Department of Veterans Affairs Health Care Personnel Enhancement Act of 2004
PL 108-445 (S.2484), enacted 12/03/2004

[108th Congress Public Law 445]
[From the U.S. Government Printing Office]


<DOC>
[DOCID: f:publ445.108]


[[Page 2635]]

DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE PERSONNEL ENHANCEMENT ACT OF 
                                  2004

[[Page 118 STAT. 2636]]

Public Law 108-445
108th Congress

                                 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. <<NOTE: Dec. 3, 2004 -  [S. 2484]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, <<NOTE: Department of 
Veterans Affairs Health Care Personnel Enhancement Act of 2004.>> 

SECTION 1. SHORT TITLE. <<NOTE: 38 USC 101 note.>> 

    This Act may be cited as the ``Department of Veterans Affairs Health 
Care Personnel Enhancement Act of 2004''.

SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.

    Except as otherwise expressly provided, whenever in this Act an 
amendment is expressed in terms of an amendment to 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.
SEC. 3. SIMPLIFICATION AND IMPROVEMENT OF GRADE AND PAY PROVISIONS 
                    FOR PHYSICIANS AND DENTISTS.

    (a) Simplification of Grades and Grade Requirements.--(1) Subsection 
(b) of section 7404 is amended--
            (A) by striking ``(1)'' after ``(b)'';
            (B) in the Physician and Dentist Schedule, by striking the 
        items relating to the grades and inserting the following:
            ``Physician grade.
            ``Dentist grade.''; and
            (C) by striking paragraph (2).

    (2) Subsection (a) of such section is amended by adding at the end 
the following: ``The pay of physicians and dentists serving in positions 
to which an Executive order applies under the preceding sentence shall 
be determined under subchapter III of this chapter instead of such 
Executive order.''.
    (b) Simplification and Improvement of Pay Authorities.--Subchapter 
III of chapter 74 is amended to read as follows:

            ``SUBCHAPTER III--PAY FOR PHYSICIANS AND DENTISTS

``Sec. 7431. Pay

    ``(a) Elements of Pay.--Pay of physicians and dentists in the 
Veterans Health Administration shall consist of three elements as 
follows:
            ``(1) Base pay as provided for under subsection (b).
            ``(2) Market pay as provided for under subsection (c).
            ``(3) Performance pay as provided under subsection (d).

[[Page 118 STAT. 2637]]

    ``(b) Base Pay.--One element of pay for physicians and dentists 
shall be base pay. Base pay shall meet the following requirements:
            ``(1) Each physician and dentist is entitled to base pay 
        determined under the Physician and Dentist Base and Longevity 
        Pay Schedule.
            ``(2) The Physician and Dentist Base and Longevity Pay 
        Schedule is composed of 15 rates of base pay designated, from 
        the lowest rate of pay to the highest rate of pay, as base pay 
        steps 1 through 15.
            ``(3) The rate of base pay payable to a physician or dentist 
        is based on the total number of the years of the service of the 
        physician or dentist in the 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                            step 2 
    years
more than 4 years and not more than 6                            step 3 
    years
more than 6 years and not more than 8                            step 4 
    years
more than 8 years and not more than 10                           step 5 
    years
more than 10 years and not more than 12                          step 6 
    years
more than 12 years and not more than 14                          step 7 
    years
more than 14 years and not more than 16                          step 8 
    years
more than 16 years and not more than 18                          step 9 
    years
more than 18 years and not more than 20                         step 10 
    years
more than 20 years and not more than 22                         step 11 
    years
more than 22 years and not more than 24                         step 12 
    years
more than 24 years and not more than 26                         step 13 
    years
more than 26 years and not more than 28                         step 14 
    years
more than 28 years                                              step 15.

            ``(4) At the same time as rates of basic pay are increased 
        for a year under section 5303 of title 5, the Secretary shall 
        increase the amount of base pay payable under this subsection 
        for that year by a percentage equal to the percentage by which 
        rates of basic pay are increased under such section for that 
        year.

