[Congressional Record Volume 154, Number 71 (Thursday, May 1, 2008)]
[Senate]
[Pages S3716-S3719]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. AKAKA:
  S. 2969. A bill to amend title 38, United States Code, to enhance the 
capacity of the Department of Veterans Affairs to recruit and retain 
nurses and other critical health-care professionals, and for other 
purposes; to the Committee on Veterans' Affairs.
  Mr. AKAKA. Mr. President, today I am introducing legislation to 
address personnel issues in the Department of Veterans Affairs. This 
legislation, proposed Veterans' Medical Personnel Recruitment and 
Retention Act of 2008, would help ensure that VA has the workforce 
necessary to serve America's veterans most effectively.
  Health care providers are the backbone of the VA system. Yet today, 
the Department faces a shortage of these professionals. Around the 
country, too many facilities are understaffed, at the cost of services 
for veterans. A recent report by the Partnership for Public Service 
gave the Veterans Health Administration poor marks for pay and 
benefits, and for family support. VHA also rated poorly among younger 
employees. To be the health care employer of choice, VA must be able to 
offer competitive salaries, work schedules, and benefits.
  As Chairman of the Committee on Veterans' Affairs, I held a hearing 
on April 9, 2008, that focused on personnel issues within the VA health 
care system. We heard detailed testimony from VA administrators and 
health care providers. Their testimony outlined the challenges VA 
faces, and suggested possible solutions.
  This legislation would benefit a wide range of positions within VA. 
Here are

[[Page S3717]]

some of the challenges VA faces, and the solutions I propose.
  Local labor markets for health care providers vary widely, and VA 
must be better prepared to compete in every market. Locality pay 
surveys are a crucial tool in this effort. However, a recent GAO report 
on nurse anesthetists revealed a locality pay system that is 
inconsistent and often dysfunctional. The bill I am introducing would 
make implementation of locality pay surveys more effective by requiring 
additional training on proper implementation, and improving 
transparency to allow for better oversight.
  This legislation would also encourage retention of experienced 
professionals by removing salary offsets for retired employees who 
choose to return to work at VA. In the coming years, a significant 
portion of the VA workforce will reach the age of retirement. 
Eliminating the salary offset by the amount of an employee's retirement 
annuity would encourage these experienced professionals to return to 
VA.
  Education benefits are often among the chief advantages of employment 
at VA, and I believe these benefits can be used for an even greater 
effect. VA has extensive programs to encourage further education within 
their workforce, and to provide financial assistance for employees with 
educational debt. This legislation would increase yearly benefit limits 
on the Education Debt Reduction Program--EDRP--and would broaden the 
goals of that program to include retention as well as recruitment. In 
so doing, the EDRP would be made available to both long-time VA 
employees and new hires. It would also reauthorize the Health 
Professionals Scholarship Program, and would broaden eligibility to a 
wider range of health professions.
  Further, to make VA more attractive to clinical researchers, this 
legislation would provide VA with authorities similar to the Loan 
Repayment Program of the National Health Service Corps. VA would be 
authorized to use funds from medical services appropriations to help 
researchers in need of financial assistance to payoff their education 
loans. This program would compliment EDRP, which is not available to 
researchers.
  In recent years, VA has been challenged to retain top administrators, 
especially those who have spent their careers at VA. Their expert 
knowledge is indispensable to the effective management of the VA health 
care system. However, given the high rates of compensation available 
outside of VA, retention of these professionals is often difficult. 
This legislation would provide VA with the authority to pay national 
administrators additional compensation so as to better compete with the 
private sector. It would also give VA the authority to increase, under 
limited circumstances, compensation for pharmacists, doctors, and 
dentists, in order for VA to be more competitive in local labor 
markets.
  VA faces many challenges in recruiting and retaining nurses. I have 
worked with VA administrators and nurses to develop solutions to these 
challenges. This legislation would give VA more tools to attract and 
keep these employees.
  Alternative work schedules are now commonly available in other health 
care systems. At VA, part-time and alternative work schedules are 
under-utilized, and as a result, VA loses prospective hires and damages 
employee morale. This legislation would clarify alternative work 
schedule and weekend duty rules. By making these schedules easier to 
implement, it is my hope that VA will expand their use.
  This bill would also make it easier for VA to hire and retain part-
time nurses by limiting probationary periods and expanding eligibility 
for overtime pay. For nurses who transition from full-time to part-
time, this legislation would eliminate the probationary period they are 
now required to serve. This provision would be extremely helpful in 
encouraging experienced nurses to extend their careers at VA beyond the 
customary age of retirement.
  In many locations, VA cannot compete with other health care systems 
for many nursing positions, particularly certified registered nurse 
anesthetists--CRNAs--and licensed practical and vocational nurses. A 
recent GAO report on CRNAs in VA noted that VA spends thousands of 
dollars on contract nurses to cover staffing gaps. The use of contract 
nurses, while appropriate in some situations, is not a permanent 
solution to the long-term staffing shortfall. The bill I am introducing 
would raise or eliminate pay caps currently placed on these difficult-
to-fill positions. These provisions are derived directly from testimony 
the Committee heard from VA nurses and administrators at the April 9, 
2008, hearing.
   This legislation would also clarify rules about emergency duty for 
VA nurses. The use of emergency mandatory overtime has been an issue in 
many VA facilities, and in other health care systems. I believe this 
legislation provides a reasonable solution. By standardizing the 
definition of ``emergency,'' it would facilitate more consistent and 
equitable use of emergency mandatory overtime.
  I believe that this legislation will give VA the tools it needs to 
recruit and retain the best health care professionals in the Nation. I 
also anticipate that it will improve employee morale, as well as 
improving transparency and oversight. As we have heard many times, VA 
faces a looming retirement crisis. The solutions proposed in this 
legislation seek to address these challenges.
  I urge my colleagues to support the proposed Veterans' Medical 
Personnel Recruitment and Retention Act of 2008.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 2969

