38 U.S.C.
United States Code, 2011 Edition
Title 38 - VETERANS’ BENEFITS
PART II - GENERAL BENEFITS
CHAPTER 17 - HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE
From the U.S. Government Publishing Office, www.gpo.gov

CHAPTER 17—HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE

SUBCHAPTER I—GENERAL

Sec.
1701.
Definitions.
1702.
Presumptions: psychosis after service in World War II and following periods of war; mental illness following service in the Persian Gulf War.
1703.
Contracts for hospital care and medical services in non-Department facilities.
1704.
Preventive health services: annual report.
1705.
Management of health care: patient enrollment system.
1706.
Management of health care: other requirements.
1707.
Limitations.
1708.
Temporary lodging.

        

SUBCHAPTER II—HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL TREATMENT

1710.
Eligibility for hospital, nursing home, and domiciliary care.
1710A.
Required nursing home care.
1710B.
Extended care services.
1710C.
Traumatic brain injury: plans for rehabilitation and reintegration into the community.
1710D.
Traumatic brain injury: comprehensive plan for long-term rehabilitation.1

        

1710E.
Traumatic brain injury: use of non-Departmental facilities for rehabilitation.1
1711.
Care during examinations and in emergencies.
1712.
Dental care; drugs and medicines for certain disabled veterans; vaccines.
1712A.
Eligibility for readjustment counseling and related mental health services.
1712B.
Counseling for former prisoners of war.
[1713.
Renumbered.]
1714.
Fitting and training in use of prosthetic appliances; guide dogs; service dogs.
1715.
Tobacco for hospitalized veterans.
1716.
Hospital care by other agencies of the United States.
1717.
Home health services; invalid lifts and other devices.
1718.
Therapeutic and rehabilitative activities.
1719.
Repair or replacement of certain prosthetic and other appliances.
1720.
Transfers for nursing home care; adult day health care.
1720A.
Treatment and rehabilitative services for persons with drug or alcohol dependency.
1720B.
Respite care.
1720C.
Noninstitutional alternatives to nursing home care.
1720D.
Counseling and treatment for sexual trauma.
1720E.
Nasopharyngeal radium irradiation.
1720F.
Comprehensive program for suicide prevention among veterans.
1720G.
Assistance and support services for caregivers.

        

SUBCHAPTER III—MISCELLANEOUS PROVISIONS RELATING TO HOSPITAL AND NURSING HOME CARE AND MEDICAL TREATMENT OF VETERANS

1721.
Power to make rules and regulations.
1722.
Determination of inability to defray necessary expenses; income thresholds.
1722A.
Copayment for medications.
1723.
Furnishing of clothing.
1724.
Hospital care, medical services, and nursing home care abroad.
1725.
Reimbursement for emergency treatment.
1726.
Reimbursement for loss of personal effects by natural disaster.
1727.
Persons eligible under prior law.
1728.
Reimbursement of certain medical expenses.
1729.
Recovery by the United States of the cost of certain care and services.
1729A.
Department of Veterans Affairs Medical Care Collections Fund.
1729B.
Consolidated patient accounting centers.
1730.
Community residential care.
1730A.
Prohibition on collection of copayments from catastrophically disabled veterans.

        

SUBCHAPTER IV—HOSPITAL CARE AND MEDICAL TREATMENT FOR VETERANS IN THE REPUBLIC OF THE PHILIPPINES

1731.
Assistance to the Republic of the Philippines.
1732.
Contracts and grants to provide for the care and treatment of United States veterans by the Veterans Memorial Medical Center.
1733.
Supervision of program by the President.
1734.
Hospital and nursing home care and medical services in the United States.
1735.
Definitions.

        

SUBCHAPTER V—PAYMENTS TO STATE HOMES

1741.
Criteria for payment.
1742.
Inspections of such homes; restrictions on beneficiaries.
1743.
Applications.
1744.
Hiring and retention of nurses: payments to assist States.
1745.
Nursing home care and medications for veterans with service-connected disabilities.

        

SUBCHAPTER VI—SICKLE CELL ANEMIA

1751.
Screening, counseling, and medical treatment.
1752.
Research.
1753.
Voluntary participation; confidentiality.
1754.
Reports.
[1761 to 1764. Repealed.]

        

[SUBCHAPTER VII—TRANSFERRED]

[1771 to 1774. Renumbered.]

        

SUBCHAPTER VIII—HEALTH CARE OF PERSONS OTHER THAN VETERANS

1781.
Medical care for survivors and dependents of certain veterans.
1782.
Counseling, training, and mental health services for immediate family members and caregivers.
1783.
Bereavement counseling.
1784.
Humanitarian care.
1785.
Care and services during certain disasters and emergencies.
1786.
Care for newborn children of women veterans receiving maternity care.

        

Amendments

2010—Pub. L. 111–163, title I, §§101(a)(2), 103(c), title II, §206(b), title V, §511(b), May 5, 2010, 124 Stat. 1137, 1140, 1146, 1164, added items 1720G, 1730A, 1782, and 1786 and struck out former item 1782 “Counseling, training, and mental health services for immediate family members”.

2008—Pub. L. 110–387, title IV, §406(b), Oct. 10, 2008, 122 Stat. 4130, added item 1729B.

Pub. L. 110–181, div. A, title XVII, §§1702(b), 1703(b), 1708(a)(3), Jan. 28, 2008, 122 Stat. 489, 490, 494, substituted “Presumptions: psychosis after service in World War II and following periods of war; mental illness following service in the Persian Gulf War” for “Presumption relating to psychosis” in item 1702 and added items 1710C to 1710E.

2007—Pub. L. 110–110, §3(a)(2), Nov. 5, 2007, 121 Stat. 1033, which directed amendment of the analysis for this chapter by adding item 1720F at the end, was executed by adding item 1720F after item 1720E, to reflect the probable intent of Congress.

2006—Pub. L. 109–461, title II, §211(a)(4), Dec. 22, 2006, 120 Stat. 3419, added item 1745.

2004—Pub. L. 108–422, title II, §201(a)(2), Nov. 30, 2004, 118 Stat. 2382, added item 1744.

2003—Pub. L. 108–7, div. K, title I, §113(a)(2), Feb. 20, 2003, 117 Stat. 482, struck out item 1729B “Health Services Improvement Fund”.

2002—Pub. L. 107–287, §4(a)(2), Nov. 7, 2002, 116 Stat. 2029, added item 1785.

Pub. L. 107–135, title II, §§201(b)(2), 208(f)(1), Jan. 23, 2002, 115 Stat. 2457, 2464, substituted “Limitations” for “Restriction on use of funds for assisted suicide, euthanasia, or mercy killing” in item 1707, struck out item 1713 “Medical care for survivors and dependents of certain veterans”, substituted “guide dogs; service dogs” for “seeing-eye dogs” in item 1714, and added item for subchapter VIII and items 1781 to 1784.

2001—Pub. L. 107–95, §5(g)(1), Dec. 21, 2001, 115 Stat. 918, struck out subchapter VII heading “TREATMENT AND REHABILITATION FOR SERIOUSLY MENTALLY ILL AND HOMELESS VETERANS” and items 1771 “General treatment”, 1772 “Therapeutic housing”, 1773 “Additional services at certain locations”, and 1774 “Coordination with other agencies and organizations”.

2000—Pub. L. 106–419, title II, §221(b), Nov. 1, 2000, 114 Stat. 1845, added item 1708.

1999—Pub. L. 106–117, title I, §§101(a)(2), (c)(2), 111(b)(2), title II, §202(b), Nov. 30, 1999, 113 Stat. 1548, 1549, 1556, 1561, added items 1710A, 1710B, 1725, and 1729B.

1998—Pub. L. 105–368, title IX, §901(b), Nov. 11, 1998, 112 Stat. 3360, added item 1720E.

1997—Pub. L. 105–114, title II, §§202(d), 206(b)(3), Nov. 21, 1997, 111 Stat. 2287, 2289, substituted “Treatment and rehabilitative services for persons with drug or alcohol dependency” for “Treatment and rehabilitation for alcohol or drug dependence or abuse disabilities” in item 1720A, struck out “: pilot program” after “home care” in item 1720C, and added item for subchapter VII and items 1771 to 1774.

Pub. L. 105–33, title VIII, §8023(a)(2), Aug. 5, 1997, 111 Stat. 667, added item 1729A.

Pub. L. 105–12, §9(i)(2), Apr. 30, 1997, 111 Stat. 27, added item 1707.

1996—Pub. L. 104–262, title I, §§101(c)(2)(B), 104(a)(2), Oct. 9, 1996, 110 Stat. 3179, 3184, added items 1705 and 1706 and substituted “Dental care; drugs and medicines for certain disabled veterans; vaccines” for “Eligibility for outpatient services” in item 1712.

1994—Pub. L. 103–452, title I, §101(f)(2)(B), Nov. 2, 1994, 108 Stat. 4784, substituted “and treatment” for “to women veterans” in item 1720D.

1992—Pub. L. 102–585, title I, §102(a)(2), title V, §§512(b), 514(b), Nov. 4, 1992, 106 Stat. 4946, 4958, added items 1704 and 1720D and struck out subchapter VII heading “PREVENTIVE HEALTH-CARE SERVICES PILOT PROGRAM” and items 1761 “Purpose”, 1762 “Definition”, 1763 “Preventive health-care services”, and 1764 “Reports”.

1991—Pub. L. 102–83, §5(b)(1), Aug. 6, 1991, 105 Stat. 406, renumbered items 601 to 664 as 1701 to 1764, respectively.

Pub. L. 102–83, §4(a)(5), Aug. 6, 1991, 105 Stat. 404, substituted “non-Department” for “non-Veterans’ Administration” in item 603.

1990—Pub. L. 101–508, title VIII, §8012(a)(2), Nov. 5, 1990, 104 Stat. 1388–345, added item 622A.

Pub. L. 101–366, title II, §201(a)(2), Aug. 15, 1990, 104 Stat. 438, added item 620C.

1988—Pub. L. 100–322, title I, §§101(h)(2), 115(g)(2), May 20, 1988, 102 Stat. 492, 502, substituted “Eligibility for outpatient services” for “Eligibility for medical treatment” in item 612, substituted “Home health services; invalid” for “Invalid” in item 617, and struck out item 620C “Community based psychiatric residential treatment for chronically mentally ill veterans”.

1987—Pub. L. 100–6, §2(b), Feb. 12, 1987, 101 Stat. 94, added item 620C.

1986—Pub. L. 99–576, title II, §201(a)(2), 100 Stat. 3254, added item 620B.

Pub. L. 99–272, title XIX, §§19011(c)(2), 19012(b)(2), Apr. 7, 1986, 100 Stat. 378, 382, added item 603, and substituted “Determination” for “Evidence” and inserted “; income thresholds” in item 622.

1985—Pub. L. 99–166, title I, §§101(b)(2), 107(b), Dec. 3, 1985, 99 Stat. 943, 946, added item 612B and struck out “; pilot program” after “disabilities” in item 620A.

1983—Pub. L. 98–160, title I, §§103(a)(3), 104(b), Nov. 21, 1983, 97 Stat. 996, 998, inserted “; adult day health care” in item 620 and added item 630.

1982—Pub. L. 97–295, §4(15), Oct. 12, 1982, 96 Stat. 1306, substituted “Hospital care, medical services, and nursing home care abroad” for “Hospital care and medical services abroad” in item 624.

1981—Pub. L. 97–72, title I, §§106(a)(2), 107(c)(2), (d)(2), Nov. 3, 1981, 95 Stat. 1051, 1052, 1053, added item 629, substituted “HOSPITAL CARE AND MEDICAL TREATMENT FOR VETERANS IN THE REPUBLIC OF THE PHILIPPINES” for “HOSPITAL AND MEDICAL CARE FOR COMMONWEALTH OF THE PHILIPPINES ARMY VETERANS” in item relating to subchapter IV, and substituted “Contracts and grants to provide for the care and treatment of United States veterans by the Veterans Memorial Medical Center” for “Contracts and grants to provide hospital care, medical services and nursing home care” in item 632.

1980—Pub. L. 96–330, title IV, §401(b), Aug. 26, 1980, 94 Stat. 1051, substituted “Evidence of inability to defray necessary expenses” for “Statement under oath” in item 622.

1979—Pub. L. 96–22, title I, §§103(a)(2), 104(b), 105(b), 106(b), June 13, 1979, 93 Stat. 50, 51, 53, added items 612A, 620A, 634, and 661 to 664 and redesignated former item 634 as 635.

1977—Pub. L. 95–62, §4(b), July 5, 1977, 91 Stat. 263, struck out item 644 “Authorization of appropriations”.

1976—Pub. L. 94–581, title II, §§202(a), 203(b), Oct. 21, 1976, 90 Stat. 2855, 2856, inserted “NURSING HOME,” in chapter heading, and, in analysis of subchapter headings and section catchlines, inserted “, NURSING HOME” in item for subchapter II, inserted “, nursing home” in item 610, substituted “Care” for “Hospitalization” in item 611, and inserted “AND NURSING HOME” in item for subchapter III.

1973—Pub. L. 93–82, title I, §§103(c), 106(b), 107(b), 109(b), Aug. 2, 1973, 87 Stat. 182, 184, 186, 187, substituted “Medical care for survivors and dependents of certain veterans” and “Fitting and training in use of prosthetic appliances; seeing-eye dogs” for “Fitting and training in use of prosthetic appliances” and “Seeing-eye dogs” in items 613 and 614 respectively, substituted “natural disaster” for “fire” in item 626, added item 628, substituted “Assistance to the Republic of the Philippines” and “Contracts and grants to provide hospital care, medical services and nursing home care” for “Grants to the Republic of the Philippines” and “Modification of agreement with the Republic of the Philippines effectuating the Act of July 1, 1948” in items 631 and 632, respectively, and added “SUBCHAPTER VI—SICKLE CELL ANEMIA” comprising items 651 to 654.

Pub. L. 93–43, §4(c)(2), June 18, 1973, 87 Stat. 79, struck out item 625 “Arrests for crimes in hospitals and domiciliary reservations”.

1969—Pub. L. 91–178, §2(b), Dec. 30, 1969, 83 Stat. 837, added item 644.

1968—Pub. L. 90–493, §3(b), Aug. 19, 1968, 82 Stat. 809, substituted “Invalid lifts and other devices” for “Invalid lifts and other devices for pensioners” in item 617.

1964—Pub. L. 88–450, §§2(b), 6(b), Aug. 19, 1964, 78 Stat. 500, 504, inserted “and other devices” in item 617 and added item 620.

1962—Pub. L. 87–850, §1(b), Oct. 23, 1962, 76 Stat. 1126, added item 619.

Pub. L. 87–574, §2(2), Aug. 6, 1962, 76 Stat. 308, added item 618.

1959—Pub. L. 86–211, §7(b), Aug. 29, 1959, 73 Stat. 436, added item 617.

1 So in original. Does not conform to section catchline.

SUBCHAPTER I—GENERAL

§1701. Definitions

For the purposes of this chapter—

(1) The term “disability” means a disease, injury, or other physical or mental defect.

(2) The term “veteran of any war” includes any veteran awarded the Medal of Honor.

(3) The term “facilities of the Department” means—

(A) facilities over which the Secretary has direct jurisdiction;

(B) Government facilities for which the Secretary contracts; and

(C) public or private facilities at which the Secretary provides recreational activities for patients receiving care under section 1710 of this title.


(4) The term “non-Department facilities” means facilities other than Department facilities.

(5) The term “hospital care” includes—

(A)(i) medical services rendered in the course of the hospitalization of any veteran, and (ii) travel and incidental expenses pursuant to the provisions of section 111 of this title;

(B) such mental health services, consultation, professional counseling, marriage and family counseling, and training for the members of the immediate family or legal guardian of a veteran, or the individual in whose household such veteran certifies an intention to live, as the Secretary considers appropriate for the effective treatment and rehabilitation of a veteran or dependent or survivor of a veteran receiving care under the last sentence of section 1781(b) of this title; and

(C)(i) medical services rendered in the course of the hospitalization of a dependent or survivor of a veteran receiving care under the last sentence of section 1781(b) of this title, and (ii) travel and incidental expenses for such dependent or survivor under the terms and conditions set forth in section 111 of this title.


(6) The term “medical services” includes, in addition to medical examination, treatment, and rehabilitative services, the following:

(A) Surgical services.

(B) Dental services and appliances as described in sections 1710 and 1712 of this title.

(C) Optometric and podiatric services.

(D) Preventive health services.

(E) Noninstitutional extended care services, including alternatives to institutional extended care that the Secretary may furnish directly, by contract, or through provision of case management by another provider or payer.

(F) In the case of a person otherwise receiving care or services under this chapter—

(i) wheelchairs, artificial limbs, trusses, and similar appliances;

(ii) special clothing made necessary by the wearing of prosthetic appliances; and

(iii) such other supplies or services as the Secretary determines to be reasonable and necessary.


(G) Travel and incidental expenses pursuant to section 111 of this title.


(7) The term “domiciliary care” includes necessary medical services and travel and incidental expenses pursuant to the provisions of section 111 of this title.

(8) The term “rehabilitative services” means such professional, counseling, and guidance services and treatment programs as are necessary to restore, to the maximum extent possible, the physical, mental, and psychological functioning of an ill or disabled person.

(9) The term “preventive health services” means—

(A) periodic medical and dental examinations;

(B) patient health education (including nutrition education);

(C) maintenance of drug use profiles, patient drug monitoring, and drug utilization education;

(D) mental health preventive services;

(E) substance abuse prevention measures;

(F) immunizations against infectious disease;

(G) prevention of musculoskeletal deformity or other gradually developing disabilities of a metabolic or degenerative nature;

(H) genetic counseling concerning inheritance of genetically determined diseases;

(I) routine vision testing and eye care services;

(J) periodic reexamination of members of likely target populations (high-risk groups) for selected diseases and for functional decline of sensory organs, together with attendant appropriate remedial intervention; and

(K) such other health-care services as the Secretary may determine to be necessary to provide effective and economical preventive health care.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1141, §601; Pub. L. 86–598, July 7, 1960, 74 Stat. 335; Pub. L. 86–639, §2, July 12, 1960, 74 Stat. 472; Pub. L. 88–481, Aug. 22, 1964, 78 Stat. 593; Pub. L. 90–612, §2, Oct. 21, 1968, 82 Stat. 1202; Pub. L. 93–82, title I, §101, Aug. 2, 1973, 87 Stat. 179; Pub. L. 94–581, title I, §102, title II, §202(b), Oct. 21, 1976, 90 Stat. 2843, 2855; Pub. L. 95–520, §5, Oct. 26, 1978, 92 Stat. 1820; Pub. L. 96–22, title I, §102(c), title II, §201(a), June 13, 1979, 93 Stat. 48, 54; Pub. L. 96–151, title II, §§201(b), 202, Dec. 20, 1979, 93 Stat. 1093, 1094; Pub. L. 97–72, title I, §101, Nov. 3, 1981, 95 Stat. 1047; Pub. L. 97–251, §4, Sept. 8, 1982, 96 Stat. 716; Pub. L. 98–105, Sept. 30, 1983, 97 Stat. 730; Pub. L. 98–160, title I, §106(a), Nov. 21, 1983, 97 Stat. 998; Pub. L. 98–528, title I, §103(a), Oct. 19, 1984, 98 Stat. 2688; Pub. L. 99–108, §2, Sept. 30, 1985, 99 Stat. 481; Pub. L. 99–166, title I, §102(a), Dec. 3, 1985, 99 Stat. 943; Pub. L. 99–272, title XIX, §§19011(d)(2), 19012(a), Apr. 7, 1986, 100 Stat. 378, 380; Pub. L. 99–576, title II, §203, Oct. 28, 1986, 100 Stat. 3255; Pub. L. 100–322, title I, §131, May 20, 1988, 102 Stat. 506; Pub. L. 102–54, §14(b)(8), June 13, 1991, 105 Stat. 283; renumbered §1701 and amended Pub. L. 102–83, §§4(a)(2)(E), (3)–(5), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–585, title V, §513, Nov. 4, 1992, 106 Stat. 4958; Pub. L. 103–446, title XII, §1202(b)(1), Nov. 2, 1994, 108 Stat. 4689; Pub. L. 104–262, title I, §§101(d)(1), 103(a), Oct. 9, 1996, 110 Stat. 3179, 3182; Pub. L. 106–117, title I, §101(b), Nov. 30, 1999, 113 Stat. 1548; Pub. L. 107–135, title II, §208(a)(1), (e)(2), Jan. 23, 2002, 115 Stat. 2461, 2463; Pub. L. 107–330, title III, §308(g)(3), Dec. 6, 2002, 116 Stat. 2828; Pub. L. 108–170, title I, §§104(a), 106(a), Dec. 6, 2003, 117 Stat. 2044, 2045; Pub. L. 110–387, title III, §301(a)(1), title VIII, §801, Oct. 10, 2008, 122 Stat. 4120, 4140.)

Codification

The text of section 1762 of this title, which was transferred to the end of this section, redesignated as par. (9), and amended by Pub. L. 102–585, was based on Pub. L. 96–22, title I, §105(a), June 13, 1979, 93 Stat. 52, §662; renumbered §1762 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.

Prior Provisions

Prior sections 1700 and 1701 were renumbered sections 3500 and 3501 of this title, respectively.

Amendments

2008—Par. (5)(B). Pub. L. 110–387, §301(a)(1), inserted “marriage and family counseling,” after “professional counseling,” and substituted “as the Secretary considers appropriate for” for “as may be essential to”.

Par. (6)(E) to (G). Pub. L. 110–387, §801(2), added subpar. (E) and redesignated former subpars. (E) and (F) as (F) and (G), respectively.

Par. (10). Pub. L. 110–387, §801(1), struck out par. (10) which read as follows:

“(10)(A) During the period beginning on November 30, 1999, and ending on December 31, 2008, the term ‘medical services’ includes noninstitutional extended care services.

“(B) For the purposes of subparagraph (A), the term ‘noninstitutional extended care services’ means such alternatives to institutional extended care which the Secretary may furnish (i) directly, (ii) by contract, or (iii) (through provision of case management) by another provider or payor.”

2003—Par. (8). Pub. L. 108–170, §104(a), struck out “(other than those types of vocational rehabilitation services provided under chapter 31 of this title)” after “programs”.

Par. (10)(A). Pub. L. 108–170, §106(a), substituted “November 30, 1999, and ending on December 31, 2008,” for “the date of the enactment of the Veterans Millennium Health Care and Benefits Act and ending on December 31, 2003,”.

2002—Par. (5). Pub. L. 107–135, §208(e)(2), substituted “1781(b)” for “1713(b)” in subpars. (B) and (C)(i).

Par. (6). Pub. L. 107–135, §208(a)(1)(A), (B), substituted “services, the following:” for “services—” in introductory provisions and struck out concluding provisions which read as follows: “For the purposes of this paragraph, a dependent or survivor of a veteran receiving care under the last sentence of section 1713(b) of this title shall be eligible for the same medical services as a veteran.”

Par. (6)(A). Pub. L. 107–135, §208(a)(1)(C), added subpar. (A) and struck out former subpar. (A) which read as follows: “(i) surgical services, dental services and appliances as described in sections 1710 and 1712 of this title, optometric and podiatric services, preventive health services, and (in the case of a person otherwise receiving care or services under this chapter) wheelchairs, artificial limbs, trusses, and similar appliances, special clothing made necessary by the wearing of prosthetic appliances, and such other supplies or services as the Secretary determines to be reasonable and necessary, except that the Secretary may not furnish sensori-neural aids other than in accordance with guidelines which the Secretary shall prescribe, and (ii) travel and incidental expenses pursuant to the provisions of section 111 of this title; and”.

Par. (6)(B) to (F). Pub. L. 107–135, §208(a)(1)(A), (C), added subpars. (B) to (F) and struck out former subpar. (B) which included in the definition of “medical services” certain necessary consultation, professional counseling, training, and mental health services.

Par. (10)(A). Pub. L. 107–330, which directed the substitution of “November 30, 1999,” for “the date of the enactment of the Veterans’ Millennium Health Care and Benefits Act”, could not be executed because the word “Veterans’ ” did not appear in text.

1999—Par. (10). Pub. L. 106–117 added par. (10).

1996—Par. (6)(A)(i). Pub. L. 104–262, §103(a), struck out “(in the case of a person otherwise receiving care or services under this chapter)” before “preventive health services,”, substituted “(in the case of a person otherwise receiving care or services under this chapter)” for “(except under the conditions described in section 1712(a)(5)(A) of this title),”, and inserted “except that the Secretary may not furnish sensori-neural aids other than in accordance with guidelines which the Secretary shall prescribe,” after “reasonable and necessary,”.

Par. (6)(B)(i)(I). Pub. L. 104–262, §101(d)(1)(A), substituted “paragraph (1) or (2) of section 1710(a)” for “section 1712(a)”.

Par. (6)(B)(i)(II). Pub. L. 104–262, §101(d)(1)(B), substituted “paragraph (1), (2) or (3) of section 1710(a)” for “section 1712(a)(5)(B)”.

1994—Par. (3). Pub. L. 103–446 made technical correction to directory language of Pub. L. 102–83, §4(a)(2)(E). See 1991 Amendment note below.

1992—Par. (6)(A)(i). Pub. L. 102–585, §513(b), substituted “preventive health services,” for “preventive health-care services as defined in section 1762 of this title,”.

Par. (9). Pub. L. 102–585, §513(a), transferred the text of section 1762 of this title to the end of this section and redesignated it as par. (9), substituted “The term ‘preventive health service’ means” for “For the purposes of this subchapter, the term ‘preventive health-care services’ means”, and redesignated pars. (1) to (11) as subpars. (A) to (K), respectively. See Codification note above.