    ``(c) Market Pay.--One element of pay for physicians and dentists 
shall be market pay. Market pay shall meet the following requirements:
            ``(1) Each physician and dentist is eligible for market pay.
            ``(2) Market pay shall consist of pay intended to reflect 
        the recruitment and retention needs for the specialty or 
        assignment (as defined by the Secretary) of a particular 
        physician or dentist in a facility of the Department of Veterans 
        Affairs.
            ``(3) The annual amount of the market pay payable to a 
        physician or dentist shall be determined by the Secretary on a 
        case-by-case basis.
            ``(4)(A) In determining the amount of market pay for 
        physicians or dentists, the Secretary shall consult two or more 
        national surveys of pay for physicians or dentists, as 
        applicable, whether prepared by private, public, or quasi-public 
        entities in order to make a general assessment of the range of 
        pays payable to physicians or dentists, as applicable.
            ``(B)(i) In determining the amount of the market pay for a 
        particular physician or dentist under this subsection, and in 
        determining a tier (if any) to apply to a physician or dentist 
        under subsection (e)(1)(B), the Secretary shall consult with

[[Page 118 STAT. 2638]]

         and consider the recommendations of an appropriate panel or 
        board composed of physicians or dentists (as applicable).
            ``(ii) A physician or dentist may not be a member of the 
        panel or board that makes recommendations under clause (i) with 
        respect to the market pay of such physician or dentist, as the 
        case may be.
            ``(iii) The Secretary should, to the extent practicable, 
        ensure that a panel or board consulted under this subparagraph 
        includes physicians or dentists (as applicable) who are 
        practicing clinicians and who do not hold management positions 
        in the medical facility of the Department at which the physician 
        or dentist subject to the consultation is employed.
            ``(5) The determination of the amount of market pay of a 
        physician or dentist shall take into account--
                    ``(A) the level of experience of the physician or 
                dentist in the specialty or assignment of the physician 
                or dentist;
                    ``(B) the need for the specialty or assignment of 
                the physician or dentist at the medical facility of the 
                Department concerned;
                    ``(C) the health care labor market for the specialty 
                or assignment of the physician or dentist, which may 
                cover any geographic area the Secretary considers 
                appropriate for the specialty or assignment;
                    ``(D) the board certifications, if any, of the 
                physician or dentist;
                    ``(E) the prior experience, if any, of the physician 
                or dentist as an employee of the Veterans Health 
                Administration; and
                    ``(F) such other considerations as the Secretary 
                considers appropriate.
            ``(6) The amount of market pay of a physician or dentist 
        shall be evaluated by the Secretary not less often than once 
        every 24 months. The amount of market pay may be adjusted as the 
        result of an evaluation under this 
        paragraph. <<NOTE: Notice.>> A physician or dentist whose market 
        pay is evaluated under this paragraph shall receive written 
        notice of the results of such evaluation in accordance with 
        procedures prescribed under section 7433 of this title.
            ``(7) No adjustment of the amount of market pay of a 
        physician or dentist under paragraph (6) may result in a 
        reduction of the amount of market pay of the physician or 
        dentist while in the same position or assignment at the medical 
        facility of the Department concerned.

    ``(d) Performance Pay.--(1) One element of pay for physicians and 
dentists shall be performance pay.
    ``(2) Performance pay shall be paid to a physician or dentist on the 
basis of the physician's or dentist's achievement of specific goals and 
performance objectives prescribed by the Secretary.
    ``(3) The Secretary shall ensure that each physician and dentist of 
the Department is advised of the specific goals or objectives that are 
to be measured by the Secretary in determining the eligibility of that 
physician or dentist for performance pay.
    ``(4) The amount of the performance pay payable to a physician or 
dentist may vary annually on the basis of individual achievement or 
attainment of the goals or objectives applicable to the physician or 
dentist under paragraph (2).

