[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 1188 Reported in Senate (RS)]






                                                       Calendar No. 190
107th CONGRESS
  1st Session
                                S. 1188

                          [Report No. 107-80]

To amend title 38, United States Code, to enhance the authority of the 
 Secretary of Veterans Affairs to recruit and retain qualified nurses 
    for the Veterans Health Administration, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 17, 2001

Mr. Rockefeller (for himself, Mr. Cleland, and Mr. Specter) introduced 
the following bill; which was read twice and referred to the Committee 
                          on Veterans' Affairs

                            October 10, 2001

Reported by Mr. Rockefeller, with an amendment and an amendment to the 
                                 title
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
To amend title 38, United States Code, to enhance the authority of the 
 Secretary of Veterans Affairs to recruit and retain qualified nurses 
    for the Veterans Health Administration, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

<DELETED>SECTION 1. SHORT TITLE; TABLE OF CONTENTS.</DELETED>

<DELETED>    (a) Short Title.--This Act may be cited as the 
``Department of Veterans Affairs Nurse Recruitment and Retention 
Enhancement Act of 2001''.</DELETED>
<DELETED>    (b) Table of Contents.--The table of contents for this Act 
is as follows:</DELETED>

<DELETED>Sec. 1. Short title; table of contents.
<DELETED>Sec. 2. References to title 38, United States Code.
        <DELETED>TITLE I--ENHANCEMENT OF RECRUITMENT AUTHORITIES

<DELETED>Sec. 101. Enhancement of employee incentive scholarship 
                            program.
<DELETED>Sec. 102. Enhancement of education debt reduction program.
<DELETED>Sec. 103. Report on requests for waivers of pay reductions for 
                            reemployed annuitants to fill nurse 
                            positions.
        <DELETED>TITLE II--ENHANCEMENT OF RETENTION AUTHORITIES

<DELETED>Sec. 201. Additional pay for Saturday tours of duty for 
                            additional health care professional in the 
                            Veterans Health Administration.
<DELETED>Sec. 202. Unused sick leave included in annuity computation of 
                            registered nurses with the Veterans Health 
                            Administration.
<DELETED>Sec. 203. Evaluation of Department of Veterans Affairs nurse 
                            managed clinics.
<DELETED>Sec. 204. Staffing levels for operations of medical 
                            facilities.
<DELETED>Sec. 205. Annual report on use of authorities to enhance 
                            retention of experienced nurses.
<DELETED>Sec. 206. Report on mandatory overtime for nurses and nurse 
                            assistants in Department of Veterans 
                            Affairs facilities.
                   <DELETED>TITLE III--OTHER MATTERS

<DELETED>Sec. 301. Organizational responsibility of the Director of the 
                            Nursing Service.
<DELETED>Sec. 302. Computation of annuity for part-time service 
                            performed by certain health-care 
                            professionals before April 7, 1986.
<DELETED>Sec. 303. Modification of nurse locality pay authorities.
<DELETED>Sec. 304. Technical amendments.

<DELETED>SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.</DELETED>

<DELETED>    Except as otherwise expressly provided, whenever in this 
Act an amendment or repeal is expressed in terms of an amendment to, or 
repeal of, a section or other provision, the reference shall be 
considered to be made to a section or other provision of title 38, 
United States Code.</DELETED>

   <DELETED>TITLE I--ENHANCEMENT OF RECRUITMENT AUTHORITIES</DELETED>

<DELETED>SEC. 101. ENHANCEMENT OF EMPLOYEE INCENTIVE SCHOLARSHIP 
              PROGRAM.</DELETED>

<DELETED>    (a) Permanent Authority.--(1) Section 7676 is 
repealed.</DELETED>
<DELETED>    (2) The table of sections at the beginning of chapter 76 
is amended by striking the item relating to section 7676.</DELETED>
<DELETED>    (b) Minimum Period of Department Employment for 
Eligibility.--Section 7672(b) is amended by striking ``2 years'' and 
inserting ``one year''.</DELETED>
<DELETED>    (c) Scholarship Amount.--Subsection (b) of section 7673 is 
amended--</DELETED>
        <DELETED>    (1) in paragraph (1), by striking ``for any one 
        year'' and inserting ``for the equivalent of one year of full-
        time coursework''; and</DELETED>
        <DELETED>    (2) by striking paragraph (2) and inserting the 
        following new paragraph (2):</DELETED>
        <DELETED>    ``(2) in the case of a participant in the Program 
        who is a part-time student, shall bear the same ratio to the 
        amount that would be paid under paragraph (1) if the 
        participant were a full-time student in the course of education 
        or training being pursued by the participant as the coursework 
        carried by the student bears to full-time coursework in that 
        course of education or training.''.</DELETED>
<DELETED>    (d) Limitation on Payment.--Subsection (c) of section 7673 
is amended to read as follows:</DELETED>
<DELETED>    ``(c) Limitations on Period of Payment.--(1) The maximum 
number of school years for which a scholarship may be paid under 
subsection (a) to a participant in the Program shall be six school 
years.</DELETED>
<DELETED>    ``(2) A participant in the Program may not receive a 
scholarship under subsection (a) for more than the equivalent of three 
years of full-time coursework.''.</DELETED>
<DELETED>    (e) Full-Time Coursework.--Section 7673 is further amended 
by adding at the end the following new subsection:</DELETED>
<DELETED>    ``(e) Full-Time Coursework.--For purposes of this section, 
full-time coursework shall consist of the following:</DELETED>
        <DELETED>    ``(1) In the case of undergraduate coursework, 30 
        semester hours per undergraduate school year.</DELETED>
        <DELETED>    ``(2) In the case of graduate coursework, 18 
        semester hours per graduate school year.''.</DELETED>
<DELETED>    (f) Annual Adjustment of Maximum Scholarship Amount.--
Section 7631 is amended--</DELETED>
        <DELETED>    (1) in subsection (a)(1), by striking ``and the 
        maximum Selected Reserve member stipend amount'' and inserting 
        ``the maximum Selected Reserve member stipend amount, the 
        maximum employee incentive scholarship amount,''; and</DELETED>
        <DELETED>    (2) in subsection (b)--</DELETED>
                <DELETED>    (A) by redesignating paragraph (4) as 
                paragraph (6); and</DELETED>
                <DELETED>    (B) by inserting after paragraph (3) the 
                following new paragraph (4):</DELETED>
        <DELETED>    ``(4) The term `maximum employee incentive 
        scholarship amount' means the maximum amount of the scholarship 
        payable to a participant in the Department of Veterans Affairs 
        Employee Incentive Scholarship Program under subchapter VI of 
        this chapter, as specified in section 7673(b)(1) of this title 
        and as previously adjusted (if at all) in accordance with this 
        section.''.</DELETED>

