[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4231 Reported in House (RH)]

                                                 Union Calendar No. 312
108th CONGRESS
  2d Session
                                H. R. 4231

                          [Report No. 108-538]

To provide for a pilot program in the Department of Veterans Affairs to 
  improve recruitment and retention of nurses, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 28, 2004

 Mr. Simmons introduced the following bill; which was referred to the 
                     Committee on Veterans' Affairs

                              June 9, 2004

     Additional sponsors: Mr. Smith of New Jersey and Mr. Bilirakis

                              June 9, 2004

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
 [For text of introduced bill, see copy of bill as introduced on April 
                               28, 2004]

_______________________________________________________________________

                                 A BILL


 
To provide for a pilot program in the Department of Veterans Affairs to 
  improve recruitment and retention of nurses, 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 ``Department of Veterans Affairs Nurse 
Recruitment and Retention Act of 2004''.

SEC. 2. PILOT PROGRAM TO STUDY INNOVATIVE RECRUITMENT TOOLS TO ADDRESS 
              NURSING SHORTAGES AT DEPARTMENT OF VETERANS AFFAIRS 
              HEALTH-CARE FACILITIES.

    (a) Pilot.--(1) Not later than 90 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall 
designate a health-care service region, or a section within such a 
region, in which health-care facilities of the Department of Veterans 
Affairs are adversely affected by a shortage of qualified nurses.
    (2) The Secretary shall conduct a pilot program in the region or 
section designated under paragraph (1) to determine the effectiveness 
of the use of innovative human-capital tools and techniques in the 
recruitment of qualified nurses for positions at Department health-care 
facilities and for the retention of nurses at such facilities. In 
carrying out the pilot program, the Secretary shall enter into a 
contract with a private-sector entity for services under the pilot 
program for recruitment of qualified nurses.
    (b) Private-Sector Recruitment Practices.--For purposes of the 
pilot program under this section, the Secretary shall identify and use 
recruitment practices that have proven effective for placing qualified 
individuals in positions that are difficult to fill due to shortages of 
qualified individuals or other factors. Recruitment practices to be 
reviewed by the Secretary for use in the pilot program shall include--
            (1) employer branding and interactive advertising 
        strategies;
            (2) Internet technologies and automated staffing systems; 
        and
            (3) the use of recruitment, advertising, and communication 
        agencies.
    (c) Streamlined Hiring Process.--In carrying out the pilot program 
under this section, the Secretary shall, at health-care facilities of 
the Department in the region or section in which the pilot program is 
conducted, revise procedures and systems for selecting and hiring 
qualified nurses to reduce the length of the hiring process. If the 
Secretary identifies measures to streamline and automate the hiring 
process that can only be implemented if authorized by law, the 
Secretary shall submit to the Committees on Veterans' Affairs of the 
Senate and House of Representatives recommendations for such changes in 
law as may be necessary to enable such measure to be implemented.
    (d) Report.--Not later than one year after the date of the 
enactment of this Act, the Secretary shall submit to the Committees on 
Veterans' Affairs of the Senate and House of Representatives a report 
on the extent to which the pilot program achieved the goal of improving 
the recruitment and retention of nurses in Department of Veterans 
Affairs health-care facilities.

SEC. 3. ALTERNATE WORK SCHEDULES FOR NURSES.