[[Page 118 STAT. 2638]]

    ``(5) The amount of performance pay payable to a physician or 
dentist in a fiscal year shall be determined in accordance with 
regulations prescribed by the Secretary, but may not exceed the lower 
of--
            ``(A) $15,000; or
            ``(B) the amount equal to 7.5 percent of the sum of the base 
        pay and the market pay payable to such physician or dentist in 
        that fiscal year.

    ``(6) A failure to meet goals or objectives applicable to a 
physician or dentist under paragraph (2) may not be the sole basis for 
an adverse personnel action against that physician or dentist.
    ``(e) Requirements and Limitations on Total Pay.--(1)(A) Not less 
often than once every two years, the Secretary shall prescribe for 
Department-wide applicability the minimum and maximum amounts of annual 
pay that may be paid under this section to physicians and the minimum 
and maximum amounts of annual pay that may be paid under this section to 
dentists.
    ``(B) The Secretary may prescribe for Department-wide applicability 
under this paragraph separate minimum and maximum amounts of pay for a 
specialty or assignment. If the Secretary prescribes separate minimum 
and maximum amounts for a specialty or assignment, the Secretary may 
establish up to four tiers of minimum and maximum amounts for such 
specialty or assignment and prescribe for each tier a minimum amount and 
a maximum amount that the Secretary determines appropriate for the 
professional responsibilities, professional achievements, and 
administrative duties of the physicians or dentists (as the case may be) 
whose pay is set within that tier.
    ``(C) <<NOTE: Federal Register, publication. Effective 
date.>> Amounts prescribed under this paragraph shall be published in 
the Federal Register, and shall not take effect until at least 60 days 
after the date of publication.

    ``(2) Except as provided in paragraph (3) and subject to paragraph 
(4), the sum of the total amount of the annual rate of base pay payable 
to a physician or dentist under subsection (b) and the market pay 
determined for the physician or dentist under subsection (c) may not be 
less than the minimum amount, nor more than the maximum amount, 
applicable to specialty or assignment of the physician or dentist under 
paragraph (1).
    ``(3) The sum of the total amount of the annual rate of base pay 
payable to a physician or dentist under subsection (b) and the market 
pay determined for the physician or dentist under subsection (c) may 
exceed the maximum amount applicable to the specialty or assignment of 
the physician or dentist under paragraph (1) as a result of an 
adjustment under paragraph (3) or (4) of subsection (b).
    ``(4) In no case may the total amount of compensation paid to a 
physician or dentist under this title in any year exceed the amount of 
annual compensation (excluding expenses) specified in section 102 of 
title 3.
    ``(f) Treatment of Pay.--Pay under subsections (b) and (c) of this 
section shall be considered pay for all purposes, including retirement 
benefits under chapters 83 and 84 of title 5 and other benefits.
    ``(g) Ancillary Effects of Decreases in Pay.--(1) A decrease in pay 
of a physician or dentist resulting from an adjustment in the amount of 
market pay of the physician or dentist under subsection (c) shall not be 
treated as an adverse action.

[[Page 118 STAT. 2640]]

    ``(2) If the pay of a physician or dentist is reduced under this 
subchapter as a result of an involuntary reassignment in connection with 
a disciplinary action taken against the physician or dentist, the 
involuntary reassignment shall be subject to appeal under subchapter V 
of this chapter.
    ``(h) Delegation of Responsibilities.--The Secretary may delegate to 
an appropriate officer or employee of the Department any responsibility 
of the Secretary under subsection (c), (d), or (e) except for the 
responsibilities of the Secretary under subsection (e)(1).

