Department of Veterans Affairs Nurse Pay Act of 1990
PL 101-366 (H.R.1199), enacted 08/15/1990

104 STAT. 430 
PUBLIC LAW 101-366—AUG. 15, 1990 
Aug. 15, 1990 
[H.R. 1199] 
Department of 
Veterans Affairs 
Nurse Pay Act of 
1990. 
Government 
organization and 
employees. 
38 u s e 101 note. 
Public Law 101-366 
101st Congress 
An Act 
To amend title 38, United States Code, to establish a system of competitive pay for 
nurses employed by the Department of Veterans Affairs, to authorize the Secretary 
of Veterans Affairs to make such system applicable to certain other health-care 
personnel, to make certain improvements in veterans' health and education pro-
grams, 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. 
This Act may be cited as the 
Nurse Pay Act of 1990". 
'Department of Veterans Affairs 
TITLE 
I—PAY 
FOR 
NURSES 
AND 
OTHER 
HEALTH-CARE 
PERSONNEL 
38 u s e 4107 
note. 
SEC. 
1
0
1
. 
RESTRUCTURING 
OF 
NURSE 
GRADE 
LEVELS 
AND 
PAY. 
(a) NEW GRADES ESTABLISHED.—The Secretary of Veterans Affairs 
shall provide four grade levels for nurses employed by the Depart-
ment of Veterans Affairs under section 4104(1) of title 38, United 
States Code, with relation to current nurse grades, as follows: 
New grades 
Current nurse grades 
38 u s e 4107 
note. 
1. Entry grade 
Junior and associate grades 
2. Intermediate 
grade 
Full and intermediate grades 
3. Senior grade.... Senior and chief grades 
4. Director 
grade 
Assistant director and director grades. 
Qo) CURRENT NURSE GRADES DEFINED.—For purposes of subsection 
(a), the term "current nurse grades" means the grades in effect on 
the day before the effective date of this Act for nurses employed by 
the Department of Veterans Affairs under section 4104(1) of title 38, 
United States Code. 
(c) CONFORMING AMENDMENT.—Section 4107(b) of title 38, United 
States Code, is amended by striking out the items under the heading 
"NURSE SCHEDULE" and inserting in lieu thereof the following: 
"Entry grade. 
"Intermediate grade. 
"Senior grade. 
"Director grade.". 
SEC. 102. RATES OF PAY AND ADMINISTRATION OF PAY FOR NEW NURSE 
GRADES AND CERTAIN OTHER HEALTH-CARE PERSONNEL. 
(a) CLARIFICATION.—Section 4104(1) of title 38, United States Code, 
is amended by inserting "registered" before "nurses". 
PUBLIC LAW 101-366—AUG. 15, 1990 
104 STAT. 431 
(b) PAY ADMINISTRATION.—Chapter 73 of such title is amended by 
inserting after subchapter III the following new subchapter: 
"SUBCHAPTER IV—PAY FOR NURSES AND OTHER HEALTH-
CARE PERSONNEL 
"§4141. Nurses and other health-care personnel: competitive pay 
"(a)(1) It is the purpose of this section to ensure, by a means 
providing increased responsibility and authority to directors of 
Department health-care facilities, that the rates of basic pay for 
health-care personnel positions described in paragraph (2) in each 
Department health-care facility (including the rates of basic pay of 
personnel employed in such positions on a part-time basis) are 
sufficient for that facility to be competitive, on the basis of pay and 
other employee benefits, with non-Department health-care facilities 
in the same labor-market area in the recruitment and retention of 
qualified personnel for those positions. 
"(2) The health-care personnel positions referred to in paragraph 
(1) (hereinafter in this section referred to as 'covered positions') are 
the following: 
"(A) Registered nurse. 
"(B) Such positions referred to in clauses (1) and (3) of section 
4104 of this title (other than the positions of physician, dentist, 
and registered nurse) as the Secretary may determine upon the 
recommendation of the Chief Medical Director. 
"(3) The rates of basic pay for covered positions in the Department 
shall be established and adjusted in accordance with this section 
instead of subsection (b)(1) of section 4107 of this title. 
"(4) The Secretary, after receiving the recommendation of the 
Regulations. 
Chief Medical Director, shall prescribe regulations setting forth 
criteria and procedures to carry out this section and section 4142 of 
this title. Requirements in such regulations for directors to provide 
and maintain documentation of actions taken under this section 
shall require no more documentation than the minimum essential 
for responsible administration. 
"(b) The Secretary shall maintain the four grade levels for nurses 
employed by the Department under section 4104(1) of this title as 
specified in the Nurse Schedule in section 4107(b) of this title. The 
Secretary shall, pursuant to regulations prescribed to carry out this 
subchapter, establish grades for other covered positions as the Sec-
retary considers appropriate. 
