102nd Congress > House > Vote 17

Date: 1991-01-30

Result: 399-1 (Passed)

Clerk session vote number: 18

Vote Subject Matter: Foreign and Defense Policy / Defense Policy Budget

Bill number: HR598

Question: On Motion to Suspend the Rules and Pass

Description: DEPARTMENT OF VETERANS AFFAIRS PHYSICIANS’ AND DENTISTS’ COMPENSATION AND LABOR RELATIONS ACT OF 1991

Bill summary: Department of Veterans Affairs Health-Care Personnel Act of 1991 - Redesignates the Veterans Health Services and Research Administration in the Department of Veterans Affairs (Department) as the Veterans Health Administration. Title I: Special Pay for Physicians and Dentists - Department of Veterans Affairs Physician and Dentist Recruitment and Retention Act of 1991 - Revises Federal provisions relating to special pay for Department physicians and dentists. Directs the Secretary of Veterans (...show more) Affairs, in order to recruit and retain highly qualified physicians and dentists, to provide special pay to such individuals under regulations prescribed by the Secretary after the Secretary has received the recommendations of the Chief Medical Director (CMD) of the Department. Conditions such special pay upon the execution of a written agreement by the physician or dentist to perform a period of obligated service within the Veterans Health Administration (VHA). Provides that such individual is not entitled to such special pay during the first three years of such service, except at the discretion of the Secretary for full-time services. Prohibits special pay for those physician and dentist positions for which there is no significant recruitment and retention problem. Authorizes the CMD to approve the payment of special pay to physicians and dentists employed on a less than half-time basis in specified circumstances. Prohibits the payment of special pay to physicians and dentists who: (1) are employed on less than a quarter-time or intermittent basis; (2) are in an internship or residency training position; or (3) are reemployed annuitants. Allows the Secretary to provide retention pay to physicians and dentists formerly receiving special pay but no longer eligible under new requirements outlined in this Act. Sets forth requirements of a written agreement, including provisions providing for: (1) a covered period of one to four years, with renewal permitted upon full completion of a prior agreement; (2) refunding of special pay on a prorated basis for unfulfilled services; (3) the waiver of such refund requirement due to circumstances beyond the control of the physician or dentist; (4) the inclusion of terms under which the Secretary and the physician or dentist may terminate the agreement; and (5) special review by the Secretary of an agreement which will differ radically (provide more than 50 percent more or more than 25 percent less) from special pay received under previous agreements or which, when added to basic pay, will exceed certain limits. Requires the Secretary to include in annual reports information concerning agreements approved or disapproved by the Secretary under which special pay differed radically or which, when combined with basic pay, exceeded a specified limit. States that all such pay limitation requirements and reports shall not apply to a proposed agreement entered into after FY 1994. Directs the Secretary to adjust special pay as necessary to reflect any change in status of a physician or dentist from part-time to full-time or vice versa. Directs the Secretary to provide special pay to eligible full-time physicians based upon specified factors, including: (1) tenure within the VHA; (2) service in a medical specialty for which it is extremely difficult to recruit and retain qualified professionals; (3) service in certain executive positions; (4) specialty or board certifications; (5) service in a geographic location for which there are extraordinary difficulties in the recruitment or retention of qualified personnel; and (6) service by a physician with exceptional qualifications within a specialty. Requires all special pay for such full-time physicians to be personally approved by the CMD on a case-by-case basis. Sets forth conditions and limitations to the payment of such special pay. Directs the Secretary to provide special pay to part-time eligible physicians based upon similar factors. Requires the Secretary to pay each such physician an amount of special pay equal to the proportion of full-time service that physician performs, up to a specified limit. Directs the Secretary to provide special pay to eligible full-time and part-time dentists based upon similar factors. Prohibits physicians or dentists receiving special pay for service in certain executive positions from receiving scarce specialty pay (another form of special pay that rewards scarce specialty areas of practice). Requires, with regard to the payment of special pay, determinations: (1) that there are extraordinary difficulties in recruitment or retention; (2) of the specific rate of special pay to be paid to each physician or dentist eligible; and (3) of whether there are extraordinary difficulties in a specific geographic location in the recruitment or retention of qualified physicians or dentists. Sets forth considerations for determinations with respect to extraordinary recruitment and retention difficulties and the payment of special pay for individual medical facilities of the Department. Provides minimum rates for the payment of special pay. Outlines the manner in which special pay is to be considered for purposes of other benefits laws for Federal employees. States that it is the policy of the Congress to assure that total pay for VHA physicians and dentists is comparable to total pay of other Government physicians and dentists and to the income of non-Federal physicians and dentists. Directs the Secretary: (1) in order to assist in implementing such policy, to obtain measures of income of such non-Department physicians and dentists and to define the bases for pay distinctions; (2) to report to the President quadrennially on appropriate amounts of special pay to VHA physicians and dentists to carry out such policy; and (3) to report to specified congressional committees annually on the use of authorities under this title. Allows the Secretary to authorize the CMD to pay advance payments, recruitment or relocation bonuses, retention allowances, and interview expenses to the following personnel in the same manner currently provided under Federal employment provisions: physicians, dentists, podiatrists, optometrists, registered nurses, physician assistants, and expanded-function dental auxiliaries. Directs the Secretary to reimburse any full-time board-certified physician or dentist appointed in the VHA for expenses incurred, up to $1,000 per year, for continuing professional education. Title II: Labor-Management Relations - Department of Veterans Affairs Labor Relations Improvement Act of 1991 - Directs the Secretary to prescribe the hours and conditions of employment and leaves of absence of the following VHA employees: physicians, dentists, podiatrists, optometrists, nurses, physician assistants, and expanded-duty dental auxiliaries. Provides