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

    ``(a) Base Pay.--The base pay of the Under Secretary for Health 
shall be the annual rate of basic pay for positions at Level III of the 
Executive Schedule under section 5314 of title 5.
    ``(b) Market Pay.--(1) In the case of an Under Secretary for Health 
who is also a physician or dentist, in addition to the base pay 
specified in subsection (a) the Under Secretary for Health may also be 
paid the market pay element of pay of physicians and dentists under 
section 7431(c) of this title.
    ``(2) The amount of market pay of the Under Secretary for Health 
under this subsection shall be established by the Secretary.
    ``(3) In establishing the amount of market pay of the Under 
Secretary for Health under this subsection, the Secretary shall utilize 
an appropriate health care labor market selected by the Secretary for 
purposes of this subsection.
    ``(c) Treatment of Pay.--Pay under this section shall be considered 
pay for all purposes, including retirement benefits under chapters 83 
and 84 of title 5 and other benefits.

``Sec. 7433. Administrative matters

    ``(a) Regulations.--(1) The Secretary shall prescribe regulations 
relating to the pay of physicians and dentists in the Veterans Health 
Administration under this subchapter.
    ``(2) In prescribing the regulations, the Secretary shall take into 
account the recommendations of the Under Secretary for Health on the 
administration of this subchapter. In formulating recommendations for 
the purpose of this paragraph, the Under Secretary shall request the 
views of representatives of labor organizations that are exclusive 
representatives of physicians and dentists of the Department and the 
views of representatives of professional organizations of physicians and 
dentists of the Department.
    ``(b) Reports.--(1) Not later than 18 months after the Secretary 
prescribes the regulations required by subsection (a), and annually 
thereafter for the next 5 years, the Secretary shall submit to the 
Committees on Veterans' Affairs of the Senate and House of 
Representatives a report on the pay of physicians and dentists in the 
Veterans Health Administration under this subchapter.
    ``(2) Each report under this subsection shall include the following:
            ``(A) A description of the rates of pay in effect during the 
        current fiscal year with a comparison to the rates in effect 
        during the fiscal year preceding the current fiscal year, set 
        forth by facility and by specialty.
            ``(B) The number of physicians and dentists who left the 
        Veterans Health Administration during the preceding fiscal year.

[[Page 118 STAT. 2641]]

            ``(C) The number of unfilled physician positions and dentist 
        positions in each specialty in the Veterans Health 
        Administration, the average and maximum lengths of time that 
        such positions have been unfilled, and an assessment of the 
        reasons that such positions remain unfilled.
            ``(D) An assessment of the impact of implementation of this 
        subchapter on efforts to recruit and retain physicians and 
        dentists in the Veterans Health Administration.

    ``(3) The first two annual reports under this subsection shall also 
include a comparison of staffing levels, contract expenditures, and 
average salaries of physicians and dentists in the Veterans Health 
Administration for the current fiscal year and for the fiscal year 
preceding the current fiscal year, set forth by facility and by 
specialty.''.
    (c) <<NOTE: 38 USC 7431 note.>> Initial Rates of Base Pay for 
Physicians and Dentists.--The initial rates of base pay established for 
the base pay steps under the Physician and Dentist Base and Longevity 
Pay Schedule provided in section 7431(b) of title 38, United States Code 
(as added by subsection (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.

    (d) <<NOTE: 38 USC 7431 note.>> Effective Date.--(1) Notwithstanding 
the 60-day waiting requirement in section 7431(e)(1)(C) of title 38, 
United States Code (as amended by subsection (b)), pay provided for a 
physician or dentist under subchapter III of chapter 74 of such title, 
as amended by subsection (b), shall take effect on the first day of the 
first pay period applicable to such physician or dentist that begins on 
or after January 1, 2006.