<DELETED>SEC. 102. ENHANCEMENT OF EDUCATION DEBT REDUCTION 
              PROGRAM.</DELETED>

<DELETED>    (a) Permanent Authority.--(1) Section 7684 is 
repealed.</DELETED>
<DELETED>    (2) The table of sections at the beginning of chapter 76 
is amended by striking the item relating to section 7684.</DELETED>
<DELETED>    (b) Eligible Individuals.--Subsection (a)(1) of section 
7682 is amended--</DELETED>
        <DELETED>    (1) by striking ``under an appointment under 
        section 7402(b) of this title in a position'' and inserting 
        ``in a position (as determined by the Secretary) providing 
        direct-patient care services or services incident to direct-
        patient care services''; and</DELETED>
        <DELETED>    (2) by striking ``(as determined by the 
        Secretary)'' and inserting ``(as so determined)''.</DELETED>
<DELETED>    (c) Maximum Debt Reduction Amount.--Section 7683(d)(1) is 
amended--</DELETED>
        <DELETED>    (1) by striking ``for a year''; and</DELETED>
        <DELETED>    (2) by striking ``exceed--'' and all that follows 
        through the end of the paragraph and inserting ``exceed $44,000 
        over a total of five years of participation in the Program, of 
        which not more than $10,000 of such payments may be made in 
        each of the fourth and fifth years of participation in the 
        Program.''.</DELETED>
<DELETED>    (d) Annual Adjustment of Maximum Debt Reduction Payments 
Amount.--(1) Section 7631, as amended by section 101(f) of this Act, is 
further amended--</DELETED>
        <DELETED>    (A) in subsection (a)(1), by inserting before the 
        period at the end of the first sentence the following: ``and 
        the maximum education debt reduction payments amount''; 
        and</DELETED>
        <DELETED>    (B) in subsection (b), by inserting after 
        paragraph (4) the following new paragraph (5):</DELETED>
        <DELETED>    ``(5) The term `maximum education debt reduction 
        payments amount' means the maximum amount of education debt 
        reduction payments payable to a participant in the Department 
        of Veterans Affairs Education Debt Reduction Program under 
        subchapter VII of this chapter, as specified in section 
        7683(d)(1) of this title and as previously adjusted (if at all) 
        in accordance with this section.''.</DELETED>
<DELETED>    (2) Notwithstanding section 7631(a)(1) of title 38, United 
States Code, as amended by paragraph (1), the Secretary of Veterans 
Affairs shall not increase the maximum education debt reduction 
payments amount under that section in calendar year 2002.</DELETED>
<DELETED>    (e) Temporary Expansion of Individuals Eligible for 
Participation in Program.--(1) Notwithstanding section 7682(c) of title 
38, United States Code, the Secretary of Veterans Affairs may treat a 
covered individual as being a recently appointed employee in the 
Veterans Health Administration under section 7682(a) of that title for 
purposes of eligibility in the Education Debt Reduction Program if the 
Secretary determines that the participation of the individual in the 
Program under this subsection would further the purposes of the 
Program.</DELETED>
<DELETED>    (2) For purposes of this subsection, a covered individual 
is any individual otherwise described by section 7682(a) of title 38, 
United States Code, as in effect on the day before the date of the 
enactment of this Act, who--</DELETED>
        <DELETED>    (A) was appointed as an employee in a position 
        described in paragraph (1) of that section, as so in effect, 
        between January 1, 1999, and September 30, 2000; and</DELETED>
        <DELETED>    (B) is an employee in such position, or in another 
        position described in paragraph (1) of that section, as so in 
        effect, at the time of application for treatment as a covered 
        individual under this subsection.</DELETED>
<DELETED>    (3) The Secretary shall make determinations regarding the 
exercise of the authority in this subsection on a case-by-case 
basis.</DELETED>
<DELETED>    (4) The Secretary may not exercise the authority in this 
subsection after December 31, 2001. The expiration of the authority in 
this subsection shall not affect the treatment of an individual under 
this subsection before that date as a covered individual for purposes 
of eligibility in the Education Debt Reduction Program.</DELETED>
<DELETED>    (5) In this subsection, the term ``Education Debt 
Reduction Program'' means the Department of Veterans Affairs Education 
Debt Reduction Program under subchapter VII of chapter 76 of title 38, 
United States Code.</DELETED>

<DELETED>SEC. 103. REPORT ON REQUESTS FOR WAIVERS OF PAY REDUCTIONS FOR 
              REEMPLOYED ANNUITANTS TO FILL NURSE POSITIONS.</DELETED>

<DELETED>    (a) Report.--Not later than November 30 of each of 2001 
and 2002, the Secretary of Veterans Affairs shall submit to the 
Committees on Veterans' Affairs of the Senate and the House of 
Representatives a report describing each request of the Secretary, 
during the fiscal year preceding such report, to the Director of the 
Office of Personnel Management for the following:</DELETED>
        <DELETED>    (1) A waiver under subsection (i)(1)(A) of section 
        8344 of title 5, United States Code, of the provisions of such 
        section in order to meet requirements of the Department of 
        Veterans Affairs for appointments to nurse positions in the 
        Veterans Health Administration.</DELETED>
        <DELETED>    (2) A waiver under subsection (f)(1)(A) of section 
        8468 of title 5, United States Code, of the provisions of such 
        section in order to meet requirements of the Department for 
        appointments to such positions.</DELETED>
        <DELETED>    (3) A grant of authority under subsection 
        (i)(1)(B) of section 8344 of title 5, United States Code, for 
        the waiver of the provisions of such section in order to meet 
        requirements of the Department for appointments to such 
        positions.</DELETED>
        <DELETED>    (4) A grant of authority under subsection 
        (f)(1)(B) of section 8468 of title 5, United States Code, for 
        the waiver of the provisions of such section in order to meet 
        requirements of the Department for appointments to such 
        positions.</DELETED>
<DELETED>    (b) Information on Responses to Requests.--The report 
under subsection (a) shall specify for each request covered by the 
report--</DELETED>
        <DELETED>    (1) the response of the Director to such request; 
        and</DELETED>
        <DELETED>    (2) if such request was granted, whether or not 
        the waiver or authority, as the case may be, assisted the 
        Secretary in meeting requirements of the Department for 
        appointments to nurse positions in the Veterans Health 
        Administration.</DELETED>

