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104th Congress Report
HOUSE OF REPRESENTATIVES
1st Session 104-225
EXTENSION OF AUTHORITY OF SECRETARY OF VETERANS AFFAIRS WITH RESPECT TO
DETERMINATION OF LOCALITY SALARIES FOR CERTAIN NURSE ANESTHETIST
POSITIONS IN THE DEPARTMENT OF VETERANS AFFAIRS
August 2, 1995.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
Mr. Stump, from the Committee on Veterans' Affairs, submitted the
R E P O R T
[To accompany H.R. 1536]
[Including cost estimate of the Congressional Budget Office]
The Committee on Veterans' Affairs, to whom was referred the
bill (H.R. 1536) to amend title 38, United States Code, to
extend for two years an expiring authority of the Secretary of
Veterans Affairs with respect to determination of locality
salaries for certain nurse anesthetist positions in the
Department of Veterans Affairs, having considered the same,
reports favorably thereon without amendment and recommends that
the bill do pass.
The Subcommittee met on May 11, 1995 and recommended H.R.
1536 to the full Committee. The full Committee met on June 15,
1995 and ordered H.R. 1536 reported favorably to the House by
unanimous voice vote.
Summary of the Reported Bill
H.R. 1536 would:
1. Amend section 7451(d)(3)(C)(iii) of title 38, United
States Code for a 2-year period by striking out ``April 1,
1995'' and inserting in lieu thereof ``December 31, 1997''.
2. The extension gives VA medical center directors the
authority to use nurse anesthetist contract agency compensation
data to ad-
just locality-based nurse anesthetist pay rates where a VA
locality survey provides insufficient data.
Background and Discussion
With the Department of Veterans Affairs Nurse Pay Act,
Public Law 101-366, Congress in 1990 established a ``locality
pay'' system for setting rates of pay for registered nurses.
The pay system vests the director of each VA hospital with
authority to establish basic pay rates for nurses at levels to
enable that facility to be competitive with other health care
facilities in the same labor market in recruitment and
retention of nurses. The sweeping changes introduced in P.L.
101-366 and questions regarding VA's administration of the new
law prompted extensive congressional oversight. This led
Congress in 1992 to adopt amendments refining the 1990 Act.
Among the problems brought to Congress' attention was a
unique issue affecting the rates of pay of VA nurse
anesthetists. Data indicated that the mechanism provided in
P.L. 101-366 failed to provide an adequate means for
determining the rates of pay for nurse anesthetists in the
pertinent labor market. Under the Nurse Pay Act, VA officials
were required to determine pay rates by reference to rates of
pay for corresponding health care professionals employed in
non-VA facilities. Prevailing practice for many hospitals,
however, is to contract for such services. VA maintained that
it could not under law consider the pay of such contractor
employees in determining appropriate pay for VA nurse
anesthetists, and was often unable to fairly compensate its
nurse anesthetists. Accordingly, provisions of the Veterans
Health Care Act of 1992, Public Law 102-585, authorized VA to
use salary data from any employer of nurse anesthetists as a
means of setting appropriate locality pay rates for these
skilled practitioners. The authority to use salary data from
sources other than a health care facility ran only through
March 1995. The Secretary of Veterans Affairs by letter of
March 3, 1995, transmitted to the Speaker of the House a draft
bill which would have extended the authority through 1999. H.R.
1536 would extend that authority through 1997.
Because of nurse anesthetists' ability to command higher
levels of compensation, it is important for VA medical centers
to have the continued flexibility this extension would permit.
No oversight findings have been submitted to the Committee
by the Committee on Government Reform and Oversight.
Congressional Budget Office Cost Estimate
The following letter was received from the Congressional
Budget Office concerning the cost of the reported bill:
Congressional Budget Office,
Washington, DC, June 20, 1995.
Hon. Bob Stump,
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.
Dear Mr. Chairman:
The Congressional Budget Office has reviewed H.R. 1536, a
bill to amend title 38, United States Code, to extend for two
years an expiring authority of the Secretary of Veterans'
Affairs with respect to determination of locality salaries for
certain nurse anesthetist positions in the Department of
Veterans Affairs, as ordered reported by the House Committee on
Veterans' Affairs on June 15, 1995.
The bill would have no significant cost to the federal
government. H.R. 1536 would not affect the budgets of state or
local governments, nor would it be subject to pay-as-you-go
procedures under section 252 of the Balanced Budget and
Emergency Deficit Control Act.
If you wish further details on this estimate, we will be
pleased to provide them.
June E. O'Neill,
Inflationary Impact Statement
The enactment of the reported bill would have no
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3 of rule XIII of the Rules of the
House of Representatives, changes in existing law made by the
bill, as reported, are shown as follows (existing law proposed
to be omitted is enclosed in black brackets, new matter is
printed in italics, existing law in which no change is proposed
is shown in roman):
SECTION 7451 OF TITLE 38, UNITED STATES CODE
Sec. 7451. Nurses and other health-care personnel: competitive pay
(a) * * *
* * * * * * *
(d)(1) * * *
* * * * * * *
(3)(A) * * *
* * * * * * *
(C)(i) * * *
* * * * * * *
(iii) The authority of the director to use such additional
data under this subparagraph with respect to certified
registered nurse anesthetists expires on [April 1, 1995]
December 31, 1997.
* * * * * * *