[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2484 Enrolled Bill (ENR)]

        S.2484

                       One Hundred Eighth Congress

                                 of the

                        United States of America


                          AT THE SECOND SESSION

          Begun and held at the City of Washington on Tuesday,
           the twentieth day of January, two thousand and four


                                 An Act


 
   To amend title 38, United States Code, to simplify and improve pay 
 provisions for physicians and dentists and to authorize alternate work 
     schedules and executive pay for nurses, and for other purposes.

    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 
Health Care Personnel Enhancement Act of 2004''.

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

    Except as otherwise expressly provided, whenever in this Act an 
amendment is expressed in terms of an amendment to a section or other 
provision, the reference shall be considered to be made to a section or 
other provision of title 38, United States Code.
SEC. 3. SIMPLIFICATION AND IMPROVEMENT OF GRADE AND PAY PROVISIONS FOR 
PHYSICIANS AND DENTISTS.
    (a) Simplification of Grades and Grade Requirements.--(1) 
Subsection (b) of section 7404 is amended--
        (A) by striking ``(1)'' after ``(b)'';
        (B) in the Physician and Dentist Schedule, by striking the 
    items relating to the grades and inserting the following:
        ``Physician grade.
        ``Dentist grade.''; and
        (C) by striking paragraph (2).
    (2) Subsection (a) of such section is amended by adding at the end 
the following: ``The pay of physicians and dentists serving in 
positions to which an Executive order applies under the preceding 
sentence shall be determined under subchapter III of this chapter 
instead of such Executive order.''.
    (b) Simplification and Improvement of Pay Authorities.--Subchapter 
III of chapter 74 is amended to read as follows:

           ``SUBCHAPTER III--PAY FOR PHYSICIANS AND DENTISTS

``Sec. 7431. Pay

    ``(a) Elements of Pay.--Pay of physicians and dentists in the 
Veterans Health Administration shall consist of three elements as 
follows:
        ``(1) Base pay as provided for under subsection (b).
        ``(2) Market pay as provided for under subsection (c).
        ``(3) Performance pay as provided under subsection (d).
    ``(b) Base Pay.--One element of pay for physicians and dentists 
shall be base pay. Base pay shall meet the following requirements:
        ``(1) Each physician and dentist is entitled to base pay 
    determined under the Physician and Dentist Base and Longevity Pay 
    Schedule.
        ``(2) The Physician and Dentist Base and Longevity Pay Schedule 
    is composed of 15 rates of base pay designated, from the lowest 
    rate of pay to the highest rate of pay, as base pay steps 1 through 
    15.
        ``(3) The rate of base pay payable to a physician or dentist is 
    based on the total number of the years of the service of the 
    physician or dentist in the Veterans Health Administration as 
    follows:

``For a physician or dentist
                                                 The rate of base pay is
   with total service of:
                                                   the rate payable for:
    two years or less.........................................


                                                                 step 1 

    more than 2 years and not more than 4 years...............


                                                                 step 2 

    more than 4 years and not more than 6 years...............


                                                                 step 3 

    more than 6 years and not more than 8 years...............


                                                                 step 4 

    more than 8 years and not more than 10 years..............


                                                                 step 5 

    more than 10 years and not more than 12 years.............


                                                                 step 6 

    more than 12 years and not more than 14 years.............


                                                                 step 7 

    more than 14 years and not more than 16 years.............


                                                                 step 8 

    more than 16 years and not more than 18 years.............


                                                                 step 9 

    more than 18 years and not more than 20 years.............


                                                                step 10 

    more than 20 years and not more than 22 years.............


                                                                step 11 

    more than 22 years and not more than 24 years.............


                                                                step 12 

    more than 24 years and not more than 26 years.............


                                                                step 13 

    more than 26 years and not more than 28 years.............


                                                                step 14 

    more than 28 years........................................


                                                                step 15.