"(c)(1) For each grade in a covered position, there shall be a range 
of basic pay. The maximum rate of basic pay for a grade shall be 133 
percent of the minimum rate of basic pay for the grade, except that, 
if the Secretary determines that a higher maximum rate is nec-
essary with respect to any such grade in order to recruit and retain 
a sufficient number of high-quality health-care personnel, the Sec-
retary may raise the maximum rate of basic pay for that grade to a 
rate not in excess of 175 percent of the minimum rate of basic pay 
for the grade. Whenever the Secretary exercises the authority under 
the preceding sentence to establish the maximum rate of basic pay 
at a rate in excess of 133 percent of the minimum rate for that 
grade, the Secretary shall, in the next annual report required by 
subsection (g), provide justification for doing so to the Committees 
on Veterans' Affairs of the Senate and House of Representatives. 
104 STAT. 432 
PUBLIC LAW 101-366—AUG. 15, 1990 
"(2) The maximum rate of basic pay for any grade for a covered 
position may not exceed the maximum rate of basic pay established 
for positions in level V of the Executive Schedule under section 5316 
of title 5. 
"(3) The range of basic pay for each such grade shall be divided 
into equal increments, known as 'steps'. The Secretary shall pre-
scribe the number of steps. Each grade in a covered position shall 
have the same number of steps. Rates of pay within a grade may not 
be established at rates other than whole steps. Any increase (other 
than an adjustment under subsection (d)) within a grade in the rate 
of basic pay payable to an employee in a covered position shall be by 
one or more of such step increments. 
"(d)(1) The rates of basic pay for each grade in a covered position 
shall be adjusted periodically in accordance with this subsection in 
order to achieve the purposes of this section. Such adjustments shall 
be made— 
"(A) whenever there is an adjustment under section 5305 of 
title 5 in the rates of pay under the General Schedule, with the 
adjustment under this subsection to have the same effective 
date as the adjustment in the rates of basic pay under the 
General Schedule; and 
"(B) at such additional times as the director of a Department 
health-care facility, with respect to employees in that grade at 
that facility, determines. 
"(2) An adjustment in rates of basic pay under this subsection for 
a grade shall be carried out by adjusting the amount of the mini-
mum rate of basic pay for that grade in accordance with paragraph 
(3) and then adjusting the other rates for that grade to conform to 
the requirements of subsection (c). Such an adjustment in the 
minimum rate of basic pay for a grade shall be made by the director 
of a Department health-care facility so as to achieve consistency 
with the beginning rate of compensation for corresponding health-
care professionals in the Bureau of Labor Statistics (BLS) labor-
market area of that facility. 
"(3)(A) In the case of a Department health-care facility located in 
an area for which there is current information, based upon an 
industry-wage survey by the Bureau of Labor Statistics for that 
labor market, on beginning rates of compensation for corresponding 
health-care professionals for the BLS labor-market area of that 
facility, the director of the facility concerned shall use that informa-
tion as the basis for making adjustments in rates of pay under this 
subsection. Whenever the Bureau of Labor Statistics releases the 
results of a new industry-wage survey for that labor market that 
includes information on beginning rates of compensation for cor-
responding health-care professionals, the director of that facility 
shall determine, not later than 30 days after the results of the 
survey are released, whether an adjustment in rates of pay for 
employees at that facility for any covered position is necessary in 
order to meet the purposes of this section. If the director determines 
that such an adjustment is necessary, the adjustment, based upon 
the information determined in the survey, shall take effect on the 
first day of the first pay period beginning after that determination. 
"(B) In the case of a Department health-care facility located in an 
area for which the Bureau of Labor Statistics does not have current 
information on beginning rates of compensation for corresponding 
health-care professionals for the labor-market area of that facility 
for any covered position, the director of that facility shall conduct a 
PUBLIC LAW 101-366—AUG. 15, 1990 
104 STAT. 433 
survey in accordance with this subparagraph and shall adjust the 
Eimount of the minimum rate of basic pay for grades in that covered 
position at that facility based upon that survey. Any such survey Regulations, 
shall be conducted in accordance with regulations prescribed by the 
Secretary. Those regulations shall be developed in consultation with 
the Secretary of Labor in order to ensure that the director of a 
facility collects information that is valid and reliable and is consist-
ent with standards of the Bureau. The survey should be conducted 
using methodology comparable to that used by the Bureau in 
making industry-wage surveys except to the extent determined 
infeasible by the Secretary. Upon conducting a survey under this 
subparagraph, the director concerned shall determine, not later 
than 30 days after the date on which the collection of information 
through the survey is completed, whether an adjustment in rates of 
pay for employees at that facility for any covered position is nec-
essary in order to meet the purposes of this section. If the director 
determines that such an adjustment is necessary, the adjustment, 
based upon the information determined in the survey, shall take 
effect on the first day of the first pay period beginning after that 
determination. 
"(C) The director of a facility may not adjust rates of basic pay 
under this subsection for any pay grade so that the minimum rate of 
basic pay for that grade is greater than the beginning rates of 
compensation for corresponding positions at 
non-Department 
health-care facilities. 
"(4) If the director of a Department health-care facility deter-
mines, after any survey under paragraph (3)(B) or at any other time 
that an adjustment in rates of pay is scheduled to take place under 
this subsection, that it is not necessary to adjust the rates of basic 
pay for employees in a grade of a covered position at that facility in 
order to carry out the purpose of this section, such an adjustment for 
employees at that facility in that grade shall not be made. When-
ever a director meikes such a determination, the director shall 
within 10 days notify the Chief Medical Director of the decision and 
the reasons for the decision. 