    (2) Pay provided for the Under Secretary for Health under subchapter 
III of chapter 74 of title 38, United States Code, as amended by this 
section shall take effect on the first day of the first pay period 
applicable to the Under Secretary that begins on or after January 1, 
2006.
    (e) Transition Provisions.-- <<NOTE: 38 USC 7431 note.>> 
            (1) Physicians and dentists.--
                    (A) Pay.--(i) The amount of the pay payable on and 
                after the date of the enactment of this Act to a 
                physician or dentist in receipt of pay under section 
                7404 or 7405 of title 38, United States Code, as of the 
                day before such date shall continue to be determined 
                under such section (as in effect on the day before such 
                date) until the effective date that is applicable under 
                subsection (d) to such physician or dentist, as the case 
                may be.
                    (ii) A physician or dentist appointed or reassigned 
                on or after the date of the enactment of this Act, but 
                before

[[Page 118 STAT. 2642]]

                the effective date applicable under subsection (d) to 
                such physician or dentist, shall be compensated in 
                accordance with applicable provisions of section 7404 or 
                7405 of title 38, United States Code (as in effect on 
                the day before date of the enactment of this Act), until 
                such effective date.
                    (B) Special pay.--(i) A special pay agreement 
                entered into by a physician or dentist under subchapter 
                III of chapter 74 of title 38, United States Code, 
                before the date of the enactment of this Act shall 
                terminate on the date of the enactment of this Act. 
                However, a physician or dentist in receipt of special 
                pay pursuant to such an agreement on that date shall 
                continue to receive special pay under the terms of such 
                agreement until the effective date that is applicable 
                under subsection (d) to such physician or dentist.
                    (ii) A physician or dentist described in 
                subparagraph (A)(ii) may be paid special pay under 
                applicable provisions of section 7433, 7434, 7435, or 
                7436 of title 38, United States Code (as in effect on 
                the day before the date of the enactment of this Act), 
                during the period beginning on the date of the 
                appointment or reassignment of such physician or 
                dentist, as the case may be, and ending on the effective 
                date applicable under subsection (d) to such physician 
                or dentist. However, no special pay agreement shall be 
                required for the payment of special pay under this 
                clause.
                    (C) Treatment of special pay.--(i) Special pay paid 
                under subparagraph (B) to a physician or dentist during 
                the period beginning on the date of the enactment of 
                this Act and ending on the effective date applicable 
                under subsection (d) to such physician or dentist shall 
                be subject to the provisions of paragraphs (1), (2), 
                (4), (5), and (6) of section 7438(b) of title 38, United 
                States Code (as in effect on the day before the date of 
                the enactment of this Act).
                    (ii) Special pay paid to a physician or dentist 
                under section 7438 of title 38, United States Code (as 
                in effect on the day before the date of the enactment of 
                this Act), shall be fully creditable for purposes of 
                computing benefits under chapters 83 and 84 of title 5, 
                United States Code.
                    (D) Preservation of pay.--The amount of pay paid to 
                a physician or dentist after the effective date of this 
                Act shall not be less than the amount of pay paid to 
                such physician or dentist on the day before the 
                effective date of this Act while such physician or 
                dentist remains in the same position or assignment.
            (2) Under secretary for health.--
                    (A) Special pay.--(i) The current special pay 
                agreement entered into by the Under Secretary for Health 
                under subchapters I and III of chapter 74 of title 38, 
                United States Code, before the date of the enactment of 
                this Act shall terminate on the date of the enactment of 
                this Act. However, the Under Secretary shall continue to 
                receive special pay under the terms of such agreement 
                until the effective date that is applicable under 
                subsection (d) to the Under Secretary.

[[Page 118 STAT. 2643]]

                    (ii) An individual appointed as Under Secretary for 
                Health on or after the date of the enactment of this Act 
                and before the effective date applicable under 
                subsection (d) to the Under Secretary shall be paid 
                special pay in accordance with the provisions of 
                sections 7432(d)(2) and 7433 of title 38, United States 
                Code (as in effect on the day before the date of the 
                enactment of this Act), during the period beginning on 
                the date of appointment and ending on such effective 
                date. However, no special pay agreement shall be 
                required for the payment of special pay under this 
                clause.
                    (B) Treatment of special pay.--Special pay paid 
                under subparagraph (A) during the period beginning on 
                the date of the enactment of this Act and ending on the 
                effective date applicable under subsection (d) to the 
                Under Secretary--
                          (i) shall be subject to the provisions of 
                      paragraphs (1), (2), (4), (5), and (6) of section 
                      7438(b) of title 38, United States Code (as in 
                      effect on the day before the date of the enactment 
                      of this Act); and
                          (ii) shall be fully creditable for purposes of 
                      computing benefits under chapters 83 and 84 of 
                      title 5, United States Code.