1991—Pub. L. 102–83, §5(a), renumbered section 601 of this title as this section.

Par. (2). Pub. L. 102–54, §14(b)(8)(A), struck out “any veteran of the Indian Wars, or” after “includes”.

Par. (3). Pub. L. 102–83, §5(c)(1), substituted “1710” for “610” in subpar. (C).

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in subpars. (A) to (C).

Pub. L. 102–83, §4(a)(2)(E), as amended by Pub. L. 103–446, substituted “facilities of the Department” for “Veterans’ Administration facilities”.

Pub. L. 102–54, §14(b)(8)(B), (C), redesignated par. (4) as (3) and struck out former par. (3) which read as follows: “The term ‘period of war’ includes each of the Indian Wars.”

Par. (4). Pub. L. 102–83, §4(a)(5), substituted “non-Department” for “non-Veterans’ Administration”.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Pub. L. 102–54, §14(b)(8)(E), redesignated par. (9) as (4).

Par. (5). Pub. L. 102–83, §5(c)(1), substituted “1713(b)” for “613(b)” in subpars. (B) and (C)(i).

Par. (6). Pub. L. 102–83, §5(c)(1), in subpar. (A) substituted “1710 and 1712” for “610 and 612”, “1762” for “662”, and “1712(a)(5)(A)” for “612(a)(5)(A)”, in subpar. (B) substituted “1712(a)” for “612(a)”, “1712(a)(5)(B)” for “612(a)(5)(B)”, and “1713(b)” for “613(b)”, and in last sentence substituted “1713(b)” for “613(b)”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Pub. L. 102–54, §14(b)(8)(D), substituted “612(a)(5)(A)” for “612(f)(1)(A)(i)” in subpar. (A)(i) and “612(a)(5)(B)” for “612(f)(1)(A)(ii)” in subpar. (B)(i)(II).

Par. (9). Pub. L. 102–54, §14(b)(8)(E), redesignated par. (9) as (4).

1988—Par. (4)(C). Pub. L. 100–322 added subpar. (C).

1986—Par. (4). Pub. L. 99–272, §19012(a)(1), struck out cl. (C) and provision following such clause, both relating to private facilities under contract as Veterans’ Administration facilities.

Par. (6)(A)(i). Pub. L. 99–272, §19011(d)(2)(A), substituted “section 612(f)(1)(A)(i)” for “section 612(f)(1)(A)”.

Par. (6)(B). Pub. L. 99–576 amended subpar. (B) generally. Prior to amendment, subpar. (B) read as follows: “such consultation, professional counseling, training, and mental health services as are necessary in connection with the treatment—

“(i) of the service-connected disability of a veteran pursuant to section 612(a) of this title, and

“(ii) in the discretion of the Administrator, of the non-service-connected disability of a veteran eligible for treatment under section 612(f)(1)(A)(ii) of this title where such services were initiated during the veteran's hospitalization and the provision of such services on an outpatient basis is essential to permit the discharge of the veteran from the hospital,

for the members of the immediate family or legal guardian of a veteran, or the individual in whose household such veteran certifies an intention to live, as may be essential to the effective treatment and rehabilitation of the veteran (including, under the terms and conditions set forth in section 111 of this title, travel and incidental expenses of such family member or individual in the case of a veteran who is receiving care for a service-connected disability, or in the case of dependent or survivor of a veteran receiving care under the last sentence of section 613(b) of this title). For the purposes of this paragraph, a dependent or survivor of a veteran receiving care under the last sentence of section 613(b) of this title shall be eligible for the same medical services as a veteran.”

Par. (6)(B)(ii). Pub. L. 99–272, §19011(d)(2)(B), substituted “section 612(f)(1)(A)(ii)” for “section 612(f)(1)(B)”.

Par. (9). Pub. L. 99–272, §19012(a)(2), added par. (9).

1985—Par. (4)(C)(v). Pub. L. 99–166, §102(a), substituted “with respect to the Commonwealth of Puerto Rico shall expire on September 30, 1988” for “(except with respect to Alaska and Hawaii) shall expire on October 31, 1985” and struck out “and to the Virgin Islands” before “of the restrictions in this subclause”.

Pub. L. 99–108 substituted “October 31, 1985” for “September 30, 1985”.

1984—Par. (4)(C)(v). Pub. L. 98–528 substituted “September 30, 1985” for “September 30, 1984”.

1983—Par. (4)(C)(v). Pub. L. 98–105 substituted “September 30, 1984” for “September 30, 1983”.

Par. (6)(a)(i). Pub. L. 98–160 inserted “(in the case of a person otherwise receiving care or services under this chapter) preventive health-care services as defined in section 662 of this title,”.

1982—Par. (4)(C)(v). Pub. L. 97–251 substituted “September 30, 1983” for “September 30, 1982”.

1981—Par. (4)(C)(v). Pub. L. 97–72 substituted “September 30, 1982” for “December 31, 1981”.

1979—Par. (4). Pub. L. 96–22, §§102(c)(1), 201(a), substituted “medical services for the treatment of any disability of a veteran described in clause (1)(B) or (2) of the first sentence, or the third sentence, of section 612(f) of this title or of a veteran described in section 612(g) of this title if the Administrator has determined, based on an examination by a physician employed by the Veterans’ Administration (or, in areas where no such physician is available, by a physician carrying out such function under a contract or fee arrangement), that the medical condition of such veteran precludes appropriate treatment in facilities described in clauses (A) and (B) of this paragraph” for “medical services for the treatment of any disability of a veteran described in clause (1)(B) or (2) of section 612(f) of this title” in subcl. (ii) of cl. (C), and added subcl. (vi) of cl. (C) and the provisions following cl. (C) relating to the periodic review of the necessity for continuing contractual arrangements in the case of veterans receiving contract care.

Par. (4)(C)(iii). Pub. L. 96–151, §202, inserted provisions respecting safe transfer of the veteran, and substituted “medical services in” for “hospital care in”.

Par. (5)(A). Pub. L. 96–151, §201(b)(1), substituted “travel” for “transportation”.

Par. (5)(C). Pub. L. 96–151, §201(b)(2), substituted provisions relating to travel and incidental expenses for provisions relating to transportation and incidental expenses.

Par. (6)(A)(i). Pub. L. 96–22, §102(c)(2), substituted “described in sections 610 and 612 of this title” for “authorized in sections 612 (b), (c), (d), and (e) of this title”.

Par. (6)(B). Pub. L. 96–151, §201(b)(3), substituted “travel and incidental expenses” for “necessary expenses of travel and subsistence”.

1978—Par. (4)(C)(v). Pub. L. 95–520 defined “Veterans’ Administration facilities” to include certain private facilities to provide medical services to obviate the need for hospital admission, deleted reference to hospital care for veterans in a territory, Commonwealth, or possession of the United States not contiguous to the forty-eight contiguous States, substituted provision requiring the annually determined hospital patient load and incidence of the provision of medical services to veterans hospitalized or treated at expense of Veterans’ Administration in Government and private facilities in each noncontiguous State to be consistent with patient load or incidence of the provision of medical services for veterans hospitalized or treated by the Veterans’ Administration within the forty-eight contiguous States for prior requirement that the annually determined average hospital patient load per thousand veteran population hospitalized at Veterans’ Administration expense in Government and private facilities in each noncontiguous State not exceed the average patient load per thousand veteran population hospitalized by the Veterans’ Administration within the forty-eight contiguous States; extended termination date for exercise of subcl. (v) authority to Dec. 31, 1981, from Dec. 31, 1978, except as to Alaska and Hawaii, and authorized waiver by the Administrator, to prevent hardship, of applicability to Puerto Rico and Virgin Islands of subcl. (v) restrictions with respect to hospital patient loads and incidence of provision of medical services.

1976—Par. (4)(A). Pub. L. 94–581, §202(b)(1), substituted “direct jurisdiction” for “direct and exclusive jurisdiction”.

Par. (4)(C). Pub. L. 94–581, §202(b)(2), inserted “when facilities described in clause (A) or (B) of this paragraph are not capable of furnishing economical care because of geographical inaccessibility or of furnishing the care or services required” after “contracts” in provisions preceding subcl. (i), substituted “to a veteran for the treatment of a service-connected disability or a disability for which a veteran was discharged” for “for persons suffering from service-connected disabilities or from disabilities for which such persons were discharged” in subcl. (i), added subcls. (ii) and (iii), redesignated former subcls. (ii) and (iii) as (iv) and (v), respectively, and in subcl. (v) as so redesignated, substituted “subclause (v)” for “clause (iii)”.

Par. (5)(A)(ii). Pub. L. 94–581, §202(b)(3), substituted “pursuant to the provisions of section 111 of this title” for “for any veteran who is in need of treatment for a service-connected disability or who is unable to defray the expense of transportation”.

Par. (5)(B). Pub. L. 94–581, §102(1), substituted “for the members of the immediate family or legal guardian of a veteran, or the individual in whose household such veteran certifies an intention to live, as may be essential to the effective treatment and rehabilitation of a veteran or dependent or survivor of a veteran receiving care under the last sentence of section 613(b) of this title; and” for “(including (i) necessary expenses for transportation if unable to defray such expenses; or (ii) necessary expenses of transportation and subsistence in the case of a veteran who is receiving care for a service-connected disability, or in the case of a dependent or survivor of a veteran receiving care under the last sentence of section 613(b) of this title, under the terms and conditions set forth in section 111 of this title) of the members of the immediate family (including legal guardians) of a veteran or such a dependent or survivor of a veteran, or in the case of a veteran or such dependent or survivor of a veteran who has no immediate family members (or legal guardian), the person in whose household such veteran, or such a dependent or survivor certifies his intention to live, as may be necessary or appropriate to the effective treatment and rehabilitation of a veteran or such a dependent or a survivor of a veteran; and”.

Par. (6). Pub. L. 94–581, §102(2), expanded definition of “medical services” to include rehabilitation services, podiatric services, and travel and incidental expenses pursuant to the provisions of section 111 of this title, and, for the members of the immediate family or legal guardian of a veteran, or the individual in whose household such veteran certifies an intention to live, as may be essential to the effective treatment and rehabilitation of the veteran, such consultation, professional counseling, training, and mental health services as are necessary in connection with the treatment of the service-connected disability of a veteran pursuant to section 612(a) of this title, and, in the discretion of the Administrator, of the non-service-connected disability of a veteran eligible for treatment under section 612(f)(1)(B) of this title where such services were initiated during the veteran's hospitalization and the provision of such services on an outpatient basis is essential to permit the discharge of the veteran from the hospital.

Par. (7). Pub. L. 94–581, §102(3), substituted “necessary medical services and travel and incidental expenses pursuant to the provisions of section 111 of this title” for “transportation and incidental expenses for veterans who are unable to defray the expenses of transportation”.

Par. (8). Pub. L. 94–581, §102(4), added par. (8).

1973—Par. (4)(C). Pub. L. 93–82, §101(a), extended the Administrator's contract authority for providing hospital care and medical services to persons suffering from service-connected disabilities or from disabilities for which such persons were discharged or released from the active military, naval, or air service and removed the limitation on such authority that such care be rendered in emergency cases only.

Par. (5). Pub. L. 93–82, §101(b), incorporated existing provisions in subpar. (A) and added subpars. (B) and (C).

Par. (6). Pub. L. 93–82, §101(c), expanded definition of “medical services” to include home health services determined by the Secretary to be necessary or appropriate for the effective and economical treatment of a disability of a veteran or a dependent or survivor of a veteran receiving care under section 613(b) of this title.

1968—Par. (4)(C)(iii). Pub. L. 90–612 expanded category of veterans of wars in the Territories, Commonwealths, or possessions of the United States to include, until December 31, 1978, veterans of such wars in States not contiguous to the forty-eight contiguous States, with the annually determined average hospital patient load per thousand of hospitalized veteran population in each such noncontiguous States not to exceed the average within the forty-eight contiguous States.

1964—Par. (2). Pub. L. 88–481 included any veteran awarded the Medal of Honor.

1960—Par. (6). Pub. L. 86–639 inserted “(except under the conditions described in section 612(f)(1))”.

Pub. L. 86–598 inserted “optometrists’ services” after “medical examination and treatment”.

Effective Date of 1994 Amendment

Section 1202(b) of Pub. L. 103–446 provided that the amendment made by that section is effective Aug. 6, 1991, and as if included in the enactment of Pub. L. 102–83.

Effective Date of 1986 Amendment

Amendment by section 19011(d)(2) of Pub. L. 99–272 applicable to hospital care, nursing home care, and medical services furnished on or after July 1, 1986, see section 19011(f) of Pub. L. 99–272, set out as a note under section 1710 of this title.

Effective Date of 1979 Amendments

Amendment by Pub. L. 96–151 effective Jan. 1, 1980, see section 206 of Pub. L. 96–151, set out as a note under section 111 of this title.

Section 107 of Pub. L. 96–22 provided that: “The amendments made to title 38, United States Code, by sections 102, 103, 104, 105, and 106 of this Act [see Tables for classification] shall be effective on October 1, 1979.”

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Effective Date of 1973 Amendment

Section 501 of Pub. L. 93–82 provided that: “The provisions of this Act [see Tables for classification] shall become effective the first day of the first calendar month following the date of enactment [Aug. 2, 1973], except that sections 105 and 106 [amending section 626 [now 1726] of this title and enacting section 628 [now 1728] of this title] shall be effective on January 1, 1971; section 107 [enacting sections 631 and 632 [now 1731 and 1732] of this title and provisions set out as note under section 1732 of this title] shall be effective July 1, 1973; and section 203 [amending former section 4107 of this title] shall become effective beginning the first pay period following thirty days after the date of enactment of this Act [Aug. 2, 1973].”

Location of Services

Pub. L. 110–387, title III, §301(b), Oct. 10, 2008, 122 Stat. 4120, provided that: “Paragraph (5) of section 1701 of title 38, United States Code, shall not be construed to prevent the Secretary of Veterans Affairs from providing services described in subparagraph (B) of such paragraph to individuals described in such subparagraph in centers under section 1712A of such title (commonly referred to as ‘Vet Centers’), Department of Veterans Affairs medical centers, community-based outpatient clinics, or in such other facilities of the Department of Veterans Affairs as the Secretary considers necessary.”

Guidelines Relating to Furnishing of Sensori-Neural Aids

Section 103(b) of Pub. L. 104–262 provided that: “Not later than 30 days after the date of the enactment of this Act [Oct. 9, 1996], the Secretary of Veterans Affairs shall prescribe the guidelines required by the amendments made by subsection (a) [amending this section] and shall furnish a copy of those guidelines to the Committees on Veterans’ Affairs of the Senate and House of Representatives.”

Study of Feasibility and Advisibility of Alternative Organizational Structures for Effective Provision of Health Care Services to Veterans

Section 1104 of Pub. L. 103–446 directed Secretary of Veterans Affairs to submit to Congress, not later than one year after Nov. 2, 1994, report and study on feasibility and advisability of alternative organizational structures, such as the establishment of a wholly-owned Government corporation or a Government-sponsored enterprise, for the effective provision of health care services to veterans.

Contract Health Care; Ratification of Action of Administrator of Veterans’ Affairs

Section 103(b) of Pub. L. 98–528 ratified actions by Administrator of Veterans’ Affairs in entering into contracts applicable to the period beginning Oct. 1, 1984, and ending Oct. 19, 1984, for care described in par. (4)(C)(v) of this section and in making waivers described in that provision.

Administration Capability To Provide Appropriate Care for Gender-Specific Disabilities of Women Veterans

Section 302 of Pub. L. 98–160, as amended by Pub. L. 102–40, title IV, §402(d)(2), May 7, 1991, 105 Stat. 239; Pub. L. 102–83, §§5(c)(2), 6(f), Aug. 6, 1991, 105 Stat. 406, 407, provided that: “The Secretary of Veterans Affairs shall ensure that each health-care facility under the direct jurisdiction of the Secretary is able, through services made available either by individuals appointed to positions in the Veterans Health Administration or under contracts or other agreements made under section 4117 [see 7409], 8111, or 8153 of title 38, United States Code, to provide appropriate care, in a timely fashion, for any gender-specific disability (as defined in section 1701(1) of such title) of a woman veteran eligible for such care under chapter 17 or chapter 31 of such title.”

Annual Report to Congress Covering Contract-Care Programs

Section 201(b) of Pub. L. 96–22, which directed Chief Medical Director of the Veterans’ Administration to report to appropriate committees of Congress, not later than Feb. 1, 1980, and annually thereafter, on implementation of former par. (4)(C)(v) of this section and amendments made to this section by section 201 of Pub. L. 96–22, and on numbers of veterans provided contract treatment (and average cost and duration thereof) in each State in certain enumerated categories, was repealed by Pub. L. 100–322, title I, §112(b), May 20, 1988, 102 Stat. 499.

Hospital Care and Medical Services Furnished by Veterans’ Administration in Puerto Rico and Virgin Islands; Report to President and Congress

Section 8 of Pub. L. 95–520, as amended by Pub. L. 96–330, title IV, §407, Aug. 26, 1980, 94 Stat. 1053, directed Administrator of Veterans’ Affairs, not later than Feb. 1, 1981, to submit a report to President and Congress on furnishing by Administration of hospital care and medical services in Puerto Rico and Virgin Islands, and set forth applicable criteria and considerations for the report.

§1702. Presumptions: psychosis after service in World War II and following periods of war; mental illness after service in the Persian Gulf War

(a) Psychosis.—For the purposes of this chapter, any veteran of World War II, the Korean conflict, the Vietnam era, or the Persian Gulf War who developed an active psychosis (1) within two years after discharge or release from the active military, naval, or air service, and (2) before July 26, 1949, in the case of a veteran of World War II, before February 1, 1957, in the case of a veteran of the Korean conflict, before May 8, 1977, in the case of a Vietnam era veteran, or before the end of the two-year period beginning on the last day of the Persian Gulf War, in the case of a veteran of the Persian Gulf War, shall be deemed to have incurred such disability in the active military, naval, or air service.

(b) Mental Illness.—For purposes of this chapter, any veteran of the Persian Gulf War who develops an active mental illness (other than psychosis) shall be deemed to have incurred such disability in the active military, naval, or air service if such veteran develops such disability—

(1) within two years after discharge or release from the active military, naval, or air service; and

(2) before the end of the two-year period beginning on the last day of the Persian Gulf War.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1141, §602; Pub. L. 90–77, title II, §203(a), Aug. 31, 1967, 81 Stat. 183; Pub. L. 97–295, §4(16), Oct. 12, 1982, 96 Stat. 1306; Pub. L. 99–576, title VII, §701(20), Oct. 28, 1986, 100 Stat. 3292; Pub. L. 102–25, title III, §334(b), Apr. 6, 1991, 105 Stat. 88; renumbered §1702, Pub. L. 102–83, §5(a), Aug. 6, 1991, 105 Stat. 406; Pub. L. 110–181, div. A, title XVII, §1708(a)(1), (2), Jan. 28, 2008, 122 Stat. 493, 494.)

Amendments

2008—Pub. L. 110–181, §1708(a)(2), substituted “Presumptions: psychosis after service in World War II and following periods of war; mental illness after service in the Persian Gulf War” for “Presumption relating to psychosis” in section catchline.

Subsecs. (a), (b). Pub. L. 110–181, §1708(a)(1), designated existing text as subsec. (a), inserted heading, and added subsec. (b).

1991—Pub. L. 102–83 renumbered section 602 of this title as this section.

Pub. L. 102–25 substituted “the Vietnam era, or the Persian Gulf War” for “or the Vietnam era”, struck out “or” before “before May 8, 1977”, and inserted “or before the end of the two-year period beginning on the last day of the Persian Gulf War, in the case of a veteran of the Persian Gulf War,” after “Vietnam era veterans,”.

1986—Pub. L. 99–576 struck out “his” before “discharge”.

1982—Pub. L. 97–295 substituted “before February 1, 1957, in the case of a veteran of the Korean conflict, or before May 8, 1977,” for “or February 1, 1957, in the case of a veteran of the Korean conflict, or before the expiration of two years following termination of the Vietnam era”.

1967—Pub. L. 90–77 made the presumption relating to psychosis applicable to any veteran of the Vietnam era who developed an active psychosis within two years after his discharge from active service and before the expiration of two years following termination of the Vietnam era.

Effective Date of 1967 Amendment

Amendment by Pub. L. 90–77 effective first day of first calendar month which begins more than ten days after Aug. 31, 1967, see section 405 of Pub. L. 90–77, set out as a note under section 101 of this title.

§1703. Contracts for hospital care and medical services in non-Department facilities

(a) When Department facilities are not capable of furnishing economical hospital care or medical services because of geographical inaccessibility or are not capable of furnishing the care or services required, the Secretary, as authorized in section 1710 of this title, may contract with non-Department facilities in order to furnish any of the following:

(1) Hospital care or medical services to a veteran for the treatment of—

(A) a service-connected disability;

(B) a disability for which a veteran was discharged or released from the active military, naval, or air service; or

(C) a disability of a veteran who has a total disability permanent in nature from a service-connected disability.


(2) Medical services for the treatment of any disability of—

(A) a veteran described in section 1710(a)(1)(B) of this title;

(B) a veteran who (i) has been furnished hospital care, nursing home care, domiciliary care, or medical services, and (ii) requires medical services to complete treatment incident to such care or services; or

(C) a veteran described in section 1710(a)(2)(E) of this title, or a veteran who is in receipt of increased pension, or additional compensation or allowances based on the need of regular aid and attendance or by reason of being permanently housebound (or who, but for the receipt of retired pay, would be in receipt of such pension, compensation, or allowance), if the Secretary has determined, based on an examination by a physician employed by the Department (or, in areas where no such physician is available, by a physician carrying out such function under a contract or fee arrangement), that the medical condition of such veteran precludes appropriate treatment in Department facilities.


(3) Hospital care or medical services for the treatment of medical emergencies which pose a serious threat to the life or health of a veteran receiving medical services in a Department facility or nursing home care under section 1720 of this title until such time following the furnishing of care in the non-Department facility as the veteran can be safely transferred to a Department facility.

(4) Hospital care for women veterans.

(5) Hospital care, or medical services that will obviate the need for hospital admission, for veterans in a State (other than the Commonwealth of Puerto Rico) not contiguous to the contiguous States, except that the annually determined hospital patient load and incidence of the furnishing of medical services to veterans hospitalized or treated at the expense of the Department in Government and non-Department facilities in each such noncontiguous State shall be consistent with the patient load or incidence of the furnishing of medical services for veterans hospitalized or treated by the Department within the 48 contiguous States and the Commonwealth of Puerto Rico.

(6) Diagnostic services necessary for determination of eligibility for, or of the appropriate course of treatment in connection with, furnishing medical services at independent Department out-patient clinics to obviate the need for hospital admission.

(7) Outpatient dental services and treatment, and related dental appliances, for a veteran described in section 1712(a)(1)(F) of this title.

(8) Diagnostic services (on an inpatient or outpatient basis) for observation or examination of a person to determine eligibility for a benefit or service under laws administered by the Secretary.


(b) In the case of any veteran for whom the Secretary contracts to furnish care or services in a non-Department facility pursuant to a provision of subsection (a) of this section, the Secretary shall periodically review the necessity for continuing such contractual arrangement pursuant to such provision.

(c) The Secretary shall include in the budget documents which the Secretary submits to Congress for any fiscal year a detailed report on the furnishing of contract care and services during the most recently completed fiscal year under this section, sections 1712A, 1720, 1720A, 1724, and 1732 of this title, and section 115 of the Veterans’ Benefits and Services Act of 1988 (Public Law 100–322; 102 Stat. 501).

(d)(1) The Secretary shall conduct a program of recovery audits for fee basis contracts and other medical services contracts for the care of veterans under this section, and for beneficiaries under sections 1781, 1782, and 1783 of this title, with respect to overpayments resulting from processing or billing errors or fraudulent charges in payments for non-Department care and services. The program shall be conducted by contract.

(2) Amounts collected, by setoff or otherwise, as the result of an audit under the program conducted under this subsection shall be available, without fiscal year limitation, for the purposes for which funds are currently available to the Secretary for medical care and for payment to a contractor of a percentage of the amount collected as a result of an audit carried out by the contractor.

(3) The Secretary shall allocate all amounts collected under this subsection with respect to a designated geographic service area of the Veterans Health Administration, net of payments to the contractor, to that region.

(4) The authority of the Secretary under this subsection terminates on September 30, 2020.

(Added Pub. L. 99–272, title XIX, §19012(b)(1), Apr. 7, 1986, 100 Stat. 380, §603; amended Pub. L. 99–166, title I, §102(b)(1), Dec. 3, 1985, 99 Stat. 943; Pub. L. 99–272, title XIX, §19012(c)(5)(A), Apr. 7, 1986, 100 Stat. 382; Pub. L. 100–322, title I, §§101(e)(3), 104, 112(a), May 20, 1988, 102 Stat. 492, 493, 499; Pub. L. 100–687, div. B, title XV, §1503(a)(1), Nov. 18, 1988, 102 Stat. 4133; Pub. L. 102–54, §14(b)(9), June 13, 1991, 105 Stat. 283; renumbered §1703 and amended Pub. L. 102–83, §§4(a)(1), (3)–(5), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 403–406; Pub. L. 102–585, title V, §501, Nov. 4, 1992, 106 Stat. 4955; Pub. L. 104–262, title I, §104(b), Oct. 9, 1996, 110 Stat. 3184; Pub. L. 108–422, title VI, §601, Nov. 30, 2004, 118 Stat. 2396; Pub. L. 109–13, div. A, title VI, §6080, May 11, 2005, 119 Stat. 302; Pub. L. 110–387, title VIII, §802, Oct. 10, 2008, 122 Stat. 4141; Pub. L. 112–37, §10(a), Oct. 5, 2011, 125 Stat. 396.)