that the authority of the Secretary to prescribe regulations with regard to such employees is subject to the right of Federal employees to engage in the collective bargaining process with respect to conditions of employment. States that such collective bargaining may not cover, or have any applicability to, any matter or question arising out of: (1) professional conduct or competence; (2) peer review; or (3) the establishment, determination, or adjustment of employee compensation. Requires any VHA employee who accepts responsibilities for professional services for remuneration other than assigned responsibilities to work a minimum 80-hour biweekly amount. Outlines those outside activities and responsibilities that such a person may not engage in or take on while an employee of the Department. Provides that whenever the CMD brings charges against a Department employee based on conduct or performance and, as a result of those charges, an adverse (disciplinary) action is taken against the employee, the employee shall have the right to appeal the action, either through: (1) a Disciplinary Appeals Board; (2) Department procedures; or (3) grievance procedures provided through collective bargaining, depending on the type of action involved. Requires the Secretary to publish in the Federal Register any proposed regulations prescribed concerning the collective bargaining or adverse action procedures. States that Disciplinary Appeals Boards shall have exclusive jurisdiction to review any case: (1) which arises out of a question of professional conduct or competence of an employee of the Department employed on a full-time basis under a permanent appointment; and (2) in which a major adverse action was taken (suspension, transfer, reduction in grade or pay, or discharge). Gives employees involved in such a case the right to: (1) advance written notice of the charges and actions that could be taken if the charges are sustained; and (2) an opportunity to be heard both orally and in writing on such charges. Requires a decision on such case by a deciding official within 21 days after the employee's response to the charges. Allows for a delay in a proposed action for up to one year while an employee seeks counseling or treatment for a condition covered under the Rehabilitation Act of 1973. Allows the Secretary to require an employee to make a written or oral response to the charges within 30 days of receipt, with extension for good cause shown. Outlines further administrative action to be taken by the Board in a major adverse action appeals procedure, together with time limitations involved in each step. States that the Secretary's execution of the Board's decision shall be the final administrative action in the case, with the affected employee entitled to judicial review of the order or decision. Requires the Secretary to prescribe procedures for the consideration of grievances of Department employees arising from adverse actions in which each action taken either: (1) is not a major adverse action; or (2) does not arise out of a question of professional conduct or competence. States that Disciplinary Appeals Boards shall not have jurisdiction to review such matters other than as part of a mixed case. States that review of an adverse action shall be provided through either Department procedures or through grievance procedures provided through collective bargaining. Outlines the rights of employees under the Department procedures to: (1) a formal review by an impartial examiner within the Department; (2) a prompt report of findings; (3) a prompt review of the examiner's findings by a higher official; and (4) legal or other representation in adverse action reviews under grievance procedures. Requires the Secretary to appoint Disciplinary Appeals Boards to hear appeals of major adverse actions taken against full-time Department employees and based on professional conduct or performance. Authorizes the chairman of such a Board to authorize disclosure to the affected employee of records or information to be reviewed during an appeal procedure. Provides for the protection of the privacy of the individuals whose records are involved. Requires the Secretary to periodically designate Department employees qualified to serve on Disciplinary Appeals Boards and to announce that a list of such qualified employees is available to any person requesting such list. Requires the Secretary to provide training in the functions and duties of such Boards and grievance procedures for employees selected to be on the panel. Title III: Miscellaneous - Requires physician assistants and expanded-function dental auxiliaries to be paid in accordance with a Nurse Schedule in effect on August 14, 1990, until the effective date of a determination by the Secretary to convert those occupations to covered positions under provisions enacted by the Department of Veterans Affairs Nurse Pay Act of 1990. Authorizes the CMD to determine the rates of pay with respect to covered Department regional and central office employees in certain grades. Requires the CMD to prescribe regulations for the adjustment of basic pay rates for such employees in order to assure that those rates are sufficient and competitive. Amends the Veterans' Health Care Amendments of 1986 to extend through FY 1991 a required annual report on the furnishing of nonservice-connected health care services to veterans. Allows the Secretary to submit an administrative reorganization plan at any time during the year. Requires a 90-day congressional notification period to expire before the Secretary may implement the reorganization. Defines a covered administrative reorganization as one involving a reduction during any fiscal year in the number of full-time equivalent employees by: (1) 15 percent or more (currently, ten); or (2) a percent which, when added to the percentage reduction in the number of such employees at a covered office or facility for the preceding fiscal year, is 25 percent (currently, 15) or more. Requires a report from the Secretary to the veterans' committees for the reorganization of any unit of the central office of the Department that is the duty station of 30 or more employees (currently, more than 25 but less than 100). Title IV: Reorganization and Redesignation of Parts IV, V, and VI of Title 38 - Reorganizes through recodification within Federal law various provisions relating to the organization and functions of the VHA, including provisions relating to organization, general authority and administration, patient rights, and research corporations within the VHA.

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Bill titles: To amend title 38, United States Code, to improve the capability of the Department of Veterans Affairs to recruit and retain physicians and dentists through increases in special pay authorities, to authorize collective bargaining over conditions of employment for health-care employees of the Department of Veterans Affairs, and for other purposes.; Department of Veterans Affairs Labor Relations Improvement Act of 1991; Department of Veterans Affairs Physician and Dentist Recruitment and Retention Act of 1991

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