    (f) Conforming Amendments.--Section 7404 is amended--
            (1) in subsection (c), by striking ``special pay'' and 
        inserting ``pay''; and
            (2) in subsection (d), by striking ``pay may not be paid'' 
        and all that follows and inserting ``pay for positions for which 
        basic pay is paid under this section may not be paid at a rate 
        in excess of the rate of basic pay authorized by section 5316 of 
        title 5 for positions in Level V of the Executive Schedule.''.

    (g) Clerical Amendment.--The table of sections at the beginning of 
chapter 74 is amended by striking the items relating to subchapter III 
and inserting the following new items:
                ``SUBCHAPTER III--PAY FOR PHYSICIANS AND DENTISTS
``Sec. 7431. Pay.
``Sec. 7432. Pay of Under Secretary for Health.
``Sec. 7433. Administrative matters.''.

SEC. 4. ALTERNATE WORK SCHEDULES FOR REGISTERED NURSES.

    (a) In General.--(1) Chapter 74 is amended by inserting after 
section 7456 the following new section:

``Sec. 7456A. Nurses: alternate work schedules

    ``(a) Applicability.--This section applies to registered nurses 
appointed under this chapter.
    ``(b) 36/40 Work Schedule.--(1)(A) Subject to paragraph (2), if the 
Secretary determines it to be necessary in order to obtain or retain the 
services of registered nurses at any Department health-care facility, 
the Secretary may provide, in the case of nurses employed at such 
facility, that such nurses who work three regularly scheduled 12-hour 
tours of duty within a work week shall be considered for all purposes to 
have worked a full 40-hour basic work week.
    ``(B) A nurse who works under the authority in subparagraph (A) 
shall be considered a 0.90 full-time equivalent employee in

[[Page 118 STAT. 2644]]

computing full-time equivalent employees for the purposes of determining 
compliance with personnel ceilings.
    ``(2)(A) Basic and additional pay for a nurse who is considered 
under paragraph (1) to have worked a full 40-hour basic work week shall 
be subject to subparagraphs (B) and (C).
    ``(B) The hourly rate of basic pay for a nurse covered by this 
paragraph for service performed as part of a regularly scheduled 36-hour 
tour of duty within the work week shall be derived by dividing the 
nurse's annual rate of basic pay by 1,872.
    ``(C) <<NOTE: Overtime pay.>> The Secretary shall pay overtime pay 
to a nurse covered by this paragraph who--
            ``(i) performs a period of service in excess of such nurse's 
        regularly scheduled 36-hour tour of duty within an 
        administrative work week;
            ``(ii) for officially ordered or approved service, performs 
        a period of service in excess of 8 hours on a day other than a 
        day on which such nurse's regularly scheduled 12-hour tour of 
        duty falls;
            ``(iii) performs a period of service in excess of 12 hours 
        for any day included in the regularly scheduled 36-hour tour of 
        duty work week; or
            ``(iv) performs a period of service in excess of 40 hours 
        during an administrative work week.