References in Text

Section 115 of the Veterans’ Benefits and Services Act of 1988, referred to in subsec. (c), is set out as a note under section 1712 of this title.

Amendments

2011—Subsec. (d)(4). Pub. L. 112–37 substituted “September 30, 2020” for “September 30, 2013”.

2008—Subsec. (d)(4). Pub. L. 110–387 substituted “September 30, 2013” for “September 30, 2008”.

2005—Subsec. (d)(2). Pub. L. 109–13 substituted “shall be available, without fiscal year limitation, for the purposes” for “shall be available for the purposes”.

2004—Subsec. (d). Pub. L. 108–422 added subsec. (d).

1996—Subsec. (a). Pub. L. 104–262, §104(b)(1), struck out “or 1712” after “, as authorized in section 1710” in introductory provisions.

Subsec. (a)(2)(A). Pub. L. 104–262, §104(b)(2)(A), substituted “1710(a)(1)(B)” for “1712(a)(1)(B)”.

Subsec. (a)(2)(B). Pub. L. 104–262, §104(b)(2)(B), added subpar. (B) and struck out former subpar. (B) which read as follows: “a veteran described in paragraph (2), (3), or (4) of section 1712(a) of this title, for a purpose described in section 1712(a)(5)(B) of this title;”.

Subsec. (a)(2)(C). Pub. L. 104–262, §104(b)(2)(C), substituted “section 1710(a)(2)(E) of this title, or a veteran who is in receipt of increased pension, or additional compensation or allowances based on the need of regular aid and attendance or by reason of being permanently housebound (or who, but for the receipt of retired pay, would be in receipt of such pension, compensation, or allowance),” for “section 1712(a)(3) (other than a veteran who is a former prisoner of war) of this title”.

Subsec. (a)(7). Pub. L. 104–262, §104(b)(3), substituted “1712(a)(1)(F)” for “1712(b)(1)(F)”.

1992—Subsec. (a)(1)(C). Pub. L. 102–585 added subpar. (C).

1991—Pub. L. 102–83, §5(a), renumbered section 603 of this title as this section.

Pub. L. 102–83, §4(a)(5), substituted “non-Department” for “non-Veterans’ Administration” in section catchline.

Subsec. (a). Pub. L. 102–83, §5(c)(1), substituted “1710 or 1712” for “610 or 612” in introductory provisions, “1712(a)(1)(B)” for “612(a)(1)(B)” in par. (2)(A), “1712(a)” for “612(a)” and “1712(a)(5)(B)” for “612(a)(5)(B)” in par. (2)(B), “1712(a)(3)” for “612(a)(3)” in par. (2)(C), “1720” for “620” in par. (3), and “1712(b)(1)(F)” for “612(b)(1)(F)” in par. (7).

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in introductory provisions and in par. (2)(C).

Pub. L. 102–83, §4(a)(5), substituted “non-Department” for “non-Veterans’ Administration” in introductory provisions and in pars. (3) and (5).

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” wherever appearing in introductory provisions and pars. (2), (3), (5), and (6).

Subsec. (a)(2)(B). Pub. L. 102–54, §14(b)(9)(A), struck out “section” before “paragraph”.

Subsec. (a)(7). Pub. L. 102–54, §14(b)(9)(B), substituted “section 612(b)(1)(F)” for “section 612(b)(1)(G)”.

Subsec. (a)(8). Pub. L. 102–83, §4(a)(1), substituted “administered by the Secretary” for “administered by the Veterans’ Administration”.

Subsec. (b). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

Pub. L. 102–83, §4(a)(5), substituted “non-Department” for “non-Veterans’ Administration”.

Subsec. (c). Pub. L. 102–83, §5(c)(1), substituted “1712A, 1720, 1720A, 1724, and 1732” for “612A, 620, 620A, 624, and 632”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

Pub. L. 102–54, §14(b)(9)(C), inserted before period at end “(Public Law 100–322; 102 Stat. 501)”.

1988—Subsec. (a). Pub. L. 100–322, §104(b)(1), substituted  “furnish  any  of  the  following:”  for “furnish—”.

Subsec. (a)(1). Pub. L. 100–322, §104(b)(2), (3), substituted “Hospital” for “hospital” and the period for semicolon at end.

Subsec. (a)(2). Pub. L. 100–322, §104(b)(2), (3), substituted “Medical” for “medical” and the period for semicolon at end.

Subsec. (a)(2)(B). Pub. L. 100–687 substituted “paragraph (2), (3), or (4) of section 612(a)” for “612(a)(4)”, and “612(a)(5)(B)” for “612(a)(5)”.

Pub. L. 100–322, §101(e)(3)(A), substituted “section 612(a)(4) of this title, for a purpose described in section 612(a)(5) of this title” for “section 612(f)(1)(A)(ii) of this title”.

Subsec. (a)(2)(C). Pub. L. 100–322, §101(e)(3)(B), substituted “section 612(a)(3) (other than a veteran who is a former prisoner of war)” for “section 612(g)”.

Subsec. (a)(3). Pub. L. 100–322, §104(a)(1), (b)(2), (3), substituted “Hospital” for “hospital”, inserted “or nursing home care under section 620 of this title”, and substituted the period for semicolon at end.

Subsec. (a)(4), (5). Pub. L. 100–322, §104(b)(2), (3), substituted “Hospital” for “hospital” and the period for semicolon at end.

Subsec. (a)(6). Pub. L. 100–322, §104(b)(2), (4), substituted “Diagnostic” for “diagnostic” and the period for “; or”.

Subsec. (a)(7). Pub. L. 100–322, §104(b)(2), substituted “Outpatient” for “outpatient”.

Subsec. (a)(8). Pub. L. 100–322, §104(a)(2), added par. (8).

Subsec. (c). Pub. L. 100–322, §112(a), added subsec. (c).

1986—Subsec. (a)(5). Pub. L. 99–272, §19012(c)(5)(A), made conforming amendment to Pub. L. 99–166, §102(b)(1). See 1985 Amendment note below.

1985—Subsec. (a)(5). Pub. L. 99–166, §102(b)(1), as amended by Pub. L. 99–272, §19012(c)(5)(A), inserted “(other than the Commonwealth of Puerto Rico)” after “in a State” and substituted “contiguous States and the Commonwealth of Puerto Rico” for “contiguous States, but the authority of the Administrator under this paragraph with respect to the Commonwealth of Puerto Rico shall expire on September 30, 1988, and until such date the Administrator may, if necessary to prevent hardship, waive the applicability to the Commonwealth of Puerto Rico of the restrictions in this paragraph with respect to hospital patient loads and the incidence of the furnishing of medical services”.

Effective Date of 1988 Amendments

Section 1503(b) of Pub. L. 100–687 provided that: “The amendments made by subsection (a)(1) [amending this section] shall apply with respect to the furnishing of medical services by contract to veterans who apply to the Veterans’ Administration for medical services after June 30, 1988.”

Section 101(i) of Pub. L. 100–322 provided that: “The amendments made by this section [amending this section and sections 612 and 617 [now 1712 and 1717] of this title] shall apply with respect to the furnishing of medical services to veterans who apply for such services after June 30, 1988.”

Effective Date of 1985 Amendment

Section 102(b)(1) of Pub. L. 99–166, as amended by Pub. L. 99–272, title XIX, §19012(c)(5)(A), Apr. 7, 1986, 100 Stat. 382, provided that the amendment made by that section is effective Oct. 1, 1988.

Demonstration Projects on Alternatives for Expanding Care for Veterans in Rural Areas

Pub. L. 111–163, title III, §303, May 5, 2010, 124 Stat. 1149, provided that:

“(a) In General.—The Secretary of Veterans Affairs may, through the Director of the Office of Rural Health, carry out demonstration projects to examine the feasibility and advisability of alternatives for expanding care for veterans in rural areas, which may include the following:

“(1) Establishing a partnership between the Department of Veterans Affairs and the Centers for Medicare and Medicaid Services of the Department of Health and Human Services to coordinate care for veterans in rural areas at critical access hospitals (as designated or certified under section 1820 of the Social Security Act (42 U.S.C. 1395i–4)).

“(2) Establishing a partnership between the Department of Veterans Affairs and the Department of Health and Human Services to coordinate care for veterans in rural areas at community health centers.

“(3) Expanding coordination between the Department of Veterans Affairs and the Indian Health Service to expand care for Indian veterans.

“(b) Geographic Distribution.—The Secretary shall ensure that the demonstration projects carried out under subsection (a) are located at facilities that are geographically distributed throughout the United States.

“(c) Report.—Not later than 2 years after the date of the enactment of this Act [May 5, 2010], the Secretary shall submit a report on the results of the demonstration projects carried out under subsection (a) to—

“(1) the Committee on Veterans’ Affairs and the Committee on Appropriations of the Senate; and

“(2) the Committee on Veterans’ Affairs and the Committee on Appropriations of the House of Representatives.

“(d) Authorization of Appropriations.—There is authorized to be appropriated to carry out this section $5,000,000 for fiscal year 2010 and each fiscal year thereafter.”

Pilot Program of Enhanced Contract Care Authority for Health Care Needs of Veterans in Highly Rural Areas

Pub. L. 110–387, title IV, §403, Oct. 10, 2008, 122 Stat. 4124, as amended by Pub. L. 111–163, title III, §308, May 5, 2010, 124 Stat. 1155, provided that:

“(a) Pilot Program Required.—

“(1) In general.—The Secretary of Veterans Affairs shall conduct a pilot program under which the Secretary provides covered health services to covered veterans through qualifying non-Department of Veterans Affairs health care providers.

“(2) Commencement.—The Secretary shall commence the conduct of the pilot program on the date that is 120 days after the date of the enactment of this Act [Oct. 10, 2008].

“(3) Termination.—A veteran may receive health services under the pilot program only during the three-year period beginning on the date of the commencement of the pilot program under paragraph (2).

“(4) Program locations.—The pilot program shall be carried out within areas selected by the Secretary for the purposes of the pilot program in at least five Veterans Integrated Service Networks (VISNs). Of the Veterans Integrated Service Networks so selected—

“(A) not less than four such networks shall include at least three highly rural counties, as determined by the Secretary upon consideration of the most recent decennial census;

“(B) not less than one such network, not including a network selected under subparagraph (A), shall include only one highly rural county, as determined by the Secretary upon consideration of the most recent decennial census;

“(C) all such networks shall include area within the borders of at least four States; and

“(D) no such networks shall be participants in the Healthcare Effectiveness through Resource Optimization pilot program of the Department of Veterans Affairs.

“(b) Covered Veterans.—For purposes of the pilot program under this section, a covered veteran is any veteran who—

“(1) is—

“(A) enrolled in the system of patient enrollment established under section 1705(a) of title 38, United States Code, as of the date of the commencement of the pilot program under subsection (a)(2); or

“(B) eligible for health care under section 1710(e)(3) of such title; and

“(2) resides in a location that is—

“(A) more than 60 minutes driving distance from the nearest Department health care facility providing primary care services, if the veteran is seeking such services;

“(B) more than 120 minutes driving distance from the nearest Department health care facility providing acute hospital care, if the veteran is seeking such care; or

“(C) more than 240 minutes driving distance from the nearest Department health care facility providing tertiary care, if the veteran is seeking such care.

“(c) Covered Health Services.—For purposes of the pilot program under this section, a covered health service with respect to a covered veteran is any hospital care, medical service, rehabilitative service, or preventative health service that is authorized to be provided by the Secretary to the veteran under chapter 17 of title 38, United States Code, or any other provision of law.

“(d) Qualifying Non-Department Health Care Providers.—For purposes of the pilot program under this section, an entity or individual is a qualifying non-Department health care provider of a covered health service if the Secretary determines that the entity or individual is qualified to furnish such service to veterans under the pilot program.

“(e) Election.—A covered veteran seeking to be provided covered health services under the pilot program under this section shall submit to the Secretary an application therefor in such form, and containing such information as the Secretary shall specify for purposes of the pilot program.

“(f) Provision of Services Through Contract.—The Secretary shall provide covered health services to veterans under the pilot program under this section through contracts with qualifying non-Department health care providers for the provision of such services.

“(g) Exchange of Medical Information.—In conducting the pilot program under this section, the Secretary shall develop and utilize a functional capability to provide for the exchange of appropriate medical information between the Department and non-Department health care providers providing health services under the pilot program.

“(h) Reports.—Not later than the 30 days after the end of each year in which the pilot program under this section is conducted, the Secretary shall submit to the Committee of Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report which includes—

“(1) the assessment of the Secretary of the pilot program during the preceding year, including its cost, volume, quality, patient satisfaction, benefit to veterans, and such other findings and conclusions with respect to pilot program as the Secretary considers appropriate; and

“(2) such recommendations as the Secretary considers appropriate regarding—

“(A) the continuation of the pilot program;

“(B) extension of the pilot program to other or all Veterans Integrated Service Networks of the Department;

“(C) making the pilot program permanent.”

Ratification of Medical Services Contracts

Section 1503(c) of Pub. L. 100–687 ratified actions of the Administrator in contracting with facilities other than Veterans’ Administration facilities for furnishing medical services incident to treatment of certain veterans receiving hospital, nursing home, or domiciliary care, who applied for such services during the period beginning July 1, 1988, and ending Nov. 18, 1988.

Puerto Rico Contract Care; Limitation on Incurring of Obligations

Section 102(b)(2)–(5) of Pub. L. 99–166, as amended by Pub. L. 99–272, title XIX, §19012(c)(5)(B), Apr. 7, 1986, 100 Stat. 382, limited Administrator's authority to incur obligations for medical services for veterans residing in Puerto Rico during fiscal years 1986 to 1988.

§1704. Preventive health services: annual report

Not later than October 31 each year, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on preventive health services. Each such report shall include the following:

(1) A description of the programs and activities of the Department with respect to preventive health services during the preceding fiscal year, including a description of the following:

(A) The programs conducted by the Department—

(i) to educate veterans with respect to health promotion and disease prevention; and

(ii) to provide veterans with preventive health screenings and other clinical services, with such description setting forth the types of resources used by the Department to conduct such screenings and services and the number of veterans reached by such screenings and services.


(B) The means by which the Secretary addressed the specific preventive health services needs of particular groups of veterans (including veterans with service-connected disabilities, elderly veterans, low-income veterans, women veterans, institutionalized veterans, and veterans who are at risk for mental illness).

(C) The manner in which the provision of such services was coordinated with the activities of the Medical and Prosthetic Research Service of the Department and the National Center for Preventive Health.

(D) The manner in which the provision of such services was integrated into training programs of the Department, including initial and continuing medical training of medical students, residents, and Department staff.

(E) The manner in which the Department participated in cooperative preventive health efforts with other governmental and private entities (including State and local health promotion offices and not-for-profit organizations).

(F) The specific research carried out by the Department with respect to the long-term relationships among screening activities, treatment, and morbidity and mortality outcomes.

(G) The cost effectiveness of such programs and activities, including an explanation of the means by which the costs and benefits (including the quality of life of veterans who participate in such programs and activities) of such programs and activities are measured.


(2) A specific description of research activities on preventive health services carried out during that period using employees, funds, equipment, office space, or other support services of the Department, with such description setting forth—

(A) the source of funds for those activities;

(B) the articles or publications (including the authors of the articles and publications) in which those activities are described;

(C) the Federal, State, or local governmental entity or private entity, if any, with which such activities were carried out; and

(D) the clinical, research, or staff education projects for which funding applications were submitted (including the source of the funds applied for) and upon which a decision is pending or was denied.


(3) An accounting of the expenditure of funds during that period by the National Center for Preventive Health under section 7318 of this title.

(Added Pub. L. 102–585, title V, §512(a), Nov. 4, 1992, 106 Stat. 4957.)

§1705. Management of health care: patient enrollment system

(a) In managing the provision of hospital care and medical services under section 1710(a) of this title, the Secretary, in accordance with regulations the Secretary shall prescribe, shall establish and operate a system of annual patient enrollment. The Secretary shall manage the enrollment of veterans in accordance with the following priorities, in the order listed:

(1) Veterans with service-connected disabilities rated 50 percent or greater.

(2) Veterans with service-connected disabilities rated 30 percent or 40 percent.

(3) Veterans who are former prisoners of war or who were awarded the Purple Heart, veterans who were awarded the medal of honor under section 3741, 6241, or 8741 of title 10 or section 491 of title 14, veterans with service-connected disabilities rated 10 percent or 20 percent, and veterans described in subparagraphs (B) and (C) of section 1710(a)(2) of this title.

(4) Veterans who are in receipt of increased pension based on a need of regular aid and attendance or by reason of being permanently housebound and other veterans who are catastrophically disabled.

(5) Veterans not covered by paragraphs (1) through (4) who are unable to defray the expenses of necessary care as determined under section 1722(a) of this title.

(6) All other veterans eligible for hospital care, medical services, and nursing home care under section 1710(a)(2) of this title.

(7) Veterans described in section 1710(a)(3) of this title who are eligible for treatment as a low-income family under section 3(b) of the United States Housing Act of 1937 (42 U.S.C. 1437a(b)) for the area in which such veterans reside, regardless of whether such veterans are treated as single person families under paragraph (3)(A) of such section 3(b) or as families under paragraph (3)(B) of such section 3(b).

(8) Veterans described in section 1710(a)(3) of this title who are not covered by paragraph (7).


(b) In the design of an enrollment system under subsection (a), the Secretary—

(1) shall ensure that the system will be managed in a manner to ensure that the provision of care to enrollees is timely and acceptable in quality;

(2) may establish additional priorities within each priority group specified in subsection (a), as the Secretary determines necessary; and

(3) may provide for exceptions to the specified priorities where dictated by compelling medical reasons.


(c)(1) The Secretary may not provide hospital care or medical services to a veteran under paragraph (2) or (3) of section 1710(a) of this title unless the veteran enrolls in the system of patient enrollment established by the Secretary under subsection (a).

(2) The Secretary shall provide hospital care and medical services under section 1710(a)(1) of this title, and under subparagraph (B) of section 1710(a)(2) of this title, for the 12-month period following such veteran's discharge or release from service, to any veteran referred to in such sections for a disability specified in the applicable subparagraph of such section, notwithstanding the failure of the veteran to enroll in the system of patient enrollment referred to in subsection (a) of this section.

(Added Pub. L. 104–262, title I, §104(a)(1), Oct. 9, 1996, 110 Stat. 3182; amended Pub. L. 106–117, title I, §112(2), Nov. 30, 1999, 113 Stat. 1556; Pub. L. 107–135, title II, §202(a), Jan. 23, 2002, 115 Stat. 2457; Pub. L. 107–330, title III, §308(g)(4), Dec. 6, 2002, 116 Stat. 2828; Pub. L. 111–163, title V, §512, May 5, 2010, 124 Stat. 1164.)

Amendments

2010—Subsec. (a)(3). Pub. L. 111–163 inserted “veterans who were awarded the medal of honor under section 3741, 6241, or 8741 of title 10 or section 491 of title 14,” after “the Purple Heart,”.

2002—Subsec. (a)(7), (8). Pub. L. 107–135 added pars. (7) and (8) and struck out former par. (7) which read as follows: “Veterans described in section 1710(a)(3) of this title.”

Subsec. (c)(1). Pub. L. 107–330 substituted “The Secretary” for “Effective on October 1, 1998, the Secretary”.

1999—Subsec. (a)(3). Pub. L. 106–117 inserted “or who were awarded the Purple Heart” after “former prisoners of war”.

Effective Date of 2002 Amendment

Pub. L. 107–135, title II, §202(c), Jan. 23, 2002, 115 Stat. 2457, provided that: “The amendments made by this section [amending this section and section 1710 of this title] shall take effect on October 1, 2002.”

Assessment of Implementation and Operation of Amendments by Pub. L. 104–262

Section 106 of title I of Pub. L. 104–262 provided that:

“(a) Assessment Systems.—The Secretary of Veterans Affairs shall establish information systems to assess the experience of the Department of Veterans Affairs in implementing sections 101, 103, and 104 [enacting this section and section 1706 of this title, amending sections 1525, 1701, 1703, 1710, 1712, 1712A, 1717, 1718, 1720, 1722, 1729, 2104, 5317, 8110, and 8111A of this title, and enacting provisions set out as a note under section 1701 of this title], including the amendments made by those sections, during fiscal year 1997. The Secretary shall establish those information systems in time to include assessments under such systems in the report required under subsection (b).

“(b) Report.—Not later than March 1, 1998, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report reflecting the experience of the Department during fiscal year 1997 on—

“(1) the effect of implementation of, and provision and management of care under, sections 101, 103, and 104 (including the amendments made by those sections) on demand for health care services from the Department of Veterans Affairs by veterans described in paragraphs (1), (2), and (3) of section 1710(a) of title 38, United States Code, as amended by section 101;

“(2) any differing patterns of demand on the part of such veterans relating to such factors as relative distance from Department facilities and prior experience, or lack of experience, as recipients of care from the Department;

“(3) the extent to which the Department has met such demand for care; and

“(4) changes in health-care delivery patterns in Department facilities and the fiscal impact of such changes.

“(c) Matters To Be Included.—The report under subsection (b) shall include detailed information with respect to fiscal year 1997 regarding the following:

“(1) The number of veterans enrolled for care at each Department medical facility and, of such veterans, the number enrolled at each such facility who had not received care from the Department during the preceding three fiscal years.

“(2) With respect to the veterans who had not received care from the Department during the three preceding fiscal years, the total cost of providing care to such veterans, shown in total and separately (A) by level of care, and (B) by reference to whether care was furnished in Department facilities or under contract arrangements.

“(3) With respect to the number of veterans described in paragraphs (1), (2), and (3) of section 1710(a) of title 38, United States Code, as amended by section 101, who applied for health care from the Department during fiscal year 1997—

“(A) the number who applied for care (shown in total and separately by facility);

“(B) the number who were denied enrollment (shown in total and separately by facility); and

“(C) the number who were denied care which was considered to be medically necessary but not of an emergency nature (shown in total and separately by facility).

“(4) The numbers and characteristics of, and the type and extent of health care furnished to, veterans enrolled for care (shown in total and separately by facility).

“(5) The numbers and characteristics of, and the type and extent of health care furnished to, veterans not enrolled for care (shown separately by reference to each class of eligibility, both in total and separately by facility).

“(6) The specific fiscal impact (shown in total and by geographic health-care delivery areas) of changes in delivery patterns instituted under the amendments made by this title [enacting this section and section 1706 of this title and amending sections 1525, 1701, 1703, 1710, 1712, 1712A, 1717, 1718, 1720, 1722, 1729, 2104, 5317, 8110, and 8111A of this title].”

§1706. Management of health care: other requirements

(a) In managing the provision of hospital care and medical services under section 1710(a) of this title, the Secretary shall, to the extent feasible, design, establish and manage health care programs in such a manner as to promote cost-effective delivery of health care services in the most clinically appropriate setting.

(b)(1) In managing the provision of hospital care and medical services under such section, the Secretary shall ensure that the Department (and each geographic service area of the Veterans Health Administration) maintains its capacity to provide for the specialized treatment and rehabilitative needs of disabled veterans (including veterans with spinal cord dysfunction, blindness, amputations, and mental illness) within distinct programs or facilities of the Department that are dedicated to the specialized needs of those veterans in a manner that (A) affords those veterans reasonable access to care and services for those specialized needs, and (B) ensures that overall capacity of the Department (and each geographic service area of the Veterans Health Administration) to provide such services is not reduced below the capacity of the Department, nationwide, to provide those services, as of October 9, 1996. The Secretary shall carry out this paragraph in consultation with the Advisory Committee on Prosthetics and Special Disabilities Programs and the Committee on Care of Severely Chronically Mentally Ill Veterans.

(2) For purposes of paragraph (1), the capacity of the Department (and each geographic service area of the Veterans Health Administration) to provide for the specialized treatment and rehabilitative needs of disabled veterans (including veterans with spinal cord dysfunction, traumatic brain injury, blindness, prosthetics and sensory aids, and mental illness) within distinct programs or facilities shall be measured for seriously mentally ill veterans as follows (with all such data to be provided by geographic service area and totaled nationally):

(A) For mental health intensive community-based care, the number of discrete intensive care teams constituted to provide such intensive services to seriously mentally ill veterans and the number of veterans provided such care.

(B) For opioid substitution programs, the number of patients treated annually and the amounts expended.

(C) For dual-diagnosis patients, the number treated annually and the amounts expended.

(D) For substance-use disorder programs—

(i) the number of beds (whether hospital, nursing home, or other designated beds) employed and the average bed occupancy of such beds;

(ii) the percentage of unique patients admitted directly to outpatient care during the fiscal year who had two or more additional visits to specialized outpatient care within 30 days of their first visit, with a comparison from 1996 until the date of the report;

(iii) the percentage of unique inpatients with substance-use disorder diagnoses treated during the fiscal year who had one or more specialized clinic visits within three days of their index discharge, with a comparison from 1996 until the date of the report;

(iv) the percentage of unique outpatients seen in a facility or geographic service area during the fiscal year who had one or more specialized clinic visits, with a comparison from 1996 until the date of the report; and

(v) the rate of recidivism of patients at each specialized clinic in each geographic service area of the Veterans Health Administration.