       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 ``Veterans' Medical Personnel 
     Recruitment and Retention Act of 2008''.

     SEC. 2. ENHANCEMENT OF AUTHORITIES FOR RETENTION OF MEDICAL 
                   PROFESSIONALS.

       (a) Secretarial Authority to Extend Title 38 Status to 
     Additional Positions.--
       (1) In general.--Paragraph (3) of section 7401 of title 38, 
     United States Code, is amended by striking ``and blind 
     rehabilitation outpatient specialists.'' and inserting the 
     following: ``blind rehabilitation outpatient specialists, and 
     such other classes of health care occupations as the 
     Secretary considers necessary for the recruitment and 
     retention needs of the Department subject to the following 
     requirements:
       ``(A) Not later than 45 days before the Secretary appoints 
     any personnel for a class of health care occupations that is 
     not specifically listed in this paragraph, the Secretary 
     shall submit to the Committee on Veterans' Affairs of the 
     Senate, the Committee on Veterans' Affairs of the House of 
     Representatives, and the Office of Management and Budget 
     notice of such appointment.
       ``(B) Before submitting notice under subparagraph (A), the 
     Secretary shall solicit comments from any labor organization 
     representing employees in such class and include such 
     comments in such notice.''.
       (2) Appointment of nurse assistants.--Such paragraph is 
     further amended by inserting ``nurse assistants,'' after 
     ``licensed practical or vocational nurses,''.
       (b) Probationary Periods for Nurses.--Section 7403(b) of 
     such title is amended--
       (1) in paragraph (1), by striking ``Appointments'' and 
     inserting ``Except as otherwise provided in this subsection, 
     appointments'';
       (2) by redesignating paragraph (2) as paragraph (4); and
       (3) by inserting after paragraph (1) the following new 
     paragraphs:
       ``(2) An appointment of a nurse under this chapter, whether 
     on a full-time basis or a part-time basis, shall be for a 
     probationary period ending upon the completion by the person 
     so appointed of 4,180 hours of work pursuant to such 
     appointment.
       ``(3) An appointment described in subsection (a) on a part-
     time basis of a person who has previously served on a full-
     time basis for the probationary period for the position 
     concerned shall be without a probationary period.''.
       (c) Prohibition on Temporary Part-Time Nurse Appointments 
     in Excess of 4,180 Hours.--Section 7405(f)(2) of such title 
     is amended by inserting after ``year'' the following: ``, 
     except that a part-time appointment of a nurse shall not 
     exceed 4,180 hours''.
       (d) Waiver of Offset From Pay for Certain Reemployed 
     Annuitants.--
       (1) In general.--Section 7405 of such title is amended by 
     adding at the end the following:
       ``(g)(1) The Secretary may waive the application of 
     sections 8344 and 8468 of title 5 (relating to annuities and 
     pay on reemployment) or any other similar provision of law 
     under a Government retirement system on a case-by-case basis 
     for an annuitant reemployed on a temporary basis under the 
     authority of subsection (a) in a position described under 
     paragraph (1) of that subsection.