"(5) Information collected by the Department in surveys con-
ducted under this subsection is not subject to disclosure under 
section 552 of title 5, 
"(6) In this subsection— 
"(A) The term 'beginning rate of compensation', with respect 
to health-care personnel positions in non-Department health-
care facilities corresponding to a grade of a covered position, 
means the sum o
f
— 
"(i) the minimum rate of pay established for personnel in 
such positions who have education, training, and experi-
ence equivalent or similar to the education, training, and 
experience required for health-care personnel employed in 
the same category of Department covered positions; and 
"(ii) other employee benefits for those positions to the 
extent that those benefits are reasonably quantifiable. 
"(B) The term 'corresponding', with respect to health-care 
personnel positions in non-Department health-care facilities, 
means those positions for which the education, training, and 
experience requirements are equivalent or similar to the edu-
cation, training, and experience requirements for health-care 
personnel positions in Department health-care facilities. 
104 STAT. 434 
PUBLIC LAW 101-366—AUG. 15, 1990 
"(e) Adjustments in rates of basic pay under subsection (d) may 
increase or reduce the rates of basic pay applicable to any grade of a 
covered position. In the case of such an adjustment that reduces the 
rates of pay for a grade, an employee serving at a Department 
health-care facility on the day before the effective date of that 
adjustment in a position affected by the adjustment may not (by 
reason of that adjustment) incur a reduction in the rate of basic pay 
applicable to that employee so long as the employee continues to 
serve in that covered position at that facility. If such an employee is 
subsequently promoted to a higher grade, or advanced to a higher 
step within the employee's grade, for which the rate of pay as so 
adjusted is lower than the employee's rate of basic pay on the day 
before the effective date of the promotion, the employee shall con-
tinue to be paid at a rate of basic pay not less than the rate of basic 
pay applicable to the employee before the promotion so long as the 
employee continues to serve in that covered position at that facility. 
Reports. 
"(f) Not later than February 1 of 1991, 1992, and 1993, the 
Secretary shall submit to the Committees on Veterans' Affairs of 
the Senate and House of Representatives a report regarding any pay 
adjustments under the authority of subsection (d)(1)(A) effective 
during the 12 months preceding the submission of the report. Each 
such report shall set forth, by health-care facility, the percentage of 
such increases and, in any case in which no increase was made, the 
basis for not providing an increase. 
Reports. 
"(g) Not later than December 1 of 1991, 1992, and 1993, the 
Secretary shall submit to the Committees on Veterans' Affairs of 
the Senate and House of Representatives a report regarding the 
exercise of the authorities provided in this section for the preceding 
fiscal year. Each such report shall include the following: 
"(1) A review of the use of the authorities provided in this 
section (including the Secretary's and Chief Medical Director's 
actions, findings, recommendations, and other activities under 
this section) during the preceding fiscal year, including an 
assessment of the effects of the exercise of such authorities on 
the ability of the Department to recruit and retain qualified 
health-care professionals for covered positions. 
"(2) The plans for the use of the authorities provided in this 
subchapter for the next fiscal year. 
"(3) A description of the rates of basic pay in effect during the 
preceding fiscal year, with a comparison to the rates in effect 
during the previous fiscal year, shown by facility and by covered 
position. 
"(4) The numbers of employees in covered positions (shown 
separately for registered nurses and for each other covered 
position) who during the preceding fiscal year (A) left employ-
ment with the Department, (B) left employment at one Depart-
ment medical facility for employment at another Department 
medical facility, or (C) changed from full-time status to part-
time status (and from part-time status to full-time status), and a 
summary of the reasons therefor. 
"(5) The number of vacancies in covered positions in the 
Administration and a summary of the reasons that those posi-
tions are vacant. 
"(6) The number of employees who during the preceding fiscal 
year left employment at a health-care facility in one Bureau of 
Labor Statistics labor-market area for employment at a health-
PUBLIC LAW 101-366—AUG. 15, 1990 
104 STAT. 435 
care facility in another such labor-market area, without chang-
ing residence. 
"(7) Justification for setting the maximum rate of basic pay 
for any grade at a rate in excess of 133 percent of the minimum 
rate of basic pay for that grade. 
"(8) The discussion required by section 4142(b)(2) of this title. 
"(h) For the purposes of this section, the term 'health-care facility' 
means a medical center, an independent outpatient clinic, or an 
independent domiciliary facility. 
"§ 4142. Nurses and other health-care personnel: administration of 
pay 
"(a)(1) Regulations prescribed under section 4141(a) of this title 
shall provide that whenever an employee in a covered position is 
given a new duty assignment which is a promotion, the rate of bsisic 
pay of that employee shall be increased at least one step increment 
in that employee's grade. 