(E) For mental health programs, the number and type of staff that are available at each facility to provide specialized mental health treatment, including satellite clinics, outpatient programs, and community-based outpatient clinics, with a comparison from 1996 to the date of the report.

(F) The number of such clinics providing mental health care, the number and type of mental health staff at each such clinic, and the type of mental health programs at each such clinic.

(G) The total amounts expended for mental health during the fiscal year.


(3) For purposes of paragraph (1), the capacity of the Department (and each geographic service area of the Veterans Health Administration) to provide for the specialized treatment and rehabilitative needs of disabled veterans within distinct programs or facilities shall be measured for veterans with spinal cord dysfunction, traumatic brain injury, blindness, or prosthetics and sensory aids as follows (with all such data to be provided by geographic service area and totaled nationally):

(A) For spinal cord injury and dysfunction specialized centers and for blind rehabilitation specialized centers, the number of staffed beds and the number of full-time equivalent employees assigned to provide care at such centers.

(B) For prosthetics and sensory aids, the annual amount expended.

(C) For traumatic brain injury, the number of patients treated annually and the amounts expended.


(4) In carrying out paragraph (1), the Secretary may not use patient outcome data as a substitute for, or the equivalent of, compliance with the requirement under that paragraph for maintenance of capacity.

(5)(A) Not later than April 1 of each year through 2008, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the Secretary's compliance, by facility and by service-network, with the requirements of this subsection. Each such report shall include information on recidivism rates associated with substance-use disorder treatment.

(B) In preparing each report under subparagraph (A), the Secretary shall use standardized data and data definitions.

(C) Each report under subparagraph (A) shall be audited by the Inspector General of the Department, who shall submit to Congress a certification as to the accuracy of each such report.

(6)(A) To ensure compliance with paragraph (1), the Under Secretary for Health shall prescribe objective standards of job performance for employees in positions described in subparagraph (B) with respect to the job performance of those employees in carrying out the requirements of paragraph (1). Those job performance standards shall include measures of workload, allocation of resources, and quality-of-care indicators.

(B) Positions described in this subparagraph are positions in the Veterans Health Administration that have responsibility for allocating and managing resources applicable to the requirements of paragraph (1).

(C) The Under Secretary shall develop the job performance standards under subparagraph (A) in consultation with the Advisory Committee on Prosthetics and Special Disabilities Programs and the Committee on Care of Severely Chronically Mentally Ill Veterans.

(c) The Secretary shall ensure that each primary care health care facility of the Department develops and carries out a plan to provide mental health services, either through referral or direct provision of services, to veterans who require such services.

(Added Pub. L. 104–262, title I, §104(a)(1), Oct. 9, 1996, 110 Stat. 3183; amended Pub. L. 105–368, title IX, §903(a), title X, §1005(b)(2), Nov. 11, 1998, 112 Stat. 3360, 3365; Pub. L. 107–95, §8(a), Dec. 21, 2001, 115 Stat. 919; Pub. L. 107–135, title II, §203, Jan. 23, 2002, 115 Stat. 2458; Pub. L. 109–461, title II, §208(a), Dec. 22, 2006, 120 Stat. 3413.)

Amendments

2006—Subsec. (b)(5)(A). Pub. L. 109–461 substituted “2008” for “2004”.

2002—Subsec. (b)(1). Pub. L. 107–135, §203(a)(1), inserted “(and each geographic service area of the Veterans Health Administration)” after “ensure that the Department” in introductory provisions and “(and each geographic service area of the Veterans Health Administration)” after “overall capacity of the Department” in cl. (B).

Subsec. (b)(2) to (4). Pub. L. 107–135, §203(a)(3), added pars. (2) to (4). Former pars. (2) and (3) redesignated (5) and (6), respectively.

Subsec. (b)(5). Pub. L. 107–135, §203(a)(2), (b), redesignated par. (2) as (5), inserted “(A)” before “Not later than”, substituted “April 1 of each year through 2004” for “April 1, 1999, April 1, 2000, and April 1, 2001”, inserted at end of subpar. (A) “Each such report shall include information on recidivism rates associated with substance-use disorder treatment.”, and added subpars. (B) and (C).

Subsec. (b)(6). Pub. L. 107–135, §203(a)(2), redesignated par. (3) as (6).

2001—Subsec. (c). Pub. L. 107–95 added subsec. (c).

1998—Subsec. (b)(1). Pub. L. 105–368, §1005(b)(2), substituted “October 9, 1996” for “the date of the enactment of this section”.

Subsec. (b)(2). Pub. L. 105–368, §903(a)(1), substituted “April 1, 1999, April 1, 2000, and April 1, 2001” for “April 1, 1997, April 1, 1998, and April 1, 1999”.

Subsec. (b)(3). Pub. L. 105–368, §903(a)(2), added par. (3).

Deadline for Prescribing Standards

Pub. L. 105–368, title IX, §903(b), Nov. 11, 1998, 112 Stat. 3361, provided that: “The standards of job performance required by paragraph (3) of section 1706(b) of title 38, United States Code, as added by subsection (a), shall be prescribed not later than January 1, 1999.”

§1707. Limitations

(a) Funds appropriated to carry out this chapter may not be used for purposes that are inconsistent with the Assisted Suicide Funding Restriction Act of 1997 (42 U.S.C. 14401 et seq.).

(b) The Secretary may furnish sensori-neural aids only in accordance with guidelines prescribed by the Secretary.

(Added Pub. L. 105–12, §9(i)(1), Apr. 30, 1997, 111 Stat. 27; amended Pub. L. 107–135, title II, §208(a)(2), (f)(2), Jan. 23, 2002, 115 Stat. 2462, 2464; Pub. L. 107–330, title III, §308(g)(5), Dec. 6, 2002, 116 Stat. 2829.)

References in Text

The Assisted Suicide Funding Restriction Act of 1997, referred to in subsec. (a), is Pub. L. 105–12, Apr. 30, 1997, 111 Stat. 23, which is classified principally to chapter 138 (§14401 et seq.) of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under section 14401 of Title 42.

Amendments

2002—Pub. L. 107–135, §208(f)(2), substituted “Limitations” for “Restriction on use of funds for assisted suicide, euthanasia, or mercy killing” as section catchline.

Pub. L. 107–135, §208(a)(2), designated existing provisions as subsec. (a) and added subsec. (b).

Subsec. (a). Pub. L. 107–330 inserted “(42 U.S.C. 14401 et seq.)” before period at end.

Effective Date

Section effective Apr. 30, 1997, and applicable to Federal payments made pursuant to obligations incurred after Apr. 30, 1997, for items and services provided on or after such date, subject to also being applicable with respect to contracts entered into, renewed, or extended after Apr. 30, 1997, as well as contracts entered into before Apr. 30, 1997, to the extent permitted under such contracts, see section 11 of Pub. L. 105–12, set out as a note under section 14401 of Title 42, The Public Health and Welfare.

§1708. Temporary lodging

(a) The Secretary may furnish persons described in subsection (b) with temporary lodging in a Fisher house or other appropriate facility in connection with the examination, treatment, or care of a veteran under this chapter or, as provided for under subsection (e)(5), in connection with benefits administered under this title.

(b) Persons to whom the Secretary may provide lodging under subsection (a) are the following:

(1) A veteran who must travel a significant distance to receive care or services under this title.

(2) A member of the family of a veteran and others who accompany a veteran and provide the equivalent of familial support for such veteran.


(c) In this section, the term “Fisher house” means a housing facility that—

(1) is located at, or in proximity to, a Department medical facility;

(2) is available for residential use on a temporary basis by patients of that facility and others described in subsection (b)(2); and

(3) is constructed by, and donated to the Secretary by, the Zachary and Elizabeth M. Fisher Armed Services Foundation.


(d) The Secretary may establish charges for providing lodging under this section. The proceeds from such charges shall be credited to the medical services account and shall be available until expended for the purposes of providing such lodging.

(e) The Secretary shall prescribe regulations to carry out this section. Such regulations shall include provisions—

(1) limiting the duration of lodging provided under this section;

(2) establishing standards and criteria under which charges are established for such lodging under subsection (d);

(3) establishing criteria for persons considered to be accompanying a veteran under subsection (b)(2);

(4) establishing criteria for the use of the premises of temporary lodging facilities under this section; and

(5) establishing any other limitations, conditions, and priorities that the Secretary considers appropriate with respect to lodging under this section.

(Added Pub. L. 106–419, title II, §221(a), Nov. 1, 2000, 114 Stat. 1844; amended Pub. L. 110–387, title IX, §901(a)(8), Oct. 10, 2008, 122 Stat. 4142.)

Amendments

2008—Subsec. (d). Pub. L. 110–387 substituted “medical services account” for “medical care account”.

SUBCHAPTER II—HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL TREATMENT

Amendments

1976—Pub. L. 94–581, title II, §202(c), Oct. 21, 1976, 90 Stat. 2855, inserted “, NURSING HOME,” in subchapter heading.

§1710. Eligibility for hospital, nursing home, and domiciliary care

(a)(1) The Secretary (subject to paragraph (4)) shall furnish hospital care and medical services which the Secretary determines to be needed—

(A) to any veteran for a service-connected disability; and

(B) to any veteran who has a service-connected disability rated at 50 percent or more.


(2) The Secretary (subject to paragraph (4)) shall furnish hospital care and medical services, and may furnish nursing home care, which the Secretary determines to be needed to any veteran—

(A) who has a compensable service-connected disability rated less than 50 percent or, with respect to nursing home care during any period during which the provisions of section 1710A(a) of this title are in effect, a compensable service-connected disability rated less than 70 percent;

(B) whose discharge or release from active military, naval, or air service was for a disability that was incurred or aggravated in the line of duty;

(C) who is in receipt of, or who, but for a suspension pursuant to section 1151 of this title (or both a suspension and the receipt of retired pay), would be entitled to disability compensation, but only to the extent that such veteran's continuing eligibility for such care is provided for in the judgment or settlement provided for in such section;

(D) who is a former prisoner of war or who was awarded the Purple Heart;

(E) who is a veteran of the Mexican border period or of World War I;

(F) who was exposed to a toxic substance, radiation, or other conditions, as provided in subsection (e); or

(G) who is unable to defray the expenses of necessary care as determined under section 1722(a) of this title.


(3) In the case of a veteran who is not described in paragraphs (1) and (2), the Secretary may, to the extent resources and facilities are available and subject to the provisions of subsections (f) and (g), furnish hospital care, medical services, and nursing home care which the Secretary determines to be needed.

(4) The requirement in paragraphs (1) and (2) that the Secretary furnish hospital care and medical services, the requirement in section 1710A(a) of this title that the Secretary provide nursing home care, the requirement in section 1710B of this title that the Secretary provide a program of extended care services, and the requirement in section 1745 of this title to provide nursing home care and prescription medicines to veterans with service-connected disabilities in State homes shall be effective in any fiscal year only to the extent and in the amount provided in advance in appropriations Acts for such purposes.

(5) During any period during which the provisions of section 1710A(a) of this title are not in effect, the Secretary may furnish nursing home care which the Secretary determines is needed to any veteran described in paragraph (1), with the priority for such care on the same basis as if provided under that paragraph.

(b)(1) The Secretary may furnish to a veteran described in paragraph (2) of this subsection such domiciliary care as the Secretary determines is needed for the purpose of the furnishing of medical services to the veteran.

(2) This subsection applies in the case of the following veterans:

(A) Any veteran whose annual income (as determined under section 1503 of this title) does not exceed the maximum annual rate of pension that would be applicable to the veteran if the veteran were eligible for pension under section 1521(d) of this title.

(B) Any veteran who the Secretary determines has no adequate means of support.


(c) While any veteran is receiving hospital care or nursing home care in any Department facility, the Secretary may, within the limits of Department facilities, furnish medical services to correct or treat any non-service-connected disability of such veteran, in addition to treatment incident to the disability for which such veteran is hospitalized, if the veteran is willing, and the Secretary finds such services to be reasonably necessary to protect the health of such veteran. The Secretary may furnish dental services and treatment, and related dental appliances, under this subsection for a non-service-connected dental condition or disability of a veteran only (1) to the extent that the Secretary determines that the dental facilities of the Department to be used to furnish such services, treatment, or appliances are not needed to furnish services, treatment, or appliances for dental conditions or disabilities described in section 1712(a) of this title, or (2) if (A) such non-service-connected dental condition or disability is associated with or aggravating a disability for which such veteran is receiving hospital care, or (B) a compelling medical reason or a dental emergency requires furnishing dental services, treatment, or appliances (excluding the furnishing of such services, treatment, or appliances of a routine nature) to such veteran during the period of hospitalization under this section.

(d) In no case may nursing home care be furnished in a hospital not under the direct jurisdiction of the Secretary except as provided in section 1720 of this title.

(e)(1)(A) A Vietnam-era herbicide-exposed veteran is eligible (subject to paragraph (2)) for hospital care, medical services, and nursing home care under subsection (a)(2)(F) for any disability, notwithstanding that there is insufficient medical evidence to conclude that such disability may be associated with such exposure.

(B) A radiation-exposed veteran is eligible for hospital care, medical services, and nursing home care under subsection (a)(2)(F) for any disease suffered by the veteran that is—

(i) a disease listed in section 1112(c)(2) of this title; or

(ii) any other disease for which the Secretary, based on the advice of the Advisory Committee on Environmental Hazards, determines that there is credible evidence of a positive association between occurrence of the disease in humans and exposure to ionizing radiation.


(C) Subject to paragraph (2) of this subsection, a veteran who served on active duty between August 2, 1990, and November 11, 1998, in the Southwest Asia theater of operations during the Persian Gulf War is eligible for hospital care, medical services, and nursing home care under subsection (a)(2)(F) for any disability, notwithstanding that there is insufficient medical evidence to conclude that such disability may be associated with such service.

(D) Subject to paragraphs (2) and (3), a veteran who served on active duty in a theater of combat operations (as determined by the Secretary in consultation with the Secretary of Defense) during a period of war after the Persian Gulf War, or in combat against a hostile force during a period of hostilities (as defined in section 1712A(a)(2)(B) of this title) after November 11, 1998, is eligible for hospital care, medical services, and nursing home care under subsection (a)(2)(F) for any illness, notwithstanding that there is insufficient medical evidence to conclude that such condition is attributable to such service.

(E) Subject to paragraph (2), a veteran who participated in a test conducted by the Department of Defense Deseret Test Center as part of a program for chemical and biological warfare testing from 1962 through 1973 (including the program designated as “Project Shipboard Hazard and Defense (SHAD)” and related land-based tests) is eligible for hospital care, medical services, and nursing home care under subsection (a)(2)(F) for any illness, notwithstanding that there is insufficient medical evidence to conclude that such illness is attributable to such testing.

(2)(A) In the case of a veteran described in paragraph (1)(A), hospital care, medical services, and nursing home care may not be provided under subsection (a)(2)(F) with respect to—

(i) a disability that is found, in accordance with guidelines issued by the Under Secretary for Health, to have resulted from a cause other than an exposure described in paragraph (4)(A)(ii); or

(ii) a disease for which the National Academy of Sciences, in a report issued in accordance with section 3 of the Agent Orange Act of 1991, has determined that there is limited or suggestive evidence of the lack of a positive association between occurrence of the disease in humans and exposure to a herbicide agent.


(B) In the case of a veteran described in subparagraph (C), (D), or (E) of paragraph (1), hospital care, medical services, and nursing home care may not be provided under subsection (a)(2)(F) with respect to a disability that is found, in accordance with guidelines issued by the Under Secretary for Health, to have resulted from a cause other than the service or testing described in such subparagraph.

(3) Hospital care, medical services, and nursing home care may not be provided under or by virtue of subsection (a)(2)(F) in the case of care for a veteran described in paragraph (1)(D) who—

(A) is discharged or released from the active military, naval, or air service after the date that is five years before the date of the enactment of the National Defense Authorization Act for Fiscal Year 2008, after a period of five years beginning on the date of such discharge or release; or

(B) is so discharged or released more than five years before the date of the enactment of that Act and who did not enroll in the patient enrollment system under section 1705 of this title before such date, after a period of three years beginning on the date of the enactment of that Act.


(4) For purposes of this subsection—

(A) The term “Vietnam-era herbicide-exposed veteran” means a veteran (i) who served on active duty in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, and (ii) who the Secretary finds may have been exposed during such service to dioxin or was exposed during such service to a toxic substance found in a herbicide or defoliant used for military purposes during such period.

(B) The term “radiation-exposed veteran” has the meaning given that term in section 1112(c)(3) of this title.


(5) When the Secretary first provides care for veterans using the authority provided in paragraph (1)(D), the Secretary shall establish a system for collection and analysis of information on the general health status and health care utilization patterns of veterans receiving care under that paragraph. Not later than 18 months after first providing care under such authority, the Secretary shall submit to Congress a report on the experience under that authority. The Secretary shall include in the report any recommendations of the Secretary for extension of that authority.

(f)(1) The Secretary may not furnish hospital care or nursing home care (except if such care constitutes hospice care) under this section to a veteran who is eligible for such care under subsection (a)(3) of this section unless the veteran agrees to pay to the United States the applicable amount determined under paragraph (2) or (4) of this subsection.

(2) A veteran who is furnished hospital care or nursing home care under this section and who is required under paragraph (1) of this subsection to agree to pay an amount to the United States in order to be furnished such care shall be liable to the United States for an amount equal to—

(A) the lesser of—

(i) the cost of furnishing such care, as determined by the Secretary; or

(ii) the amount determined under paragraph (3) of this subsection; and


(B) before September 30, 2012, an amount equal to $10 for every day the veteran receives hospital care and $5 for every day the veteran receives nursing home care.


(3)(A) In the case of hospital care furnished during any 365-day period, the amount referred to in paragraph (2)(A)(ii) of this subsection is—

(i) the amount of the inpatient Medicare deductible, plus

(ii) one-half of such amount for each 90 days of care (or fraction thereof) after the first 90 days of such care during such 365-day period.


(B) In the case of nursing home care furnished during any 365-day period, the amount referred to in paragraph (2)(A)(ii) of this subsection is the amount of the inpatient Medicare deductible for each 90 days of such care (or fraction thereof) during such 365-day period.

(C)(i) Except as provided in clause (ii) of this subparagraph, in the case of a veteran who is admitted for nursing home care under this section after being furnished, during the preceding 365-day period, hospital care for which the veteran has paid the amount of the inpatient Medicare deductible under this subsection and who has not been furnished 90 days of hospital care in connection with such payment, the veteran shall not incur any liability under paragraph (2) of this subsection with respect to such nursing home care until—

(I) the veteran has been furnished, beginning with the first day of such hospital care furnished in connection with such payment, a total of 90 days of hospital care and nursing home care; or

(II) the end of the 365-day period applicable to the hospital care for which payment was made,


whichever occurs first.

(ii) In the case of a veteran who is admitted for nursing home care under this section after being furnished, during any 365-day period, hospital care for which the veteran has paid an amount under subparagraph (A)(ii) of this paragraph and who has not been furnished 90 days of hospital care in connection with such payment, the amount of the liability of the veteran under paragraph (2) of this subsection with respect to the number of days of such nursing home care which, when added to the number of days of such hospital care, is 90 or less, is the difference between the inpatient Medicare deductible and the amount paid under such subparagraph until—

(I) the veteran has been furnished, beginning with the first day of such hospital care furnished in connection with such payment, a total of 90 days of hospital care and nursing home care; or

(II) the end of the 365-day period applicable to the hospital care for which payment was made,


whichever occurs first.

(D) In the case of a veteran who is admitted for hospital care under this section after having been furnished, during the preceding 365-day period, nursing home care for which the veteran has paid the amount of the inpatient Medicare deductible under this subsection and who has not been furnished 90 days of nursing home care in connection with such payment, the veteran shall not incur any liability under paragraph (2) of this subsection with respect to such hospital care until—

(i) the veteran has been furnished, beginning with the first day of such nursing home care furnished in connection with such payment, a total of 90 days of nursing home care and hospital care; or

(ii) the end of the 365-day period applicable to the nursing home care for which payment was made,


whichever occurs first.

(E) A veteran may not be required to make a payment under this subsection for hospital care or nursing home care furnished under this section during any 90-day period in which the veteran is furnished medical services under paragraph (3) of subsection (a) to the extent that such payment would cause the total amount paid by the veteran under this subsection for hospital care and nursing home care furnished during that period and under subsection (g) for medical services furnished during that period to exceed the amount of the inpatient Medicare deductible in effect on the first day of such period.

(F) A veteran may not be required to make a payment under this subsection or subsection (g) for any days of care in excess of 360 days of care during any 365-calendar-day period.

(4) In the case of a veteran covered by this subsection who is also described by section 1705(a)(7) of this title, the amount for which the veteran shall be liable to the United States for hospital care under this subsection shall be an amount equal to 20 percent of the total amount for which the veteran would otherwise be liable for such care under subparagraphs (2)(B) and (3)(A) but for this paragraph.

(5) For the purposes of this subsection, the term “inpatient Medicare deductible” means the amount of the inpatient hospital deductible in effect under section 1813(b) of the Social Security Act (42 U.S.C. 1395e(b)) on the first day of the 365-day period applicable under paragraph (3) of this subsection.

(g)(1) The Secretary may not furnish medical services (except if such care constitutes hospice care) under subsection (a) of this section (including home health services under section 1717 of this title) to a veteran who is eligible for hospital care under this chapter by reason of subsection (a)(3) of this section unless the veteran agrees to pay to the United States in the case of each outpatient visit the applicable amount or amounts established by the Secretary by regulation.

(2) A veteran who is furnished medical services under subsection (a) of this section and who is required under paragraph (1) of this subsection to agree to pay an amount to the United States in order to be furnished such services shall be liable to the United States, in the case of each visit in which such services are furnished to the veteran, for an amount which the Secretary shall establish by regulation.

(3) This subsection does not apply with respect to home health services under section 1717 of this title to the extent that such services are for improvements and structural alterations.

(h) Nothing in this section requires the Secretary to furnish care to a veteran to whom another agency of Federal, State, or local government has a duty under law to provide care in an institution of such government.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1141, §610; Pub. L. 87–583, §1, Aug. 14, 1962, 76 Stat. 381; Pub. L. 89–358, §8, Mar. 3, 1966, 80 Stat. 27; Pub. L. 89–785, title III, §304, Nov. 7, 1966, 80 Stat. 1377; Pub. L. 91–500, §4, Oct. 22, 1970, 84 Stat. 1096; Pub. L. 93–82, title I, §102, Aug. 2, 1973, 87 Stat. 180; Pub. L. 94–581, title II, §§202(d), 210(a)(1), Oct. 21, 1976, 90 Stat. 2855, 2862; Pub. L. 96–22, title I, §102(a), June 13, 1979, 93 Stat. 47; Pub. L. 97–37, §5(a), Aug. 14, 1981, 95 Stat. 936; Pub. L. 97–72, title I, §102(a), Nov. 3, 1981, 95 Stat. 1047; Pub. L. 98–160, title VII, §701, Nov. 21, 1983, 97 Stat. 1008; Pub. L. 99–166, title I, §103, Dec. 3, 1985, 99 Stat. 944; Pub. L. 99–272, title XIX, §19011(a), (d)(3), Apr. 7, 1986, 100 Stat. 372, 379; Pub. L. 99–576, title II, §237(a), (b)(1), Oct. 28, 1986, 100 Stat. 3267; Pub. L. 100–322, title I, §102(a), May 20, 1988, 102 Stat. 492; Pub. L. 100–687, div. B, title XII, §1202, Nov. 18, 1988, 102 Stat. 4125; Pub. L. 101–508, title VIII, §8013(a), Nov. 5, 1990, 104 Stat. 1388–346; Pub. L. 102–4, §5, Feb. 6, 1991, 105 Stat. 15; Pub. L. 102–54, §14(b)(10), June 13, 1991, 105 Stat. 283; renumbered §1710 and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–405, title III, §302(c)(1), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 103–210, §§1(a), 2(a), Dec. 20, 1993, 107 Stat. 2496, 2497; Pub. L. 103–446, title XII, §1201(d)(2), Nov. 2, 1994, 108 Stat. 4684; Pub. L. 103–452, title I, §103(a)(1), Nov. 2, 1994, 108 Stat. 4786; Pub. L. 104–110, title I, §101(a)(1), Feb. 13, 1996, 110 Stat. 768; Pub. L. 104–262, title I, §§101(a), (b), (d)(2)–(4), 102(a), Oct. 9, 1996, 110 Stat. 3178, 3179, 3181; Pub. L. 104–275, title V, §505(c), Oct. 9, 1996, 110 Stat. 3342; Pub. L. 105–33, title VIII, §§8021(a)(1), 8023(b)(1), (2), Aug. 5, 1997, 111 Stat. 664, 667; Pub. L. 105–114, title II, §209(a), title IV, §402(a), Nov. 21, 1997, 111 Stat. 2290, 2294; Pub. L. 105–368, title I, §102(a), title X, §1005(b)(3), Nov. 11, 1998, 112 Stat. 3321, 3365; Pub. L. 106–117, title I, §§101(f), 112(1), title II, §201(b), Nov. 30, 1999, 113 Stat. 1550, 1556, 1561; Pub. L. 106–419, title II, §224(b), Nov. 1, 2000, 114 Stat. 1846; Pub. L. 107–135, title II, §§202(b), 209(a), 211, Jan. 23, 2002, 115 Stat. 2457, 2464, 2465; Pub. L. 107–330, title III, §308(g)(6), Dec. 6, 2002, 116 Stat. 2829; Pub. L. 108–170, title I, §102, Dec. 6, 2003, 117 Stat. 2044; Pub. L. 109–444, §2(a), Dec. 21, 2006, 120 Stat. 3304; Pub. L. 109–461, title II, §211(a)(3)(B), title X, §§1003, 1006(b), Dec. 22, 2006, 120 Stat. 3419, 3465, 3468; Pub. L. 110–161, div. I, title II, §231, Dec. 26, 2007, 121 Stat. 2273; Pub. L. 110–181, div. A, title XVII, §1707, Jan. 28, 2008, 122 Stat. 493; Pub. L. 110–329, div. E, title II, §224, Sept. 30, 2008, 122 Stat. 3713; Pub. L. 110–387, title IV, §409, title VIII, §§803, 804(a), Oct. 10, 2008, 122 Stat. 4130, 4141; Pub. L. 111–163, title V, §§513, 517, May 5, 2010, 124 Stat. 1164, 1167.)

