An Act to amend the Veterans' Administration Physician and Dentist Pay Comparability Act of 1975, as amended, in order to extend the authority to enter into special-pay agreements with physicians and dentists; to amend title 38 of the United States Code to modify certain provisions relating to special-pay agreements; and for other purposes.
PL 95-201 (H.R.8175), enacted 11/23/1977

PUBLIC LAW 95-201—NOV. 23, 1977 
91 STAT. 1429 
Public Law 95-201 
95th Congress 
An Act 
To amend the Veterans' Administration Physician and Dentist Pay Compara-
bility Act of 1975, as amended, in order to extend tlie autliority to enter into 
special-pay agreements with physicians and dentists; to amend title 38 of the 
United States Code to modify certain provisions relating to special-pay agree-
ments ; and for other purposes. 
Be it enacted hy the Senate and House of Representatives 
of the 
United States of America in Congress assembled^ That this Act may 
be cited as the "Veterans' Administration Physician and Dentist Pay 
Comparability Amendments of 1977". 
SEC. 2. Section 6(a) (2) of the Veterans* Administration Physician 
and Dentist Pay Comparability Act of 1975 (Public Law 94-123; 
89 Stat. 069), as amended, is amended by striking out "September 30, 
1977" and inserting in lieu thereof "September 30,1978". 
SEC. 3. (a) Section 4118 of title 38, United States Code, is amended 
by— 
(1) amending subsection (a) (1) by— 
(A) striking out "he" and inserting in lieu thereof "the 
Administrator"; 
(B) striking out "of," after "duration" and inserting in 
lieu thereof a comma and "of"; and 
(C) striking out "number of years" after "specified" and 
inserting in lieu thereof "period" ; 
(2) striking out in subsection (a) (3) "pursuant to" and 
inserting in lieu thereof "in accordance with", and inserting at the 
end thereof the following new sentence: "Not later than one 
year after making any such recruitment and retention deter-
mination and each year thereafter, the Chief Medical Director 
shall make a redetermination in accordance with such regula-
tions, and, in the event any such determination was made more 
than one year prior to the date of enactment of this sentence, 
the Chief Medical Director shall make such redetermination not 
later than ninety days after such enactment date."; 
(3) inserting at the end of subsection (e) (1) the following new 
sentences: "Any physician or dentist who entered into an 
agreement under this section and has not failed to refund any 
amount which such physician or dentist became obligated to 
refund under any such agreement shall be eligible to enter into 
a subsequent agreement under this section. Notwithstanding 
the provisions of the preceding two sentences, no agreement 
entered into under this section shall extend beyond September 30, 
1981, and any agreement entered into under this section after 
September 30, 1980, may be for a period of less than one year if 
the expiration date thereof is September 30, 1981."; and 
(4) amending subsection (e) (2) (A) by— 
(A) inserting a comma and "or such lesser period of 
service as provided for in the final sentence of paragraph 
(1) of this subsection." after "service"; and 
(B) striking out "the Chief Medical Director, pursuant 
to the regulations prescribed under this section, determines" 
and inserting in lieu thereof "the Chief Medical Director 
Nov. 23, 1977 
[H.R. 8175] 
Veterans' 
Administration 
Physician and 
Dentist Pay 
Comparability 
Amendments of 
1977. 
38 u s e 101 note. 
38 u s e 4118 
note. 
Redetermination. 
Eligibility. 
91 STAT. 1430 
PUBLIC LAW 95-201—NOV. 23, 1977 
Special-pay 
agreements, 
ree 
valuation. 
Report to 
Congress. 
38 use 4118 
note. 
Ante, p. 1429. 
2 u s e 351 et seq. 
Publication in 
Federal Register. 
38 u s e 4118 
note. 
English 
proficiency 
requirement. 
38 use 4105 
note. 
Supra. 
determines, 
in 
accordance 
with 
regulations 
prescribed 
under subsection (a) of this section,". 
(b) Prior to the execution after April 30, 1978, of any written 
agreement entered into with a physician or dentist under section 4118 
of title 38, United States Code (as amended by subsection (a) of 
this section), (1) the Chief Medical Director of the Veterans' 
Administration shall reevaluate, in view of the executive level pay 
increase made pursuant to section 225 of the Federal Salary Act of 
1967, ett'ective February 27, 1977, with respect to the Veterans' 
Administration, the need for special-pay agreements, as authorized 
in such section 4118, in order to recruit and retain highly qualified 
physicians or dentists in each category of positions in the Department 
of Medicine and Surgery, and report to Congress not later than 
April 30, 1978, on the results of such reevaluation with respect to 
each such category; and (2) notwithstanding such section 4118, 
the Administrator of Veterans' Affairs, upon the recommendation 
of the Chief Medical Director and based upon such reevaluations, 
may promulgate a regulation reducing the amount of primary special 
pay for any such category to the extent the Administrator finds such 
primary special pay is not necessary to recruit and retain highly 
qualified physicians or dentists in such category. If a determination 
is made to reduce the amount of such primary special pay for any 
such category, the regulation promulgating the reduction shall be 
published in the Federal Register not less than thirty days prior to 
its effective date. 
(c) The Administrator, not later than thirty days after the date of 
enactment of this Act, may enter into, under section 4118 of title 38, 
United States Code (as amended by subsection (a) of this section), 
with any otherwise eligible physician or dentist who was appointed to 
a position in the Department of Medicine and Surgery in the Veterans' 
Administration during the period beginning on October 1, 1977, and 
ending on the date of enactment of this Act, a special-pay agreement 
providing for the payment of special pay to such physician or dentist 
retroactive to the date such physician or dentist was appointed to such 
position. 
SEC. 4. (a)(1) Section 4105 of title 38. United States Code, is 
amended by inserting at the end thereof the following new subsection: 
"(c) Notwithstanding any other provision of law, no person may be 
appointed under section 4104(1) of this title after the effective date of 
this subsection to serve in the Department of Medicine and Surgery in 
any direct patient-care capacity unless the Chief Medical Director 
determines, in accordance with regulations w^hich the Administrator 
shall prescribe, that such person possesses such basic proficiency in 
spoken and written English as will permit such degree of communica-
tion with patients and other health-care personnel as will enable 
such person to carry out such person's health-care responsibilities 
satisfactorily.". 
(2) Section 4114 of title 38, LTnited States Code, is amended by 
inserting at the end thereof the following new subsection: 
"(f) No person may be appointed under this section after the 
effective date of this subsection to an occupational category described 
in section 4104(1) of this title or in subsection (b) of this section unless 
such person meets the requirements established in section 4105(c) of 
this title and regulations prescribed thereunder.". 
(3) Notwithstanding any other provision of law, with respect to 
persons other than those described in subsection (c) of section 4105 
and subsection (f) of section 4114 of title 38, United States Code (as 
added by paragraphs (1) and (2) of this subsection), who are 
PUBLIC LAW 95-201—NOV. 23, 1977 
91 STAT. 1431 
appointed after the date of enactment of this Act in the Department of 
Medicine and Surgery in the Veterans" Administration in any direct 
patient-care capacity, and with respect to persons described in such 
subsections who are appointed after such enactment date and prior 
to January 1,1978, the Administrator of Veterans' Affairs, upon the 
recommendation of the Chief Medical Director, shall take appropriate 
steps to provide reasonable assurance that such persons possess such 
basic proficiency in spoken and written English as will permit such 
degree of communication with patients and other health-care per-
sonnel as will enable such persons to carry out their health-care 
responsibilities satisfactorily. 
(4) The amendments made by paragraphs (1) and (2) of this 
subsection shall be effective on January 1, 1978. 
(b) Not later than April 1, 1978, the Administrator of Veterans' 
Affairs shall submit to the Committees on Veterans' Affairs of the 
House of Representatives and the Senate a report (1) describing activi-
ties undertaken and the persons affected in order to carry out sub-
section (c) of section 4105 and subsection (f) of section 4114 of title 
38, United States Code (as added by paragraphs (1) and (2) of sub-
section (a) of this section), and subsections (a)(3) and (c) of this 
section, and (2) providing— 
(A) a description of the extent to which there are persons 
employed by the Veterans' Administration, on or prior to the 
date of enactment of this Act, in any direct patient-care capacity 
in the Department of Medicine and Surgery, who do not possess 
such basic proficiency in spoken and written English as produces 
the degree of comnmnication with patients and other health-care 
personnel as is necessary to enable such persons to carry out their 
health-care responsibilities satisfactorily; 
(B) data describing the characteristics and categories of 
positions of any such persons; and 
(C) if, in the opinion of the Administrator, the description 
and data being provided pursuant to subclauses (A) and (B) 
of clause (2) of this subsection indicate that there is a problem 
with respect to the satisfactory performance of such health-care 
responsibilities arising from such lack of proficiency, a plan to 
promote the achievement of such proficiency as will enable the 
persons involved to carry out their health-care responsibilities 
satisfactorily as well as to deal with any need which the Admin-
istrator believes will exist to promote such proficiency on the part 
of persons appointed after such enactment date who the Admin-
istrator has reason to believe do not, in fact, possess such 
proficiency, including (i) the cost of implementing such plan in 
each of the succeeding five fiscal years, and (ii) the time periods 
in which such proficiency on the part of such persons (broken 
down by appropriate categories and characteristics) can be 
expected to be achieved. 