    ``(D) The Secretary may provide a nurse to whom this subsection 
applies with additional pay under section 7453 of this title for any 
period included in a regularly scheduled 12-hour tour of duty.
    ``(3) A nurse who works a work schedule described 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 every nine hours of absence.
    ``(c) Holiday Pay.--A nurse working a work schedule under subsection 
(b) that includes a holiday designated by law or Executive order shall 
be eligible for holiday pay under section 7453(d) of this title for any 
service performed by the nurse on such holiday under such section.
    ``(d) 9-Month Work Schedule for Certain Nurses.--(1) 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 3 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 such fiscal year.
    ``(2) A nurse who works under the authority in paragraph (1) shall 
be considered a 0.75 full-time equivalent employee in computing full-
time equivalent employees for the purposes of determining compliance 
with personnel ceilings.
    ``(3) Work under this subsection shall be considered part-time 
service for purposes of computing benefits under chapters 83 and 84 of 
title 5.
    ``(4) A nurse who works under the authority in paragraph (1) shall 
be considered a full-time employee for purposes of chapter 89 of title 
5.
    ``(e) Notification of Modification of Benefits.--The Secretary shall 
provide each employee with respect to whom an alternate work schedule 
under this section may apply written notice of the effect, if any, that 
the alternate work schedule will have on the employee's health care 
premium, retirement, life insurance

[[Page 118 STAT. 2645]]

premium, probationary status, or other benefit or condition of 
employment. <<NOTE: Deadline.>> The notice shall be provided not later 
than 14 days before the employee consents to the alternate work 
schedule.

    ``(f) Regulations.--The Secretary shall prescribe regulations to 
carry out this section.''.
    (2) The table of sections at the beginning of chapter 74 is amended 
by inserting after the item relating to section 7456 the following new 
item:

``Sec. 7456A. Nurses: alternate work schedules.''.

    (b) Policy Against Certain Work Hours.--(1) It is the sense of 
Congress to encourage the Secretary of Veterans Affairs to prevent work 
hours by nurses providing direct patient care in excess of 12 
consecutive hours or in excess of 60 hours in any 7-day period, except 
in the case of nurses providing emergency care.
    (2) <<NOTE: Deadline. Certification.>> Not later than one year after 
the date of the enactment of this Act and every year thereafter for the 
next two years, the Secretary shall certify to Congress whether or not 
each Veterans Health Administration facility has in place, as of the 
date of such certification, a policy designed to prevent work hours by 
nurses providing direct patient care (other than nurses providing 
emergency care) in excess of 12 consecutive hours or in excess of 60 
hours in any 7-day period.

SEC. 5. NURSE EXECUTIVE SPECIAL PAY.

    Section 7452 is amended by adding at the end the following new 
subsection:
    ``(g)(1) In order to recruit and retain highly qualified Department 
nurse executives, the Secretary may, in accordance with regulations 
prescribed by the Secretary, pay special pay to the nurse executive at 
each location as follows:
            ``(A) Each Department health care facility.
            ``(B) The Central Office.

    ``(2) The amount of special pay paid to a nurse executive under 
paragraph (1) shall be not less than $10,000 or more than $25,000.
    ``(3) The amount of special pay paid to a nurse executive under 
paragraph (1) shall be based on factors such as the grade of the nurse 
executive position, the scope and complexity of the nurse executive 
position, the personal qualifications of the nurse executive, the 
characteristics of the health care facility concerned, the nature and 
number of specialty care units at the health care facility concerned, 
demonstrated difficulties in recruitment and retention of nurse 
executives at the health care facility concerned, and such other factors 
as the Secretary considers appropriate.
    ``(4) Special pay paid to a nurse executive under paragraph (1) 
shall be in addition to any other pay (including basic pay) and 
allowances to which the nurse executive is entitled, and shall be 
considered pay for all purposes, including retirement benefits under 
chapters 83 and 84 of title 5, and other benefits, but shall

[[Page 118 STAT. 2646]]

not be considered basic pay for purposes of adverse actions under 
subchapter V of this chapter.''.

    Approved December 3, 2004.

LEGISLATIVE HISTORY--S. 2484:
---------------------------------------------------------------------------

SENATE REPORTS: No. 108-357 (Comm. on Veterans' Affairs).
CONGRESSIONAL RECORD, Vol. 150 (2004):
            Oct. 5, considered and passed Senate.
            Nov. 17, considered and passed House.

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