"(2) A nurse serving in a head nurse position shall while so 
serving receive basic pay at a rate two step increments above the 
rate that would otherwise be applicable to the nurse. If such a nurse 
is in the highest or next-to-highest step for that nurse's grade, the 
preceding sentence shall be applied by extrapolation to create addi-
tional steps only for the purposes of this paragraph. The limitation 
in section 4141(c)(1) of this title shall not apply with respect to 
increased basic pay under this paragraph. 
"(3) An employee in a covered position who is promoted to the 
next higher grade shall be appointed in that grade at a step having a 
rate of basic pay that is greater than the rate of basic pay applicable 
to the employee in a covered position on the day before the effective 
date of the promotion. 
"(b)(1) Under regulations which the Secretary prescribes for the 
administration of this section, the director of a Department health-
care facility (A) shall pay a cash bonus (in an amount to be deter-
mined by the director not to exceed $2,000) to an employee in a 
covered position at that facility who becomes certified in a specialty 
recognized by the Department, and (B) may provide such a bonus to 
an employee in such a position who has demonstrated both exem-
plary job performance and exemplary job achievement. The author-
ity of the Secretary under this subsection is in addition to any other 
authority of the Secretary to provide job performance incentives. 
"(2) The Secretary shall include in the annual report under 
section 4141(g) of this title a discussion of the use during the period 
covered by the report of the payment of bonuses under this subsec-
tion and other job performance incentives available to the Sec-
retary. 
"(c)(1) The Secretary shall provide (in regulations prescribed for 
the administration of this section) that the director of a Department 
health-care facility, in making a new appointment of a person under 
section 4104(1) of this title as an employee in a covered position for 
employment at that facility, may make that appointment at a rate 
of pay described in paragraph (3) without being subject to a require-
ment for prior approval at any higher level of authority within the 
Department in any case in which the director determines that it is 
necessary to do so in order to obtain the services of employees in 
covered positions in cases in which vacancies exist at that health-
care facility. 
104 STAT. 436 
PUBLIC LAW 101-366—AUG. 15, 1990 
"(2) Such a determination may be made by the director of a 
health-care facility only in order to recruit employees in covered 
positions with specialized skills, especially employees with skills 
which are especially difficult or demanding. 
"(3) A rate of pay referred to in paragraph (1) is a rate of basic pay 
in excess of the minimum rate of basic pay applicable to the grade in 
which the appointment is made (but not in excess of the maximum 
rate of basic pay for that grade). 
"(4) Whenever the director of a health-care facility makes an 
appointment described in paragraph (1) without prior approval at a 
higher level of authority within the Department, the director 
shall— 
"(A) state in a document the reasons for employing the 
employee in a covered position at a rate of pay in excess of the 
minimum rate of basic pay applicable to the grade in which the 
employee is appointed (and retain that document on file); and 
"(B) in the first budget documents submitted to the Secretary 
by the director after the employee is employed, include docu-
mentation for the need for such increased rates of basic pay 
described in clause (A). 
"(5) Whenever the director of a health-care facility makes an 
appointment described in paragraph (1) on the basis of a determina-
tion described in paragraph (2), the covered employee appointed may 
continue to receive pay at a rate higher than that which would 
otherwise be applicable to that employee only so long as the em-
ployee continues to serve in a position requiring the specialized 
skills with respect to which the determination was made. 
"(d) Whenever the director of a health-care facility makes an 
appointment described in subsection (c)(1), the director may (without 
a regard to any requirement for prior approval at any higher level 
of authority within the Department) increase the rate of pay of 
other employees in the same covered position at that facility who 
are in the grade in which the appointment is made and are serving 
in a position requiring the specialized skills with respect to which 
the determination under subsection (c)(2) concerning the appoint-
ment was made. Any such increase shall continue in effect with 
respect to any employee only so long as the employee continues to 
serve in such a position. 
"(e) An employee in a covered position employed under section 
4104(1) of this title who (without a break in employment) transfers 
from one Department health-care facility to another may not be 
reduced in grade or step within grade (except pursuant to a discipli-
nary action otherwise authorized by law) if the duties of the position 
to which the employee transfers are similar to the duties of the 
position from which the employee transferred. The rate of basic pay 
of such employee shall be established at the new health-care facility 
in a manner consistent with the practices at that facility for an 
employee of that grade and step. 
"(f) In this section, the term 'covered position' has the meaning 
given that term in section 4141 of this title.". 
(c) CONFORMING AMENDMENTS.—Section 4107(e)(1) of such title is 
amended by striking out "in subsection (bXl) of this section". 
(d) CLERICAL AMENDMENT.—The table of sections at the beginning 
of chapter 73 of such title is amended by inserting after the item 
relating to section 4134 the following: 
PUBLIC LAW 101-366—AUG. 15, 1990 
104 STAT. 437 
"SUBCHAPTEK IV—PAY FOR NURSES AND OTHER HEALTH-CARE PERSONNEL 
"4141. Nurses and other health-care personnel: competitive pay. 
"4142. Nurses and other health-care personnel: administration of pay.". 
^ 
SEC. 103. REPEAL OF LIMITATION ON HOURLY RATE OF OVERTIME PAY. 
Section 4107(eX5) of title 88, United States Code, is amended by 
striking out ", not to exceed" in the first sentence and all that 
follows through "Nurse Schedule". 
SEC. 104. EFFECTIVE DATE. 
38 USC 4141 
(a) IN GENERAL.—(1) Except as provided in subsection (b), section 
101 and the amendments made by section 102 shall take effect on 
the date of enactment. 
(2) The amendment made by section 103 shall take effect on April 
1,1991. 
(h) NEW PAY RATES.—The rates of basic pay established pursuant 
to section 4141 of title 38, United States Code, as added by section 
102, shall take effect for covered positions (as defined in that section) 
with respect to the first pay period beginning on or after April 1, 
1991. 
TITLE II—MISCELLANEOUS 
SEC. 201. PILOT PROGRAM ON PROVISION OF NONINSTITUTIONAL ALTER-
NATIVES TO NURSING HOME CARE. 
(a) AUTHORITY TO PROVIDE FOR NONINSTITUTIONAL CARE.—(1) Sub-
chapter II of chapter 17 of title 38, United States Code, is amended 
by adding at the end the following new section: 
"§620C. Noninstitutional alternatives to nursing home care: pilot 
program 
"(a) During the four-year period beginning on October 1, 1990, the 
Secretary may conduct a pilot program for the furnishing of medi-
cal, rehabilitative, and health-related services in noninstitutional 
settings for veterans who are eligible under this chapter for, and are 
in need of, nursing home care and who— 
"(1) are in receipt of, or are in need of, nursing home care 
primarily for the treatment of a service-connected disability; or 
"(2) have a service-connected disability rated at 50 percent or 
more. 
"O^XD Under the pilot program conducted pursuant to subsection 
(a), the Secretary shall (A) furnish appropriate health-related serv-
ices solely through contracts with appropriate public and private 
agencies that provide such services, and (B) designate Department 
health-care employees to furnish case management services to vet-
eran furnished services under the program. 
"(2) For the purposes of paragraph (1), the term 'case management 
services' includes the coordination and facilitation of all services 
furnished to a veteran by the Department of Veterans Affairs, 
either directly or through contract, including assessment of needs, 
planning, referral (including referral for services to be furnished by 
the Department, either directly or through a contract, or by an 
entity other than the Department), monitoring, reassessment, and 
followup. 
104 STAT. 438 
PUBLIC LAW 101-366—AUG. 15, 1990 
"(c) The Secretary may provide in-kind assistance (through the 
services of Department of Veterans Affairs employees and the shar-
ing of other Department resources) to a facility furnishing services 
to veterans under subsection (b)(1)(A). Any such in-kind assistance 
shall be provided under a contract between the Department and the 
facility concerned. The Secretary may provide such assistance only 
for use solely in the furnishing of appropriate services under this 
section and only if, under such contract, the Department receives 
reimbursement for the full cost of such assistance (including the cost 
of services and supplies and normal depreciation and amortization 
of equipment). Such reimbursement may be made by reduction in 
the charges to the United States or by payment to the United States. 
Any funds received through such reimbursement shall be credited to 
funds allotted to the Department facility that provided the assist-
ance. 
"(d) The total cost of providing services or in-kind assistance in the 
case of any veteran for any fiscal year under the pilot program may 
not exceed 65 percent of the cost that would have been incurred by 
the Department during that fiscal year if the veteran had been 
furnished, instead, nursing home care under section 610 of this title 
during that fiscal year. 
"(e) The authority of the Secretary to enter into contracts under 
this section shall be effective for any fiscal year only to the extent 
that appropriations are available.". 
(2) The table of sections at the beginning of chapter 17 of such title 
is amended by inserting after the item relating to section 620B the 
following new item: 
"620C. Noninstitutional alternatives to nursing home care: pilot program.". 
38 use 620C 
(b) REPORT.—Not later than February 1, 1994, the Secretary of 
^°^- 
Veterans Affairs shall submit to the Committees on Veterans' Af-
fairs of the Senate and House of Representatives a report setting 
forth the Secretary's evaluation, findings, and conclusions regarding 
the conduct, through September 30, 1993, of the pilot program 
required by section 620C of title 38, United States Code (as added by 
subsection (a)), and the results of the furnishing of care under such 
pilot program for the participating veterans. The report shall in-
clude a description of the conduct of the pilot program (including a 
description of the veterans furnished services and of the services 
furnished under the pilot program), and any plans for administra-
tive action, and any recommendations for legislation, that the 
Secretary considers appropriate to include in the report. 
SEC. 202. SHARING OF SPECIALIZED MEDICAL RESOURCES. 
