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91ST CONGRESS 1st Session

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SENATE

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REPORT No. 91-485

SHARING PROGRAM OF AND EMPLOYMENT OF CERTAIN PROFESSIONAL PERSONNEL IN THE DEPARTMENT OF MEDICINE AND SURGERY, VETERANS' ADMINISTRATION

OCTOBER 17, 1969.-Ordered to be printed

Filed under authority of the order of the Senate of October 16, 1969

Mr. CRANSTON, from the Committee on Labor and Public Welfare, submitted the following

REPORT

[To accompany H.R. 9634]

The Committee on Labor and Public Welfare, to which was referred the bill (H.R. 9634) to amend title 38 of the United States Code in order to improve and make more effective the Veterans' Administration program of sharing specialized medical resources, having considered the same, reports favorably thereon with amendments and recommends that the bill as amended do pass.

COMMITTEE AMENDMENTS

The amendments are as follows:

On page 1, insert after the enacting clause:

That section 4114 of title 38, United States Code, is amended by inserting in subsection (a) (3) (A) immediately after the first sentence thereof the following: "Temporary full-time appointments of persons who have successfully completed a full course of nursing in a recognized school of nursing, approved by the Administrator, and are pending registration as a graduate nurse in a State, shall not exceed one year."

SEC. 2. Section 4114 of title 38, United States Code, is amended by deleting "(b)" at the beginning of subsection (b) and inserting in lieu therof "(b)(1)" and by adding the following new paragraph:

"(2) In order to more efficiently carry out the provisions of paragraph (1) of this subsection, the Administrator may contract with one or more hospitals, medical schools, or medical installations having hospital facilities and partici

pating with the Veterans' Administration in the training of
interns or residents to provide for the central administration
of stipend payments, provision of fringe benefits, and main-
tenance of records for such interns and residents by the
designation of one such institution to serve as an agency for
this purpose. The Administrator may pay to such designated
central administrative agency, without regard to any other
law or regulation governing the expenditure of Government
moneys either in advance or in arrears, an amount to cover
the cost for the period such intern or resident serves in a
Veterans' Administration hospital of (A) such stipends as
fixed by the Administrator pursuant to paragraph (1) of
this subsection, (B) hospitalization, medical care, and life
insurance, and any other employee benefits as are agreed
upon by the participating institutions for the period that
such intern or resident serves in a Veterans' Administration
hospital, (C) tax on employers pursuant to chapter 21 of
the Internal Revenue Code of 1954, where applicable, and
in addition, (D) an amount to cover a pro rata share of the
cost of expense of such central administrative agency. Any
amounts paid by the Administrator to such fund to cover
the cost of hospitalization, medical care, or life insurance
or other employee benefits shall be in lieu of any benefits
of like nature to which such intern or resident may be entitled
under the provisions of title 5 of the United States Code,
and the acceptance of stipends and employee benefits from
the designated central administrative agency shall constitute
a waiver by the recipient of any claim he might have to
any payment of stipends or employee benefits to which he
may be entitled under this title or title 5 of the United States
Code. Notwithstanding the foregoing, any period of service
of any
such intern or resident in a Veterans' Administration
hospital shall be deemed creditable service for the purposes
of section 8332 of title 5 of the United States Code. The
agreement may further provide that the designated central
administrative agency shall make all appropriate deduc-
tions from the stipend of each intern and resident for local,
State, and Federal taxes, maintain all records pertinent
thereto and make proper deposits thereof, and shall maintain
all records pertinent to the leave accrued by each intern and
resident for the period during which he serves in a partici-
pating hospital, including a Veterans' Administration hos-
pital. Such leave may be pooled, and the intern or resident
may be afforded leave by the hospital in which he is serving
at the time the leave is to be used to the extent of his total
accumulated leave, whether or not earned at the hospital in
which he is serving at the time the leave is to be afforded.”

SEC. 3. Section 4114 of title 38, United States Code, is amended by inserting in subsection (d) (1) immediately after the word "physician" the following: "or dentist".

On page 4, line 11, strike out "That section" and insert in lieu thereof "SEC. 4. Section"

S. Rept. 91-485

The title is amended to read as follows:

An Act to amend title 38 of the United States Code to authorize the Administrator of Veterans' Affairs to appoint certain persons in the nursing service in the Department of Medicine and Surgery of the Veterans' Administration and to enter into agreements with hospitals, medical schools, or medical installations for the central administration of a program of training for interns or residents, and to improve and make more effective the Veterans' Administration program of sharing specialized medical resources, and for other purposes.

The purpose of the amendments is to incorporate within the House-passed bill another administration proposal contained in S. 2623, to authorize the Veterans' Administration to appoint certain persons in the nursing service and as research dentists and to enter into agreements for the central administration of shared and rotating training programs for interns and residents.

INTRODUCTION

The Subcommittee on Veterans' Affairs conducted hearings on H.R. 9634 and S. 2623 on July 17, 1969. Testimony was presented by spokesmen of the administration, veterans' organizations, and by U.S. Senators. In executive session on October 2, 1969, the subcommittee considered H. R. 9634 and S. 2623 and unanimously ordered H. R. 9634, amended to include the text of S. 2623 reported to the full Labor and Public Welfare Committee. The Committee on Labor and Public Welfare met in executive session on October 9, 1969, at which time H.R. 9634 was unanimously approved and ordered reported.

EXPLANATION OF THE BILL

Sections 1, 2, and 3 incorporate the provisions of S. 2623 to amend 38 U.S.C. $4114, to provide greater flexibility in the Veterans' Administration hospital and medical care program. The modifications these sections make would generally provide the Administrator of Veterans' Affairs with greater administrative discretion in the appointment of nurses, particularly in recruiting career nurses; in the Veterans' Administration internship and residency program by authorizing agreements for the central administration of the administrative and personnel aspects of the programs of those interns and residents serving part time in Veterans' Administration hospitals and part time in other non-Federal hospitals; and in the appointment of dentists of high academic and research standing on a temporary full-time or part-time basis.

More specific explanations of these three sections follow:

Section 1 of the bill provides for the amendment of section 4114(a) (3) (A) of title 38, United States Code, to authorize for the temporary full-time appointment, for a period not to exceed 1 year, of persons who have completed a full course of nursing in a recognized school of nursing and are awaiting registration.

Nursing school graduates who are awaiting registration in a State are recruited for the purpose of ultimate career appointment as nurses

S. Rept. 91-485

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