[[Page S3718]]

       ``(2) An annuitant to whom a waiver under paragraph (1) is 
     in effect shall not be considered an employee for purposes of 
     any Government retirement system.
       ``(3) An annuitant to whom a waiver under paragraph (1) is 
     in effect shall be subject to the provisions of chapter 71 of 
     title 5 (including all labor authority and labor 
     representative collective bargaining agreements) applicable 
     to the position to which appointed.
       ``(4) In this subsection:
       ``(A) The term `annuitant' means an annuitant under a 
     Government retirement system.
       ``(B) The term `employee' has the meaning under section 
     2105 of title 5.
       ``(C) The term `Government retirement system' means a 
     retirement system established by law for employees of the 
     Government of the United States.''.
       (2) Effective date.--The amendment made by paragraph (1) 
     shall take effect on the date that is six months after the 
     date of the enactment of this Act, and shall apply to pay 
     periods beginning on or after such effective date.
       (e) Minimum Rate of Basic Pay for Appointees to the Office 
     of the Under Secretary for Health Set to Lowest Rate of Basic 
     Pay Payable for a Senior Executive Service Position.--
       (1) In general.--Section 7404(a) of such title is amended--
       (A) by striking ``The annual'' and inserting ``(1) The 
     annual'';
       (B) by striking ``The pay'' and inserting the following:
       ``(2) The pay'';
       (C) by striking ``under the preceding sentence'' and 
     inserting ``under paragraph (1)''; and
       (D) by adding at the end the following:
       ``(3) The minimum rate of basic pay for a position to which 
     an Executive order applies under paragraph (1) and is not 
     described by paragraph (2) may not be less than the lowest 
     rate of basic pay payable for a Senior Executive Service 
     position under section 5382 of title 5.''.
       (2) Effective date.--The amendments made by paragraph (1) 
     shall take effect on the first day of the first pay period 
     beginning after the day that is 180 days after the date of 
     the enactment of this Act.
       (f) Comparability Pay Program for Appointees to the Office 
     of the Under Secretary for Health.--Section 7410 of such 
     title is amended--
       (1) by striking ``The Secretary may'' and inserting ``(a) 
     In General.--The Secretary may''; and
       (2) by adding at the end the following new subsection:
       ``(b) Comparability Pay for Appointees to the Office of the 
     Under Secretary for Health.--(1) The Secretary may authorize 
     the Under Secretary for Health to provide comparability pay 
     of not more than $100,000 per year to individuals of the 
     Veterans Health Administration appointed under section 7306 
     of this title who are not physicians or dentists to achieve 
     annual pay levels for such individuals that are comparable 
     with annual pay levels of individuals with similar positions 
     in the private sector.
       ``(2) Comparability pay under paragraph (1) for an 
     individual is in addition to all other pay, awards, and 
     performance bonuses paid to such individual under this title.
       ``(3) Except as provided in paragraph (4), comparability 
     pay under paragraph (1) for an individual shall be considered 
     basic pay for all purposes, including retirement benefits 
     under chapters 83 and 84 of title 5, and other benefits.
       ``(4) Comparability pay under paragraph (1) for an 
     individual shall not be considered basic pay for purposes of 
     adverse actions under subchapter V of this chapter.
       ``(5) Comparability pay under paragraph (1) may not be 
     awarded to an individual in an amount that would result in an 
     aggregate amount of pay (including bonuses and awards) 
     received by such individual in a year under this title that 
     is greater than the annual pay of the President.''.
       (g) Special Incentive Pay for Department Pharmacist 
     Executives.--Section 7410 of such title, as amended by 
     subsection (f), is further amended by adding at the end the 
     following new subsection:
       ``(c) Special Incentive Pay for Department Pharmacist 
     Executives.--(1) In order to recruit and retain highly 
     qualified Department pharmacist executives, the Secretary may 
     authorize the Under Secretary for Health to pay special 
     incentive pay of not more than $40,000 per year to an 
     individual of the Veterans Health Administration who is a 
     pharmacist executive.
       ``(2) In determining whether and how much special pay to 
     provide to such individual, the Under Secretary shall 
     consider the following:
       ``(A) The grade and step of the position of the individual.
       ``(B) The scope and complexity of the position of the 
     individual.
       ``(C) The personal qualifications of the individual.
       ``(D) The characteristics of the labor market concerned.
       ``(E) Such other factors as the Secretary considers 
     appropriate.