(a) EXPANSION OF PURPOSE.—Section 5051 of title 38, United States 
Code, is amended by striking out "hospitals" both places it appears 
in the first sentence and inserting in lieu thereof "health-care 
facilities", 
(b) EXPANSION OF AUTHORITY.—Section 5053 of such title is 
amended— 
(1) in subsection (a)— 
(A) by striking out "hospitals" the first place it appears 
and all that follows through "community" and inserting in 
lieu thereof "health-care facilities and other health-care 
facilities (including organ banks, blood banks, or similar 
institutions), research centers, or medical schools"; and 
(B) by striking out the last sentence; and 
(2) in subsection (b)— 
PUBLIC LAW 101-366—AUG. 15, 1990 
104 STAT. 439 
(A) in the first sentence, by striking out "a charge" and 
all that follows and inserting in lieu thereof "a methodol-
ogy that provides appropriate flexibility to the heads of the 
facilities concerned to establish an appropriate reimburse-
ment rate after taking into account local conditions and 
needs and the actual costs to the providing facility of the 
resource involved."; and 
(B) in the second sentence, by inserting before the period 
"and to funds that have been allotted to the facility that 
furnished the resource involved". 
SEC. 203. TEMPORARY APPOINTMENTS OF HEALTH-CARE PERSONNEL. 
Section 4114(a)(3) of title 38, United States Code, is amended— 
(1) in subparagraph (A), by striking out the penultimate 
sentence and inserting in lieu thereof the following: "Tem-
porary full-time appointments of persons who have successfully 
completed a full course of nursing in a recognized school of 
nursing approved by the Secretary, or who have successfully 
completed a full course of training for any category of personnel 
described in paragraph (3) of section 4104 of this title in a 
recognized education or training institution approved by the 
Secretary, and who are pending registration or licensure in a 
State, or certification by a national board recognized by the 
Secretary, shall not exceed two years."; and 
(2) by striking out subparagraph (C) and inserting in lieu 
thereof the following: 
"(C) A student who has a temporary appointment under this 
paragraph and who is pursuing a full course of nursing in a recog-
nized school of nursing approved by the Secretary, or who is pursu-
ing a full course of training for any category of personnel described 
in paragraph (3) of section 4104 of this title in a recognized edu-
cation or training institution approved by the Secretary, may be 
reappointed for a period not to exceed the duration of the student's 
academic program.". 
SEC. 204. REPORT ON POST-TRAUMATIC STRESS DISORDER. 
Section 201(e)(1) of the Veterans' Benefits Amendments of 1989 
(Public Law 101-237; 103 Stat. 2066) is amended by inserting "and 
38 USC 612A 
not later than February 1, 1991," after "Not later than February 1, "o^e. 
1990,". 
SEC. 205. HEALTH PROFESSIONALS EDUCATIONAL ASSISTANCE PRO-
GRAMS. 
(a) COORDINATION WITH DEPARTMENT OF DEFENSE PROGRAMS.—(1) 
Chapter 76 of title 38, United States Code, is amended by adding at 
the end the following new subchapter: 
"SUBCHAPTER V—STIPEND PROGRAM FOR MEMBERS OF 
THE SELECTED RESERVE 
"§ 4351. Authority for program 
"(a) As part of the Educational Assistance Program, the Secretary 
of Veterans Affairs may select qualified individuals to receive assist-
ance under this subchapter. 
"(b) To be eligible to receive assistance under this subchapter, an 
individual must be accepted for enrollment or be enrolled as a full-
time student at a qualifying educational institution in a course of 
104 STAT. 440 
PUBLIC LAW 101-366—AUG. 15, 1990 
education or training that is approved by the Secretary and that 
leads toward completion of a degree in a health profession involving 
direct patient care or care incident to direct patient care. 
"§ 4352. Eligibility: individuals entitled to beneHts under the GI 
Bill program for members of the Selected Reserve 
"The Secretary of Veterans Affairs may not approve an applica-
tion under section 4303 of this title of an individual applying to 
receive assistance under this subchapter unless— 
"(1) the individual is entitled to benefits under chapter 106 of 
title 10; and 
"(2) the score of the individual on the Armed Forces Qualifica-
tion Test was above the 50th percentile. 
"§ 4353. Amount of assistance 
"The Secretary may pay to a person selected to receive assistance 
under this subchapter the amount of $400 (adjusted in accordance 
with section 4331 of this title) for each month of the person's 
enrollment in a program of education or training covered by the 
agreement of the person entered into under section 4303 of this title. 
Payment of such benefits for any period shall be coordinated with 
any payment of benefits for the same period under chapter 106 of 
title 10. 
"§ 4354. Obligated service 
"A person receiving assistance under this subchapter shall pro-
vide service in the full-time clinical practice of the person's profes-
sion as a full-time employee of the Department for the period of 
obligated service provided in the agreement of such person entered 
into under section 4303 of this title. 
"§ 4355. Breach of agreement; liability 
"(a)(1) Subject to paragraph (2), an individual who is receiving or 
has received a reserve member stipend under this subchapter and 
who fails to perform the service for which the individual is obligated 
under section 4354 of this title shall be liable to the United States in 
an amount determined in accordance with section 4317(c)(1) of this 
title. 
"(2) An individual who, as a result of performing active duty 
(including active duty for training), is unable to perform the service 
for which the individual is obligated under section 4354 of this title 
shall be permitted to perform that service upon completion of the 
active duty service (or active duty for training). The Secretary may, 
by regulation, waive the requirement for the performance of the 
service for which the individual is obligated under section 4354 of 
this title in any case in which the Secretary determines that the 
individual is unable to perform the service for reasons beyond the 
control of the individual or in any case in which the waiver would be 
in the best interest of the individual and the United States. 