References in Text

Section 3 of the Agent Orange Act of 1991, referred to in subsec. (e)(2)(A)(ii), is section 3 of Pub. L. 102–4, which is set out as a note under section 1116 of this title.

The date of the enactment of the National Defense Authorization Act for Fiscal Year 2008, referred to in subsec. (e)(3), is the date of enactment of Pub. L. 110–181, which was approved Jan. 28, 2008.

Codification

The text of subsec. (f) of section 1712 of this title, which was transferred to this section, redesignated subsec. (g), and amended by Pub. L. 104–262, §101(b)(2), was based on Pub. L. 86–639, §1, July 12, 1960, 74 Stat. 472; Pub. L. 91–102, Oct. 30, 1969, 83 Stat. 168; Pub. L. 93–82, title I, §103(a), Aug. 2, 1973, 87 Stat. 180; Pub. L. 94–581, title I, §103(a)(3)–(7), title II, §202(f)(2), Oct. 21, 1976, 90 Stat. 2844, 2856; Pub. L. 96–22, title I, §102(b), June 13, 1979, 93 Stat. 47; Pub. L. 97–37, §5(b), Aug. 14, 1981, 95 Stat. 937; Pub. L. 97–72, title I, §103(b)(2), Nov. 3, 1981, 95 Stat. 1049; Pub. L. 97–295, §4(17)(C), Oct. 12, 1982, 96 Stat. 1306; Pub. L. 99–166, title I, §104, Dec. 3, 1985, 99 Stat. 944; Pub. L. 99–272, title XIX, §19011(b)(2), Apr. 7, 1986, 100 Stat. 375; Pub. L. 99–576, title II, §§202(1), 237(b)(2), Oct. 28, 1986, 100 Stat. 3254, 3267; Pub. L. 100–322, title I, §101(e)(1), May 20, 1988, 102 Stat. 491; Pub. L. 101–508, title VIII, §8013(b), Nov. 5, 1990, 104 Stat. 1388–346; Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(c)(1), Aug. 6, 1991, 105 Stat. 404–406.

Prior Provisions

A prior section 1710 was renumbered section 3510 of this title.

Amendments

2010—Subsec. (e)(1)(C). Pub. L. 111–163, §513(2), substituted “paragraph (2)” for “paragraphs (2) and (3)” and inserted “between August 2, 1990, and November 11, 1998,” after “on active duty”.

Subsec. (e)(3). Pub. L. 111–163, §513(1), substituted “subsection (a)(2)(F)” for “subsection (a)(2)(F)—” in introductory provisions, struck out subpar. (C) designation before “in the case”, redesignated cls. (i) and (ii) of former subpar. (C) as subpars. (A) and (B), respectively, realigned margins, and struck out former subpars. (A) and (B), which read as follows:

“(A) in the case of care for a veteran described in paragraph (1)(A), after December 31, 2002;

“(B) in the case of care for a veteran described in paragraph (1)(C), after December 31, 2002; and”.

Subsec. (f)(2)(B). Pub. L. 111–163, §517, amended subpar. (B) generally. Prior to amendment, subpar. (B) read as follows: “before September 30, 2010, an amount equal to $10 for every day the veteran receives hospital care and $5 for every day the veteran receives nursing home care.”

2008—Subsec. (e)(1)(E). Pub. L. 110–387, §803(b), substituted “paragraph (2)” for “paragraphs (2) and (3)”.

Subsec. (e)(3)(B). Pub. L. 110–387, §803(a)(1), inserted “and” after the semicolon at end.

Subsec. (e)(3)(C). Pub. L. 110–387, §803(a)(2), substituted a period at end for “; and”.

Pub. L. 110–181 amended subpar. (C) generally. Prior to amendment subpar. (C) read as follows: “in the case of care for a veteran described in paragraph (1)(D), after a period of 2 years beginning on the date of the veteran's discharge or release from active military, naval, or air service; and”.

Subsec. (e)(3)(D). Pub. L. 110–387, §803(a)(3), struck out subpar. (D) which read as follows: “in the case of care for a veteran described in paragraph (1)(E), after December 31, 2007”.

Subsec. (f)(1). Pub. L. 110–387, §409(1), inserted “(except if such care constitutes hospice care)” after “nursing home care”.

Subsec. (f)(2)(B). Pub. L. 110–387, §804(a), which directed substitution of “September 30, 2010” for “September 30, 2008”, was executed by making the substitution for “September 30, 2009” to reflect the probable intent of Congress and the amendment by Pub. L. 110–329. See below.

Pub. L. 110–329 substituted “September 30, 2009,” for “September 30, 2008,”.

Subsec. (g)(1). Pub. L. 110–387, §409(2), inserted “(except if such care constitutes hospice care)” after “medical services”.

2007—Subsec. (f)(2)(B). Pub. L. 110–161 substituted “September 30, 2008,” for “September 30, 2007,”.

2006—Subsec. (a)(4). Pub. L. 109–461, §211(a)(3)(B), struck out “and” before “the requirement in section 1710B of this title” and inserted “, and the requirement in section 1745 of this title to provide nursing home care and prescription medicines to veterans with service-connected disabilities in State homes” after “a program of extended care services”.

Subsec. (e)(3)(D). Pub. L. 109–461, §1006(b), provided that as of the enactment of Pub. L. 109–461, the amendments made by Pub. L. 109–444 were deemed for all purposes not to have taken effect and that Pub. L. 109–444 ceased to be in effect. See Amendment notes below and section 1006(b) of Pub. L. 109–461, set out as a Coordination of Provisions With Pub. L. 109–444 note under section 101 of this title.

Pub. L. 109–461, §1003, substituted “December 31, 2007” for “December 31, 2005”.

Pub. L. 109–444, which substituted “December 31, 2007” for “December 31, 2005”, was terminated by Pub. L. 109–461, §1006(b). See Amendment notes above.

2003—Subsec. (e)(1)(E). Pub. L. 108–170, §102(1), added subpar. (E).

Subsec. (e)(2)(B). Pub. L. 108–170, §102(2), substituted “subparagraph (C), (D), or (E) of paragraph (1)” for “paragraph (1)(C) or (1)(D)” and “service or testing described in such subparagraph” for “service described in that paragraph”.

Subsec. (e)(3)(D). Pub. L. 108–170, §102(3), added subpar. (D).

2002—Subsec. (e)(1)(D). Pub. L. 107–330 substituted “November 11, 1998” for “the date of the enactment of this subparagraph”.

Subsec. (e)(3)(B). Pub. L. 107–135, §211, substituted “December 31, 2002” for “December 31, 2001”.

Subsec. (f)(1). Pub. L. 107–135, §202(b)(1), inserted “or (4)” after “paragraph (2)”.

Subsec. (f)(2)(B). Pub. L. 107–135, §209(a), substituted “September 30, 2007” for “September 30, 2002”.

Subsec. (f)(4), (5). Pub. L. 107–135, §202(b)(2), (3), added par. (4) and redesignated former par. (4) as (5).

2000—Subsec. (a)(4). Pub. L. 106–419 inserted “the requirement in section 1710A(a) of this title that the Secretary provide nursing home care,” after “medical services,” and struck out comma after “extended care services”.

1999—Subsec. (a)(1). Pub. L. 106–117, §101(f)(1), struck out “, and may furnish nursing home care,” after “medical services” in introductory provisions.

Subsec. (a)(2)(A). Pub. L. 106–117, §101(f)(2), inserted “or, with respect to nursing home care during any period during which the provisions of section 1710A(a) of this title are in effect, a compensable service-connected disability rated less than 70 percent” after “50 percent”.

Subsec. (a)(2)(D). Pub. L. 106–117, §112(1), inserted “or who was awarded the Purple Heart” after “former prisoner of war”.

Subsec. (a)(4). Pub. L. 106–117, §101(f)(3), inserted “, and the requirement in section 1710B of this title that the Secretary provide a program of extended care services,” after “medical services”.

Subsec. (a)(5). Pub. L. 106–117, §101(f)(4), added par. (5).

Subsec. (g)(1). Pub. L. 106–117, §201(b)(1), substituted “in the case of each outpatient visit the applicable amount or amounts established by the Secretary by regulation” for “the amount determined under paragraph (2) of this subsection”.

Subsec. (g)(2). Pub. L. 106–117, §201(b)(2), substituted “which the Secretary shall establish by regulation.” for “equal to 20 percent of the estimated average cost (during the calendar year in which the services are furnished) of an outpatient visit in a Department facility. Such estimated average cost shall be determined by the Secretary.”

1998—Subsec. (e)(1)(D). Pub. L. 105–368, §102(a)(1), added subpar. (D).

Subsec. (e)(2)(A)(ii). Pub. L. 105–368, §1005(b)(3), substituted “section 3” for “section 2”.

Subsec. (e)(2)(B). Pub. L. 105–368, §102(a)(2), inserted “or (1)(D)” after “paragraph (1)(C)”.

Subsec. (e)(3)(A). Pub. L. 105–368, §102(a)(3)(A), struck out “and” at end.

Subsec. (e)(3)(B). Pub. L. 105–368, §102(a)(3)(B), substituted “December 31, 2001; and” for “December 31, 1998.”

Subsec. (e)(3)(C). Pub. L. 105–368, §102(a)(3)(C), added subpar. (C).

Subsec. (e)(5). Pub. L. 105–368, §102(a)(4), added par. (5).

1997—Subsec. (a)(2)(B). Pub. L. 105–114, §402(a), struck out “compensable” before “disability”.

Subsec. (a)(2)(F). Pub. L. 105–114, §209(a)(1), substituted “other conditions” for “environmental hazard”.

Subsec. (e)(1)(C). Pub. L. 105–114, §209(a)(2), substituted “served” for “the Secretary finds may have been exposed while serving” and “associated with such service” for “associated with such exposure” and struck out “to a toxic substance or environmental hazard” after “Persian Gulf War”.

Subsec. (e)(2)(B). Pub. L. 105–114, §209(a)(3), substituted “the service” for “an exposure”.

Subsec. (f)(2)(B). Pub. L. 105–33, §8021(a)(1), inserted “before September 30, 2002,” after “(B)”.

Subsec. (f)(4), (5). Pub. L. 105–33, §8023(b)(1), redesignated par. (5) as (4) and struck out former par. (4) which read as follows: “Amounts collected or received on behalf of the United States under this subsection shall be deposited in the Treasury as miscellaneous receipts.”

Subsec. (g)(4). Pub. L. 105–33, §8023(b)(2), struck out par. (4) which read as follows: “Amounts collected or received by the Department under this subsection shall be deposited in the Treasury as miscellaneous receipts.”

1996—Subsec. (a). Pub. L. 104–262, §101(a), amended subsec. (a) generally, revising and restating provisions in former pars. (1) to (3) relating to eligibility for care as pars. (1) to (4).

Subsec. (c)(1). Pub. L. 104–262, §101(d)(2), substituted “section 1712(a)” for “section 1712(b)”.

Subsec. (e)(1)(A), (B). Pub. L. 104–262, §102(a)(1), added subpars. (A) and (B) and struck out former subpars. (A) and (B) which read as follows:

“(A) Subject to paragraphs (2) and (3) of this subsection, a veteran—

“(i) who served on active duty in the Republic of Vietnam during the Vietnam era, and

“(ii) who the Secretary finds may have been exposed during such service to dioxin or was exposed during such service to a toxic substance found in a herbicide or defoliant used in connection with military purposes during such era,

is eligible for hospital care and nursing home care under subsection (a)(1)(G) of this section for any disability, notwithstanding that there is insufficient medical evidence to conclude that such disability may be associated with such exposure.

“(B) Subject to paragraphs (2) and (3) of this subsection, a veteran who the Secretary finds was exposed while serving on active duty to ionizing radiation from the detonation of a nuclear device in connection with such veteran's participation in the test of such a device or with the American occupation of Hiroshima and Nagasaki, Japan, during the period beginning on September 11, 1945, and ending on July 1, 1946, is eligible for hospital care and nursing home care under subsection (a)(1)(G) of this section for any disability, notwithstanding that there is insufficient medical evidence to conclude that such disability may be associated with such exposure.”

Subsec. (e)(1)(C). Pub. L. 104–262, §101(d)(3), substituted “hospital care, medical services, and nursing home care under subsection (a)(2)(F)” for “hospital care and nursing home care under subsection (a)(1)(G) of this section”.

Subsec. (e)(2). Pub. L. 104–262, §102(a)(2), added par. (2) and struck out former par. (2) which read as follows: “Hospital and nursing home care may not be provided under subsection (a)(1)(G) of this section with respect to a disability that is found, in accordance with guidelines issued by the Under Secretary for Health, to have resulted from a cause other than an exposure described in subparagraph (A), (B), or (C) of paragraph (1) of this subsection.”

Subsec. (e)(3). Pub. L. 104–262, §102(a)(2), added par. (3) and struck out former par. (3) which read as follows: “Hospital and nursing home care and medical services may not be provided under or by virtue of subsection (a)(1)(G) of this section after December 31, 1996.”

Pub. L. 104–110 substituted “after December 31, 1996” for “after June 30, 1995, or, in the case of care for a veteran described in paragraph (1)(C), after December 31, 1995”.

Subsec. (e)(4). Pub. L. 104–262, §102(a)(2), added par. (4).

Subsec. (e)(4)(A). Pub. L. 104–275 substituted “during the period beginning on January 9, 1962, and ending on May 7, 1975,” for “during the Vietnam era,” in cl. (i) and “such period” for “such era” in cl. (ii).

Subsec. (f)(1). Pub. L. 104–262, §101(d)(4)(A), substituted “subsection (a)(3)” for “subsection (a)(2)”.

Subsec. (f)(3)(E). Pub. L. 104–262, §101(d)(4)(B), substituted “paragraph (3) of subsection (a)” for “section 1712(a) of this title” and “subsection (g)” for “section 1712(f) of this title”.

Subsec. (f)(3)(F). Pub. L. 104–262, §101(d)(4)(C), substituted “subsection (g)” for “section 1712(f) of this title”.

Subsec. (g). Pub. L. 104–262, §101(b)(2), redesignated subsec. (f) of section 1712 of this title as subsec. (g) of this section and substituted “subsection (a)(3) of this section” for “section 1710(a)(2) of this title” in par. (1). See Codification note above.

Pub. L. 104–262, §101(b)(1), redesignated subsec. (g) as (h).

Subsec. (h). Pub. L. 104–262, §101(b)(1), redesignated subsec. (g) as (h).

1994—Subsec. (e)(3). Pub. L. 103–452 substituted “June 30, 1995” for “June 30, 1994” and “December 31, 1995” for “December 31, 1994”.

Subsec. (f)(3)(E). Pub. L. 103–446 substituted “section 1712(a)” for “section 1712(f)” and “section 1712(f)” for “section 1712(f)(4)”.

1993—Subsec. (a)(1)(G). Pub. L. 103–210, §1(a)(1), substituted “substance, radiation, or environmental hazard” for “substance or radiation”.

Subsec. (e)(1)(C). Pub. L. 103–210, §1(a)(2)(A), added subpar. (C).

Subsec. (e)(2). Pub. L. 103–210, §1(a)(2)(B), substituted “subparagraph (A), (B), or (C)” for “subparagraph (A) or (B)”.

Subsec. (e)(3). Pub. L. 103–210, §2(a), substituted “June 30, 1994” for “December 31, 1993”.

Pub. L. 103–210, §1(a)(2)(C), inserted before period at end “, or, in the case of care for a veteran described in paragraph (1)(C), after December 31, 1994”.

1992—Subsec. (e)(2). Pub. L. 102–405 substituted “Under Secretary for Health” for “Chief Medical Director”.

1991—Pub. L. 102–83, §5(a), renumbered section 610 of this title as this section.

Subsec. (a)(1). Pub. L. 102–83, §5(c)(1), substituted “1151” for “351” in subpar. (C) and “1722(a)” for “622(a)” in subpar. (I).

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places in introductory provisions.

Subsec. (a)(1)(H). Pub. L. 102–54 substituted “the Mexican border period” for “the Spanish-American War, the Mexican border period,”.

Subsec. (a)(3). Pub. L. 102–83, §5(c)(1), substituted “1703” for “603” and “1720” for “620”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Subsec. (b). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Subsec. (b)(2)(A). Pub. L. 102–83, §5(c)(1), substituted “1503” for “503” and “1521(d)” for “521(d)”.

Subsec. (c). Pub. L. 102–83, §5(c)(1), substituted “1712(b)” for “612(b)”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” wherever appearing.

Subsec. (d). Pub. L. 102–83, §5(c)(1), substituted “1720” for “620”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Subsec. (e)(1). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in subpars. (A)(ii) and (B).

Subsec. (e)(3). Pub. L. 102–4 substituted “1993” for “1990”.

Subsec. (f)(3)(E), (F). Pub. L. 102–83, §5(c)(1), substituted “1712(f)” for “612(f)” and “1712(f)(4)” for “612(f)(4)” in subpar. (E) and “1712(f)” for “612(f)” in subpar. (F).

Subsec. (g). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

1990—Subsec. (a)(1)(I). Pub. L. 101–508, §8013(a)(1)(A), substituted “section 622(a)” for “section 622(a)(1)”.

Subsec. (a)(2). Pub. L. 101–508, §8013(a)(1)(B), added par. (2) and struck out former par. (2) which read as follows:

“(A) To the extent that resources and facilities are available, the Administrator may furnish hospital care and nursing home care which the Administrator determines is needed to a veteran for a non-service-connected disability if the veteran has an income level described in section 622(a)(2) of this title.

“(B) In the case of a veteran who is not described in paragraph (1) of this subsection or in subparagraph (A) of this paragraph, the Administrator may furnish hospital care and nursing home care which the Administrator determines is needed to the veteran for a non-service-connected disability—

“(i) to the extent that resources and facilities are otherwise available; and

“(ii) subject to the provisions of subsection (f) of this section.”

Subsec. (f)(1), (2). Pub. L. 101–508, §8013(a)(2)(A), added pars. (1) and (2) and struck out former pars. (1) and (2) which read as follows:

“(1) The Administrator may not furnish hospital care or nursing home care under this section to a veteran who is eligible for such care by reason of subsection (a)(2)(B) of this section unless the veteran agrees to pay to the United States the applicable amount determined under paragraph (2) of this subsection.

“(2) A veteran who is furnished hospital care or nursing home care under this section and who is required under paragraph (1) of this subsection to agree to pay an amount to the United States in order to be furnished such care shall be liable to the United States for an amount equal to the lesser of—

“(A) the cost of furnishing such care, as determined by the Administrator; and

“(B) the amount determined under paragraph (3) of this subsection.”

Subsec. (f)(3)(A), (B). Pub. L. 101–508, §8013(a)(2)(B), substituted “paragraph (2)(A)(ii)” for “paragraph (2)(B)”.

1988—Subsec. (b). Pub. L. 100–233 amended subsec. (b) generally. Prior to amendment, subsec. (b) read as follows: “The Administrator, within the limits of Veterans’ Administration facilities, may furnish domiciliary care to—

“(1) a veteran who was discharged or released from the active military, naval, or air service for a disability incurred or aggravated in line of duty, or a person who is in receipt of disability compensation, when such person is suffering from a permanent disability or tuberculosis or neuropsychiatric ailment and is incapacitated from earning a living and has no adequate means of support; and

“(2) a veteran who is in need of domiciliary care if such veteran is unable to defray the expenses of necessary domiciliary care.”

Subsec. (e)(3). Pub. L. 100–687 substituted “December 31, 1990” for “September 30, 1989”.

1986—Subsec. (a). Pub. L. 99–576, §237(a), inserted “who is in receipt of, or” after “veteran” in par. (1)(C).

Pub. L. 99–272, §19011(a)(1), amended subsec. (a) generally. Prior to amendment, subsec. (a) read as follows: “The Administrator, within the limits of Veterans’ Administration facilities, may furnish hospital care or nursing home care which the Administrator determines is needed to—

“(1)(A) any veteran for a service-connected disability; or

“(B) any veteran for a non-service-connected disability if such veteran is unable to defray the expenses of necessary hospital or nursing home care;

“(2) a veteran whose discharge or release from the active military, naval, or air service was for a disability incurred or aggravated in line of duty;

“(3) a person (A) who is in receipt of, or but for the receipt of retirement pay would be entitled to, disability compensation, or (B) who, but for a suspension pursuant to section 351 of this title (or both such a suspension and the receipt of retired pay), would be entitled to disability compensation, but only to the extent that such person's continuing eligibility for such care is provided for in the judgment or settlement described in such section;

“(4) a veteran who is a former prisoner of war;

“(5) a veteran who meets the conditions of subsection (e) of this section; and

“(6) any veteran for a non-service-connected disability if such veteran is sixty-five years of age or older.”

Subsec. (e)(1)(A), (B). Pub. L. 99–272, §19011(d)(3)(A), substituted “is eligible for hospital care and nursing home care under subsection (a)(1)(G)” for “may be furnished hospital care or nursing home care under subsection (a)(5)”.

Subsec. (e)(2), (3). Pub. L. 99–272, §19011(d)(3)(B), substituted “subsection (a)(1)(G)” for “subsection (a)(5)”.

Subsec. (f). Pub. L. 99–272, §19011(a)(2), added subsec. (f).

Subsec. (f)(3)(F). Pub. L. 99–576, §237(b)(1), added subpar. (F).

Subsec. (g). Pub. L. 99–272, §19011(a)(2), added subsec. (g).

1985—Subsec. (e)(3). Pub. L. 99–166 substituted “after September 30, 1989” for “after the end of the one-year period beginning on the date the Administrator submits to the appropriate committees of Congress the first report required by section 307(b)(2) of the Veterans Health Programs Extension and Improvement Act of 1979 (Public Law 96–151; 93 Stat. 1098)”.

1983—Subsec. (a)(3). Pub. L. 98–160 inserted “(A)” after “a person” and, after “disability compensation”, inserted “or (B) who, but for a suspension pursuant to section 351 of this title (or both such a suspension and the receipt of retired pay), would be entitled to disability compensation, but only to the extent that such person's continuing eligibility for such care is provided for in the judgment or settlement described in such section”.

1981—Subsec. (a). Pub. L. 97–72, §102(a)(1), added cl. (5) and redesignated former cl. (5) as (6).

Pub. L. 97–37 added cl. (4) and redesignated former cl. (4) as (5).

Subsec. (e). Pub. L. 97–72, §102(a)(2), added subsec. (e).

1979—Subsec. (c). Pub. L. 96–22 inserted provisions relating to the furnishing of dental services and treatment and related dental appliances for non-service-connected dental conditions or disabilities of veterans.

1976—Pub. L. 94–581, §202(d)(1), inserted “, nursing home,” in section catchline.

Subsec. (a). Pub. L. 94–581, §§202(d)(2), 210(a)(1)(A), (B), substituted “the Administrator determines” for “he determines” in provisions preceding par. (1) and substituted “such veteran” for “he” and “necessary hospital or nursing home care” for “necessary hospital care” in subpar. (B) of par. (1).

Subsec. (b)(1). Pub. L. 94–581, §210(a)(1)(C), substituted “such person” for “he”.

Subsec. (b)(2). Pub. L. 94–581, §§202(d)(3), 210(a)(1)(B), substituted “a veteran who is in need of domiciliary care if such veteran” for “a veteran of any war or of service after January 31, 1955, who is in need of domiciliary care, if he”.

Subsec. (c). Pub. L. 94–581, §210(a)(1)(B), substituted “for which such veteran is hospitalized” for “for which he is hospitalized”.

Subsec. (d). Pub. L. 94–581, §202(d)(4), substituted “direct jurisdiction” for “direct and exclusive jurisdiction”.

1973—Subsec. (a). Pub. L. 93–82, §102(1), (2), extended authority of the Administrator to furnish nursing home care, and in par. (1)(B), substituted “any veteran for a” for “a veteran of any war or of service after January 31, 1955, for”.

Subsec. (c). Pub. L. 93–82, §102(3), expanded provision regarding medical services to include nursing home care and struck out requirement that the Administrator make a determination in each instance that the non-service-connected disability would be in the veteran's interest, would not prolong his hospitalization, and, would not interfere with the furnishing of hospital facilities to other veterans.

Subsec. (d). Pub. L. 93–82, §102(4), added subsec. (d).

1970—Subsec. (a). Pub. L. 91–500 added cl. (4).

1966—Pub. L. 89–358 inserted “or of service after January 31, 1955,” after “veteran of any war” in subsecs. (a)(1)(B) and (b)(2).

Subsec. (c). Pub. L. 89–785 added subsec. (c).

1962—Subsec. (a)(1). Pub. L. 87–583 provided for hospital care to any veteran for a service-connected disability instead of to a veteran of any war for a service-connected disability incurred or aggravated during a period of war in subpar. (A) and incorporated existing provisions in subpar. (B).