    (a) Enhanced Shift Flexibility.--Chapter 74 of title 38, United 
States Code, is amended by inserting after section 7456 the following 
new section:
``Sec. 7456a. Alternate work schedules
    ``(a) Applicability.--This section applies to registered nurses 
appointed under this chapter.
    ``(b) 36/40 Work Schedule.--(1) Subject to paragraph (2), if the 
Secretary determines it to be necessary in order to obtain or retain 
the services of registered nurses at a Department health-care facility, 
the Secretary may provide, in the case of registered nurses employed at 
that facility, that such a nurse who works three regularly scheduled 
12-hour tours of duty within a workweek shall be considered for all 
purposes (except computation of full-time equivalent employees for the 
purposes of determining compliance with personnel ceilings) to have 
worked a full 40-hour basic workweek. Such a schedule may be referred 
to as a `36/40 work schedule'.
    ``(2)(A) Basic and additional pay for a registered nurse who is 
considered under paragraph (1) to have worked a full 40-hour basic 
workweek is subject to subparagraphs (B) and (C).
    ``(B) The hourly rate of basic pay for such a nurse for service 
performed as part of a regularly scheduled 36-hour tour of duty within 
the workweek shall be derived by dividing the nurse's annual rate of 
basic pay by 1,872.
    ``(C)(i) Such a nurse who performs a period of service in excess of 
such nurse's regularly scheduled 36-hour tour of duty within a workweek 
is entitled to overtime pay under section 7453(e) of this title, or 
other applicable law, for officially ordered or approved service 
performed in excess of--
            ``(I) eight hours on a day other than a day on which such 
        nurse's regularly scheduled 12-hour tour falls;
            ``(II) 12 hours for any day included in the regularly 
        scheduled 36-hour tour of duty; and
            ``(III) 40 hours during an administrative workweek.
    ``(ii) Except as provided in clause (i), a registered nurse to whom 
this subsection is applicable is not entitled to additional pay under 
section 7453 of this title, or other applicable law, for any period 
included in a regularly scheduled 12-hour tour of duty.
    ``(3) A nurse who works a 36/40 work schedule described in this 
subsection who is absent on approved sick leave or annual leave during 
a regularly scheduled 12-hour tour of duty shall be charged for such 
leave at a rate of ten hours of leave for nine hours of absence.
    ``(c) 7/7 Work Schedule--(1) Subject to paragraph (2), if the 
Secretary determines it to be necessary in order to obtain or retain 
the services of registered nurses at a Department health-care facility, 
the Secretary may provide, in the case of registered nurses employed at 
such facility, that such a nurse who works seven regularly scheduled 
10-hour tours of duty, with seven days off duty, within a two-week pay 
period, shall be considered for all purposes (except computation of 
full-time equivalent employees for the purposes of determining 
compliance with personnel ceilings) to have worked a full 80 hours for 
the pay period. Such a schedule may be referred to as a `7/7 work 
schedule'.
    ``(2)(A) Basic and additional pay for a registered nurse who is 
considered under paragraph (1) to have worked a full 80-hour pay period 
is subject to subparagraphs (B) and (C).
    ``(B) The hourly rate of basic pay for such a nurse for service 
performed as part of a regularly scheduled 70-hour tour of duty within 
the pay period shall be derived by dividing the nurse's annual rate of 
basic pay by 1,820.
    ``(C)(i) Such a nurse who performs a period of service in excess of 
such nurse's regularly scheduled 70-hour tour of duty within a pay 
period is entitled to overtime pay under section 7453(e) of this title, 
or other applicable law, for officially ordered or approved service 
performed in excess of--
            ``(I) eight hours on a day other than a day on which such 
        nurse's regularly scheduled 10-hour tour falls;
            ``(II) 10 hours for any day included in the regularly 
        scheduled 70-hour tour of duty; and
            ``(III) 80 hours during a pay period.
    ``(ii) Except as provided in subparagraph (i), a registered nurse 
to whom this subsection is applicable is not entitled to additional pay 
under section 7453 of this title, or other applicable law, for any 
period included in a regularly scheduled 10-hour tour of duty.
    ``(3) A nurse who works a 7/7 work schedule described in this 
subsection who is absent on approved sick leave or annual leave during 
a regularly scheduled 12-hour tour of duty shall be charged for such 
leave at a rate of eight hours of leave for seven hours of absence.
    ``(d) 9-Month Work Schedule.--The Secretary may authorize a 
registered nurse appointed under section 7405 of this title, with the 
nurse's written consent, to work full-time for nine months with three 
months off duty, within a fiscal year, and be paid at 75 percent of the 
full-time rate for such nurse's grade for each pay period of that 
fiscal year. A nurse working on such a schedule for any fiscal year 
shall be considered a \3/4\ full-time equivalent employee for that 
fiscal year in computing full-time equivalent employees for the 
purposes of determining compliance with personnel ceilings. Service on 
such a schedule shall be considered to be part-time service for 
purposes of computing benefits under chapters 83 and 84 of title 5.
    ``(e) Regulations.--The Secretary shall prescribe regulations for 
the implementation of this section.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 74 of such title is amended by inserting after the item 
relating to section 7456 the following new item:

``7456a. Alternate work schedules.''.

SEC. 4. APPOINTMENT OF NURSES WHO DO NOT HAVE BACCALAUREATE DEGREES.

    Section 7403 of title 38, United States Code, is amended by adding 
at the end the following new subsection:
    ``(h) In a case in which a registered nurse applying for an 
appointment under this chapter as a registered nurse has presented the 
qualifications established under subsection (a) for such an 
appointment, the lack of a baccalaureate degree in nursing shall not be 
a bar to appointment, and in such a case the registered nurse shall not 
be denied appointment on that basis.''.

SEC. 5. TECHNICAL CORRECTION TO LISTING OF CERTAIN HYBRID POSITIONS IN 
              VETERANS HEALTH ADMINISTRATION.

    Section 7401(3) of title 38, United States Code, is amended--
            (1) by striking ``and dental technologists'' and inserting 
        ``technologists, dental hygienists, dental assistants''; and
            (2) by striking ``technicians, therapeutic radiologic 
        technicians, and social workers'' and inserting 
        ``technologists, therapeutic radiologic technologists, social 
        workers, blind rehabilitation specialists, and blind 
        rehabilitation outpatient specialists''.

