ENHANCEMENT OF AUTHORITIES FOR RETENTION OF MEDICAL PROFESSIONALS.

SEC. 601. 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 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) Such other classes of health care occupations—“(i) are not occupations relating to administrative, clerical, or physical plant maintenance and protective services;124 STAT. 1168“(ii) that would otherwise receive basic pay in accordance with the General Schedule under section 5332 of title 5;“(iii) provide, as determined by the Secretary, direct patient care services or services incident to direct patient services; and“(iv) would not otherwise be available to provide medical care or treatment for veterans.“(B) 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.“(C) Before submitting notice under subparagraph (B), 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 Registered Nurses.—Section 7403(b) 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) With respect to the appointment of a registered nurse under this chapter, paragraph (1) shall apply with respect to such appointment regardless of whether such appointment is on a full-time basis or a part-time basis.“(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 Registered Nurse Appointments in Excess of 2 Years.—Section 7405 is amended by adding at the end the following new subsection:“(g)(1) Except as provided in paragraph (3), employment of a registered nurse on a temporary part-time basis under subsection (a)(1) shall be for a probationary period of two years.“(2) Except as provided in paragraph (3), upon completion by a registered nurse of the probationary period described in paragraph (1)—“(A) the employment of such nurse shall—“(i) no longer be considered temporary; and“(ii) be considered an appointment described in section 7403(a) of this title; and“(B) the nurse shall be considered to have served the probationary period required by section 7403(b).“(3) This subsection shall not apply to appointments made on a term limited basis of less than or equal to three years of—124 STAT. 1169“(A) nurses with a part-time appointment resulting from an academic affiliation or teaching position in a nursing academy of the Department;“(B) nurses appointed as a result of a specific research proposal or grant; or“(C) nurses who are not citizens of the United States and appointed under section 7407(a) of this title.”.(d) Rate of Basic Pay for Appointees to the Office of the Under Secretary for Health Set to Rate of Basic Pay for Senior Executive Service Positions.—(1) In general.—Section 7404(a) 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 new paragraph:“(3)(A) The rate of basic pay for a position to which an Executive order applies under paragraph (1) and is not described by paragraph (2) shall be set in accordance with section 5382 of title 5 as if such position were a Senior Executive Service position (as such term is defined in section 3132(a) of title 5).“(B) A rate of basic pay for a position may not be set under subparagraph (A) in excess of—“(i) in the case the position is not described in clause (ii), the rate of basic pay payable for level III of the Executive Schedule; or“(ii) in the case that the position is covered by a performance appraisal system that meets the certification criteria established by regulation under section 5307(d) of title 5, the rate of basic pay payable for level II of the Executive Schedule.“(C) Notwithstanding the provisions of subsection (d) of section 5307 of title 5, the Secretary may make any certification under that subsection instead of the Office of Personnel Management and without concurrence of the Office of Management and Budget.”.(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.(e) Special Incentive Pay for Department Pharmacist Executives.—Section 7410 is amended—(1) by striking “The Secretary may” and inserting the following:“(a) In General.—The Secretary may”; and(2) by adding at the end the following new subsection:“(b) 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.124 STAT. 1170“(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.”.(f) Pay for Physicians and Dentists.—(1) Non-foreign cost of living adjustment allowance.—Section 7431(b) is amended by adding at the end the following new paragraph:“(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) 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) is amended by striking “concerned.” and inserting “concerned, unless there is a change in board certification or reduction of privileges.”.(g) Adjustment of Pay Cap for Nurses.—Section 7451(c)(2) is amended by striking “level V” and inserting “level IV”.(h) Exemption for Certified Registered Nurse Anesthetists From Limitation on Authorized Competitive Pay.—Section 7451(c)(2) 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.”.(i) Increased Limitation on Special Pay for Nurse Executives.—Section 7452(g)(2) is amended by striking “$25,000” and inserting “$100,000”.(j) Locality Pay Scale Computations.—(1) Education, training, and support for facility directors in wage surveys.—Section 7451(d)(3) 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 124 STAT. 1171 care facilities in the conduct and use of surveys, including the use of third-party surveys, under this paragraph.”.(2) Information on methodology used in wage surveys.—Section 7451(e)(4) 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), as amended by paragraph (2) of this subsection, 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.”.(k) Eligibility of Part-Time Nurses for Additional Nurse Pay.—(1) In general.—Section 7453 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 “service on such tour” and inserting “such service”; 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 “service on such tour” and inserting “such service”; 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.—Paragraph (3) of section 7454(b) is amended to read as follows:“(3) Employees appointed under section 7408 of this title performing service on a tour of duty, any part of which is within the period commencing at midnight Friday and ending at midnight 124 STAT. 1172 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.”.(l) Enhanced Authority To Increase Rates of Basic Pay To Obtain or Retain Services of Certain Persons.—Section 7455(c) is amended to read as follows:“(c)(1) Subject to paragraph (2), the amount of any increase under subsection (a) in the minimum rate for any grade may not (except in the case of nurse anesthetists, licensed practical nurses, licensed vocational nurses, nursing positions otherwise covered by title 5, pharmacists, and licensed physical therapists) exceed the maximum rate of basic pay (excluding any locality-based comparability payment under section 5304 of title 5 or similar provision of law) for the grade or level by more than 30 percent.“(2) No rate may be established under this section in excess of the rate of basic pay payable for level IV of the Executive Schedule.”.