       ``(3) Special incentive pay under paragraph (1) for an 
     individual is in addition to all other pay (including basic 
     pay) and allowances to which the individual is entitled.
       ``(4) Except as provided in paragraph (5), special 
     incentive pay under paragraph (1) for an individual shall be 
     considered basic pay for all purposes, including retirement 
     benefits under chapters 83 and 84 of title 5, and other 
     benefits.
       ``(5) Special incentive pay under paragraph (1) for an 
     individual shall not be considered basic pay for purposes of 
     adverse actions under subchapter V of this chapter.
       ``(6) Special incentive pay under paragraph (1) may not be 
     awarded to an individual in an amount that would result in an 
     aggregate amount of pay (including bonuses and awards) 
     received by such individual in a year under this title that 
     is greater than the annual pay of the President.''.
       (h) Pay for Physicians and Dentists.--
       (1) Non-foreign cost of living adjustment allowance.--
     Section 7431(b) of such title is amended by adding at the end 
     the following:
       ``(5) The non-foreign cost of living adjustment allowance 
     authorized under section 5941 of title 5 for physicians and 
     dentists whose pay is set under this section shall be 
     determined as a percentage of base pay only.''.
       (2) Market pay determinations for physicians and dentists 
     in administrative or executive leadership positions.--Section 
     7431(c)(4)(B)(i) of such title is amended by adding at the 
     end the following: ``The Secretary may exempt physicians and 
     dentists occupying administrative or executive leadership 
     positions from the requirements of the previous sentence.''.
       (3) Exception to prohibition on reduction of market pay.--
     Section 7431(c)(7) of such title is amended by striking 
     ``concerned.'' and inserting ``concerned, unless there is a 
     change in board certification or reduction of privileges.''.
       (i) Adjustment of Pay Cap for Nurses.--Section 7451(c)(2) 
     of such title is amended by striking ``title 5'' and 
     inserting ``title 5 or the level of GS-15 as prescribed under 
     section 5332 of such title, whichever is greater''.
       (j) Exemption for Certified Registered Nurse Anesthetists 
     From Limitation on Authorized Competitive Pay.--Section 
     7451(c)(2) of such title is further amended by adding at the 
     end the following new sentence: ``The maximum rate of basic 
     pay for a grade for the position of certified registered 
     nurse anesthetist pursuant to an adjustment under subsection 
     (d) may exceed the maximum rate otherwise provided in the 
     preceding sentence.''.
       (k) Locality Pay Scale Computations.--
       (1) Education, training, and support for facility directors 
     in wage surveys.--Section 7451(d)(3) of such title is amended 
     by adding at the end the following new subparagraph:
       ``(F) The Under Secretary for Health shall provide 
     appropriate education, training, and support to directors of 
     Department health-care facilities in the conduct and use of 
     surveys under this paragraph.''.
       (2) Information on methodology used in wage surveys.--
     Section 7451(e)(4) of such title is amended--
       (A) by redesignating subparagraph (D) as subparagraph (E); 
     and
       (B) by inserting after subparagraph (C) the following new 
     subparagraph (D):
       ``(D) In any case in which the director conducts such a 
     wage survey during the period covered by the report and makes 
     adjustment in rates of basic pay applicable to one or more 
     covered positions at the facility, information on the 
     methodology used in making such adjustment or adjustments.''.
       (3) Disclosure of information to persons in covered 
     positions.--Section 7451(e) of such title is further amended 
     by adding at the end the following new paragraph:
       ``(6)(A) Upon the request of an individual described in 
     subparagraph (B) for a report provided under paragraph (4) 
     with respect to a Department health-care facility, the Under 
     Secretary for Health or the director of such facility shall 
     provide to the individual the most current report for such 
     facility provided under such paragraph.
       ``(B) An individual described in this subparagraph is--
       ``(i) an individual in a covered position at a Department 
     health-care facility; or
       ``(ii) a representative of the labor organization 
     representing that individual who is designated by that 
     individual to make the request.''.
       (l) Increased Limitation on Special Pay for Nurse 
     Executives.--Section 7452(g)(2) of such title is amended by 
     striking ``$25,000'' and inserting ``$100,000''.
       (m) Eligibility of Part-Time Nurses for Additional Nurse 
     Pay.--
       (1) In general.--Section 7453 of such title is amended--
       (A) in subsection (a), by striking ``a nurse'' and 
     inserting ``a full-time nurse or part-time nurse'';
       (B) in subsection (b)--
       (i) in the first sentence--

       (I) by striking ``on a tour of duty'';
       (II) by striking ``on such tour''; and
       (III) by striking ``of such tour'' and inserting ``of such 
     service''; and

       (ii) in the second sentence, by striking ``of such tour'' 
     and inserting ``of such service'';
       (C) in subsection (c)--
       (i) by striking ``on a tour of duty''; and
       (ii) by striking ``on such tour''; and
       (D) in subsection (e)--
       (i) in paragraph (1), by striking ``eight hours in a day'' 
     and inserting ``eight consecutive hours''; and
       (ii) in paragraph (5)(A), by striking ``tour of duty'' and 
     inserting ``period of service''.
       (2) Exclusion of application of additional nurse pay 
     provisions to certain additional employees.--Section 
     7454(b)(3) of such title is amended to read as follows:
       ``(3) Employees appointed under section 7408 of this title 
     performing service on a tour

[[Page S3719]]

     of duty, any part of which is within the period commencing at 
     midnight Friday and ending at midnight Sunday, shall receive 
     additional pay in addition to the rate of basic pay provided 
     such employees for each hour of service on such tour at a 
     rate equal to 25 percent of such employee's hourly rate of 
     basic pay.''.
       (n) Exemption of Additional Nurse Positions From Limitation 
     on Increase in Rates of Basic Pay.--Section 7455(c)(1) of 
     such title is amended by inserting after ``nurse 
     anesthetists,'' the following: ``licensed practical nurses, 
     licensed vocational nurses, and nursing positions otherwise 
     covered by title 5,''.

     SEC. 3. LIMITATIONS ON OVERTIME DUTY, WEEKEND DUTY, AND 
                   ALTERNATIVE WORK SCHEDULES FOR NURSES.

       (a) Overtime Duty.--
       (1) In general.--Subchapter IV of chapter 74 of title 38, 
     United States Code, is amended by adding at the end the 
     following new section:

     ``Sec. 7459. Nurses: special rules for overtime duty

       ``(a) Limitation.--Except as provided in subsection (c), 
     the Secretary may not require a nurse to work more than 40 
     hours (or 24 hours if such nurse is covered under section 
     7456) in an administrative work week or more than eight 
     consecutive hours (or 12 hours if such nurse is covered under 
     section 7456 or 7456A).
       ``(b) Voluntary Overtime.--(1) A nurse may on a voluntary 
     basis elect to work hours otherwise prohibited by subsection 
     (a).
       ``(2) The refusal of a nurse to work hours prohibited by 
     subsection (a) shall not be grounds to discriminate (within 
     the meaning of section 704(a) of the Civil Rights Act of 1964 
     (42 U.S.C. 2000e-3(a))) against the nurse, dismissal or 
     discharge of the nurse, or any other adverse personnel action 
     against the nurse.
       ``(c) Overtime Under Emergency Circumstances.--(1) Subject 
     to paragraph (2), the Secretary may require a nurse to work 
     hours otherwise prohibited by subsection (a) if--
       ``(A) the work is a consequence of an emergency that could 
     not have been reasonably anticipated;
       ``(B) the emergency is non-recurring and is not caused by 
     or aggravated by the inattention of the Secretary or lack of 
     reasonable contingency planning by the Secretary;
       ``(C) the Secretary has exhausted all good faith, 
     reasonable attempts to obtain voluntary workers;
       ``(D) the nurse has critical skills and expertise that are 
     required for the work; and
       ``(E) the work involves work for which the standard of care 
     for a patient assignment requires continuity of care through 
     completion of a case, treatment, or procedure.
       ``(2) A nurse may not be required to work hours under this 
     subsection after the requirement for a direct role by the 
     nurse in responding to medical needs resulting from the 
     emergency ends.
       ``(d) Nurse Defined.--In this section, the term `nurse' 
     includes the following;
       ``(1) A registered nurse.
       ``(2) A licensed practical or vocational nurse.
       ``(3) A nurse assistant appointed under this chapter or 
     title 5.
       ``(4) Any other nurse position designated by the Secretary 
     for purposes of this section.''.
       (2) 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 7458 the following new 
     item:

``7459. Nurses: special rules for overtime duty.''.

       (b) Weekend Duty.--Section 7456 of such title is amended--
       (1) in subsection (a) by striking ``regularly scheduled 12-
     hour tour of duty'' and inserting ``scheduled 12-hour periods 
     of service'';
       (2) in subsection (b)--
       (A) in paragraph (2), by striking ``service performed as 
     part of a regularly scheduled 12-hour tour of duty'' and 
     inserting ``any service performed''; and
       (B) in paragraph (3)--
       (i) in subparagraph (A), by striking ``regularly scheduled 
     two 12-hour tours of duty'' and inserting ``scheduled 12-hour 
     period of service'';
       (ii) in subparagraph (B), by striking ``regularly scheduled 
     two 12-hour tour of duty'' and inserting ``scheduled 12-hour 
     period of service''; and
       (iii) in subparagraph (C), by striking ``regularly 
     scheduled two 12-hour tours of duty'' and inserting 
     ``scheduled two 12-hour periods of service'';
       (3) by striking subsection (c); and
       (4) by redesignating subsection (d) as (c).
       (c) Alternate Work Schedules.--
       (1) In general.--Section 7456A(b)(1)(A) of such title is 
     amended by striking ``three regularly scheduled'' and all 
     that follows through the period at the end and inserting 
     ``six regularly scheduled 12-hour periods of service within a 
     pay period shall be considered for all purposes to have 
     worked a full 80-hour pay period.''.
       (2) Conforming amendments.--Section 7456A(b) of such title 
     is amended--
       (A) in the subsection heading, by striking ``36/40'' and 
     inserting ``72/80'';
       (B) in paragraph (2)--
       (i) in subparagraph (A), by striking ``40-hour basic work 
     week'' and inserting ``80-hour pay period'';
       (ii) in subparagraph (B), by striking ``regularly scheduled 
     36-hour tour of duty within the work week'' and inserting 
     ``scheduled 72-hour period of service within the bi-weekly 
     pay period'';
       (iii) in subparagraph (C)--

       (I) in clause (i), by striking ``regularly scheduled 36-
     hour tour of duty within an administrative work week'' and 
     inserting ``scheduled 72-hour period of service within an 
     administrative pay period'';
       (II) in clause (ii), by striking ``regularly scheduled 12-
     hour tour of duty'' and inserting ``scheduled 12-hour period 
     of service''; and
       (III) in clause (iii), by striking ``regularly scheduled 
     36-hour tour of duty work week'' and inserting ``scheduled 
     72-hour period of service pay period''; and

       (iv) in subparagraph (D), by striking ``regularly scheduled 
     12-hour tour of duty'' and inserting ``scheduled 12-hour 
     period of service''; and
       (C) in paragraph (3), by striking ``regularly scheduled 12-
     hour tour of duty'' and inserting ``scheduled 12-hour period 
     of service''.

     SEC. 4. IMPROVEMENTS TO CERTAIN EDUCATIONAL ASSISTANCE 
                   PROGRAMS.

       (a) Reinstatement of Health Professionals Educational 
     Assistance Scholarship Program.--
       (1) In general.--Section 7618 of title 38, United States 
     Code, is amended by striking ``December 31, 1998'' and 
     inserting ``December 31, 2013''.
       (2) Expansion of eligibility requirements.--Paragraph (2) 
     of section 7612(b) of such title is amended by striking 
     ``(under section'' and all that follows through the period at 
     the end and inserting the following: ``as an appointee under 
     paragraph (1) or (3) of section 7401 of this title.''.
       (b) Improvements to Education Debt Reduction Program.--
       (1) Inclusion of employee retention as purpose of 
     program.--Section 7681(a)(2) of such title is amended by 
     inserting ``and retention'' after ``recruitment'' the first 
     time it appears.
       (2) Eligibility.--Section 7682 of such title is amended--
       (A) in subsection (a)(1), by striking ``a recently 
     appointed'' and inserting ``an''; and
       (B) by striking subsection (c).
       (3) Maximum amounts of assistance.--Section 7683(d)(1) of 
     such title is amended--
       (A) by striking ``$44,000'' and inserting ``$60,000''; and
       (B) by striking ``$10,000'' and inserting ``$12,000''.
       (c) Loan Repayment Program for Clinical Researchers From 
     Disadvantaged Backgrounds.--
       (1) In general.--The Secretary of Veterans Affairs may, in 
     consultation with the Secretary of Health and Human Services, 
     utilize the authorities available in section 487E of the 
     Public Health Service Act (42 U.S.C. 288-5) for the repayment 
     of the principal and interest of educational loans of 
     appropriately qualified health professionals who are from 
     disadvantaged backgrounds in order to secure clinical 
     research by such professionals for the Veterans Health 
     Administration.
       (2) Limitations.--The exercise by the Secretary of Veterans 
     Affairs of the authorities referred to in paragraph (1) shall 
     be subject to the conditions and limitations specified in 
     paragraphs (2) and (3) of section 487E(a) of the Public 
     Health Service Act (42 U.S.C. 288-5(2) and (3)).
       (3) Funding.--Amounts for the repayment of principal and 
     interest of educational loans under this subsection shall be 
     derived from amounts available to the Secretary of Veterans 
     for the Veterans Health Administration for Medical Services.

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