SEC. 6. ASSISTANCE FOR HIRING AND RETENTION OF NURSES AT STATE VETERANS 
              HOMES.

    (a) In General.--(1) Chapter 17 of title 38, United States Code, is 
amended by inserting after section 1743 the following new section:
``Sec. 1744. Hiring and retention of nurses: payments to assist States
    ``(a) Payment Program.--The Secretary shall make payments to States 
under this section for the purpose of assisting State homes in the 
hiring and retention of nurses and the reduction of nursing shortages 
at State homes.
    ``(b) Eligible Recipients.--Payments to a State for a fiscal year 
under this section shall, subject to submission of an application, be 
made to any State that during that year--
            ``(1) receives per diem payments under this subchapter for 
        that fiscal year; and
            ``(2) has in effect an employee incentive scholarship 
        program or other employee incentive program at a State home 
        designed to promote the hiring and retention of nursing staff 
        and to reduce nursing shortages at that home.
    ``(c) Use of Funds Received.--A State may use an amount received 
under this section only to provide funds for a program described in 
subsection (b)(2). Any program shall meet such criteria as the 
Secretary may prescribe. In prescribing such criteria, the Secretary 
shall take into consideration the need for flexibility and innovation.
    ``(d) Limitations on Amount of Payment.--(1) A payment under this 
section may not be used to provide more than 50 percent of the costs 
for a fiscal year of the employee incentive scholarship or other 
incentive program for which the payment is made.
    ``(2) The amount of the payment to a State under this section for 
any fiscal year is, for each State home in that State with a program 
described in subsection (b)(2), the amount equal to 2 percent of the 
amount of payments estimated to be made to that State, for that State 
home, under section 1741 of this title for that fiscal year.
    ``(e) Applications.--A payment under this section for any fiscal 
year with respect to any State home may only be made based upon an 
application submitted by the State seeking the payment with respect to 
that State home. Any such application shall describe the nursing 
shortage at the State home and the employee incentive scholarship 
program or other incentive program described in subsection (c) for 
which the payment is sought.
    ``(f) Source of Funds.--Payments under this section shall be made 
from funds available for other payments under this subchapter.
    ``(g) Disbursement.--Payments under this section to a State home 
shall be made as part of the disbursement of payments under section 
1741 of this title with respect to that State home.
    ``(h) Use of Certain Receipts.--The Secretary shall require as a 
condition of any payment under this section that, in any case in which 
the State home receives a refund payment made by an employee in breach 
of the terms of an agreement for employee assistance that used funds 
provided under this section, the payment shall be returned to the State 
home's incentive program account and credited as a non-Federal funding 
source.
    ``(i) Annual Report From Payment Recipients.--Any State home 
receiving a payment under this section for any fiscal year, shall, as a 
condition of the payment, be required to agree to provide to the 
Secretary a report setting forth in detail the use of funds received 
through the payment, including a descriptive analysis of how effective 
the incentive program has been on nurse staffing in the State home 
during that fiscal year. The report for any fiscal year shall be 
provided to the Secretary within 60 days of the close of the fiscal 
year and shall be subject to audit by the Secretary. Eligibility for a 
payment under this section for any later fiscal year is contingent upon 
the receipt by the Secretary of the annual report under this subsection 
for the previous year in accordance with this subsection.
    ``(j) Regulations.--The Secretary shall prescribe regulations to 
carry out this section. The regulations shall include the establishment 
of criteria for the award of payments under this section.''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after section 1743 the following new item:

``1744. Hiring and retention of nurses: payments to assist States.''.
    (b) Implementation.--The Secretary of Veterans Affairs shall 
implement section 1744 of title 38, United States Code, as added by 
subsection (a), as expeditiously as possible. The Secretary shall 
establish such interim procedures as necessary so as to ensure that 
payments are made to eligible States under that section commencing not 
later than January 1, 2005, notwithstanding that regulations under 
subsection (j) of that section may not have become final.

SEC. 7. TECHNICAL CLARIFICATION.

    Section 8111(d)(2) of title 38, United States Code, is amended by 
inserting before the period at the end of the last sentence the 
following: ``and shall be available for any purpose authorized by this 
section''.

SEC. 8. UNDER SECRETARY FOR HEALTH.

    Section 305(a)(2) of title 38, United States Code, is amended--
            (1) in the matter preceding subparagraph (A), by striking 
        ``shall be a doctor of medicine and''; and
            (2) in subparagraph (A), by striking ``and in health-care'' 
        and inserting ``or in health-care''.




                                                 Union Calendar No. 312

108th CONGRESS

  2d Session

                               H. R. 4231

                          [Report No. 108-538]

_______________________________________________________________________

                                 A BILL

To provide for a pilot program in the Department of Veterans Affairs to 
  improve recruitment and retention of nurses, and for other purposes.

_______________________________________________________________________

                              June 9, 2004

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed