I
106TH CONGRESS
2D SESSION
H. R. 5109
To amend title 38, United States Code, to improve the personnel system
of the Veterans Health Administration, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
SEPTEMBER 6, 2000
Mr. STEARNS (for himself, Mr. GUTIERREZ, Mr. STUMP, and Mr. EVANS) in-
troduced the following bill; which was referred to the Committee on Vet-
erans’ Affairs
A BILL
To amend title 38, United States Code, to improve the
personnel system of the Veterans Health Administration,
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; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Department of Veterans Affairs Health Care Personnel
Act of 2000’’.
(b) TABLE OF CONTENTS.—The table of contents of
this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. References to title 38, United States Code.
TITLE I—PERSONNEL MATTERS
Sec. 101. Revised authority for pay adjustments for nurses employed by the
Department of Veterans Affairs.
Sec. 102. Special pay for dentists.
Sec. 103. Exemption for pharmacists from ceiling on special salary rates.
Sec. 104. Physician assistant advisers to Under Secretary for Health.
Sec. 105. Temporary full-time appointments of certain medical personnel.
Sec. 106. Qualifications of social workers.
Sec. 107. Extension of temporary early retirement authority.
TITLE II—CONSTRUCTION AUTHORIZATION
Sec. 201. Authorization of major medical facility projects.
Sec. 202. Authorization of appropriations.
TITLE III—MILITARY SERVICE ISSUES
Sec. 301. Military service history.
Sec. 302. Study of post-traumatic stress disorder in Vietnam veterans.
TITLE IV—MEDICAL ADMINISTRATION
Sec. 401. Pilot program for coordination of hospital benefits.
Sec. 402. Benefits for persons disabled by participation in compensated work
therapy program.
Sec. 403. Extension of authority to establish research and education corpora-
tions.
Sec. 404. Department of Veterans Affair Fisher Houses.
Sec. 405. Extension of annual report of Committee on Mentally Ill Veterans.
Sec. 406. Exception of recapture rule.
Sec. 407. Change to enhanced use lease congressional notification period.
Sec. 408. Technical and conforming changes.
Sec. 409. Appointment of Veterans Benefits Administration claims examiners
(also titled Veterans Service Representatives) on a fee basis.
Sec. 410. Release of reversionary interest of the United States in certain real
property previously conveyed to the State of Tennessee.
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 provi-
sion, the reference shall be considered to be made to a
section or other provision of title 38, United States Code.
TITLE I—PERSONNEL MATTERS
SEC. 101. ANNUAL NATIONAL PAY COMPARABILITY AD-
JUSTMENT FOR NURSES EMPLOYED BY DE-
PARTMENT OF VETERANS AFFAIRS.
(a) REVISED PAY ADJUSTMENT PROCEDURES.—Sec-
tion 7451 is amended—
(1) in subsection (d)—
(A) in paragraph (1)—
(i) by striking ‘‘The rates’’ and insert-
ing ‘‘Subject to subsection (e), the rates’’;
and
(ii) in subparagraph (A), by inserting
‘‘and to be by the same percentage’’ after
‘‘to have the same effective date’’;
(B) in paragraph (2), by striking ‘‘Such’’
in the second sentence and inserting ‘‘Except as
provided in paragraph (1)(A), such’’;
(C) in paragraph (3)(B)—
(i) by inserting after the first sentence
the following new sentence: ‘‘To the extent
practicable, the director shall use third-
party industry wage surveys to meet the
requirements of the preceding sentence.’’;
(ii) by inserting before the penul-
timate sentence the following new sentence:
‘‘To the extent practicable, all surveys con-
ducted pursuant to this subparagraph or
subparagraph (A) shall include the collec-
tion of salary midpoints, actual salaries,
lowest and highest salaries, average sala-
ries, bonuses, incentive pays, differential
pays, actual beginning rates of pay and
such other information needed to meet the
purpose of this section.’’; and
(iii) in the penultimate sentence, by
inserting ‘‘or published’’ after ‘‘com-
pleted’’;
(D) by striking clause (iii) of paragraph
(3)(C);
(2) by striking subsection (e) and inserting the
following:
‘‘(e)(1) An adjustment in a rate of basic pay under
subsection (d) may not reduce the rate of basic pay appli-
cable to any grade of a covered position.