   <DELETED>TITLE II--ENHANCEMENT OF RETENTION AUTHORITIES</DELETED>

<DELETED>SEC. 201. ADDITIONAL PAY FOR SATURDAY TOURS OF DUTY FOR 
              ADDITIONAL HEALTH CARE PROFESSIONAL IN THE VETERANS 
              HEALTH ADMINISTRATION.</DELETED>

<DELETED>    (a) In General.--Section 7454(b) is amended--</DELETED>
        <DELETED>    (1) by inserting ``(1)'' after ``(b)''; 
        and</DELETED>
        <DELETED>    (2) by adding at the end the following new 
        paragraph:</DELETED>
<DELETED>    ``(2) Health care professionals employed in positions 
referred to in paragraph (1) shall be entitled to additional pay on the 
same basis as provided for nurses in section 7453(c) of this 
title.''.</DELETED>
<DELETED>    (b) Applicability.--The amendments made by subsection (a) 
shall take effect on the date of the enactment of this Act, and shall 
apply with respect to pay periods beginning on or after that 
date.</DELETED>

<DELETED>SEC. 202. UNUSED SICK LEAVE INCLUDED IN ANNUITY COMPUTATION OF 
              REGISTERED NURSES WITH THE VETERANS HEALTH 
              ADMINISTRATION.</DELETED>

<DELETED>    (a) Annuity Computation.--Section 8415 of title 5, United 
States Code, is amended by adding at the end the following:</DELETED>
<DELETED>    ``(i) In computing an annuity under this subchapter, the 
total service of an employee who retires from the position of a 
registered nurse with the Veterans Health Administration on an 
immediate annuity, or dies while employed in that position leaving any 
survivor entitled to an annuity, includes the days of unused sick leave 
to the credit of that employee under a formal leave system, except that 
such days shall not be counted in determining average pay or annuity 
eligibility under this subchapter.''.</DELETED>
<DELETED>    (b) Deposit Not Required.--Section 8422(d) of title 5, 
United States Code, is amended--</DELETED>
        <DELETED>    (1) by inserting ``(1)'' before ``Under such 
        regulations''; and</DELETED>
        <DELETED>    (2) by adding at the end the following:</DELETED>
<DELETED>    ``(2) Deposit may not be required for days of unused sick 
leave credited under section 8415(i).''.</DELETED>
<DELETED>    (c) Effective Date.--The amendments made by this section 
shall take effect 60 days after the date of the enactment of this Act, 
and shall apply to individuals who separate from service on or after 
that effective date.</DELETED>

<DELETED>SEC. 203. EVALUATION OF DEPARTMENT OF VETERANS AFFAIRS NURSE 
              MANAGED CLINICS.</DELETED>

<DELETED>    (a) Evaluation.--The Secretary of Veterans Affairs shall 
carry out an evaluation of the efficacy of the nurse managed health 
care clinics of the Department of Veterans Affairs. The Secretary shall 
complete the evaluation not later than 18 months after the date of the 
enactment of this Act.</DELETED>
<DELETED>    (b) Clinics To Be Evaluated.--(1) In carrying out the 
evaluation under subsection (a), the Secretary consider nurse managed 
health care clinics, including primary care clinics and geriatric care 
clinics, located in three different Veterans Integrated Service 
Networks (VISNs) of the Department.</DELETED>
<DELETED>    (2) If there are not nurse managed health care clinics 
located in three different Veterans Integrated Service Networks as of 
the commencement of the evaluation, the Secretary shall--</DELETED>
        <DELETED>    (A) establish nurse managed health care clinics in 
        additional Veterans Integrated Services Networks such that 
        there are nurse managed health care clinics in three different 
        Veterans Integrated Service Networks for purposes of the 
        evaluation; and</DELETED>
        <DELETED>    (B) include such clinics, as so established, in 
        the evaluation.</DELETED>
<DELETED>    (c) Matters To Be Evaluated.--In carrying out the 
evaluation under subsection (a), the Secretary shall address the 
following:</DELETED>
        <DELETED>    (1) Patient satisfaction.</DELETED>
        <DELETED>    (2) Provider experiences.</DELETED>
        <DELETED>    (3) Cost of care.</DELETED>
        <DELETED>    (4) Access to care, including waiting time for 
        care.</DELETED>
        <DELETED>    (5) The functional status of patients receiving 
        care.</DELETED>
        <DELETED>    (6) Any other matters the Secretary considers 
        appropriate.</DELETED>
<DELETED>    (d) Report.--Not later than 18 months after the date of 
the enactment of this Act, the Secretary shall submit to the Committees 
on Veterans' Affairs of the Senate and the House of Representatives a 
report on the evaluation carried out under subsection (a). The report 
shall address the matters specified in subsection (c) and include any 
other information, and any recommendations, that the Secretary 
considers appropriate.</DELETED>

<DELETED>SEC. 204. STAFFING LEVELS FOR OPERATIONS OF MEDICAL 
              FACILITIES.</DELETED>

<DELETED>    (a) In General.--Section 8110(a) is amended--</DELETED>
        <DELETED>    (1) in paragraph (1), by inserting after 
        ``complete care of patients,'' in the fifth sentence the 
        following: ``and in a manner consistent with the policies of 
        the Secretary on overtime,''; and</DELETED>
        <DELETED>    (2) in paragraph (2)--</DELETED>
                <DELETED>    (A) by inserting ``, including the 
                staffing required to maintain such capacities,'' after 
                ``all Department medical facilities'';</DELETED>
                <DELETED>    (B) by striking ``and to minimize'' and 
                inserting ``, to minimize''; and</DELETED>
                <DELETED>    (C) by inserting before the period the 
                following: ``, and to ensure that eligible veterans are 
                provided such care and services in an appropriate 
                manner''.</DELETED>
<DELETED>    (b) Nationwide Policy on Staffing.--Paragraph (3) of that 
section is amended--</DELETED>
        <DELETED>    (1) in subparagraph (A), by inserting ``the 
        adequacy of staff levels for compliance with the policy 
        established under subparagraph (C),'' after ``regarding''; 
        and</DELETED>
        <DELETED>    (2) by inserting after subparagraph (B) the 
        following new subparagraph:</DELETED>
<DELETED>    ``(C) The Secretary shall, in consultation with the Under 
Secretary for Health, establish a nationwide policy on the staffing of 
Department medical facilities in order to ensure that such facilities 
have adequate staff for the provision to veterans of appropriate, high-
quality care and services. The policy shall take into account the 
staffing levels and mixture of staff skills required for the range of 
care and services provided veterans in Department 
facilities.''.</DELETED>

<DELETED>SEC. 205. ANNUAL REPORT ON USE OF AUTHORITIES TO ENHANCE 
              RETENTION OF EXPERIENCED NURSES.</DELETED>

<DELETED>    (a) Annual Report.--(1) Subchapter II of chapter 73 is 
amended by adding at the end the following new section:</DELETED>
<DELETED>``Sec. 7324. Annual report on use of authorities to enhance 
              retention of experienced nurses</DELETED>
<DELETED>    ``(a) Annual Report.--Not later than January 31 each year, 
the Secretary, acting through the Under Secretary for Health, shall 
submit to Congress a report on the use during the preceding year of 
authorities for purposes of retaining experienced nurses in the 
Veterans Health Administration, as follows:</DELETED>
        <DELETED>    ``(1) The authorities under chapter 76 of this 
        title.</DELETED>
        <DELETED>    ``(2) The authority under VA Directive 5102.1, 
        relating to the Department of Veterans Affairs nurse 
        qualification standard, dated November 10, 1999, or any 
        successor directive.</DELETED>
        <DELETED>    ``(3) Any other authorities available to the 
        Secretary for those purposes.</DELETED>
<DELETED>    ``(b) Report Elements.--Each report under subsection (a) 
shall specify for the period covered by such report, for each 
Department medical facility and for each Veterans Integrated Service 
Network, the following:</DELETED>
        <DELETED>    ``(1) The number of waivers requested under the 
        authority referred to in subsection (a)(2), and the number of 
        waivers granted under that authority, to promote to the Nurse 
        II grade or Nurse III grade under the Nurse Schedule under 
        section 7404(b)(1) of this title any nurse who has not 
        completed a bachelors of science in nursing in a recognized 
        school of nursing, set forth by age, race, and years of 
        experience of the individuals subject to such waiver requests 
        and waivers, as the case may be.</DELETED>
        <DELETED>    ``(2) The programs carried out to facilitate the 
        use of nursing education programs by experienced nurses, 
        including programs for flexible scheduling, scholarships, 
        salary replacement pay, and on-site classes.''.</DELETED>
<DELETED>    (2) The table of sections at the beginning of chapter 73 
is amended by inserting after the item relating to section 7323 the 
following new item:</DELETED>

<DELETED>``7324. Annual report on use of authorities to enhance 
                            retention of experienced nurses.''.
<DELETED>    (b) Initial Report.--The initial report required under 
section 7324 of title 38, United States Code, as added by subsection 
(a), shall be submitted in 2002.</DELETED>

<DELETED>SEC. 206. REPORT ON MANDATORY OVERTIME FOR NURSES AND NURSE 
              ASSISTANTS IN DEPARTMENT OF VETERANS AFFAIRS 
              FACILITIES.</DELETED>

<DELETED>    (a) Report.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall submit 
to the Committees on Veterans' Affairs of the Senate and the House of 
Representatives a report on the mandatory overtime required of licensed 
nurses and nurse assistants providing direct patient care at Department 
of Veterans Affairs medical facilities during 2001.</DELETED>
<DELETED>    (b) Mandatory Overtime.--For purposes of the report under 
subsection (a), mandatory overtime shall consist of any period in which 
a nurse or nurse assistant is mandated or otherwise required, whether 
directly or indirectly, to work or be in on-duty status in excess of--
</DELETED>
        <DELETED>    (1) a scheduled workshift or duty 
        period;</DELETED>
        <DELETED>    (2) 12 hours in any 24-hour period; or</DELETED>
        <DELETED>    (3) 80 hours in any period of 14 consecutive 
        days.</DELETED>
<DELETED>    (c) Elements.--The report under subsection (a) shall 
include the following:</DELETED>
        <DELETED>    (1) A description of the amount of mandatory 
        overtime described in that subsection at each Department 
        medical facility during the period covered by the 
        report.</DELETED>
        <DELETED>    (2) A description of the mechanisms employed by 
        the Secretary to monitor overtime of the nurses and nurse 
        assistants referred to in that subsection.</DELETED>
        <DELETED>    (3) An assessment of the effects of the mandatory 
        overtime of such nurses and nurse assistants on patient care, 
        including its contribution to medical errors.</DELETED>
        <DELETED>    (4) Recommendations regarding mechanisms for 
        preventing requirements for amounts of mandatory overtime in 
        other than emergency situations by such nurses and nurse 
        assistants.</DELETED>
        <DELETED>    (5) Any other matters that the Secretary considers 
        appropriate.</DELETED>

              <DELETED>TITLE III--OTHER MATTERS</DELETED>

<DELETED>SEC. 301. ORGANIZATIONAL RESPONSIBILITY OF THE DIRECTOR OF THE 
              NURSING SERVICE.</DELETED>

<DELETED>    Section 7306(a)(5) is amended by inserting ``, and report 
directly to,'' after ``responsible to''.</DELETED>

<DELETED>SEC. 302. COMPUTATION OF ANNUITY FOR PART-TIME SERVICE 
              PERFORMED BY CERTAIN HEALTH-CARE PROFESSIONALS BEFORE 
              APRIL 7, 1986.</DELETED>

<DELETED>    Section 7426 is amended--</DELETED>
        <DELETED>    (1) by redesignating subsection (c) as subsection 
        (d); and</DELETED>
        <DELETED>    (2) by inserting after subsection (b) the 
        following new subsection (c):</DELETED>
<DELETED>    ``(c) The provisions of subsection (b) shall not apply to 
the part-time service before April 7, 1986, of a registered nurse, 
physician assistant, or expanded-function dental auxiliary. In 
computing the annuity under the applicable provision of law specified 
in that subsection of an individual covered by the preceding sentence, 
the service described in that sentence shall be credited as full-time 
service.''.</DELETED>

<DELETED>SEC. 303. MODIFICATION OF NURSE LOCALITY PAY 
              AUTHORITIES.</DELETED>

<DELETED>    Section 7451 is amended--</DELETED>
        <DELETED>    (1) in subsection (d)(3)--</DELETED>
                <DELETED>    (A) in subparagraph (A), by striking 
                ``beginning rates of'' each time it appears;</DELETED>
                <DELETED>    (B) in subparagraph (B), by striking 
                ``beginning rates of''; and</DELETED>
                <DELETED>    (C) in subparagraph (C)(i), by striking 
                ``beginning rates of'' each time it appears;</DELETED>
        <DELETED>    (2) in subsection (d)(4)--</DELETED>
                <DELETED>    (A) by striking ``or at any other time 
                that an adjustment in rates of pay is scheduled to take 
                place under this subsection'' in the first sentence; 
                and</DELETED>
                <DELETED>    (B) by striking the second sentence; 
                and</DELETED>
        <DELETED>    (3) in subsection (e)(4)--</DELETED>
                <DELETED>    (A) in subparagraph (A), by striking 
                ``grade in a'';</DELETED>
                <DELETED>    (B) in subparagraph (B)--</DELETED>
                        <DELETED>    (i) by striking ``grade of a''; 
                        and</DELETED>
                        <DELETED>    (ii) by striking ``that grade'' 
                        and inserting ``that position''; and</DELETED>
                <DELETED>    (C) in subparagraph (D), by striking 
                ``grade of a''.</DELETED>

<DELETED>SEC. 304. TECHNICAL AMENDMENTS.</DELETED>

<DELETED>    Section 7631(b) is amended by striking ``this subsection'' 
each place it appears and inserting ``this section''.</DELETED>

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Department of 
Veterans Affairs Medical Programs Enhancement Act of 2001''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. References to title 38, United States Code.

  TITLE I--ENHANCEMENT OF NURSE RECRUITMENT AND RETENTION AUTHORITIES

Sec. 101. Short title.

                  Subtitle A--Recruitment Authorities

Sec. 111. Enhancement of employee incentive scholarship program.
Sec. 112. Enhancement of education debt reduction program.
Sec. 113. Report on requests for waivers of pay reductions for 
                            reemployed annuitants to fill nurse 
                            positions.

                   Subtitle B--Retention Authorities

Sec. 121. Additional pay for Saturday tours of duty for additional 
                            health care professional in the Veterans 
                            Health Administration.
Sec. 122. Unused sick leave included in annuity computation of 
                            registered nurses with the Veterans Health 
                            Administration.
Sec. 123. Evaluation of Department of Veterans Affairs nurse managed 
                            clinics.
Sec. 124. Staffing levels for operations of medical facilities.
Sec. 125. Annual report on use of authorities to enhance retention of 
                            experienced nurses.
Sec. 126. Report on mandatory overtime for nurses and nurse assistants 
                            in Department of Veterans Affairs 
                            facilities.

                     Subtitle C--Other Authorities

Sec. 131. Organizational responsibility of the Director of the Nursing 
                            Service.
Sec. 132. Computation of annuity for part-time service performed by 
                            certain health-care professionals before 
                            April 7, 1986.
Sec. 133. Modification of nurse locality pay authorities.

                        TITLE II--OTHER MATTERS

Sec. 201. Modification and enhancement of authority to provide dog-
                            guides and service dogs to veterans with 
                            disabilities.
Sec. 202. Additional basis for establishment of inability to defray 
                            expenses of necessary care.
Sec. 203. Funds for field offices of the Office of Research Compliance 
                            and Assurance.
Sec. 204. Technical amendments.

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

    Except as otherwise expressly provided, whenever in this Act an 
amendment or repeal is expressed in terms of an amendment to, or repeal 
of, a section or other provision, the reference shall be considered to 
be made to a section or other provision of title 38, United States 
Code.

  TITLE I--ENHANCEMENT OF NURSE RECRUITMENT AND RETENTION AUTHORITIES

SEC. 101. SHORT TITLE.

    This title may be cited as the ``Department of Veterans Affairs 
Nurse Recruitment and Retention Enhancement Act of 2001''.

                  Subtitle A--Recruitment Authorities

SEC. 111. ENHANCEMENT OF EMPLOYEE INCENTIVE SCHOLARSHIP PROGRAM.

    (a) Permanent Authority.--(1) Section 7676 is repealed.
    (2) The table of sections at the beginning of chapter 76 is amended 
by striking the item relating to section 7676.
    (b) Minimum Period of Department Employment for Eligibility.--
Section 7672(b) is amended by striking ``2 years'' and inserting ``one 
year''.
    (c) Scholarship Amount.--Subsection (b) of section 7673 is 
amended--
            (1) in paragraph (1), by striking ``for any one year'' and 
        inserting ``for the equivalent of one year of full-time 
        coursework''; and
            (2) by striking paragraph (2) and inserting the following 
        new paragraph (2):
            ``(2) in the case of a participant in the Program who is a 
        part-time student, shall bear the same ratio to the amount that 
        would be paid under paragraph (1) if the participant were a 
        full-time student in the course of education or training being 
        pursued by the participant as the coursework carried by the 
        student bears to full-time coursework in that course of 
        education or training.''.
    (d) Limitation on Payment.--Subsection (c) of section 7673 is 
amended to read as follows:
    ``(c) Limitations on Period of Payment.--(1) The maximum number of 
school years for which a scholarship may be paid under subsection (a) 
to a participant in the Program shall be six school years.
    ``(2) A participant in the Program may not receive a scholarship 
under subsection (a) for more than the equivalent of three years of 
full-time coursework.''.
    (e) Full-Time Coursework.--Section 7673 is further amended by 
adding at the end the following new subsection:
    ``(e) Full-Time Coursework.--For purposes of this section, full-
time coursework shall consist of the following:
            ``(1) In the case of undergraduate coursework, 30 semester 
        hours per undergraduate school year.
            ``(2) In the case of graduate coursework, 18 semester hours 
        per graduate school year.''.
    (f) Annual Adjustment of Maximum Scholarship Amount.--Section 7631 
is amended--
            (1) in subsection (a)(1), by striking ``and the maximum 
        Selected Reserve member stipend amount'' and inserting ``the 
        maximum Selected Reserve member stipend amount, the maximum 
        employee incentive scholarship amount,''; and
            (2) in subsection (b)--
                    (A) by redesignating paragraph (4) as paragraph 
                (6); and
                    (B) by inserting after paragraph (3) the following 
                new paragraph (4):
            ``(4) The term `maximum employee incentive scholarship 
        amount' means the maximum amount of the scholarship payable to 
        a participant in the Department of Veterans Affairs Employee 
        Incentive Scholarship Program under subchapter VI of this 
        chapter, as specified in section 7673(b)(1) of this title and 
        as previously adjusted (if at all) in accordance with this 
        section.''.

SEC. 112. ENHANCEMENT OF EDUCATION DEBT REDUCTION PROGRAM.

    (a) Permanent Authority.--(1) Section 7684 is repealed.
    (2) The table of sections at the beginning of chapter 76 is amended 
by striking the item relating to section 7684.
    (b) Eligible Individuals.--Subsection (a)(1) of section 7682 is 
amended--
            (1) by striking ``under an appointment under section 
        7402(b) of this title in a position'' and inserting ``in a 
        position (as determined by the Secretary) providing direct-
        patient care services or services incident to direct-patient 
        care services''; and
            (2) by striking ``(as determined by the Secretary)'' and 
        inserting ``(as so determined)''.
    (c) Maximum Debt Reduction Amount.--Section 7683(d)(1) is amended--
            (1) by striking ``for a year''; and
            (2) by striking ``exceed--'' and all that follows through 
        the end of the paragraph and inserting ``exceed $44,000 over a 
        total of five years of participation in the Program, of which 
        not more than $10,000 of such payments may be made in each of 
        the fourth and fifth years of participation in the Program.''.
    (d) Annual Adjustment of Maximum Debt Reduction Payments Amount.--
(1) Section 7631, as amended by section 101(f) of this Act, is further 
amended--
            (A) in subsection (a)(1), by inserting before the period at 
        the end of the first sentence the following: ``and the maximum 
        education debt reduction payments amount''; and
            (B) in subsection (b), by inserting after paragraph (4) the 
        following new paragraph (5):
            ``(5) The term `maximum education debt reduction payments 
        amount' means the maximum amount of education debt reduction 
        payments payable to a participant in the Department of Veterans 
        Affairs Education Debt Reduction Program under subchapter VII 
        of this chapter, as specified in section 7683(d)(1) of this 
        title and as previously adjusted (if at all) in accordance with 
        this section.''.
    (2) Notwithstanding section 7631(a)(1) of title 38, United States 
Code, as amended by paragraph (1), the Secretary of Veterans Affairs 
shall not increase the maximum education debt reduction payments amount 
under that section in calendar year 2002.
    (e) Temporary Expansion of Individuals Eligible for Participation 
in Program.--(1) Notwithstanding section 7682(c) of title 38, United 
States Code, the Secretary of Veterans Affairs may treat a covered 
individual as being a recently appointed employee in the Veterans 
Health Administration under section 7682(a) of that title for purposes 
of eligibility in the Education Debt Reduction Program if the Secretary 
determines that the participation of the individual in the Program 
under this subsection would further the purposes of the Program.
    (2) For purposes of this subsection, a covered individual is any 
individual otherwise described by section 7682(a) of title 38, United 
States Code, as in effect on the day before the date of the enactment 
of this Act, who--
            (A) was appointed as an employee in a position described in 
        paragraph (1) of that section, as so in effect, between January 
        1, 1999, and September 30, 2000; and
            (B) is an employee in such position, or in another position 
        described in paragraph (1) of that section, as so in effect, at 
        the time of application for treatment as a covered individual 
        under this subsection.
    (3) The Secretary shall make determinations regarding the exercise 
of the authority in this subsection on a case-by-case basis.
    (4) The Secretary may not exercise the authority in this subsection 
after December 31, 2001. The expiration of the authority in this 
subsection shall not affect the treatment of an individual under this 
subsection before that date as a covered individual for purposes of 
eligibility in the Education Debt Reduction Program.
    (5) In this subsection, the term ``Education Debt Reduction 
Program'' means the Department of Veterans Affairs Education Debt 
Reduction Program under subchapter VII of chapter 76 of title 38, 
United States Code.

SEC. 113. REPORT ON REQUESTS FOR WAIVERS OF PAY REDUCTIONS FOR 
              REEMPLOYED ANNUITANTS TO FILL NURSE POSITIONS.

    (a) Report.--Not later than November 30 of each of 2001 and 2002, 
the Secretary of Veterans Affairs shall submit to the Committees on 
Veterans' Affairs of the Senate and the House of Representatives a 
report describing each request of the Secretary, during the fiscal year 
preceding such report, to the Director of the Office of Personnel 
Management for the following:
            (1) A waiver under subsection (i)(1)(A) of section 8344 of 
        title 5, United States Code, of the provisions of such section 
        in order to meet requirements of the Department of Veterans 
        Affairs for appointments to nurse positions in the Veterans 
        Health Administration.
            (2) A waiver under subsection (f)(1)(A) of section 8468 of 
        title 5, United States Code, of the provisions of such section 
        in order to meet requirements of the Department for 
        appointments to such positions.
            (3) A grant of authority under subsection (i)(1)(B) of 
        section 8344 of title 5, United States Code, for the waiver of 
        the provisions of such section in order to meet requirements of 
        the Department for appointments to such positions.
            (4) A grant of authority under subsection (f)(1)(B) of 
        section 8468 of title 5, United States Code, for the waiver of 
        the provisions of such section in order to meet requirements of 
        the Department for appointments to such positions.
    (b) Information on Responses to Requests.--The report under 
subsection (a) shall specify for each request covered by the report--
            (1) the response of the Director to such request; and
            (2) if such request was granted, whether or not the waiver 
        or authority, as the case may be, assisted the Secretary in 
        meeting requirements of the Department for appointments to 
        nurse positions in the Veterans Health Administration.

                   Subtitle B--Retention Authorities

SEC. 121. ADDITIONAL PAY FOR SATURDAY TOURS OF DUTY FOR ADDITIONAL 
              HEALTH CARE PROFESSIONAL IN THE VETERANS HEALTH 
              ADMINISTRATION.

    (a) In General.--Section 7454(b) is amended--
            (1) by inserting ``(1)'' after ``(b)''; and
            (2) by adding at the end the following new paragraph:
    ``(2) Health care professionals employed in positions referred to 
in paragraph (1) shall be entitled to additional pay on the same basis 
as provided for nurses in section 7453(c) of this title.''.
    (b) Applicability.--The amendments made by subsection (a) shall 
take effect on the date of the enactment of this Act, and shall apply 
with respect to pay periods beginning on or after that date.

SEC. 122. UNUSED SICK LEAVE INCLUDED IN ANNUITY COMPUTATION OF 
              REGISTERED NURSES WITH THE VETERANS HEALTH 
              ADMINISTRATION.

    (a) Annuity Computation.--Section 8415 of title 5, United States 
Code, is amended by adding at the end the following:
    ``(i) In computing an annuity under this subchapter, the total 
service of an employee who retires from the position of a registered 
nurse with the Veterans Health Administration on an immediate annuity, 
or dies while employed in that position leaving any survivor entitled 
to an annuity, includes the days of unused sick leave to the credit of 
that employee under a formal leave system, except that such days shall 
not be counted in determining average pay or annuity eligibility under 
this subchapter.''.
    (b) Deposit Not Required.--Section 8422(d) of title 5, United 
States Code, is amended--
            (1) by inserting ``(1)'' before ``Under such regulations''; 
        and
            (2) by adding at the end the following:
    ``(2) Deposit may not be required for days of unused sick leave 
credited under section 8415(i).''.
    (c) Effective Date.--The amendments made by this section shall take 
effect 60 days after the date of the enactment of this Act, and shall 
apply to individuals who separate from service on or after that 
effective date.