Effective Date of 2006 Amendment

Pub. L. 109–461, title II, §211(a)(5), Dec. 22, 2006, 120 Stat. 3419, provided that: “The amendments made by this subsection [enacting section 1745 of this title and amending this section and sections 1741 and 1745 of this title] shall take effect 90 days after the date of the enactment of this Act [Dec. 22, 2006].”

Effective Date of 2002 Amendment

Amendment by section 202(b) of Pub. L. 107–135 effective Oct. 1, 2002, see section 202(c) of Pub. L. 107–135, set out as a note under section 1705 of this title.

Effective Date of 1999 Amendment

Amendment by section 101(f) of Pub. L. 106–117 effective Nov. 30, 1999, with provisions of subsec. (f) of this section not applicable to any day of nursing home care on or after the effective date of regulations under section 101(h)(2) of Pub. L. 106–117, see section 101(h) of Pub. L. 106–117, set out as an Effective Date note under section 1710B of this title.

Pub. L. 106–117, title II, §201(c), as added by Pub. L. 106–419, title II, §224(c), Nov. 1, 2000, 114 Stat. 1846, provided that: “The amendments made by subsection (b) [amending this section] shall apply with respect to medical services furnished under section 1710(a) of title 38, United States Code, on or after the effective date of the regulations prescribed by the Secretary of Veterans Affairs to establish the amounts required to be established under paragraphs (1) and (2) of section 1710(g) of that title, as amended by subsection (b).”

Effective Date of 1997 Amendment

Section 8023(g) of Pub. L. 105–33 provided that:

“(1) Except as provided in paragraph (2), this section [enacting section 1729A of this title, amending this section and sections 712, 1722A, and 1729 of this title, and enacting provisions set out as notes under sections 1729 and 1729A of this title] and the amendments made by this section shall take effect on October 1, 1997.

“(2) The amendments made by subsection (d) [amending section 1729 of this title] shall take effect on the date of the enactment of this Act [Aug. 5, 1997].”

Effective Date of 1996 Amendment

Amendment by Pub. L. 104–275 effective Jan. 1, 1997, with no benefit to be paid or provided by reason of such amendment for any period before such date, see section 505(d) of Pub. L. 104–275, set out as a note under section 101 of this title.

Effective Date of 1993 Amendment

Section 1(c)(1) of Pub. L. 103–210 provided that: “The amendments made by subsections (a) and (b) [amending this section and section 1712 of this title] shall take effect as of August 2, 1990.”

Effective Date of 1990 Amendments

Pub. L. 102–145, §111, Oct. 28, 1991, 105 Stat. 970, provided that: “Notwithstanding any other provision of this joint resolution or any other law, the amendments made by sections 8012 and 8013 of the Omnibus Budget Reconciliation Act of 1990 (Public Law 101–508) [enacting section 622A [now 1722A] of this title and amending this section and sections 612 [now 1712] and 622 [now 1722] of this title] shall remain in effect through the period covered by this joint resolution [see section 106 of Pub. L. 102–145, 105 Stat. 970, as amended by Pub. L. 102–163, 105 Stat. 1048].”

Pub. L. 102–109, §111, Sept. 30, 1991, 105 Stat. 553, provided that: “Notwithstanding any other provision of this joint resolution or any other law, the amendments made by sections 8012 and 8013 of the Omnibus Budget Reconciliation Act of 1990 (Public Law 101–508) [enacting section 622A [now 1722A] of this title and amending this section and sections 612 [now 1712] and 622 [now 1722] of this title] shall remain in effect through the period covered by this joint resolution [see section 106 of Pub. L. 102–109, 105 Stat. 553].”

Section 8013(d) and (e) of Pub. L. 101–508, as amended by Pub. L. 102–139, title V, §518(b), Oct. 28, 1991, 105 Stat. 779; Pub. L. 102–568, title VI, §606(b), Oct. 29, 1992, 106 Stat. 4343; Pub. L. 103–66, title XII, §12002(a), Aug. 10, 1993, 107 Stat. 414; Pub. L. 105–33, title VIII, §8021(a)(2), Aug. 5, 1997, 111 Stat. 665, provided that:

“(d) Effective Date.—The amendments made by this section [amending this section and sections 612 and 622 [now 1712 and 1722] of this title] shall apply with respect to hospital care and medical services received after October 31, 1990, or the date of the enactment of this Act [Nov. 5, 1990], whichever is later.

“[(e) Repealed. Pub. L. 105–33, title VIII, §8021(a)(2), Aug. 5, 1997, 111 Stat. 665.]”

Effective Date of 1986 Amendments

Section 237(c) of Pub. L. 99–576 provided that: “The amendments made by this section [amending this section and section 612 [now 1712] of this title] shall take effect as of April 7, 1986.”

Section 19011(f) of Pub. L. 99–272 provided that:

“(1) Except as provided in paragraph (2), the amendments made by this section [amending this section and sections 525, 601, 612, 612A, 620, 622, and 663 [now 1525, 1701, 1712, 1712A, 1720, 1722, and 1763] of this title and enacting provisions set out as notes under this section and section 1722 of this title] shall apply to hospital care, nursing home care, and medical services furnished on or after July 1, 1986.

“(2)(A) The provisions of sections 610 and 622 [now 1710 and 1722] of title 38, United States Code, as in effect on the day before the date of the enactment of this Act [Apr. 7, 1986], shall apply with respect to hospital and nursing home care furnished on or after July 1, 1986, to veterans furnished such care or services on June 30, 1986, but only to the extent that such care is furnished with respect to the same episode of care for which it was furnished on June 30, 1986, as determined by the Administrator pursuant to regulations which the Administrator shall prescribe.

“(B) During the months of July and August 1986, the Administrator may, in order to continue a course of treatment begun before July 1, 1986, furnish medical services to a veteran on an ambulatory or outpatient basis without regard to the amendments made by this section.

“(C) For the purposes of this paragraph, the term ‘episode of care’ means a period of consecutive days—

“(i) beginning with the first day on which a veteran is furnished hospital or nursing home care; and

“(ii) ending on the day of the veteran's discharge from the hospital or nursing home facility, as the case may be.”

Effective Date of 1981 Amendment

Section 5(d) of Pub. L. 97–37 provided that: “The amendments made by this section [amending this section and section 612 [now 1712] of this title] shall take effect on October 1, 1981”.

Effective Date of 1979 Amendment

Amendment by Pub. L. 96–22 effective Oct. 1, 1979, see section 107 of Pub. L. 96–22, set out as a note under section 1701 of this title.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Effective Date of 1973 Amendment

Amendment by Pub. L. 93–82 effective Sept. 1, 1973, see section 501 of Pub. L. 93–82, set out as a note under section 1701 of this title.

Savings Provision

Section 102(b) of Pub. L. 104–262 provided that: “The provisions of sections 1710(e) and 1712(a) of title 38, United States Code, as in effect on the day before the date of the enactment of this Act [Oct. 9, 1996], shall continue to apply on and after such date with respect to the furnishing of hospital care, nursing home care, and medical services for any veteran who was furnished such care or services before such date of enactment on the basis of presumed exposure to a substance or radiation under the authority of those provisions, but only for treatment for a disability for which such care or services were furnished before such date.”

Savings Provision for Pub. L. 100–322

Section 102(c) of Pub. L. 100–322 provided that: “The amendment made by subsection (a) [amending this section] shall not limit or restrict the eligibility for domiciliary care of a veteran who was a patient or a resident in a State home facility or a Veterans’ Administration domiciliary facility during the period beginning on January 1, 1987, and ending on April 1, 1988.”

Pilot Program on Assistance for Child Care for Certain Veterans Receiving Health Care

Pub. L. 111–163, title II, §205, May 5, 2010, 124 Stat. 1144, provided that:

“(a) Pilot Program Required.—The Secretary of Veterans Affairs shall carry out a pilot program to assess the feasibility and advisability of providing, subject to subsection (b), assistance to qualified veterans described in subsection (c) to obtain child care so that such veterans can receive health care services described in subsection (c).

“(b) Limitation on Period of Payments.—Assistance may only be provided to a qualified veteran under the pilot program for receipt of child care during the period that the qualified veteran—

“(1) receives the types of health care services described in subsection (c) at a facility of the Department; and

“(2) requires travel to and return from such facility for the receipt of such health care services.

“(c) Qualified Veterans.—For purposes of this section, a qualified veteran is a veteran who is—

“(1) the primary caretaker of a child or children; and

“(2)(A) receiving from the Department—

“(i) regular mental health care services;

“(ii) intensive mental health care services; or

“(iii) such other intensive health care services that the Secretary determines that provision of assistance to the veteran to obtain child care would improve access to such health care services by the veteran; or

“(B) in need of regular or intensive mental health care services from the Department, and but for lack of child care services, would receive such health care services from the Department.

“(d) Locations.—The Secretary shall carry out the pilot program in no fewer than three Veterans Integrated Service Networks selected by the Secretary for purposes of the pilot program.

“(e) Duration.—The pilot program shall be carried out during the 2-year period beginning on the date of the commencement of the pilot program.

“(f) Forms of Child Care Assistance.—

“(1) In general.—Child care assistance under this section may include the following:

“(A) Stipends for the payment of child care offered by licensed child care centers (either directly or through a voucher program) which shall be, to the extent practicable, modeled after the Department of Veterans Affairs Child Care Subsidy Program established pursuant to section 630 of the Treasury and General Government Appropriations Act, 2002 (Public Law 107–67; 115 Stat. 552) [now 40 U.S.C. 590(g)].

“(B) Direct provision of child care at an on-site facility of the Department of Veterans Affairs.

“(C) Payments to private child care agencies.

“(D) Collaboration with facilities or programs of other Federal departments or agencies.

“(E) Such other forms of assistance as the Secretary considers appropriate.

“(2) Amounts of stipends.—In the case that child care assistance under this section is provided as a stipend under paragraph (1)(A), such stipend shall cover the full cost of such child care.

“(g) Report.—Not later than 6 months after the completion of the pilot program, the Secretary shall submit to Congress a report on the pilot program. The report shall include the findings and conclusions of the Secretary as a result of the pilot program, and shall include such recommendations for the continuation or expansion of the pilot program as the Secretary considers appropriate.

“(h) Authorization of Appropriations.—There is authorized to be appropriated to the Secretary of Veterans Affairs to carry out the pilot program $1,500,000 for each of fiscal years 2010 and 2011.”

Grants for Veterans Service Organizations for Transportation of Highly Rural Veterans

Pub. L. 111–163, title III, §307, May 5, 2010, 124 Stat. 1154, provided that:

“(a) Grants Authorized.—

“(1) In general.—The Secretary of Veterans Affairs shall establish a grant program to provide innovative transportation options to veterans in highly rural areas.

“(2) Eligible recipients.—The following may be awarded a grant under this section:

“(A) State veterans service agencies.

“(B) Veterans service organizations.

“(3) Use of funds.—A State veterans service agency or veterans service organization awarded a grant under this section may use the grant amount to—

“(A) assist veterans in highly rural areas to travel to Department of Veterans Affairs medical centers; and

“(B) otherwise assist in providing transportation in connection with the provision of medical care to veterans in highly rural areas.

“(4) Maximum amount.—The amount of a grant under this section may not exceed $50,000.

“(5) No matching requirement.—The recipient of a grant under this section shall not be required to provide matching funds as a condition for receiving such grant.

“(b) Regulations.—The Secretary shall prescribe regulations for—

“(1) evaluating grant applications under this section; and

“(2) otherwise administering the program established by this section.

“(c) Definitions.—In this section:

“(1) Highly rural.—The term ‘highly rural’, in the case of an area, means that the area consists of a county or counties having a population of less than seven persons per square mile.

“(2) Veterans service organization.—The term ‘veterans service organization’ means any organization recognized by the Secretary of Veterans Affairs for the representation of veterans under section 5902 of title 38, United States Code.

“(d) Authorization of Appropriations.—There is authorized to be appropriated $3,000,000 for each of fiscal years 2010 through 2014 to carry out this section.”

Continuation of Authority

Pub. L. 110–92, §161, as added by Pub. L. 110–149, §2, Dec. 21, 2007, 121 Stat. 1819, provided that: “Notwithstanding section 106 [121 Stat. 990], the authority to provide care and services under section 1710(e)(1)(E) of title 38, United States Code, shall continue in effect through September 30, 2008.”

Personal Emergency Response System for Veterans With Service-Connected Disabilities

Pub. L. 107–135, title II, §210, Jan. 23, 2002, 115 Stat. 2464, provided that:

“(a) Evaluation and Study.—The Secretary of Veterans Affairs shall carry out an evaluation and study of the feasibility and desirability of providing a personal emergency response system to veterans who have service-connected disabilities. The evaluation and study shall be commenced not later than 60 days after the date of the enactment of this Act [Jan. 23, 2002].

“(b) Report.—Not later than 180 days after the date of the enactment of this Act, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the evaluation and study under subsection (a). The Secretary shall include in the report the Secretary's findings resulting from the evaluation and study and the Secretary's conclusion as to whether the Department of Veterans Affairs should provide a personal emergency response system to veterans with service-connected disabilities.

“(c) Authority To Provide System.—If the Secretary concludes in the report under subsection (b) that a personal emergency response system should be provided by the Department of Veterans Affairs to veterans with service-connected disabilities—

“(1) the Secretary may provide such a system, without charge, to any veteran with a service-connected disability who is enrolled under section 1705 of title 38, United States Code, and who submits an application for such a system under subsection (d); and

“(2) the Secretary may contract with one or more vendors to furnish such a system.

“(d) Application.—A personal emergency response system may be provided to a veteran under subsection (c)(1) only upon the submission by the veteran of an application for the system. Any such application shall be in such form and manner as the Secretary may require.

“(e) Definition.—For purposes of this section, the term ‘personal emergency response system’ means a device—

“(1) that can be activated by an individual who is experiencing a medical emergency to notify appropriate emergency medical personnel that the individual is experiencing a medical emergency; and

“(2) that provides the individual's location through a Global Positioning System indicator.”

Chiropractic Treatment

Pub. L. 107–135, title II, §204, Jan. 23, 2002, 115 Stat. 2459, provided that:

“(a) Requirement for Program.—Subject to the provisions of this section, the Secretary of Veterans Affairs shall carry out a program to provide chiropractic care and services to veterans through Department of Veterans Affairs medical centers and clinics.

“(b) Eligible Veterans.—Veterans eligible to receive chiropractic care and services under the program are veterans who are enrolled in the system of patient enrollment under section 1705 of title 38, United States Code.

“(c) Location of Program.—The program shall be carried out at sites designated by the Secretary for purposes of the program. The Secretary shall designate at least one site for such program in each geographic service area of the Veterans Health Administration. The sites so designated shall be medical centers and clinics located in urban areas and in rural areas.

“(d) Care and Services Available.—The chiropractic care and services available under the program shall include a variety of chiropractic care and services for neuro-musculoskeletal conditions, including subluxation complex.

“(e) Other Administrative Matters.—(1) The Secretary shall carry out the program through personal service contracts and by appointment of licensed chiropractors in Department medical centers and clinics.

“(2) As part of the program, the Secretary shall provide training and materials relating to chiropractic care and services to Department health care providers assigned to primary care teams for the purpose of familiarizing such providers with the benefits of chiropractic care and services.

“(f) Regulations.—The Secretary shall prescribe regulations to carry out this section.

“(g) Chiropractic Advisory Committee.—(1) The Secretary shall establish an advisory committee to provide direct assistance and advice to the Secretary in the development and implementation of the chiropractic health program.

“(2) The membership of the advisory committee shall include members of the chiropractic care profession and such other members as the Secretary considers appropriate.

“(3) Matters on which the advisory committee shall assist and advise the Secretary shall include the following:

“(A) Protocols governing referral to chiropractors.

“(B) Protocols governing direct access to chiropractic care.

“(C) Protocols governing scope of practice of chiropractic practitioners.

“(D) Definition of services to be provided.

“(E) Such other matters the Secretary determines to be appropriate.

“(4) The advisory committee shall cease to exist on December 31, 2004.”

Pub. L. 106–117, title III, §303, Nov. 30, 1999, 113 Stat. 1572, provided that:

“(a) Establishment of Program.—Not later than 120 days after the date of the enactment of this Act [Nov. 30, 1999], the Under Secretary for Health of the Department of Veterans Affairs, after consultation with chiropractors, shall establish a policy for the Veterans Health Administration regarding the role of chiropractic treatment in the care of veterans under chapter 17 of title 38, United States Code.

“(b) Definitions.—For purposes of this section:

“(1) The term ‘chiropractic treatment’ means the manual manipulation of the spine performed by a chiropractor for the treatment of such musculo-skeletal conditions as the Secretary considers appropriate.

“(2) The term ‘chiropractor’ means an individual who—

“(A) is licensed to practice chiropractic in the State in which the individual performs chiropractic services; and

“(B) holds the degree of doctor of chiropractic from a chiropractic college accredited by the Council on Chiropractic Education.”

Implementation Report

Pub. L. 105–368, title I, §102(b), Nov. 11, 1998, 112 Stat. 3322, provided that: “Not later than October 1, 1999, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the Secretary's plan for establishing and operating the system for collection and analysis of information required by paragraph (5) of section 1710(e) of title 38, United States Code, as added by subsection (a)(4) [amending this section].”

Demonstration Projects for Treatment of Persian Gulf Illness

Section 209(b) of Pub. L. 105–114 provided that:

“(1) The Secretary of Veterans Affairs shall carry out a program of demonstration projects to test new approaches to treating, and improving the satisfaction with such treatment of, Persian Gulf veterans who suffer from undiagnosed and ill-defined disabilities. The program shall be established not later than July 1, 1998, and shall be carried out at up to 10 geographically dispersed medical centers of the Department of Veterans Affairs.

“(2) At least one of each of the following models shall be used at no less than two of the demonstration projects:

“(A) A specialized clinic which serves Persian Gulf veterans.

“(B) Multidisciplinary treatment aimed at managing symptoms.

“(C) Use of case managers.

“(3) A demonstration project under this subsection may be undertaken in conjunction with another funding entity, including agreements under section 8111 of title 38, United States Code.

“(4) The Secretary shall make available from appropriated funds (which have been retained for contingent funding) $5,000,000 to carry out the demonstration projects.

“(5) The Secretary may not approve a medical center as a location for a demonstration project under this subsection unless a peer review panel has determined that the proposal submitted by that medical center is among those proposals that have met the highest competitive standards of clinical merit and the Secretary has determined that the facility has the ability to—

“(A) attract the participation of clinicians of outstanding caliber and innovation to the project; and

“(B) effectively evaluate the activities of the project.

“(6) In determining which medical centers to select as locations for demonstration projects under this subsection, the Secretary shall give special priority to medical centers that have demonstrated a capability to compete successfully for extramural funding support for research into the effectiveness and cost-effectiveness of the care provided under the demonstration project.”

Patient Privacy for Women Patients

Section 322 of Pub. L. 104–262 provided that:

“(a) Identification of Deficiencies.—The Secretary of Veterans Affairs shall conduct a survey of each medical center under the jurisdiction of the Secretary to identify deficiencies relating to patient privacy afforded to women patients in the clinical areas at each such center which may interfere with appropriate treatment of such patients.

“(b) Correction of Deficiencies.—The Secretary shall ensure that plans and, where appropriate, interim steps to correct the deficiencies identified in the survey conducted under subsection (a) are developed and are incorporated into the Department's construction planning processes and, in cases in which it is cost-effective to do so, are given a high priority.

“(c) Reports to Congress.—The Secretary shall compile an annual inventory, by medical center, of deficiencies identified under subsection (a) and of plans and, where appropriate, interim steps, to correct such deficiencies. The Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives, not later than October 1, 1997, and not later than October 1 each year thereafter through 1999 a report on such deficiencies. The Secretary shall include in such report the inventory compiled by the Secretary, the proposed corrective plans, and the status of such plans.”

Hospice Care Study

Section 341 of Pub. L. 104–262 provided that:

“(a) Study Required.—The Secretary of Veterans Affairs shall conduct a research study to determine the desirability of the Secretary furnishing hospice care to terminally ill veterans and to evaluate the most cost-effective and efficient way to do so. The Secretary shall carry out the study using resources and personnel of the Department.

“(b) Conduct of Study.—In carrying out the study required by subsection (a), the Secretary shall—

“(1) evaluate the programs, and the program models, through which the Secretary furnishes hospice care services within or through facilities of the Department of Veterans Affairs and the programs and program models through which non-Department facilities provide such services;

“(2) assess the satisfaction of patients, and family members of patients, in each of the program models covered by paragraph (1);

“(3) compare the costs (or range of costs) of providing care through each of the program models covered by paragraph (1); and

“(4) identify any barriers to providing, procuring, or coordinating hospice services through any of the program models covered by paragraph (1).

“(c) Program Models.—For purposes of subsection (b)(1), the Secretary shall evaluate a variety of types of models for delivery of hospice care, including the following:

“(1) Direct furnishing of full hospice care by the Secretary.

“(2) Direct furnishing of some hospice services by the Secretary.

“(3) Contracting by the Secretary for the furnishing of hospice care, with a commitment that the Secretary will provide any further required hospital care for the patient.

“(4) Contracting for all required care to be furnished outside the Department.

“(5) Referral of the patient for hospice care without a contract.

“(d) Report.—Not later than April 1, 1998, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the research study. The report shall set forth the Secretary's findings and recommendations. The Secretary shall include in the report information on the extent to which the Secretary advises veterans concerning their eligibility for hospice care and information on the number of veterans (as of the time of the report) who are in each model of hospice care described in subsection (c) and the average cost per patient of hospice care for each such model.”

Ratification of Actions During Period of Expired Authority

Pub. L. 106–419, title II, §224(d), Nov. 1, 2000, 114 Stat. 1846, provided that: “Any action taken by the Secretary of Veterans Affairs under section 1710(g) of title 38, United States Code, during the period beginning on November 30, 1999, and ending on the date of the enactment of this Act [Nov. 1, 2000] is hereby ratified.”

Section 103 of title I of Pub. L. 104–110 provided that: “Any action taken by the Secretary of Veterans Affairs before the date of the enactment of this Act [Feb. 13, 1996] under a provision of law amended by this title [amending this section, sections 1712, 1720A, 1720C, 3703, 3710, 3720, 3731, 3735, 7451, 7618, and 8169 of this title, sections 11448 and 11450 of Title 42, The Public Health and Welfare, and provisions set out as notes under sections 1712, 1718, and 7721 of this title] that was taken during the period beginning on the date on which the authority of the Secretary under that provision of law expired and ending on the date of the enactment of this Act shall be considered to have the same force and effect as if the amendment to that provision of law made by this title had been in effect at the time of that action.”

Section 105 of Pub. L. 103–452 provided that: “Any action of the Secretary of Veterans Affairs under section 1710(e) of title 38, United States Code, during the period beginning on July 1, 1994, and ending on the date of the enactment of this Act [Nov. 2, 1994] is hereby ratified.”

Reimbursement for Hospital, Nursing Home or Outpatient Services Expenses

Section 1(c)(2) of Pub. L. 103–210 directed Secretary of Veterans Affairs, on request, to reimburse any veteran who paid the United States an amount under 38 U.S.C. 1710(f) or 1712(f) for hospital care, nursing home care, or outpatient services furnished by the Secretary to the veteran before Dec. 20, 1993, on the basis of a finding that the veteran may have been exposed to a toxic substance or environmental hazard during the Persian Gulf War, with amount of reimbursement to be amount that was paid by the veteran for such care or services.

Health Care Services for Women

Pub. L. 102–585, title I, §106, Nov. 4, 1992, 106 Stat. 4947, provided that:

“(a) General Authority.—In furnishing hospital care and medical services under chapter 17 of title 38, United States Code, the Secretary of Veterans Affairs may provide to women the following health care services:

“(1) Papanicolaou tests (pap smears).

“(2) Breast examinations and mammography.

“(3) General reproductive health care, including the management of menopause, but not including under this section infertility services, abortions, or pregnancy care (including prenatal and delivery care), except for such care relating to a pregnancy that is complicated or in which the risks of complication are increased by a service-connected condition.

“(b) Responsibilities of Directors of Facilities.—The Secretary shall ensure that directors of medical facilities of the Department identify and assess opportunities under the authority provided in title II of this Act [38 U.S.C. 8111 note] to (1) expand the availability of, and access to, health care services for women veterans under sections 1710 and 1712 of title 38, United States Code, and (2) provide counseling, care, and services authorized by this title [see Short Title of 1992 Amendment note set out under section 101 of this title].”

Report on Health Care and Research

Pub. L. 102–585, title I, §107, Nov. 4, 1992, 106 Stat. 4947, as amended by Pub. L. 104–262, title III, §324, Oct. 9, 1996, 110 Stat. 3197, provided that:

“(a) In general.—Not later than January 1 of 1993 and each year thereafter through 1998, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the provision of health care services and the conduct of research carried out by, or under the jurisdiction of, the Secretary relating to women veterans.

“(b) Contents.—The report under subsection (a) shall include the following information with respect to the most recent fiscal year before the date of the report:

“(1) The number of women veterans who have received services described in section 106 of this Act [set out as a note above] in facilities under the jurisdiction of the Secretary (or the Secretary of Defense), shown by reference to the Department facility which provided (or, in the case of Department of Defense facilities, arranged) those services;

“(2) A description of (A) the services provided at each such facility (including information on the number of inpatient stays and the number of outpatient visits through which such services were provided), and (B) the extent to which each such facility relies on contractual arrangements under section 1703 or 8153 of title 38, United States Code, to furnish care to women veterans in facilities which are not under the jurisdiction of the Secretary where the provision of such care is not furnished in a medical emergency.