        ``(4) At the same time as rates of basic pay are increased for 
    a year under section 5303 of title 5, the Secretary shall increase 
    the amount of base pay payable under this subsection for that year 
    by a percentage equal to the percentage by which rates of basic pay 
    are increased under such section for that year.
    ``(c) Market Pay.--One element of pay for physicians and dentists 
shall be market pay. Market pay shall meet the following requirements:
        ``(1) Each physician and dentist is eligible for market pay.
        ``(2) Market pay shall consist of pay intended to reflect the 
    recruitment and retention needs for the specialty or assignment (as 
    defined by the Secretary) of a particular physician or dentist in a 
    facility of the Department of Veterans Affairs.
        ``(3) The annual amount of the market pay payable to a 
    physician or dentist shall be determined by the Secretary on a 
    case-by-case basis.
        ``(4)(A) In determining the amount of market pay for physicians 
    or dentists, the Secretary shall consult two or more national 
    surveys of pay for physicians or dentists, as applicable, whether 
    prepared by private, public, or quasi-public entities in order to 
    make a general assessment of the range of pays payable to 
    physicians or dentists, as applicable.
        ``(B)(i) In determining the amount of the market pay for a 
    particular physician or dentist under this subsection, and in 
    determining a tier (if any) to apply to a physician or dentist 
    under subsection (e)(1)(B), the Secretary shall consult with and 
    consider the recommendations of an appropriate panel or board 
    composed of physicians or dentists (as applicable).
        ``(ii) A physician or dentist may not be a member of the panel 
    or board that makes recommendations under clause (i) with respect 
    to the market pay of such physician or dentist, as the case may be.
        ``(iii) The Secretary should, to the extent practicable, ensure 
    that a panel or board consulted under this subparagraph includes 
    physicians or dentists (as applicable) who are practicing 
    clinicians and who do not hold management positions in the medical 
    facility of the Department at which the physician or dentist 
    subject to the consultation is employed.
        ``(5) The determination of the amount of market pay of a 
    physician or dentist shall take into account--
            ``(A) the level of experience of the physician or dentist 
        in the specialty or assignment of the physician or dentist;
            ``(B) the need for the specialty or assignment of the 
        physician or dentist at the medical facility of the Department 
        concerned;
            ``(C) the health care labor market for the specialty or 
        assignment of the physician or dentist, which may cover any 
        geographic area the Secretary considers appropriate for the 
        specialty or assignment;
            ``(D) the board certifications, if any, of the physician or 
        dentist;
            ``(E) the prior experience, if any, of the physician or 
        dentist as an employee of the Veterans Health Administration; 
        and
            ``(F) such other considerations as the Secretary considers 
        appropriate.
        ``(6) The amount of market pay of a physician or dentist shall 
    be evaluated by the Secretary not less often than once every 24 
    months. The amount of market pay may be adjusted as the result of 
    an evaluation under this paragraph. A physician or dentist whose 
    market pay is evaluated under this paragraph shall receive written 
    notice of the results of such evaluation in accordance with 
    procedures prescribed under section 7433 of this title.
        ``(7) No adjustment of the amount of market pay of a physician 
    or dentist under paragraph (6) may result in a reduction of the 
    amount of market pay of the physician or dentist while in the same 
    position or assignment at the medical facility of the Department 
    concerned.
    ``(d) Performance Pay.--(1) One element of pay for physicians and 
dentists shall be performance pay.
    ``(2) Performance pay shall be paid to a physician or dentist on 
the basis of the physician's or dentist's achievement of specific goals 
and performance objectives prescribed by the Secretary.
    ``(3) The Secretary shall ensure that each physician and dentist of 
the Department is advised of the specific goals or objectives that are 
to be measured by the Secretary in determining the eligibility of that 
physician or dentist for performance pay.
    ``(4) The amount of the performance pay payable to a physician or 
dentist may vary annually on the basis of individual achievement or 
attainment of the goals or objectives applicable to the physician or 
dentist under paragraph (2).
    ``(5) The amount of performance pay payable to a physician or 
dentist in a fiscal year shall be determined in accordance with 
regulations prescribed by the Secretary, but may not exceed the lower 
of--
        ``(A) $15,000; or
        ``(B) the amount equal to 7.5 percent of the sum of the base 
    pay and the market pay payable to such physician or dentist in that 
    fiscal year.
    ``(6) A failure to meet goals or objectives applicable to a 
physician or dentist under paragraph (2) may not be the sole basis for 
an adverse personnel action against that physician or dentist.
    ``(e) Requirements and Limitations on Total Pay.--(1)(A) Not less 
often than once every two years, the Secretary shall prescribe for 
Department-wide applicability the minimum and maximum amounts of annual 
pay that may be paid under this section to physicians and the minimum 
and maximum amounts of annual pay that may be paid under this section 
to dentists.
    ``(B) The Secretary may prescribe for Department-wide applicability 
under this paragraph separate minimum and maximum amounts of pay for a 
specialty or assignment. If the Secretary prescribes separate minimum 
and maximum amounts for a specialty or assignment, the Secretary may 
establish up to four tiers of minimum and maximum amounts for such 
specialty or assignment and prescribe for each tier a minimum amount 
and a maximum amount that the Secretary determines appropriate for the 
professional responsibilities, professional achievements, and 
administrative duties of the physicians or dentists (as the case may 
be) whose pay is set within that tier.
    ``(C) Amounts prescribed under this paragraph shall be published in 
the Federal Register, and shall not take effect until at least 60 days 
after the date of publication.
    ``(2) Except as provided in paragraph (3) and subject to paragraph 
(4), the sum of the total amount of the annual rate of base pay payable 
to a physician or dentist under subsection (b) and the market pay 
determined for the physician or dentist under subsection (c) may not be 
less than the minimum amount, nor more than the maximum amount, 
applicable to specialty or assignment of the physician or dentist under 
paragraph (1).
    ``(3) The sum of the total amount of the annual rate of base pay 
payable to a physician or dentist under subsection (b) and the market 
pay determined for the physician or dentist under subsection (c) may 
exceed the maximum amount applicable to the specialty or assignment of 
the physician or dentist under paragraph (1) as a result of an 
adjustment under paragraph (3) or (4) of subsection (b).
    ``(4) In no case may the total amount of compensation paid to a 
physician or dentist under this title in any year exceed the amount of 
annual compensation (excluding expenses) specified in section 102 of 
title 3.
    ``(f) Treatment of Pay.--Pay under subsections (b) and (c) of this 
section shall be considered pay for all purposes, including retirement 
benefits under chapters 83 and 84 of title 5 and other benefits.
    ``(g) Ancillary Effects of Decreases in Pay.--(1) A decrease in pay 
of a physician or dentist resulting from an adjustment in the amount of 
market pay of the physician or dentist under subsection (c) shall not 
be treated as an adverse action.
    ``(2) If the pay of a physician or dentist is reduced under this 
subchapter as a result of an involuntary reassignment in connection 
with a disciplinary action taken against the physician or dentist, the 
involuntary reassignment shall be subject to appeal under subchapter V 
of this chapter.
    ``(h) Delegation of Responsibilities.--The Secretary may delegate 
to an appropriate officer or employee of the Department any 
responsibility of the Secretary under subsection (c), (d), or (e) 
except for the responsibilities of the Secretary under subsection 
(e)(1).

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

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

``Sec. 7433. Administrative matters

    ``(a) Regulations.--(1) The Secretary shall prescribe regulations 
relating to the pay of physicians and dentists in the Veterans Health 
Administration under this subchapter.
    ``(2) In prescribing the regulations, the Secretary shall take into 
account the recommendations of the Under Secretary for Health on the 
administration of this subchapter. In formulating recommendations for 
the purpose of this paragraph, the Under Secretary shall request the 
views of representatives of labor organizations that are exclusive 
representatives of physicians and dentists of the Department and the 
views of representatives of professional organizations of physicians 
and dentists of the Department.
    ``(b) Reports.--(1) Not later than 18 months after the Secretary 
prescribes the regulations required by subsection (a), and annually 
thereafter for the next 5 years, the Secretary shall submit to the 
Committees on Veterans' Affairs of the Senate and House of 
Representatives a report on the pay of physicians and dentists in the 
Veterans Health Administration under this subchapter.
    ``(2) Each report under this subsection shall include the 
following:
        ``(A) A description of the rates of pay in effect during the 
    current fiscal year with a comparison to the rates in effect during 
    the fiscal year preceding the current fiscal year, set forth by 
    facility and by specialty.
        ``(B) The number of physicians and dentists who left the 
    Veterans Health Administration during the preceding fiscal year.
        ``(C) The number of unfilled physician positions and dentist 
    positions in each specialty in the Veterans Health Administration, 
    the average and maximum lengths of time that such positions have 
    been unfilled, and an assessment of the reasons that such positions 
    remain unfilled.
        ``(D) An assessment of the impact of implementation of this 
    subchapter on efforts to recruit and retain physicians and dentists 
    in the Veterans Health Administration.
    ``(3) The first two annual reports under this subsection shall also 
include a comparison of staffing levels, contract expenditures, and 
average salaries of physicians and dentists in the Veterans Health 
Administration for the current fiscal year and for the fiscal year 
preceding the current fiscal year, set forth by facility and by 
specialty.''.
    (c) Initial Rates of Base Pay for Physicians and Dentists.--The 
initial rates of base pay established for the base pay steps under the 
Physician and Dentist Base and Longevity Pay Schedule provided in 
section 7431(b) of title 38, United States Code (as added by subsection 
(b)), are as follows:

Base Pay Step:
                                                            Rate of Pay:
    1.........................................................


                                                                $90,000 

    2.........................................................


                                                                $93,000 

    3.........................................................


                                                                $96,000 

    4.........................................................


                                                                $99,000 

    5.........................................................


                                                               $102,000 

    6.........................................................


                                                               $105,000 

    7.........................................................


                                                               $108,000 

    8.........................................................


                                                               $111,000 

    9.........................................................


                                                               $114,000 

    10........................................................


                                                               $117,000 

    11........................................................


                                                               $120,000 

    12........................................................


                                                               $123,000 

    13........................................................


                                                               $126,000 

    14........................................................


                                                               $129,000 

    15........................................................


                                                               $132,000.

    (d) Effective Date.--(1) Notwithstanding the 60-day waiting 
requirement in section 7431(e)(1)(C) of title 38, United States Code 
(as amended by subsection (b)), pay provided for a physician or dentist 
under subchapter III of chapter 74 of such title, as amended by 
subsection (b), shall take effect on the first day of the first pay 
period applicable to such physician or dentist that begins on or after 
January 1, 2006.
    (2) Pay provided for the Under Secretary for Health under 
subchapter III of chapter 74 of title 38, United States Code, as 
amended by this section shall take effect on the first day of the first 
pay period applicable to the Under Secretary that begins on or after 
January 1, 2006.
    (e) Transition Provisions.--
        (1) Physicians and dentists.--
            (A) Pay.--(i) The amount of the pay payable on and after 
        the date of the enactment of this Act to a physician or dentist 
        in receipt of pay under section 7404 or 7405 of title 38, 
        United States Code, as of the day before such date shall 
        continue to be determined under such section (as in effect on 
        the day before such date) until the effective date that is 
        applicable under subsection (d) to such physician or dentist, 
        as the case may be.
            (ii) A physician or dentist appointed or reassigned on or 
        after the date of the enactment of this Act, but before the 
        effective date applicable under subsection (d) to such 
        physician or dentist, shall be compensated in accordance with 
        applicable provisions of section 7404 or 7405 of title 38, 
        United States Code (as in effect on the day before date of the 
        enactment of this Act), until such effective date.
            (B) Special pay.--(i) A special pay agreement entered into 
        by a physician or dentist under subchapter III of chapter 74 of 
        title 38, United States Code, before the date of the enactment 
        of this Act shall terminate on the date of the enactment of 
        this Act. However, a physician or dentist in receipt of special 
        pay pursuant to such an agreement on that date shall continue 
        to receive special pay under the terms of such agreement until 
        the effective date that is applicable under subsection (d) to 
        such physician or dentist.
            (ii) A physician or dentist described in subparagraph 
        (A)(ii) may be paid special pay under applicable provisions of 
        section 7433, 7434, 7435, or 7436 of title 38, United States 
        Code (as in effect on the day before the date of the enactment 
        of this Act), during the period beginning on the date of the 
        appointment or reassignment of such physician or dentist, as 
        the case may be, and ending on the effective date applicable 
        under subsection (d) to such physician or dentist. However, no 
        special pay agreement shall be required for the payment of 
        special pay under this clause.
            (C) Treatment of special pay.--(i) Special pay paid under 
        subparagraph (B) to a physician or dentist during the period 
        beginning on the date of the enactment of this Act and ending 
        on the effective date applicable under subsection (d) to such 
        physician or dentist shall be subject to the provisions of 
        paragraphs (1), (2), (4), (5), and (6) of section 7438(b) of 
        title 38, United States Code (as in effect on the day before 
        the date of the enactment of this Act).
            (ii) Special pay paid to a physician or dentist under 
        section 7438 of title 38, United States Code (as in effect on 
        the day before the date of the enactment of this Act), shall be 
        fully creditable for purposes of computing benefits under 
        chapters 83 and 84 of title 5, United States Code.
            (D) Preservation of pay.--The amount of pay paid to a 
        physician or dentist after the effective date of this Act shall 
        not be less than the amount of pay paid to such physician or 
        dentist on the day before the effective date of this Act while 
        such physician or dentist remains in the same position or 
        assignment.
        (2) Under secretary for health.--
            (A) Special pay.--(i) The current special pay agreement 
        entered into by the Under Secretary for Health under 
        subchapters I and III of chapter 74 of title 38, United States 
        Code, before the date of the enactment of this Act shall 
        terminate on the date of the enactment of this Act. However, 
        the Under Secretary shall continue to receive special pay under 
        the terms of such agreement until the effective date that is 
        applicable under subsection (d) to the Under Secretary.
            (ii) An individual appointed as Under Secretary for Health 
        on or after the date of the enactment of this Act and before 
        the effective date applicable under subsection (d) to the Under 
        Secretary shall be paid special pay in accordance with the 
        provisions of sections 7432(d)(2) and 7433 of title 38, United 
        States Code (as in effect on the day before the date of the 
        enactment of this Act), during the period beginning on the date 
        of appointment and ending on such effective date. However, no 
        special pay agreement shall be required for the payment of 
        special pay under this clause.
            (B) Treatment of special pay.--Special pay paid under 
        subparagraph (A) during the period beginning on the date of the 
        enactment of this Act and ending on the effective date 
        applicable under subsection (d) to the Under Secretary--
                (i) shall be subject to the provisions of paragraphs 
            (1), (2), (4), (5), and (6) of section 7438(b) of title 38, 
            United States Code (as in effect on the day before the date 
            of the enactment of this Act); and
                (ii) shall be fully creditable for purposes of 
            computing benefits under chapters 83 and 84 of title 5, 
            United States Code.
    (f) Conforming Amendments.--Section 7404 is amended--
        (1) in subsection (c), by striking ``special pay'' and 
    inserting ``pay''; and
        (2) in subsection (d), by striking ``pay may not be paid'' and 
    all that follows and inserting ``pay for positions for which basic 
    pay is paid under this section may not be paid at a rate in excess 
    of the rate of basic pay authorized by section 5316 of title 5 for 
    positions in Level V of the Executive Schedule.''.
    (g) Clerical Amendment.--The table of sections at the beginning of 
chapter 74 is amended by striking the items relating to subchapter III 
and inserting the following new items:
        ``SUBCHAPTER III--PAY FOR PHYSICIANS AND DENTISTS
``Sec. 7431. Pay.
``Sec. 7432. Pay of Under Secretary for Health.
``Sec. 7433. Administrative matters.''.
SEC. 4. ALTERNATE WORK SCHEDULES FOR REGISTERED NURSES.
    (a) In General.--(1) Chapter 74 is amended by inserting after 
section 7456 the following new section:

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

    ``(a) Applicability.--This section applies to registered nurses 
appointed under this chapter.
    ``(b) 36/40 Work Schedule.--(1)(A) Subject to paragraph (2), if the 
Secretary determines it to be necessary in order to obtain or retain 
the services of registered nurses at any Department health-care 
facility, the Secretary may provide, in the case of nurses employed at 
such facility, that such nurses who work three regularly scheduled 12-
hour tours of duty within a work week shall be considered for all 
purposes to have worked a full 40-hour basic work week.
    ``(B) A nurse who works under the authority in subparagraph (A) 
shall be considered a 0.90 full-time equivalent employee in computing 
full-time equivalent employees for the purposes of determining 
compliance with personnel ceilings.
    ``(2)(A) Basic and additional pay for a nurse who is considered 
under paragraph (1) to have worked a full 40-hour basic work week shall 
be subject to subparagraphs (B) and (C).
    ``(B) The hourly rate of basic pay for a nurse covered by this 
paragraph for service performed as part of a regularly scheduled 36-
hour tour of duty within the work week shall be derived by dividing the 
nurse's annual rate of basic pay by 1,872.
    ``(C) The Secretary shall pay overtime pay to a nurse covered by 
this paragraph who--
        ``(i) performs a period of service in excess of such nurse's 
    regularly scheduled 36-hour tour of duty within an administrative 
    work week;
        ``(ii) for officially ordered or approved service, performs a 
    period of service in excess of 8 hours on a day other than a day on 
    which such nurse's regularly scheduled 12-hour tour of duty falls;
        ``(iii) performs a period of service in excess of 12 hours for 
    any day included in the regularly scheduled 36-hour tour of duty 
    work week; or
        ``(iv) performs a period of service in excess of 40 hours 
    during an administrative work week.
    ``(D) The Secretary may provide a nurse to whom this subsection 
applies with additional pay under section 7453 of this title for any 
period included in a regularly scheduled 12-hour tour of duty.
    ``(3) A nurse who works a work schedule described in this 
subsection who is absent on approved sick leave or annual leave during 
a regularly scheduled 12-hour tour of duty shall be charged for such 
leave at a rate of ten hours of leave for every nine hours of absence.
    ``(c) Holiday Pay.--A nurse working a work schedule under 
subsection (b) that includes a holiday designated by law or Executive 
order shall be eligible for holiday pay under section 7453(d) of this 
title for any service performed by the nurse on such holiday under such 
section.
    ``(d) 9-Month Work Schedule for Certain Nurses.--(1) The Secretary 
may authorize a registered nurse appointed under section 7405 of this 
title, with the nurse's written consent, to work full time for nine 
months with 3 months off duty, within a fiscal year, and be paid at 75 
percent of the full-time rate for such nurse's grade for each pay 
period of such fiscal year.
    ``(2) A nurse who works under the authority in paragraph (1) shall 
be considered a 0.75 full-time equivalent employee in computing full-
time equivalent employees for the purposes of determining compliance 
with personnel ceilings.
    ``(3) Work under this subsection shall be considered part-time 
service for purposes of computing benefits under chapters 83 and 84 of 
title 5.
    ``(4) A nurse who works under the authority in paragraph (1) shall 
be considered a full-time employee for purposes of chapter 89 of title 
5.
    ``(e) Notification of Modification of Benefits.--The Secretary 
shall provide each employee with respect to whom an alternate work 
schedule under this section may apply written notice of the effect, if 
any, that the alternate work schedule will have on the employee's 
health care premium, retirement, life insurance premium, probationary 
status, or other benefit or condition of employment. The notice shall 
be provided not later than 14 days before the employee consents to the 
alternate work schedule.
    ``(f) Regulations.--The Secretary shall prescribe regulations to 
carry out this section.''.
    (2) The table of sections at the beginning of chapter 74 is amended 
by inserting after the item relating to section 7456 the following new 
item:
``Sec. 7456A. Nurses: alternate work schedules.''.

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

SEC. 5. NURSE EXECUTIVE SPECIAL PAY.

    Section 7452 is amended by adding at the end the following new 
subsection:
    ``(g)(1) In order to recruit and retain highly qualified Department 
nurse executives, the Secretary may, in accordance with regulations 
prescribed by the Secretary, pay special pay to the nurse executive at 
each location as follows:
        ``(A) Each Department health care facility.
        ``(B) The Central Office.
    ``(2) The amount of special pay paid to a nurse executive under 
paragraph (1) shall be not less than $10,000 or more than $25,000.
    ``(3) The amount of special pay paid to a nurse executive under 
paragraph (1) shall be based on factors such as the grade of the nurse 
executive position, the scope and complexity of the nurse executive 
position, the personal qualifications of the nurse executive, the 
characteristics of the health care facility concerned, the nature and 
number of specialty care units at the health care facility concerned, 
demonstrated difficulties in recruitment and retention of nurse 
executives at the health care facility concerned, and such other 
factors as the Secretary considers appropriate.
    ``(4) Special pay paid to a nurse executive under paragraph (1) 
shall be in addition to any other pay (including basic pay) and 
allowances to which the nurse executive is entitled, and shall be 
considered pay for all purposes, including retirement benefits under 
chapters 83 and 84 of title 5, and other benefits, but shall not be 
considered basic pay for purposes of adverse actions under subchapter V 
of this chapter.''.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.