SEC. 123. EVALUATION OF DEPARTMENT OF VETERANS AFFAIRS NURSE MANAGED 
              CLINICS.

    (a) Evaluation.--The Secretary of Veterans Affairs shall carry out 
an evaluation of the efficacy of the nurse managed health care clinics 
of the Department of Veterans Affairs. The Secretary shall complete the 
evaluation not later than 18 months after the date of the enactment of 
this Act.
    (b) Clinics To Be Evaluated.--(1) In carrying out the evaluation 
under subsection (a), the Secretary consider nurse managed health care 
clinics, including primary care clinics and geriatric care clinics, 
located in three different Veterans Integrated Service Networks (VISNs) 
of the Department.
    (2) If there are not nurse managed health care clinics located in 
three different Veterans Integrated Service Networks as of the 
commencement of the evaluation, the Secretary shall--
            (A) establish nurse managed health care clinics in 
        additional Veterans Integrated Services Networks such that 
        there are nurse managed health care clinics in three different 
        Veterans Integrated Service Networks for purposes of the 
        evaluation; and
            (B) include such clinics, as so established, in the 
        evaluation.
    (c) Matters To Be Evaluated.--In carrying out the evaluation under 
subsection (a), the Secretary shall address the following:
            (1) Patient satisfaction.
            (2) Provider experiences.
            (3) Cost of care.
            (4) Access to care, including waiting time for care.
            (5) The functional status of patients receiving care.
            (6) Any other matters the Secretary considers appropriate.
    (d) Report.--Not later than 18 months after the date of the 
enactment of this Act, the Secretary shall submit to the Committees on 
Veterans' Affairs of the Senate and the House of Representatives a 
report on the evaluation carried out under subsection (a). The report 
shall address the matters specified in subsection (c) and include any 
other information, and any recommendations, that the Secretary 
considers appropriate.

SEC. 124. STAFFING LEVELS FOR OPERATIONS OF MEDICAL FACILITIES.

    (a) In General.--Section 8110(a) is amended--
            (1) in paragraph (1), by inserting after ``complete care of 
        patients,'' in the fifth sentence the following: ``and in a 
        manner consistent with the policies of the Secretary on 
        overtime,''; and
            (2) in paragraph (2)--
                    (A) by inserting ``, including the staffing 
                required to maintain such capacities,'' after ``all 
                Department medical facilities'';
                    (B) by striking ``and to minimize'' and inserting 
                ``, to minimize''; and
                    (C) by inserting before the period the following: 
                ``, and to ensure that eligible veterans are provided 
                such care and services in an appropriate manner''.
    (b) Nationwide Policy on Staffing.--Paragraph (3) of that section 
is amended--
            (1) in subparagraph (A), by inserting ``the adequacy of 
        staff levels for compliance with the policy established under 
        subparagraph (C),'' after ``regarding''; and
            (2) by inserting after subparagraph (B) the following new 
        subparagraph:
    ``(C) The Secretary shall, in consultation with the Under Secretary 
for Health, establish a nationwide policy on the staffing of Department 
medical facilities in order to ensure that such facilities have 
adequate staff for the provision to veterans of appropriate, high-
quality care and services. The policy shall take into account the 
staffing levels and mixture of staff skills required for the range of 
care and services provided veterans in Department facilities.''.

SEC. 125. ANNUAL REPORT ON USE OF AUTHORITIES TO ENHANCE RETENTION OF 
              EXPERIENCED NURSES.

    (a) Annual Report.--(1) Subchapter II of chapter 73 is amended by 
adding at the end the following new section:
``Sec. 7324. Annual report on use of authorities to enhance retention 
              of experienced nurses
    ``(a) Annual Report.--Not later than January 31 each year, the 
Secretary, acting through the Under Secretary for Health, shall submit 
to Congress a report on the use during the preceding year of 
authorities for purposes of retaining experienced nurses in the 
Veterans Health Administration, as follows:
            ``(1) The authorities under chapter 76 of this title.
            ``(2) The authority under VA Directive 5102.1, relating to 
        the Department of Veterans Affairs nurse qualification 
        standard, dated November 10, 1999, or any successor directive.
            ``(3) Any other authorities available to the Secretary for 
        those purposes.
    ``(b) Report Elements.--Each report under subsection (a) shall 
specify for the period covered by such report, for each Department 
medical facility and for each Veterans Integrated Service Network, the 
following:
            ``(1) The number of waivers requested under the authority 
        referred to in subsection (a)(2), and the number of waivers 
        granted under that authority, to promote to the Nurse II grade 
        or Nurse III grade under the Nurse Schedule under section 
        7404(b)(1) of this title any nurse who has not completed a 
        bachelors of science in nursing in a recognized school of 
        nursing, set forth by age, race, and years of experience of the 
        individuals subject to such waiver requests and waivers, as the 
        case may be.
            ``(2) The programs carried out to facilitate the use of 
        nursing education programs by experienced nurses, including 
        programs for flexible scheduling, scholarships, salary 
        replacement pay, and on-site classes.''.
    (2) The table of sections at the beginning of chapter 73 is amended 
by inserting after the item relating to section 7323 the following new 
item:

``7324. Annual report on use of authorities to enhance retention of 
                            experienced nurses.''.
    (b) Initial Report.--The initial report required under section 7324 
of title 38, United States Code, as added by subsection (a), shall be 
submitted in 2002.

SEC. 126. REPORT ON MANDATORY OVERTIME FOR NURSES AND NURSE ASSISTANTS 
              IN DEPARTMENT OF VETERANS AFFAIRS FACILITIES.

    (a) Report.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall submit 
to the Committees on Veterans' Affairs of the Senate and the House of 
Representatives a report on the mandatory overtime required of licensed 
nurses and nurse assistants providing direct patient care at Department 
of Veterans Affairs medical facilities during 2001.
    (b) Mandatory Overtime.--For purposes of the report under 
subsection (a), mandatory overtime shall consist of any period in which 
a nurse or nurse assistant is mandated or otherwise required, whether 
directly or indirectly, to work or be in on-duty status in excess of--
            (1) a scheduled workshift or duty period;
            (2) 12 hours in any 24-hour period; or
            (3) 80 hours in any period of 14 consecutive days.
    (c) Elements.--The report under subsection (a) shall include the 
following:
            (1) A description of the amount of mandatory overtime 
        described in that subsection at each Department medical 
        facility during the period covered by the report.
            (2) A description of the mechanisms employed by the 
        Secretary to monitor overtime of the nurses and nurse 
        assistants referred to in that subsection.
            (3) An assessment of the effects of the mandatory overtime 
        of such nurses and nurse assistants on patient care, including 
        its contribution to medical errors.
            (4) Recommendations regarding mechanisms for preventing 
        mandatory overtime in other than emergency situations by such 
        nurses and nurse assistants.
            (5) Any other matters that the Secretary considers 
        appropriate.