“(3) The steps taken by each such facility to expand the provision of services at such facility (or under arrangements with a Department of Defense facility) to women veterans.

“(4) A description (as of October 1 of the year preceding the year in which the report is submitted) of the status of any research relating to women veterans being carried out by or under the jurisdiction of the Secretary, including research under section 109 of this Act [former 38 U.S.C. 7303 note].

“(5) A description of the actions taken by the Secretary to foster and encourage the expansion of such research.”

Coordination of Women's Services

Pub. L. 102–585, title I, §108, Nov. 4, 1992, 106 Stat. 4948, provided that: “The Secretary of Veterans Affairs shall ensure that an official in each regional office of the Veterans Health Administration shall serve as a coordinator of women's services. The responsibilities of such official shall include the following:

“(1) Conducting periodic assessments of the needs for services of women veterans within such region.

“(2) Planning to meet such needs.

“(3) Assisting in carrying out the purposes of section 106(b) of this title [set out above].

“(4) Coordinating the training of women veterans coordinators who are assigned to Department facilities in the region under the jurisdiction of such regional coordinator.

“(5) Providing appropriate technical support and guidance to Department facilities in that region with respect to outreach activities to women veterans.”

Population Study of Women Veterans

Pub. L. 102–585, title I, §110, Nov. 4, 1992, 106 Stat. 4948, as amended by Pub. L. 103–452, title I, §102(c), Nov. 2, 1994, 108 Stat. 4786, directed Secretary of Veterans Affairs, in consultation with Advisory Committee on Women Veterans, to conduct a study to determine needs of veterans who are women for health-care services, based on an appropriate sample of veterans who are women, and to submit to Congress, not later than 9 months after Nov. 4, 1992, an interim report describing information and advice obtained from Advisory Committee and status of study, and to submit, not later than Dec. 31, 1995, a final report describing results of study.

Demonstration Project To Evaluate Installation of Telephones for Patient Use at Department of Veterans Affairs Health-Care Facilities

Pub. L. 102–585, title V, §525, Nov. 4, 1992, 106 Stat. 4960, directed Secretary of Veterans Affairs to carry out a demonstration project to evaluate feasibility and desirability of providing telephone service in patient rooms in Department of Veterans Affairs health-care facilities which do not currently provide such service, use of telephones by patients of such health-care facilities, and relative feasibility and cost-effectiveness of a variety of options for providing such service, and submit to Congress a report on the demonstration project not later than Sept. 30, 1994.

Reports on Furnishing of Health Care and Implementation of Changes in Eligibility

Section 19011(e) of Pub. L. 99–272, as amended by Pub. L. 100–527, §10(1), (2), Oct. 25, 1988, 102 Stat. 2640, 2641; Pub. L. 101–237, title II, §201(d), Dec. 18, 1989, 103 Stat. 2066; Pub. L. 102–40, title III, §302, May 7, 1991, 105 Stat. 208; Pub. L. 102–83, §5(c)(2), Aug. 6, 1991, 105 Stat. 406; Pub. L. 102–291, §4, May 20, 1992, 106 Stat. 179, directed Administrator of Veterans Affairs to submit to Congress a report for each fiscal year through fiscal year 1992 concerning implementation of the amendments made by section 19011 of Pub. L. 99–272, which amended this section and sections 1525, 1701, 1712, 1712A, 1720, 1722, and 1763 of this title and enacted provisions set out as notes under this section and section 1722 of this title, specified detailed information required to be submitted in each report, and provided that each report be submitted not later than the Feb. 1 following the end of the fiscal year for which it is submitted.

Chiropractic Services Pilot Program

Section 109 of Pub. L. 99–166 directed Administrator of Veterans’ Affairs to conduct a pilot program to evaluate therapeutic benefits and cost-effectiveness of furnishing certain chiropractic services to veterans eligible for medical services under this chapter, provided that the pilot program be carried out during period beginning Jan. 1, 1986, and ending Dec. 31, 1988, and directed Administrator to submit to Committees on Veterans’ Affairs of Senate and House of Representatives not later than Apr. 1, 1989, a report on implementation, operation, and results of the pilot program.

§1710A. Required nursing home care

(a) The Secretary (subject to section 1710(a)(4) of this title) shall provide nursing home care which the Secretary determines is needed (1) to any veteran in need of such care for a service-connected disability, and (2) to any veteran who is in need of such care and who has a service-connected disability rated at 70 percent or more.

(b)(1) The Secretary shall ensure that a veteran described in subsection (a) who continues to need nursing home care is not, after placement in a Department nursing home, transferred from the facility without the consent of the veteran, or, in the event the veteran cannot provide informed consent, the representative of the veteran.

(2) Nothing in subsection (a) may be construed as authorizing or requiring that a veteran who is receiving nursing home care in a Department nursing home on the date of the enactment of this section be displaced, transferred, or discharged from the facility.

(c) The Secretary shall ensure that nursing home care provided under subsection (a) is provided in an age-appropriate manner.

(d) The provisions of subsection (a) shall terminate on December 31, 2013.

(Added Pub. L. 106–117, title I, §101(a)(1), Nov. 30, 1999, 113 Stat. 1547; amended Pub. L. 106–419, title II, §224(a), Nov. 1, 2000, 114 Stat. 1846; Pub. L. 108–170, title I, §106(b), Dec. 6, 2003, 117 Stat. 2046; Pub. L. 110–181, div. A, title XVII, §1706(b), Jan. 28, 2008, 122 Stat. 493; Pub. L. 110–387, title VIII, §805, Oct. 10, 2008, 122 Stat. 4141.)

References in Text

The date of the enactment of this section, referred to in subsec. (b)(2), is the date of enactment of Pub. L. 106–117, which was approved Nov. 30, 1999.

Amendments

2008—Subsec. (c). Pub. L. 110–181 added subsec. (c). Former subsec. (c) redesignated (d).

Subsec. (d). Pub. L. 110–387 substituted “December 31, 2013” for “December 31, 2008”.

Pub. L. 110–181 redesignated former subsec. (c) as (d).

2003—Subsec. (c). Pub. L. 108–170 substituted “December 31, 2008” for “December 31, 2003”.

2000—Subsec. (a). Pub. L. 106–419 inserted “(subject to section 1710(a)(4) of this title)” after “The Secretary”.

Finding Related to Age-Appropriate Nursing Home Care

Pub. L. 110–181, div. A, title XVII, §1706(a), Jan. 28, 2008, 122 Stat. 493, provided that: “Congress finds that young veterans who are injured or disabled through military service and require long-term care should have access to age-appropriate nursing home care.”

Report to Congressional Committees

Pub. L. 106–117, title I, §101(i), Nov. 30, 1999, 113 Stat. 1550, required the Secretary of Veterans Affairs to submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the operation of section 101 of Pub. L. 106–117 not later than January 1, 2003.

§1710B. Extended care services

(a) The Secretary (subject to section 1710(a)(4) of this title and subsection (c) of this section) shall operate and maintain a program to provide extended care services to eligible veterans in accordance with this section. Such services shall include the following:

(1) Geriatric evaluation.

(2) Nursing home care (A) in facilities operated by the Secretary, and (B) in community-based facilities through contracts under section 1720 of this title.

(3) Domiciliary services under section 1710(b) of this title.

(4) Adult day health care under section 1720(f) of this title.

(5) Such other noninstitutional alternatives to nursing home care as the Secretary may furnish as medical services under section 1701(10) 1 of this title.

(6) Respite care under section 1720B of this title.


(b) The Secretary shall ensure that the staffing and level of extended care services provided by the Secretary nationally in facilities of the Department during any fiscal year is not less than the staffing and level of such services provided nationally in facilities of the Department during fiscal year 1998.

(c)(1) Except as provided in paragraph (2), the Secretary may not furnish extended care services for a non-service-connected disability other than in the case of a veteran who has a compensable service-connected disability unless the veteran agrees to pay to the United States a copayment (determined in accordance with subsection (d)) for any period of such services in a year after the first 21 days of such services provided that veteran in that year.

(2) Paragraph (1) shall not apply—

(A) to a veteran whose annual income (determined under section 1503 of this title) is less than the amount in effect under section 1521(b) of this title;

(B) to a veteran being furnished hospice care under this section; or

(C) with respect to an episode of extended care services that a veteran is being furnished by the Department on November 30, 1999.


(d)(1) A veteran who is furnished extended care services under this chapter and who is required under subsection (c) to pay an amount to the United States in order to be furnished such services shall be liable to the United States for that amount.

(2) In implementing subsection (c), the Secretary shall develop a methodology for establishing the amount of the copayment for which a veteran described in subsection (c) is liable. That methodology shall provide for—

(A) establishing a maximum monthly copayment (based on all income and assets of the veteran and the spouse of such veteran);

(B) protecting the spouse of a veteran from financial hardship by not counting all of the income and assets of the veteran and spouse (in the case of a spouse who resides in the community) as available for determining the copayment obligation; and

(C) allowing the veteran to retain a monthly personal allowance.


(e)(1) There is established in the Treasury of the United States a revolving fund known as the Department of Veterans Affairs Extended Care Fund (hereinafter in this section referred to as the “fund”). Amounts in the fund shall be available, without fiscal year limitation and without further appropriation, exclusively for the purpose of providing extended care services under subsection (a).

(2) All amounts received by the Department under this section shall be deposited in or credited to the fund.

(Added Pub. L. 106–117, title I, §101(c)(1), Nov. 30, 1999, 113 Stat. 1548; amended Pub. L. 107–14, §8(a)(2), (16), June 5, 2001, 115 Stat. 34, 35; Pub. L. 107–103, title V, §509(b), Dec. 27, 2001, 115 Stat. 997; Pub. L. 108–422, title II, §204, Nov. 30, 2004, 118 Stat. 2382.)

References in Text

Section 1701(10) of this title, referred to in subsec. (a)(5), was repealed by Pub. L. 110–387, title VIII, §801(1), Oct. 10, 2008, 122 Stat. 4140.

Amendments

2004—Subsec. (c)(2)(B), (C). Pub. L. 108–422 added subpar. (B) and redesignated former subpar. (B) as (C).

2001—Subsec. (c)(2)(B). Pub. L. 107–103 inserted “on” before “November 30, 1999”.

Pub. L. 107–14, §8(a)(2), substituted “November 30, 1999” for “on the date of the enactment of the Veterans Millennium Health Care and Benefits Act”.

Subsec. (e)(1). Pub. L. 107–14, §8(a)(16), substituted “hereinafter” for “hereafter”.

Effective Date of 2004 Amendment

Pub. L. 108–422, title IV, §411(f), (g), Nov. 30, 2004, 118 Stat. 2390, provided that:

“(f) Contingent Effectiveness.—Subsection (d) [enacting provisions set out as a note under section 8118 of this title] and the amendments made by subsection (c) [repealing section 8116 of this title] shall take effect at the end of the 30-day period beginning on the date on which the Secretary of Veterans Affairs certifies to Congress that the Secretary is in compliance with subsection (b) of section 1710B of title 38, United States Code.

“(g) Annual Update.—Following a certification under subsection (f), the Secretary shall submit to Congress an annual update on that certification.”

Effective Date

Pub. L. 106–117, title I, §101(h), Nov. 30, 1999, 113 Stat. 1550, provided that:

“(1) Except as provided in paragraph (2), the amendments made by this section [enacting this section and section 1710A of this title and amending sections 1701, 1710, 1720, 1720B and 1741 of this title] shall take effect on the date of the enactment of this Act [Nov. 30, 1999].

“(2) Subsection (c) of section 1710B of title 38, United States Code (as added by subsection (b)), shall take effect on the effective date of regulations prescribed by the Secretary of Veterans Affairs under subsections (c) and (d) of such section. The Secretary shall publish the effective date of such regulations in the Federal Register.

“(3) The provisions of section 1710(f) of title 38, United States Code, shall not apply to any day of nursing home care on or after the effective date of regulations under paragraph (2).”

Pilot Program on Improvement of Caregiver Assistance Services

Pub. L. 109–461, title II, §214, Dec. 22, 2006, 120 Stat. 3423, as amended by Pub. L. 110–387, §809, Oct. 10, 2008, 122 Stat. 4142, provided that:

“(a) In General.—Commencing not later than 120 days after the date of the enactment of this Act [Dec. 22, 2006], the Secretary of Veterans Affairs shall carry out a pilot program to assess the feasibility and advisability of various mechanisms to expand and improve caregiver assistance services.

“(b) Duration of Pilot Program.—The pilot program required by subsection (a) shall be carried out during the three-year period beginning on the date of the commencement of the pilot program.

“(c) Caregiver Assistance Services.—For purposes of this section, the term ‘caregiver assistance services’ means services of the Department of Veterans Affairs that assist caregivers of veterans. Such services including the following:

“(1) Adult-day health care services.

“(2) Coordination of services needed by veterans, including services for readjustment and rehabilitation.

“(3) Transportation services.

“(4) Caregiver support services, including education, training, and certification of family members in caregiver activities.

“(5) Home care services.

“(6) Respite care.

“(7) Hospice services.

“(8) Any modalities of non-institutional long-term care.

“(d) Authorization of Appropriations.—There are authorized to be appropriated to the Department of Veterans Affairs $5,000,000 for each of fiscal years 2007 through 2009 to carry out the pilot program authorized by this section.

“(e) Allocation of Funds to Facilities.—The Secretary shall allocate funds appropriated pursuant to the authorization of appropriations in subsection (d) to individual medical facilities of the Department in such amounts as the Secretary determines appropriate, based upon proposals submitted by such facilities for the use of such funds for improvements to the support of the provision of caregiver assistance services. Special consideration should be given to rural facilities, including those without a long-term care facility of the Department.

“(f) Report.—Not later than one year after the date of the enactment of this Act [Dec. 22, 2006], the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the implementation of this section. The report shall include—

“(1) a description and assessment of the activities carried out under the pilot program;

“(2) information on the allocation of funds to facilities of the Department under subsection (e); and

“(3) a description of the improvements made with funds so allocated to the support of the provision of caregiver assistance services.”

Pilot Programs Relating to Long-Term Care

Pub. L. 106–117, title I, §102, Nov. 30, 1999, 113 Stat. 1551, as amended by Pub. L. 108–422, title II, §203, Nov. 30, 2004, 118 Stat. 2382, provided that:

“(a) Pilot Programs.—The Secretary [of Veterans Affairs] shall carry out three pilot programs for the purpose of determining the effectiveness of different models of all-inclusive care-delivery in reducing the use of hospital and nursing home care by frail, elderly veterans.

“(b) Locations of Pilot Programs.—In selecting locations in which the pilot programs will be carried out, the Secretary may not select more than one location in any given health care region of the Veterans Health Administration.

“(c) Scope of Services Under Pilot Programs.—Each of the pilot programs under this section shall be designed to provide participating veterans with integrated, comprehensive services which include the following:

“(1) Adult-day health care services on an eight-hour per day, five-day per week basis.

“(2) Medical services (including primary care, preventive services, and nursing home care, as needed).

“(3) Coordination of needed services.

“(4) Transportation services.

“(5) Home care services.

“(6) Respite care.

“(d) Program Requirements.—In carrying out the pilot programs under this section, the Secretary shall—

“(1) employ the use of interdisciplinary care-management teams to provide the required array of services;

“(2) determine the appropriate number of patients to be enrolled in each program and the criteria for enrollment; and

“(3) ensure that funding for each program is based on the complex care category under the resource allocation system (known as the Veterans Equitable Resource Allocation system) established pursuant to section 429 of Public Law 104–204 (110 Stat. 2929).

“(e) Design of Pilot Programs.—To the maximum extent feasible, the Secretary shall use the following three models in designing the three pilot programs under this section:

“(1) Under one of the pilot programs, the Secretary shall provide services directly through facilities and personnel of the Department [of Veterans Affairs].

“(2) Under one of the pilot programs, the Secretary shall provide services through a combination of—

“(A) services provided under contract with appropriate public and private entities; and

“(B) services provided through facilities and personnel of the Department.

“(3) Under one of the pilot programs, the Secretary shall arrange for the provision of services through a combination of—

“(A) services provided through cooperative arrangements with appropriate public and private entities; and

“(B) services provided through facilities and personnel of the Department.

“(f) In-Kind Assistance.—In providing for the furnishing of services under a contract in carrying out the pilot program described in subsection (e)(2), the Secretary may, subject to reimbursement, provide in-kind assistance (through the services of Department employees and the sharing of other Department resources) to a facility furnishing care to veterans. Such reimbursement may be made by reduction in the charges to the Secretary under such contract.

“(g) Limitation.—In providing for the furnishing of services in carrying out a pilot program described in subsection (e)(2) or (e)(3), the Secretary shall make payment for services only to the extent that payment for such services is not otherwise covered (notwithstanding any provision of title XVIII or XIX of the Social Security Act [42 U.S.C. 1395 et seq., 1396 et seq.]) by another government or nongovernment entity or program.

“(h) Duration of Programs.—(1) The authority of the Secretary to provide services under a pilot program under this section shall cease on the date that is three years after the date of the commencement of that pilot program.

“(2) In the case of a veteran who is participating in a pilot program under this section as of the end of the three-year period applicable to that pilot program under paragraph (1), the Secretary may continue to provide to that veteran any of the services that could be provided under the pilot program. The authority to provide services to any veteran under the preceding sentence applies during the period beginning on the date specified in paragraph (1) with respect to that pilot program and ending on December 31, 2005.

“(i) Report.—(1) Not later than nine months after the completion of all of the pilot programs under this section, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report on those programs.

“(2) The report shall include the following:

“(A) A description of the implementation and operation of each such program.

“(B) An analysis comparing use of institutional care and use of other services among enrollees in each of the pilot programs with the experience of comparable patients who are not enrolled in one of the pilot programs.

“(C) An assessment of the satisfaction of participating veterans with each of those programs.

“(D) An assessment of the health status of participating veterans in each of those programs and of the ability of those veterans to function independently.

“(E) An analysis of the costs and benefits under each of those programs.”

Pilot Program Relating to Assisted Living

Pub. L. 106–117, title I, §103, Nov. 30, 1999, 113 Stat. 1552, as amended by Pub. L. 108–170, title I, §107, Dec. 6, 2003, 117 Stat. 2046, provided that:

“(a) Program Authority.—The Secretary [of Veterans Affairs] may carry out a pilot program for the purpose of determining the feasibility and practicability of enabling eligible veterans to secure needed assisted living services as an alternative to nursing home care.

“(b) Locations of Pilot Program.—(1) The pilot program shall be carried out in a designated health care region of the Department [of Veterans Affairs] selected by the Secretary for purposes of this section.

“(2)(A) In addition to the health care region of the Department selected for the pilot program under paragraph (1), the Secretary may also carry out the pilot program in not more than one additional designated health care region of the Department selected by the Secretary for purposes of this section.

“(B) Notwithstanding subsection (f), the authority of the Secretary to provide services under the pilot program in a health care region of the Department selected under subparagraph (A) shall cease on the date that is three years after the commencement of the provision of services under the pilot program in the health care region.

“(c) Scope of Program.—In carrying out the pilot program, the Secretary may enter into contracts with appropriate facilities for the provision for a period of up to six months of assisted living services on behalf of eligible veterans in the region where the program is carried out.

“(d) Eligible Veterans.—A veteran is an eligible veteran for purposes of this section if the veteran—

“(1) is eligible for placement assistance by the Secretary under section 1730(a) of title 38, United States Code;

“(2) is unable to manage routine activities of daily living without supervision and assistance; and

“(3) could reasonably be expected to receive ongoing services after the end of the contract period under another government program or through other means.

“(e) Report.—(1) Not later than 90 days before the end of the pilot program under this section, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report on the program.

“(2) The report under paragraph (1) shall include the following:

“(A) A description of the implementation and operation of the program.

“(B) An analysis comparing use of institutional care among participants in the program with the experience of comparable patients who are not enrolled in the program.

“(C) A comparison of assisted living services provided by the Department through the pilot program with domiciliary care provided by the Department.

“(D) The Secretary's recommendations, if any, regarding an extension of the program.

“(f) Duration.—The authority of the Secretary to provide services under the pilot program shall cease on the date that is three years after the date of the commencement of the pilot program.

“(g) Definition.—For purposes of this section, the term ‘assisted living services’ means services in a facility that provides room and board and personal care for and supervision of residents as necessary for the health, safety, and welfare of residents.

“(h) Standards.—The Secretary may not enter into a contract with a facility under this section unless the facility meets the standards established in regulations prescribed under section 1730 of title 38, United States Code.”

1 See References in Text note below.

§1710C. Traumatic brain injury: plans for rehabilitation and reintegration into the community

(a) Plan Required.—The Secretary shall, for each individual who is a veteran or member of the Armed Forces who receives inpatient or outpatient rehabilitative hospital care or medical services provided by the Department for a traumatic brain injury—

(1) develop an individualized plan for the rehabilitation and reintegration of the individual into the community; and

(2) provide such plan in writing to the individual—

(A) in the case of an individual receiving inpatient care, before the individual is discharged from inpatient care or after the individual's transition from serving on active duty as a member of the Armed Forces to receiving outpatient care provided by the Department; or

(B) as soon as practicable following a diagnosis of traumatic brain injury by a Department health care provider.


(b) Contents of Plan.—Each plan developed under subsection (a) shall include, for the individual covered by such plan, the following:

(1) Rehabilitation objectives for improving the physical, cognitive, and vocational functioning of the individual with the goal of maximizing the independence and reintegration of such individual into the community.

(2) Access, as warranted, to all appropriate rehabilitative components of the traumatic brain injury continuum of care, and where appropriate, to long-term care services.

(3) A description of specific rehabilitative treatments and other services to achieve the objectives described in paragraph (1), which shall set forth the type, frequency, duration, and location of such treatments and services.

(4) The name of the case manager designated in accordance with subsection (d) to be responsible for the implementation of such plan.

(5) Dates on which the effectiveness of such plan will be reviewed in accordance with subsection (f).


(c) Comprehensive Assessment.—(1) Each plan developed under subsection (a) shall be based on a comprehensive assessment, developed in accordance with paragraph (2), of—

(A) the physical, cognitive, vocational, and neuropsychological and social impairments of the individual; and

(B) the family education and family support needs of the individual after the individual is discharged from inpatient care or at the commencement of and during the receipt of outpatient care and services.


(2) The comprehensive assessment required under paragraph (1) with respect to an individual is a comprehensive assessment of the matters set forth in that paragraph by a team, composed by the Secretary for purposes of the assessment, of individuals with expertise in traumatic brain injury, including any of the following:

(A) A neurologist.

(B) A rehabilitation physician.

(C) A social worker.

(D) A neuropsychologist.

(E) A physical therapist.

(F) A vocational rehabilitation specialist.

(G) An occupational therapist.

(H) A speech language pathologist.

(I) A rehabilitation nurse.

(J) An educational therapist.

(K) An audiologist.

(L) A blind rehabilitation specialist.

(M) A recreational therapist.

(N) A low vision optometrist.

(O) An orthotist or prosthetist.

(P) An assistive technologist or rehabilitation engineer.

(Q) An otolaryngology physician.

(R) A dietician.

(S) An opthamologist.1

(T) A psychiatrist.


(d) Case Manager.—(1) The Secretary shall designate a case manager for each individual described in subsection (a) to be responsible for the implementation of the plan developed for that individual under that subsection and the coordination of the individual's medical care.

(2) The Secretary shall ensure that each case manager has specific expertise in the care required by the individual for whom the case manager is designated, regardless of whether the case manager obtains such expertise through experience, education, or training.

(e) Participation and Collaboration in Development of Plans.—(1) The Secretary shall involve each individual described in subsection (a), and the family or legal guardian of such individual, in the development of the plan for such individual under that subsection to the maximum extent practicable.

(2) The Secretary shall collaborate in the development of a plan for an individual under subsection (a) with a State protection and advocacy system if—

(A) the individual covered by the plan requests such collaboration; or

(B) in the case of such an individual who is incapacitated, the family or guardian of the individual requests such collaboration.


(3) In the case of a plan required by subsection (a) for a member of the Armed Forces who is serving on active duty, the Secretary shall collaborate with the Secretary of Defense in the development of such plan.

(4) In developing vocational rehabilitation objectives required under subsection (b)(1) and in conducting the assessment required under subsection (c), the Secretary shall act through the Under Secretary for Health in coordination with the Vocational Rehabilitation and Employment Service of the Department of Veterans Affairs.

(f) Evaluation.—

(1) Periodic review by secretary.—The Secretary shall periodically review the effectiveness of each plan developed under subsection (a). The Secretary shall refine each such plan as the Secretary considers appropriate in light of such review.

(2) Request for review by veterans.—In addition to the periodic review required by paragraph (1), the Secretary shall conduct a review of the plan for an individual under paragraph (1) at the request of the individual, or in the case of an individual who is incapacitated, at the request of the guardian or designee of the individual.


(g) State Designated Protection and Advocacy System Defined.—In this section, the term “State protection and advocacy system” means a system established in a State under subtitle C of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (42 U.S.C. 15041 et seq.) to protect and advocate for the rights of persons with development disabilities.

(Added Pub. L. 110–181, div. A, title XVII, §1702(a), Jan. 28, 2008, 122 Stat. 486.)

References in Text

The Developmental Disabilities Assistance and Bill of Rights Act of 2000, referred to in subsec. (g), is Pub. L. 106–402, Oct. 30, 2000, 114 Stat. 1677. Subtitle C of the Act probably means subtitle C of title I of the Act, which is classified generally to part C (§15041 et seq.) of subchapter I of chapter 144 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under section 15001 of Title 42 and Tables.