‘‘(2) The director of a Department health-care facil-
ity, in determining whether to carry out a wage survey
under subsection (d)(3) with respect to rates of basic pay
for a grade of a covered position, may not consider as a
factor in such determination the absence of a current re-
cruitment or retention problem for personnel in that grade
of that position. The director shall make such a deter-
mination based upon whether, in accordance with criteria
established by the Secretary, there is a significant pay-
related staffing problem at that facility in any grade for
a position. If the director determines that there is such
a problem, or that such a problem is likely to exist in the
near future, the Director shall provide for a wage survey
in accordance with paragraph (3) of subsection (d).
‘‘(3) The Under Secretary for Health may, to the ex-
tent necessary to carry out the purposes of subsection (d),
modify any determination made by the director of a De-
partment health-care facility with respect to adjusting the
rates of basic pay applicable to covered positions. Upon
such action by the Under Secretary, any adjustment shall
take effect on the first day of the first pay period begin-
ning after such action. The Secretary shall ensure that
the Under Secretary establishes a mechanism for the exer-
cise of the authority in the preceding sentence.
‘‘(4) Each director of a Department health-care facil-
ity shall provide to the Secretary, not later than July 31
each year, a report on staffing for covered positions at
that facility. The report shall include the following:
‘‘(A) Information on turnover rates and vacancy
rates for each grade in a covered position, including
a comparison of those rates with the rates for the
preceding three years.
‘‘(B) The director’s findings concerning the re-
view and evaluation of the facility’s staffing situa-
tion, including whether there is, or is likely to be, in
accordance with criteria established by the Sec-
retary, a significant pay-related staffing problem at
that facility for any grade of a covered position and,
if so, whether a wage survey was conducted, or will
be conducted with respect to that grade.
‘‘(C) In any case in which the director conducts
such a wage survey during the period covered by the
report, information describing the survey and any
actions taken or not taken based on the survey, and
the reasons for taking (or not taking) such actions.
‘‘(D) In any case in which the director, after
finding that there is, or is likely to be, in accordance
with criteria established by the Secretary, a signifi-
cant pay-related staffing problem at that facility for
any grade of a covered position, determines not to
conduct a wage survey with respect to that position,
a statement of the reasons why the director did not
conduct such a survey.
‘‘(5) Not later than September 30 of each year, the
Secretary shall submit to the Committees on Veterans’ Af-
fairs of the Senate and House of Representatives a report
on staffing for covered positions at Department healthcare
facilities. Each such report shall include the following:
‘‘(A) A summary and analysis of the informa-
tion contained in the most recent reports submitted
by facility directors under paragraph (4).
‘‘(B) The information for each such facility
specified in paragraph (4).’’;
(3) in subsection (f)—
(A) by striking ‘‘February 1 of 1991,
1992, and 1993’’ and inserting ‘‘March 1 of
each year’’; and
(B) by striking ‘‘subsection (d)(1)(A)’’ and
inserting ‘‘subsection (d)’’; and
(4) by striking subsection (g) and redesignating
subsection (h) as subsection (g).
(b) REQUIRED CONSULTATIONS WITH NURSES.—(1)
Subchapter II of chapter 73 is amended by adding at the
end the following new section:
‘‘§ 7323. Required consultations with nurses
‘‘The Under Secretary for Health shall ensure that—
‘‘(1) the director of a geographic service area,
in formulating policy relating to the provision of pa-
tient care, shall consult regularly with a senior nurse
executive or senior nurse executives; and
‘‘(2) the director of a medical center shall, to
the extent feasible, include a registered nurse as a
member of any committee used at that medical cen-
ter to provide recommendations or decisions on med-
ical center operations or policy affecting clinical
services, clinical outcomes, budget, or resources.’’.
(2) The table of sections at the beginning of such
chapter is amended by inserting after the item relating
to section 7322 the following new item:
‘‘7323. Required consultations with nurses.’’.
SEC. 102. SPECIAL PAY FOR DENTISTS.
(a) FULL-TIME STATUS PAY.—Paragraph (1) of sec-
tion 7435(b) is amended by striking ‘‘$3,500’’ and insert-
ing ‘‘$9,000’’.
(b) SPECIAL PAY FOR POST-GRADUATE TRAINING.—
Such section is amended by adding at the end the fol-
lowing new paragraph:
‘‘(8) For a dentist who has successfully com-
pleted a post-graduate year of hospital-based train-
ing in a program accredited by the American Dental
Association, an annual rate of $2,000 for each of the
first two years of service after successful completion
of that training.’’.
(c) TENURE PAY.—The table in paragraph (2)(A) of
that section is amended to read as follows:
‘‘Length of Service
Rate
Minimum
Maximum
1 year but less than 2 years ...................................
$1,000
$2,000
2 years but less than 3 years .................................
4,000
5,000
4 years but less than 7 years .................................
5,000
8,000
8 years but less than 11 years ...............................
8,000
12,000
12 years but less than 19 years .............................
12,000
15,000
20 years or more ....................................................
15,000
18,000.’’.
(d) SCARCE SPECIALTY PAY.—Paragraph (3)(A) of
that section is amended by striking ‘‘$20,000’’ and insert-
ing ‘‘$30,000’’.
(e) GEOGRAPHIC PAY.—Paragraph (6) of that sec-
tion is amended by striking ‘‘$5,000’’ and inserting
‘‘$12,000’’.
(f) RESPONSIBILITY PAY.—(1) The table in para-
graph (4)(A) is amended to read as follows:
‘‘Position
Rate
Minimum
Maximum
Chief of Staff or in an Executive Grade ................
$14,500
$25,000
Director Grade .......................................................
25,000
Service Chief (or in a comparable position as de-
termined by the Secretary) .................................
4,500
15,000.’’.
(2) The table in paragraph (4)(B) is amended to read
as follows:
‘‘Position
Rate
Deputy Service Director .................................................................
$20,000
Service Director ..............................................................................
25,000
Deputy Assistant Under Secretary for Health ...............................
27,500
Assistant Under Secretary for Health (or in a comparable posi-
tion as determined by the Secretary) .........................................
30,000.’’.
(g) CREDITING OF INCREASED TENURE PAY FOR
CIVIL
SERVICE
RETIREMENT.—Section 
7438(b) 
is
amended—
(1) by redesignating paragraph (5) as para-
graph (6); and
(2) by inserting after paragraph (4) the fol-
lowing new paragraph:
‘‘(5) Notwithstanding paragraphs (1) and (2), a den-
tist employed as a dentist in the Veterans Health Adminis-
tration on the effective date of section 102 of the Depart-
ment of Veterans Affairs Health Care Personnel Act of
2000 shall be entitled to have special pay paid to the den-
tist under section 7435(b)(2)(A) of this title (referred to
as ‘tenure pay’) considered basic pay for the purposes of
chapter 83 or 84, as appropriate, of title 5 only as follows:
‘‘(A) In an amount equal to the amount that
would have been so considered under such section on
the day before such effective date based on the rates
of special pay the dentist was entitled to receive
under that section on the day before such effective
date.
‘‘(B) With respect to any amount of special pay
received under that section in excess of the amount
such dentist was entitled to receive under such sec-
tion on the day before such effective date, in an
amount equal to 25 percent of such excess amount
for each two years that the physician or dentist has
completed as a physician or dentist in the Veterans
Health Administration after such effective date.’’.
(h) EFFECTIVE DATE.—The amendments made by
this section shall apply with respect to agreements entered
into by dentists under subchapter III of chapter 74 of title
38, United States Code, on or after the later of—
(1) the date of the enactment of this Act; and
(2) October 1, 2000.
(i) TRANSITION.—(1) In the case of an agreement en-
tered into by a dentist under subchapter III of chapter
74 of title 38, United States Code, before the date of the
enactment of this Act that expires after the effective date
specified in subsection (h), the Secretary of Veterans Af-
fairs and the dentist concerned may agree to terminate
that agreement as of that effective date in order to permit
a new agreement in accordance with section 7435 of such
title, as amended by this section, to take effect as of that
effective date.
(2) In the case of an agreement entered into under
such subchapter before the date of the enactment of this
Act that expires during the period beginning on the date
of the enactment of this Act and ending on the effective
date specified in subsection (h)(2), an extension or renewal
of that agreement may not extend beyond that effective
date.
(3) In the case of a dentist who begins employment
with the Department of Veterans Affairs during the period
beginning on the date of the enactment of this Act and
ending on the effective date specified in subsection (h)(2)
who is eligible for an agreement under subchapter III of
chapter 74 of title 38, United States Code, any such
agreement may not extend beyond that effective date.
SEC. 103. EXEMPTION FOR PHARMACISTS FROM CEILING
ON SPECIAL SALARY RATES.
Section 7455(c)(1) is amended by inserting ‘‘, phar-
macists,’’ after ‘‘anesthetists’’.
SEC. 104. PHYSICIAN ASSISTANT ADVISER TO UNDER SEC-
RETARY FOR HEALTH.
Section 7306(f) is amended—
(1) by striking ‘‘and’’ at the end of paragraph
(1);
(2) by striking the period at the end of para-
graph (2) and inserting ‘‘; and’’; and
(3) by adding at the end the following new
paragraph:
‘‘(3) a physician assistant with appropriate ex-
perience (who may have a permanent duty station at
a Department medical care facility in reasonable
proximity to Washington, DC) advises the Under
Secretary on all matters relating to the utilization
and employment of physician assistants in the Ad-
ministration.’’.
SEC. 105. TEMPORARY FULL-TIME APPOINTMENTS OF CER-
TAIN MEDICAL PERSONNEL.
(a) PHYSICIAN
ASSISTANTS
AWAITING
CERTIFI-
CATION
OR
LICENSURE.—Paragraph (2) of section
7405(c) is amended to read as follows:
‘‘(2) A temporary full-time appointment may not be
made for a period in excess of two years in the case of
a person who—
‘‘(A) has successfully completed—
‘‘(i) a full course of nursing in a recog-
nized school of nursing, approved by the Sec-
retary; or
‘‘(ii) a full course of training for any cat-
egory of personnel described in paragraph (3)
of section 7401 of this title, or as a physician
assistant, in a recognized education or training
institution approved by the Secretary; and
‘‘(B) is pending registration or licensure in a
State or certification by a national board recognized
by the Secretary.’’.
(b) MEDICAL SUPPORT PERSONNEL.—That section
is further amended—
(1) by redesignating paragraph (3) as para-
graph (4); and
(2) by inserting after paragraph (2) the fol-
lowing new paragraph (3):
‘‘(3)(A) Temporary full-time appointments of persons
in positions referred to in subsection (a)(1)(D) shall not
exceed three years.
‘‘(B) Temporary full-time appointments under this
paragraph may be renewed for one or more additional pe-
riods not in excess of three years each.’’.
SEC. 106. QUALIFICATIONS OF SOCIAL WORKERS.
Section 7402(9) is amended by striking ‘‘a person
must’’ and all that follows and inserting ‘‘a person must—
‘‘(1) hold a master’s degree in social work from
a college or university approved by the Secretary;
and
‘‘(2) be licensed or certified to independently
practice social work in a State, except that the Sec-
retary may waive the requirement of licensure or
certification for an individual social worker for a
reasonable period of time recommended by the
Under Secretary for Health.’’.
SEC. 107. EXTENSION OF TEMPORARY EARLY RETIREMENT
AUTHORITY.
The Department of Veterans Affairs Employment
Reduction Assistance Act of 1999 (title XI of Public Law
106–117; 5 U.S.C. 5597 note) is amended as follows:
(1) Section 1102(c) is amended to read as fol-
lows:
‘‘(c) LIMITATION.—The plan under subsection (a)
shall be limited to 8,110 positions within the Depart-
ment.’’.
(2) Section 1105(a) is amended by striking ‘‘26
percent’’ and inserting ‘‘15 percent’’.
(3) Section 1109(a) is amended by striking
‘‘December 31, 2000’’ and inserting ‘‘December 31,
2002’’.
TITLE II—CONSTRUCTION
AUTHORIZATION
SEC. 201. AUTHORIZATION OF MAJOR MEDICAL FACILITY
PROJECTS.
(a) FISCAL YEAR 2001 PROJECTS.—The Secretary
of Veterans Affairs may carry out the following major
medical facility projects, with each project to be carried
out in the amount specified for that project:
(1) Construction of a psychogeriatric care build-
ing at the Department of Veterans Affairs Medical
Center, Palo Alto, California, in an amount not to
exceed $26,600,000.
(2) Construction of a utility plant and electrical
vault at the Department of Veterans Affairs Medical
Center, Miami, Florida, in an amount not to exceed
$23,600,000.
(3) Seismic corrections, clinical consolidation,
and other improvements at the Department of Vet-
erans Affairs Medical Center, Long Beach, Cali-
fornia, in an amount not to exceed $51,700,000.
(b) ADDITIONAL FISCAL YEAR 2000 PROJECT.—The
Secretary is authorized to carry out a project for the ren-
ovation of psychiatric nursing units at the Department of
Veterans Affairs Medical Center, Murfreesboro, Ten-
nessee, in an amount not to exceed $14,000,000.
SEC. 202. AUTHORIZATION OF APPROPRIATIONS.
(a) IN GENERAL.—There are authorized to be appro-
priated to the Secretary of Veterans Affairs for fiscal
years 2001 and 2002 for the Construction, Major
Projects, account, $101,900,000 for the projects author-
ized in section 101(a).
(b) LIMITATION.—The projects authorized in section
101(a) may only be carried out using—
(1) funds appropriated for fiscal year 2001 or
2002 pursuant to the authorization of appropria-
tions in subsection (a);
(2) funds appropriated for Construction, Major
Projects for a fiscal year before fiscal year 2001 that
remain available for obligation; and
(3) funds appropriated for Construction, Major
Projects for fiscal year 2001 or 2002 for a category
of activity not specific to a project.
TITLE III—MILITARY SERVICE
ISSUES
SEC. 301. MILITARY SERVICE HISTORY.
(a) MILITARY HISTORIES.—The Secretary of Vet-
erans Affairs, in carrying out the responsibilities of the
Secretary under chapter 17 of title 38, United States
Code, shall ensure that—
(1) during at least one clinical evaluation of a
patient in a facility of the Department, a protocol is
used to identify pertinent military experiences and
exposures of the patient that may contribute to the
health status of the patient; and
(2) pertinent information relating to the mili-
tary history of the patient is included in the Depart-
ment’s medical records of the patient.
(b) REPORT.—Not later than nine months after the
date of the enactment of this Act, the Secretary shall sub-
mit to the Committees on Veterans’ Affairs of the Senate
and House of Representatives a report on the feasibility
and desirability of using a computer-based system in con-
ducting clinical evaluations referred to in subsection
(a)(1).
SEC. 302. STUDY OF POST-TRAUMATIC STRESS DISORDER
IN VIETNAM VETERANS.
(a) STUDY
ON
POST-TRAUMATIC
STRESS
DIS-
ORDER.—Not later than 10 months after the date of the
enactment of this Act, the Secretary of Veterans Affairs
shall enter into a contract with an appropriate entity to
carry out a study on post-traumatic stress disorder.
(b) FOLLOW-UP STUDY.—The contract under sub-
section (a) shall provide for a follow-up study to the study
conducted in accordance with section 102 of the Veterans
Health Care Amendments of 1983 (Public Law 98–160).
Such follow-up study shall use the data base and sample
of the previous study.
(c) INFORMATION TO BE INCLUDED.—The study
conducted pursuant to this section shall be designed to
yield information on—
(1) the long-term course of post-traumatic
stress disorder;