                     Subtitle C--Other Authorities

SEC. 131. ORGANIZATIONAL RESPONSIBILITY OF THE DIRECTOR OF THE NURSING 
              SERVICE.

    Section 7306(a)(5) is amended by inserting ``, and report directly 
to,'' after ``responsible to''.

SEC. 132. COMPUTATION OF ANNUITY FOR PART-TIME SERVICE PERFORMED BY 
              CERTAIN HEALTH-CARE PROFESSIONALS BEFORE APRIL 7, 1986.

    Section 7426 is amended by adding at the end the following new 
subsection:
    ``(c) The provisions of subsection (b) shall not apply to the part-
time service before April 7, 1986, of a registered nurse, physician 
assistant, or expanded-function dental auxiliary. In computing the 
annuity under the applicable provision of law specified in that 
subsection of an individual covered by the preceding sentence, the 
service described in that sentence shall be credited as full-time 
service.''.

SEC. 133. MODIFICATION OF NURSE LOCALITY PAY AUTHORITIES.

    Section 7451 is amended--
            (1) in subsection (d)(3)--
                    (A) in subparagraph (A), by striking ``beginning 
                rates of'' each place it appears;
                    (B) in subparagraph (B), by striking ``beginning 
                rates of'' the first place it appears; and
                    (C) in subparagraph (C)(i), by striking ``beginning 
                rates of'' each place it appears;
            (2) in subsection (d)(4)--
                    (A) by striking ``or at any other time that an 
                adjustment in rates of pay is scheduled to take place 
                under this subsection'' in the first sentence; and
                    (B) by striking the second sentence; and
            (3) in subsection (e)(4)--
                    (A) in subparagraph (A), by striking ``grade in 
                a'';
                    (B) in subparagraph (B)--
                            (i) by striking ``grade of a''; and
                            (ii) by striking ``that grade'' and 
                        inserting ``that position''; and
                    (C) in subparagraph (D), by striking ``grade of 
                a''.

                        TITLE II--OTHER MATTERS

SEC. 201. MODIFICATION AND ENHANCEMENT OF AUTHORITY TO PROVIDE DOG-
              GUIDES AND SERVICE DOGS TO VETERANS WITH DISABILITIES.

    (a) Enhancement of Authority.--Subsection (b) of section 1714 is 
amended to read as follows:
    ``(b)(1) The Secretary may provide any blind veteran who is 
entitled to disability compensation with--
            ``(A) a dog-guide trained for the aid of the blind; and
            ``(B) mechanical or electronic equipment for aid in 
        overcoming the disability of blindness.
    ``(2) The Secretary may provide a service dog to the following:
            ``(A) Any hearing-impaired veteran who is entitled to 
        disability compensation.
            ``(B) Any veteran with a spinal cord injury or dysfunction 
        who is entitled to disability compensation.
            ``(C) Any veteran entitled to disability compensation who 
        has any other chronic physical or mental impairment that 
        substantially limits mobility, hearing, or activities of daily 
        living in order to assist such veteran in overcoming such 
        physical or mental impairment.
    ``(3) In providing a dog-guide or service dog to a veteran under 
this subsection, the Secretary may pay travel and incidental expenses 
(under the terms and conditions set forth in section 111 of this title) 
of the veteran to and from the veteran's home and incurred in becoming 
adjusted to the dog-guide or service dog, as the case may be.''.
    (b) Conforming and Clerical Amendments.--(1) The section heading of 
that section is amended to read as follows:
``Sec. 1714. Fitting and training in use of prosthetic appliances; dog-
              guides and service dogs''
    (2) The table of section at the beginning of chapter 17 is amended 
by striking the item relating to section 1714 and inserting the 
following new item:

``1714. Fitting and training in use of prosthetic appliances; dog-
                            guides and service dogs.''.

SEC. 202. ADDITIONAL BASIS FOR ESTABLISHMENT OF INABILITY TO DEFRAY 
              EXPENSES OF NECESSARY CARE.

    (a) Additional Basis.--Section 1722(a) is amended--
            (1) in paragraph (2), by striking ``or'' at the end;
            (2) in paragraph (3), by striking the period at the end and 
        inserting ``; or''; and
            (3) by adding at the end the following new paragraph:
            ``(4) the veteran (including any applicable part of the 
        veteran's family) is eligible for treatment as a low-income 
        family under section 3 of the United States Housing Act of 1937 
        (42 U.S.C. 1437a) for the area in which the veteran resides.''.
    (b) Applicability.--The amendments made by subsection (a) shall 
take effect on January 1, 2002, and shall apply with respect to years 
beginning after December 31, 2001.

SEC. 203. FUNDS FOR FIELD OFFICES OF THE OFFICE OF RESEARCH COMPLIANCE 
              AND ASSURANCE.

    (a) In General.--Amounts for the activities of the field offices of 
the Office of Research Compliance and Assurance of the Department of 
Veterans Affairs shall be derived from amounts appropriated for the 
Department of Veterans Affairs for the Veterans Health Administration 
for Medical Care, rather than from amounts appropriated for the 
Veterans Health Administration for Medical and Prosthetic Research.
    (b) Applicability.--Subsection (a) shall apply with respect to 
fiscal years after fiscal year 2001.

SEC. 204. TECHNICAL AMENDMENTS.

    Section 7631(b) is amended by striking ``this subsection'' each 
place it appears and inserting ``this section''.
    Amend the title to read: ``A Bill to amend title 38, United States 
Code, to enhance the authority of the Secretary of Veterans Affairs to 
recruit and retain qualified nurses for the Veterans Health 
Administration, to provide an additional basis for establishing the 
inability of veterans to defray expenses of necessary medical care, to 
modify other authorities relating to health care for veterans, and for 
other purposes.''.




                                                       Calendar No. 190

107th CONGRESS

  1st Session

                                S. 1188

                          [Report No. 107-80]

_______________________________________________________________________

                                 A BILL

To amend title 38, United States Code, to enhance the authority of the 
 Secretary of Veterans Affairs to recruit and retain qualified nurses 
    for the Veterans Health Administration, and for other purposes.

_______________________________________________________________________

                            October 10, 2001

        Reported with an amendment and an amendment to the title