘(c) USE OF FUNDS RECEIVED.—A State may use 
an amount received under this section only to provide 
funds for a program described in subsection (b)(2). Any 
program shall meet such criteria as the Secretary may
prescribe. In prescribing such criteria, the Secretary shall 
take into consideration the need for flexibility and innova-
tion. 
‘‘(d) LIMITATIONS ON AMOUNT OF PAYMENT.—(1) 
A payment under this section may not be used to provide 
more than 50 percent of the costs for a fiscal year of the 
employee incentive scholarship or other incentive program 
for which the payment is made. 
‘‘(2) The amount of the payment to a State under 
this section for any fiscal year is, for each State home 
in that State with a program described in subsection 
(b)(2), the amount equal to 2 percent of the amount of 
payments estimated to be made to that State, for that 
State home, under section 1741 of this title for that fiscal 
year. 
‘‘(e) APPLICATIONS.—A payment under this section 
for any fiscal year with respect to any State home may 
only be made based upon an application submitted by the 
State seeking the payment with respect to that State 
home. Any such application shall describe the nursing 
shortage at the State home and the employee incentive 
scholarship program or other incentive program described 
in subsection (c) for which the payment is sought.
‘‘(f) SOURCE OF FUNDS.—Payments under this sec-
tion shall be made from funds available for other pay-
ments under this subchapter. 
‘‘(g) DISBURSEMENT.—Payments under this section 
to a State home shall be made as part of the disbursement 
of payments under section 1741 of this title with respect 
to that State home. 
‘‘(h) USE OF CERTAIN RECEIPTS.—The Secretary 
shall require as a condition of any payment under this sec-
tion that, in any case in which the State home receives 
a refund payment made by an employee in breach of the 
terms of an agreement for employee assistance that used 
funds provided under this section, the payment shall be 
returned to the State home’s incentive program account 
and credited as a non-Federal funding source. 
‘‘(i) ANNUAL REPORT FROM PAYMENT RECIPI-
ENTS.—Any State home receiving a payment under this 
section for any fiscal year, shall, as a condition of the pay-
ment, be required to agree to provide to the Secretary a 
report setting forth in detail the use of funds received 
through the payment, including a descriptive analysis of 
how effective the incentive program has been on nurse 
staffing in the State home during that fiscal year. The 
report for any fiscal year shall be provided to the Sec-
retary within 60 days of the close of the fiscal year and
shall be subject to audit by the Secretary. Eligibility for 
a payment under this section for any later fiscal year is 
contingent upon the receipt by the Secretary of the annual 
report under this subsection for the previous year in ac-
cordance with this subsection. 
‘‘(j) REGULATIONS.—The Secretary shall prescribe 
regulations to carry out this section. The regulations shall 
include the establishment of criteria for the award of pay-
ments under this section.’’. 
(2) The table of sections at the beginning of such 
chapter is amended by inserting after section 1743 the 
following new item:
‘‘1744. Hiring and retention of nurses: payments to assist States.’’.
(b) IMPLEMENTATION.—The Secretary of Veterans 
Affairs shall implement section 1744 of title 38, United 
States Code, as added by subsection (a), as expeditiously 
as possible. The Secretary shall establish such interim pro-
cedures as necessary so as to ensure that payments are 
made to eligible States under that section commencing not 
later than January 1, 2005, notwithstanding that regula-
tions under subsection (j) of that section may not have 
become final.
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