"(b) Any amount owed the United States under subsection (a) of 
this section shall be paid to the United States during the one-year 
period beginning on the date of the breach of the agreement.". 
(2) The table of sections at the beginning of such chapter is 
amended by adding at the end the following new items: 
" S U B C H A P T E R V—STIPEND PROGRAM FOR MEMBERS OF THE SELECTED RESERVE 
"4351. Authority for program. 
PUBLIC LAW 101-366—AUG. 15, 1990 
104 STAT. 441 
"4352. Eligibility: individuals entitled to benefits under the GI Bill program for 
members of the Selected Rraerve. 
"4353. Amount of assist£ince. 
"4354. Obligated service. 
"4355. Breach of agreement; liability.". 
(b) PERIODIC ADJUSTMENTS IN AMOUNT OF ASSISTANCE.—Section 
4331 of such title is amended— 
(1) in the first sentence of subsection (a)(1)— 
(A) by striking out "amount and" and inserting in lieu 
thereof "amount,"; and 
(B) by striking out "amount." and inserting in lieu 
thereof "amount, and the maximum Selected Reserve 
member stipend amount."; 
(2) in subsection (b)— 
(A) by redesignating paragraph (3) as paragraph (4); and 
(B) by inserting after paragraph (2) the following new 
paragraph (3): 
"(3) The term 'maximum Selected Reserve member stipend 
amount' means the maximum amount of assistance provided to 
a person receiving assistance under subchapter V of this chap-
ter, £is specified in section 4353 of this title and as previously 
adjusted (if at all) in accordance with this subsection.". 
(c) CONFORMING AMENDMENTS.—(1) Section 4301(a) of such title is 
amended— 
(A) by striking out "and" at the end of paragraph (1); 
(B) by striking out the period at the end of paragraph (2) and 
inserting in lieu thereof "; and"; and 
(C) by adding at the end the following: 
"(3) the Selected Reserve member stipend program provided 
for under subchapter V of this chapter.". 
(2) Section 4302 of such title is amended by inserting "under 
subchapter I or II of this chapter" in subsections (a) and (b) after 
"Educational Assistance Program". 
(3) Section 4304 of such title is amended by striking out "sub-
chapter II or III" in paragraphs (IXA), (2)(D), and (5) and inserting in 
lieu thereof "subchapters II, III, or V". 
SEC. 206. ADMINISTRATION. 
(a) IN GENERAL.—Chapter 36 of title 38, United States Code, is 
amended by inserting after section 1784 the following new section: 
"§ 1784A. Procedures relating to computer matching program 
"(a)(1) Notwithstanding section 552a(p) of title 5 and subject to 
paragraph (2) of this subsection, the Secretary may suspend, termi-
nate, reduce, or make a final denied of any financial assistance or 
payment under an educational assistance program provided for in 
chapter 30 or 32 of this title or in chapter 106 of title 10 in the case 
of any individual, or take other adverse action against such individ-
ual, based on information produced by a matching program with the 
Department of Defense. 
"(2) The Secretary may not take any action referred to in 
paragraph (1) of this subsection until— 
"(A) the individual concerned has been provided a written 
notice containing a statement of the findings of the Secretary 
based on the matching program, a description of the proposed 
action, and notice of the individual's right to contest such 
findings within 10 days after the date of the notice; and 
104 STAT. 442 
PUBLIC LAW 101-366—AUG. 15, 1990 
"(B) the 10-day period referred to in subparagraph (A) of this 
paragraph has expired. 
"(3) In computing the 10-day period referred to in paragraph (2) of 
this subsection, Saturdays, Sundays, and Federal holidays shall be 
excluded. 
"(b) For the purposes of subsection (q) of section 552a of title 5, 
compliance with the provisions of subsection (a) of this section shall 
be considered compliance with the provisions of subsection (p) of 
such section 552a. 
"(c) For purposes of this section, the term 'matching program' has 
the same meaning provided in section 552a(a)(8) of title 5.". 
38 use 1434 
(b) RATIFICATION.—Any use by the Department of Veterans Af-
note. 
fairs, during the period beginning on July 2,1990, and ending on the 
date of the enactment of this Act, of any category of information 
provided by the Department of Defense or the Department of 
Transportation for making determinations described in section 
413(b) of the Veterans' Benefits Amendments of 1989 (Public Law 
38 use 1434 
101-237) is hereby ratified. 
^ 
(c) CLERICAL AMENDMENT.—The table of sections at the beginning 
of such chapter is amended by inserting after the item relating to 
section 1784 the following new item: 
"1784A. Procedures relating to computer matching programs.". 
5 u s e 552a note. 
(d) EFFECTIVE D A T E DELAYED FOR CERTAIN EDUCATION BENEFITS 
COMPUTER MATCHING PROGRAMS.—(1) In the case of computer 
matching programs between the Department of Veterans Affairs 
and the Department of Defense in the administration of education 
benefits programs under chapters 30 and 32 of title 38 and chapter 
106 of title 10, United States Code, the amendments made to section 
552a of title 5, United States Code, by the Computer Matching and 
Privacy Protection Act of 1988 (other than the amendments made by 
section lOOt)) of that Act) shall take effect on October 1, 1990. 