(c) Section 5001 of title 38, United States Code, is amended by 
inserting at the end thereof the following new subsection: 
"(h) When the Administrator determines, in accordance with regu-
lations which the Administrator shall prescribe, that a Veterans' 
Administration facility serves a substantial number of veterans with 
limited English-speaking ability, the Administrator shall establish 
and implement procedures, upon the recommendation of the Chief 
Medical Director, to ensure the identification of sufficient numbers 
of individuals on such facility's staff who are fluent in both the 
Effective date. 
38 use 4105 
note. 
Report to 
congressional 
committees. 
38 use 4105 
note. 
Ante, p. 1430. 
Dual language 
speaking staff 
members, 
identification. 
91 STAT. 1432 
PUBLIC LAW 95-201—NOV. 23, 1977 
Podiatrists and 
optometrists. 
Effective date. 
38 use 4107 
note. 
Employment 
conversion, 
effective date. 
38 use 4107 
note. 
language most appropriate to such veterans and in Englisli and whose 
responsibilities shall include providing guidance to such veterans and 
to appropriate Veterans' Administration staff members with respect 
to cultural sensitivities and bridging linguistic and cultural differ-
ences,". 
SEC. 5. (a) (1) The salary schedule under the heading "SKCTION 4103 
SCHEDULE" in section 4107 of title 38, United States Code, is amended 
by sti'iking out "$36,338 minimum to $46,026 maximum"' after "Direc-
tor of Podiatric Service,"" and inserting in lieu thereof "$39,629 
minimum to $50,197 maximum.". 
(2) The salary schedule under the heading "CLINICAL PODIATRIST 
AND OPTOMETRIST SCHEDULE"' in scctiou 4107 of title 38, United States 
Code, is amended to read as follows: 
"Chief grade, $33,789 minimuui to $43,923 nuiximum. 
"Senior grade. $28,725 minimum to $37,347 nuiximum. 
"Intermediate grade, $24,308 minimmn to $31,598 maximum. 
"Full grade, $20,442 minimum to $26,571 maximum. 
"Associate grade, $17,056 minimum to $22,177 maximujn.". 
(3) The amendments made by paragraphs (1) and (2) of this 
subsection shall be effective retroactive to the period beginning on 
October 21, 1976, and ending on October 8, 1977. Notwithstanding 
any other provision of hnv, the Administrator of Veterans' Affairs 
shall establish retroactively for such period intermediate rates of basic 
pay between the nunimum and maximum pay ranges prescribed in 
the salary schedule under the heading "SECTION 4IO3 SCHEDULE" for 
the Director of Podiatric Service and in the "CLINICAL PODIATRIST 
AND OPTOMETRIST SCHEDULE" in sectiou 4107 of title 38, United States 
Code. 
(b) Notwithstanding any other provision of law, each person 
employed in the Department of Medicine and Surgery in the 
Veterans' Administration as a podiatrist or optometrist shall be 
converted f I'om employment under part I I I of title 5, United States 
Code, to full-time employment under section 4104(1), or temporary 
full-time 
employment or part-time 
employment 
under 
section 
4114(a)(1) (A), "of title 38, United States "Code, and each such 
conversion (including application of the applicable rates of basic 
pay provided for in the amendments made by subsection (a) of this 
section) shall be effective retroactive to October 21, 1976, or the most 
recent date of appointment in the Department of Medicine and 
Surgery of the employee concerned under such part I I I , whichever 
is the later. 
Approved November 23, 1977. 
LEGISLATIVE HISTORY: 
HOUSE REPORT No. 95-585 (Comm. on Veterans'Affairs). 
eONGRESSIONAL REeORD, Vol 123 (1977): 
Sept. 12, considered and passed House. 
Nov. 3, considered in Senate. 
Nov. 4, considered and passed Senate, amended; House concurred in Senate 
amendments.