(2) For purposes of this subsection, the term "matching program" 
has the same meaning provided in section 552a(a)(8) of title 5, 
United States Code. 
38 u s e 1622 
SEC. 207. REFUNDS FOR CERTAIN SERVICE ACADEMY GRADUATES. 
^°^' 
(a) IN GENERAL.—Upon receipt before January 1, 1992, of an 
application from an individual described in subsection Ot))(3), the 
Secretary of Veterans Affairs shall— 
(1) not later than 60 days after receiving such application, 
refund to the individual concerned the amount, if any, of the 
individual's unused contributions to the VEAP Account; 
(2)(A) if the individual has received educational assistance 
under chapter 32 of title 38, United States Code, for the pursuit 
of a program of education, pay to the individual (out of funds 
appropriated to the readjustment benefits account) a sum equal 
to the amount by which the amount of the educational assist-
ance that the individual would have received under chapter 34 
of such title for the pursuit of such program exceeds the amount 
of the educational assistance that the individual did receive 
under such chapter 32 for the pursuit of such program; or 
(B) if the individual has not received educational assistance 
under such chapter 32, pay to the individual (out of funds 
appropriated to the Department of Veterans Affairs Readjust-
ment Benefits account) a sum equal to the amount of edu-
cational assistance that the individual would have received 
under chapter 34 of such title for the pursuit of a program of 
PUBLIC LAW 101-366—AUG. 15, 1990 
104 STAT. 443 
education if the individual had been entitled to assistance under 
such program during the period ending on December 31, 1989; 
and 
(3) refund to the Secretary of Defense the unused contribu-
tions by such Secretary to the VEAP Account on behalf of such 
individual. 
(b) DEFINITIONS.—For purposes of this section— 
(1) the term "VEAP Account" means the Post-Vietnam Era 
Veterans Education Account established pursuant to section 
1622(a) of title 38, United States Code; 
(2) the term "active duty" has the same meaning given such 
term by section 101(21) of such title 38; 
(3) the term "individual described in subsection (b)(3)" means 
an individual who— 
(A) before January 1, 1977, commenced the third aca-
demic year as a cadet or midshipman at one of the service 
academies or the third academic year as a member of the 
Senior Reserve Officers' Training Corps in a program of 
educational assistance under section 2104 or 2107 of title 10, 
United States Code; 
(B) served on active duty for a period of more than 180 
days pursuant to an appointment as a commissioned officer 
received upon graduation from one of the service academies 
or upon satisfactory completion of advanced training (as 
defined in section 2101 of such title 10) as a member of the 
Senior Reserve Officers' Training Corps; 
(C) after such period of active duty, was discharged or 
released therefrom under conditions other than dishonor-
able or continued to serve on active duty without a break in 
service; and 
(D) if enrolled under the program of educational assist-
ance provided under chapter 32 of title 38, United States 
Code, submits to the Secretary of Veterans Affairs, as part 
of the application made by the individual under subsection 
(a) in such form and manner as such Secretary shall pre-
scribe by January 1, 1991, an irrevocable election to be 
disenroUed from such program at that time; and 
(4) the term "service academies" means the United States 
Military Academy, the United States Naval Academy, the 
United States Air Force Academy, and the United States Coast 
Guard Academy. 
SEC. 208. LIMITATIONS ON CHANGES OF PROGRAMS OF EDUCATION. 
(a) IN GENERAL.—Section 1791(b) of title 38, United States Code, is 
amended by striking out "The" through "additional change" and 
inserting in lieu thereof "The Secretary, in accordance with proce-
dures that the Secretary may establish, may approve a change other 
than a change under subsection (a) of this section". 
(b) EFFECTIVE DATE.—The amendment made by subsection (a) 
shall take effect on June 1,1991. 
SEC. 209. NAMING OF DEPARTMENT OF VETERANS AFFAIRS MEDICAL 
CENTER IN SAGINAW, MICHIGAN. 
The Department of Veterans Affairs medical center in Saginaw, 
Michigan, shall after the date of the enactment of this Act be known 
and designated as the "Aleda E. Lutz Department of Veterans 
Affairs Medical Center". Any reference to such medical center in 
38 u s e 1791 
note. 
Public buildings 
and grounds. 
104 STAT. 444 
PUBLIC LAW 101-366—AUG. 15, 1990 
any law, regulation, map, document, record, or other paper of the 
United States shall after such date be deemed to be a reference to 
the Aleda E. Lutz Department of Veterans Affairs Medical Center. 
Approved August 15, 1990. 
LEGISLATIVE HISTORY—H.R. 1199: 
HOUSE REPORTS: No. 101-106 (Ck)mm. on Veterans' Affairs). 
CONGRESSIONAL RECORD: 
Vol. 135 (1989): June 27, considered and passed House. 
Vol. 136 (1990): Aug. 2, considered and passed Senate, amended. 
Aug. 3, House concurred in Senate amendments.