Research, Education, and Clinical Care Program on Traumatic Brain Injury

Pub. L. 110–181, div. A, title XVII, §1704, Jan. 28, 2008, 122 Stat. 490, provided that:

“(a) In General.—To improve the provision of health care by the Department of Veterans Affairs to veterans with traumatic brain injuries, the Secretary of Veterans Affairs shall—

“(1) conduct research, including—

“(A) research on the sequelae of mild to severe forms of traumatic brain injury;

“(B) research on visually-related neurological conditions;

“(C) research on seizure disorders;

“(D) research on means of improving the diagnosis, rehabilitative treatment, and prevention of such sequelae;

“(E) research to determine the most effective cognitive and physical therapies for such sequelae;

“(F) research on dual diagnosis of post-traumatic stress disorder and traumatic brain injury;

“(G) research on improving facilities of the Department concentrating on traumatic brain injury care; and

“(H) research on improving the delivery of traumatic brain injury care by the Department;

“(2) educate and train health care personnel of the Department in recognizing and treating traumatic brain injury; and

“(3) develop improved models and systems for the furnishing of traumatic brain injury care by the Department.

“(b) Collaboration.—In carrying out research under subsection (a), the Secretary of Veterans Affairs shall collaborate with—

“(1) facilities that conduct research on rehabilitation for individuals with traumatic brain injury;

“(2) facilities that receive grants for such research from the National Institute on Disability and Rehabilitation Research of the Department of Education; and

“(3) the Defense and Veterans Brain Injury Center of the Department of Defense and other relevant programs of the Federal Government (including Centers of Excellence).

“(c) Dissemination of Useful Information.—The Under Secretary of Veterans Affairs for Health shall ensure that information produced by the research, education and training, and clinical activities conducted under this section that may be useful for other activities of the Veterans Health Administration is disseminated throughout the Veterans Health Administration.

“(d) Traumatic Brain Injury Registry.—

“(1) In general.—The Secretary of Veterans Affairs shall establish and maintain a registry to be known as the ‘Traumatic Brain Injury Veterans Health Registry’ (in this section referred to as the ‘Registry’).

“(2) Description.—The Registry shall include the following information:

“(A) A list containing the name of each individual who served as a member of the Armed Forces in Operation Enduring Freedom or Operation Iraqi Freedom who exhibits symptoms associated with traumatic brain injury, as determined by the Secretary of Veterans Affairs, and who—

“(i) applies for care and services furnished by the Department of Veterans Affairs under chapter 17 of title 38, United States Code; or

“(ii) files a claim for compensation under chapter 11 of such title on the basis of any disability which may be associated with such service.

“(B) Any relevant medical data relating to the health status of an individual described in subparagraph (A) and any other information the Secretary considers relevant and appropriate with respect to such an individual if the individual—

“(i) grants permission to the Secretary to include such information in the Registry; or

“(ii) is deceased at the time such individual is listed in the Registry.

“(3) Notification.—When possible, the Secretary shall notify each individual listed in the Registry of significant developments in research on the health consequences of military service in the Operation Enduring Freedom and Operation Iraqi Freedom theaters of operations.”

Pilot Program on Assisted Living Services for Veterans With Traumatic Brain Injury

Pub. L. 110–181, div. A, title XVII, §1705, Jan. 28, 2008, 122 Stat. 491, provided that:

“(a) Pilot Program.—Beginning not later than 90 days after the date of the enactment of this Act [Jan. 28, 2008], the Secretary of Veterans Affairs, in collaboration with the Defense and Veterans Brain Injury Center of the Department of Defense, shall carry out a five-year pilot program to assess the effectiveness of providing assisted living services to eligible veterans to enhance the rehabilitation, quality of life, and community integration of such veterans.

“(b) Program Locations.—

“(1) In general.—The pilot program shall be carried out at locations selected by the Secretary for purposes of the pilot program. Of the locations so selected—

“(A) at least one location shall be in each health care region of the Veterans Health Administration of the Department of Veterans Affairs that contains a polytrauma center of the Department of Veterans Affairs; and

“(B) any location other than a location described in subparagraph (A) shall be in an area that contains a high concentration of veterans with traumatic brain injuries, as determined by the Secretary.

“(2) Special consideration for veterans in rural areas.—The Secretary shall give special consideration to providing veterans in rural areas with an opportunity to participate in the pilot program.

“(c) Provision of Assisted Living Services.—

“(1) Agreements.—In carrying out the pilot program, the Secretary may enter into agreements for the provision of assisted living services on behalf of eligible veterans with a provider participating under a State plan or waiver under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).

“(2) Standards.—The Secretary may not place, transfer, or admit a veteran to any facility for assisted living services under the pilot program unless the Secretary determines that the facility meets such standards as the Secretary may prescribe for purposes of the pilot program. Such standards shall, to the extent practicable, be consistent with the standards of Federal, State, and local agencies charged with the responsibility of licensing or otherwise regulating or inspecting such facilities.

“(d) Continuation of Case Management and Rehabilitation Services.—In carrying out the pilot program, the Secretary shall—

“(1) continue to provide each veteran who is receiving assisted living services under the pilot program with rehabilitative services; and

“(2) designate employees of the Veterans Health Administration of the Department of Veterans Affairs to furnish case management services for veterans participating in the pilot program.

“(e) Report.—

“(1) In general.—Not later than 60 days after the completion of the pilot program, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the pilot program.

“(2) Contents.—The report required by paragraph (1) shall include the following:

“(A) A description of the pilot program.

“(B) An assessment of the utility of the activities under the pilot program in enhancing the rehabilitation, quality of life, and community reintegration of veterans with traumatic brain injury.

“(C) Such recommendations as the Secretary considers appropriate regarding the extension or expansion of the pilot program.

“(f) Definitions.—In this section:

“(1) The term ‘assisted living services’ means services of a facility in providing room, board, and personal care for and supervision of residents for their health, safety, and welfare.

“(2) The term ‘case management services’ includes the coordination and facilitation of all services furnished to a veteran by the Department of Veterans Affairs, either directly or through a contract, including assessment of needs, planning, referral (including referral for services to be furnished by the Department, either directly or through a contract, or by an entity other than the Department), monitoring, reassessment, and followup.

“(3) The term ‘eligible veteran’ means a veteran who—

“(A) is enrolled in the patient enrollment system of the Department of Veterans Affairs under section 1705 of title 38, United States Code;

“(B) has received hospital care or medical services provided by the Department of Veterans Affairs for a traumatic brain injury;

“(C) is unable to manage routine activities of daily living without supervision and assistance, as determined by the Secretary; and

“(D) could reasonably be expected to receive ongoing services after the end of the pilot program under this section under another program of the Federal Government or through other means, as determined by the Secretary.”

1 So in original.

§1710D. Traumatic brain injury: comprehensive program for long-term rehabilitation

(a) Comprehensive Program.—In developing plans for the rehabilitation and reintegration of individuals with traumatic brain injury under section 1710C of this title, the Secretary shall develop and carry out a comprehensive program of long-term care for post-acute traumatic brain injury rehabilitation that includes residential, community, and home-based components utilizing interdisciplinary treatment teams.

(b) Location of Program.—The Secretary shall carry out the program developed under subsection (a) in each Department polytrauma rehabilitation center designated by the Secretary.

(c) Eligibility.—A veteran is eligible for care under the program developed under subsection (a) if the veteran is otherwise eligible to receive hospital care and medical services under section 1710 of this title and—

(1) served on active duty in a theater of combat operations (as determined by the Secretary in consultation with the Secretary of Defense) during a period of war after the Persian Gulf War, or in combat against a hostile force during a period of hostilities (as defined in section 1712A(a)(2)(B) of this title) after November 11, 1998;

(2) is diagnosed as suffering from moderate to severe traumatic brain injury; and

(3) is unable to manage routine activities of daily living without supervision or assistance, as determined by the Secretary.


(d) Report.—Not later than one year after the date of the enactment of this section, and annually thereafter, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report containing the following information:

(1) A description of the operation of the program.

(2) The number of veterans provided care under the program during the year preceding such report.

(3) The cost of operating the program during the year preceding such report.

(Added Pub. L. 110–181, div. A, title XVII, §1702(a), Jan. 28, 2008, 122 Stat. 488.)

References in Text

The date of the enactment of this section, referred to in subsec. (d), is the date of enactment of Pub. L. 110–181, which was approved Jan. 28, 2008.

§1710E. Traumatic brain injury: use of non-Department facilities for rehabilitation

(a) Cooperative Agreements.—The Secretary, in implementing and carrying out a plan developed under section 1710C of this title, may provide hospital care and medical services through cooperative agreements with appropriate public or private entities that have established long-term neurobehavioral rehabilitation and recovery programs.

(b) Covered Individuals.—The care and services provided under subsection (a) shall be made available to an individual—

(1) who is described in section 1710C(a) of this title; and

(2)(A) to whom the Secretary is unable to provide such treatment or services at the frequency or for the duration prescribed in such plan; or

(B) for whom the Secretary determines that it is optimal with respect to the recovery and rehabilitation for such individual.


(c) Authorities of State Protection and Advocacy Systems.—Nothing in subtitle C of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 shall be construed as preventing a State protection and advocacy system (as defined in section 1710C(g) of this title) from exercising the authorities described in such subtitle with respect to individuals provided rehabilitative treatment or services under section 1710C of this title in a non-Department facility.

(d) Standards.—The Secretary may not provide treatment or services as described in subsection (a) at a non-Department facility under such subsection unless such facility maintains standards for the provision of such treatment or services established by an independent, peer-reviewed organization that accredits specialized rehabilitation programs for adults with traumatic brain injury.

(Added Pub. L. 110–181, div. A, title XVII, §1703(a), Jan. 28, 2008, 122 Stat. 489; amended Pub. L. 111–163, title V, §509, May 5, 2010, 124 Stat. 1162.)

References in Text

The Developmental Disabilities Assistance and Bill of Rights Act of 2000, referred to in subsec. (c), is Pub. L. 106–402, Oct. 30, 2000, 114 Stat. 1677. Subtitle C of the Act probably means subtitle C of title I of the Act, which is classified generally to part C (§15041 et seq.) of subchapter I of chapter 144 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under section 15001 of Title 42 and Tables.

Amendments

2010—Subsecs. (b) to (d). Pub. L. 111–163 added subsecs. (b) and (d) and redesignated former subsec. (b) as (c).

§1711. Care during examinations and in emergencies

(a) The Secretary may furnish hospital care incident to physical examinations where such examinations are necessary in carrying out the provisions of other laws administered by the Secretary.

[(b) Repealed. Pub. L. 107–135, title II, §208(d), Jan. 23, 2002, 115 Stat. 2463.]

(c)(1) The Secretary may contract with any organization named in, or approved by the Secretary under, section 5902 of this title to provide for the furnishing by the Secretary, on a reimbursable basis (as prescribed by the Secretary), of emergency medical services to individuals attending any national convention of such organization, except that reimbursement shall not be required for services furnished under this subsection to the extent that the individual receiving such services would otherwise be eligible under this chapter for medical services.

(2) The authority of the Secretary to enter into contracts under this subsection shall be effective for any fiscal year only to such extent or in such amounts as are provided in appropriation Acts.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1142, §611; Pub. L. 94–581, title II, §§202(e), 210(a)(2), Oct. 21, 1976, 90 Stat. 2856, 2862; Pub. L. 96–22, title II, §202, June 13, 1979, 93 Stat. 54; Pub. L. 96–128, title V, §501(a), Nov. 28, 1979, 93 Stat. 987; Pub. L. 102–40, title IV, §402(d)(1), May 7, 1991, 105 Stat. 239; renumbered §1711 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 107–135, title II, §208(d), Jan. 23, 2002, 115 Stat. 2463.)

Prior Provisions

Prior section 1711 was renumbered section 3511 of this title.

Amendments

2002—Subsec. (b). Pub. L. 107–135 struck out subsec. (b) which read as follows: “The Secretary may furnish hospital care or medical services as a humanitarian service in emergency cases, but the Secretary shall charge for such care at rates prescribed by the Secretary.”

1991—Pub. L. 102–83, §5(a), renumbered section 611 of this title as this section.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Subsec. (c)(1). Pub. L. 102–40 substituted “5902” for “3402”.

1979—Subsec. (c). Pub. L. 96–22 added subsec. (c).

Subsec. (c)(1). Pub. L. 96–128 substituted “named in, or approved by the Administrator under,” for “recognized by the Administrator for the purposes of”.

1976—Pub. L. 94–581, §202(e)(1), substituted “Care” for “Hospitalization” in section catchline.

Subsec. (a). Pub. L. 94–581, §210(a)(2)(A), substituted “administered by the Administrator” for “administered by him”.

Subsec. (b). Pub. L. 94–581, §§202(e)(2), 210(a)(2)(B), substituted “hospital care or medical services” for “hospital care”, “the Administrator shall charge” for “he shall charge”, and “prescribed by the Administrator” for “prescribed by him”.

Effective Date of 1979 Amendment

Amendment by Pub. L. 96–128 effective Nov. 28, 1979, see section 601(b) of Pub. L. 96–128, set out as a note under section 1114 of this title.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

§1712. Dental care; drugs and medicines for certain disabled veterans; vaccines

(a)(1) Outpatient dental services and treatment, and related dental appliances, shall be furnished under this section only for a dental condition or disability—

(A) which is service-connected and compensable in degree;

(B) which is service-connected, but not compensable in degree, but only if—

(i) the dental condition or disability is shown to have been in existence at the time of the veteran's discharge or release from active military, naval, or air service;

(ii) the veteran had served on active duty for a period of not less than 180 days or, in the case of a veteran who served on active duty during the Persian Gulf War, 90 days immediately before such discharge or release;

(iii) application for treatment is made within 180 days after such discharge or release, except that (I) in the case of a veteran who reentered active military, naval, or air service within 90 days after the date of such veteran's prior discharge or release from such service, application may be made within 180 days from the date of such veteran's subsequent discharge or release from such service, and (II) if a disqualifying discharge or release has been corrected by competent authority, application may be made within 180 days after the date of correction; and

(iv) the veteran's certificate of discharge or release from active duty does not bear a certification that the veteran was provided, within the 90-day period immediately before the date of such discharge or release, a complete dental examination (including dental X-rays) and all appropriate dental services and treatment indicated by the examination to be needed;


(C) which is a service-connected dental condition or disability due to combat wounds or other service trauma, or of a former prisoner of war;

(D) which is associated with and is aggravating a disability resulting from some other disease or injury which was incurred in or aggravated by active military, naval, or air service;

(E) which is a non-service-connected condition or disability of a veteran for which treatment was begun while such veteran was receiving hospital care under this chapter and such services and treatment are reasonably necessary to complete such treatment;

(F) from which a veteran who is a former prisoner of war is suffering;

(G) from which a veteran who has a service-connected disability rated as total is suffering; or

(H) the treatment of which is medically necessary (i) in preparation for hospital admission, or (ii) for a veteran otherwise receiving care or services under this chapter.


(2) The Secretary concerned shall at the time a member of the Armed Forces is discharged or released from a period of active military, naval, or air service of not less than 180 days or, in the case of a veteran who served on active duty during the Persian Gulf War, 90 days provide to such member a written explanation of the provisions of clause (B) of paragraph (1) of this subsection and enter in the service records of the member a statement signed by the member acknowledging receipt of such explanation (or, if the member refuses to sign such statement, a certification from an officer designated for such purpose by the Secretary concerned that the member was provided such explanation).

(3) The total amount which the Secretary may expend for furnishing, during any twelve-month period, outpatient dental services, treatment, or related dental appliances to a veteran under this section through private facilities for which the Secretary has contracted under clause (1), (2), or (5) of section 1703(a) of this title may not exceed $1,000 unless the Secretary determines, prior to the furnishing of such services, treatment, or appliances and based on an examination of the veteran by a dentist employed by the Department (or, in an area where no such dentist is available, by a dentist conducting such examination under a contract or fee arrangement), that the furnishing of such services, treatment, or appliances at such cost is reasonably necessary.

(4)(A) Except as provided in subparagraph (B) of this paragraph, in any year in which the President's Budget for the fiscal year beginning October 1 of such year includes an amount for expenditures for contract dental care under the provisions of this subsection and section 1703 of this title during such fiscal year in excess of the level of expenditures made for such purpose during fiscal year 1978, the Secretary shall, not later than February 15 of such year, submit a report to the appropriate committees of the Congress justifying the requested level of expenditures for contract dental care and explaining why the application of the criteria prescribed in section 1703 of this title for contracting with private facilities and in the second sentence of section 1710(c) of this title for furnishing incidental dental care to hospitalized veterans will not preclude the need for expenditures for contract dental care in excess of the fiscal year 1978 level of expenditures for such purpose. In any case in which the amount included in the President's Budget for any fiscal year for expenditures for contract dental care under such provisions is not in excess of the level of expenditures made for such purpose during fiscal year 1978 and the Secretary determines after the date of submission of such budget and before the end of such fiscal year that the level of expenditures for such contract dental care during such fiscal year will exceed the fiscal year 1978 level of expenditures, the Secretary shall submit a report to the appropriate committees of the Congress containing both a justification (with respect to the projected level of expenditures for such fiscal year) and an explanation as required in the preceding sentence in the case of a report submitted pursuant to such sentence. Any report submitted pursuant to this paragraph shall include a comment by the Secretary on the effect of the application of the criteria prescribed in the second sentence of section 1710(c) of this title for furnishing incidental dental care to hospitalized veterans.

(B) A report under subparagraph (A) of this paragraph with respect to a fiscal year is not required if, in the documents submitted by the Secretary to the Congress in justification for the amounts included for Department programs in the President's Budget, the Secretary specifies with respect to contract dental care described in such subparagraph—

(i) the actual level of expenditures for such care in the fiscal year preceding the fiscal year in which such Budget is submitted;

(ii) a current estimate of the level of expenditures for such care in the fiscal year in which such Budget is submitted; and

(iii) the amount included in such Budget for such care.


(b) Dental services and related appliances for a dental condition or disability described in paragraph (1)(B) of subsection (a) shall be furnished on a one-time completion basis, unless the services rendered on a one-time completion basis are found unacceptable within the limitations of good professional standards, in which event such additional services may be afforded as are required to complete professionally acceptable treatment.

(c) Dental appliances, wheelchairs, artificial limbs, trusses, special clothing, and similar appliances to be furnished by the Secretary under this section may be procured by the Secretary either by purchase or by manufacture, whichever the Secretary determines may be advantageous and reasonably necessary.

(d) The Secretary shall furnish to each veteran who is receiving additional compensation or allowance under chapter 11 of this title, or increased pension as a veteran of a period of war, by reason of being permanently housebound or in need of regular aid and attendance, such drugs and medicines as may be ordered on prescription of a duly licensed physician as specific therapy in the treatment of any illness or injury suffered by such veteran. The Secretary shall continue to furnish such drugs and medicines so ordered to any such veteran in need of regular aid and attendance whose pension payments have been discontinued solely because such veteran's annual income is greater than the applicable maximum annual income limitation, but only so long as such veteran's annual income does not exceed such maximum annual income limitation by more than $1,000.

(e) In order to assist the Secretary of Health and Human Services in carrying out national immunization programs under other provisions of law, the Secretary may authorize the administration of immunizations to eligible veterans who voluntarily request such immunizations in connection with the provision of care for a disability under this chapter in any Department health care facility. Any such immunization shall be made using vaccine furnished by the Secretary of Health and Human Services at no cost to the Department. For such purpose, notwithstanding any other provision of law, the Secretary of Health and Human Services may provide such vaccine to the Department at no cost. Section 7316 of this title shall apply to claims alleging negligence or malpractice on the part of Department personnel granted immunity under such section.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1142, §612; Pub. L. 86–639, §1, July 12, 1960, 74 Stat. 472; Pub. L. 87–377, §1, Oct. 4, 1961, 75 Stat. 806; Pub. L. 87–583, §2, Aug. 14, 1962, 76 Stat. 381; Pub. L. 88–430, Aug. 14, 1964, 78 Stat. 438; Pub. L. 88–450, §7, Aug. 19, 1964, 78 Stat. 504; Pub. L. 88–664, §8, Oct. 13, 1964, 78 Stat. 1096; Pub. L. 90–77, title II, §203(b), Aug. 31, 1967, 81 Stat. 183; Pub. L. 91–102, Oct. 30, 1969, 83 Stat. 168; Pub. L. 91–500, §§2, 3, Oct. 22, 1970, 84 Stat. 1096; Pub. L. 91–588, §§4, 9(f), Dec. 24, 1970, 84 Stat. 1583, 1585; Pub. L. 93–82, title I, §103(a), Aug. 2, 1973, 87 Stat. 180; Pub. L. 94–581, title I, §103(a), title II, §§202(f), 210(a)(3), Oct. 21, 1976, 90 Stat. 2844, 2856, 2862; Pub. L. 95–588, title III, §302, Nov. 4, 1978, 92 Stat. 2506; Pub. L. 96–22, title I, §§101, 102(b), June 13, 1979, 93 Stat. 47; Pub. L. 96–151, title II, §§203, 204, Dec. 20, 1979, 93 Stat. 1094; Pub. L. 97–35, title XX, §2002(a), Aug. 13, 1981, 95 Stat. 781; Pub. L. 97–37, §§3(b), 5(b), (c), Aug. 14, 1981, 95 Stat. 936, 937; Pub. L. 97–72, title I, §§102(b), 103(a), (b), Nov. 3, 1981, 95 Stat. 1048, 1049; Pub. L. 97–295, §4(17), (95)(A), Oct. 12, 1982, 96 Stat. 1306, 1313; Pub. L. 99–166, title I, §104, Dec. 3, 1985, 99 Stat. 944; Pub. L. 99–272, title XIX, §§19011(b), 19012(c)(1), (2), Apr. 7, 1986, 100 Stat. 375, 382; Pub. L. 99–576, title II, §§202, 231(b), 237(b)(2), title VII, §702(5), Oct. 28, 1986, 100 Stat. 3254, 3263, 3267, 3301; Pub. L. 100–322, title I, §§101(a)–(c), (d)(2), (e)(1), (2), (f), (g)(1), (h)(1), 106, May 20, 1988, 102 Stat. 489–492, 494; Pub. L. 101–508, title VIII, §8013(b), Nov. 5, 1990, 104 Stat. 1388–346; Pub. L. 102–25, title III, §334(a), (c), Apr. 6, 1991, 105 Stat. 88, 89; renumbered §1712 and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), (5), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–86, title III, §§301, 302, Aug. 14, 1991, 105 Stat. 416; Pub. L. 102–585, title I, §103, Nov. 4, 1992, 106 Stat. 4946; Pub. L. 103–210, §1(b), Dec. 20, 1993, 107 Stat. 2496; Pub. L. 103–446, title XII, §1201(d)(3), Nov. 2, 1994, 108 Stat. 4684; Pub. L. 103–452, title I, §§101(e), 103(a)(2), Nov. 2, 1994, 108 Stat. 4784, 4786; Pub. L. 104–110, title I, §101(a)(2), Feb. 13, 1996, 110 Stat. 768; Pub. L. 104–262, title I, §101(b)(2)–(c)(2)(A), Oct. 9, 1996, 110 Stat. 3179; Pub. L. 106–419, title IV, §404(a)(3), Nov. 1, 2000, 114 Stat. 1864; Pub. L. 108–170, title I, §101(a), Dec. 6, 2003, 117 Stat. 2043; Pub. L. 110–181, div. A, title XVII, §1709, Jan. 28, 2008, 122 Stat. 494.)

Prior Provisions

Prior section 1712 was renumbered section 3512 of this title.

Amendments

2008—Subsec. (a)(1)(B)(iii). Pub. L. 110–181 substituted “180 days after such discharge” for “90 days after such discharge”, “180 days from the date of such veteran's subsequent discharge” for “90 days from the date of such veteran's subsequent discharge”, and “180 days after the date of correction” for “90 days after the date of correction”.

2003—Subsec. (a)(1)(F). Pub. L. 108–170 struck out “and who was detained or interned for a period of not less than 90 days” after “war”.

2000—Subsec. (a)(4)(A). Pub. L. 106–419 substituted “this subsection” for “subsection (a) of this section (other than paragraphs (3)(B) and (3)(C) of that subsection)” after “under the provisions” in first sentence.

1996—Pub. L. 104–262, §101(c)(2)(A), substituted “Dental care; drugs and medicines for certain disabled veterans; vaccines” for “Eligibility for outpatient services” in section catchline.

Subsec. (a). Pub. L. 104–262, §101(c)(1)(A), (B), redesignated subsec. (b) as (a) and struck out former subsec. (a) which required and authorized the Secretary to furnish on an ambulatory or outpatient basis medical services for certain veterans.

Subsec. (a)(1)(D). Pub. L. 104–110 substituted “December 31, 1996” for “December 31, 1995”.

Subsec. (b). Pub. L. 104–262, §101(c)(1)(B), (C), redesignated subsec. (c) as (b) and substituted “subsection (a)” for “subsection (b) of this section”. Former subsec. (b) redesignated (a).

Subsecs. (c) to (e). Pub. L. 104–262, §101(c)(1)(B), redesignated subsecs. (d), (h), and (j) as (c), (d), and (e), respectively. Former subsec. (c) redesignated (b).

Subsec. (f). Pub. L. 104–262, §101(b)(2), redesignated subsec. (f) as subsec. (g) of section 1710 of this title.

Subsec. (h). Pub. L. 104–262, §101(c)(1)(B), redesignated subsec. (h) as (d).

Subsec. (i). Pub. L. 104–262, §101(c)(1)(A), struck out subsec. (i), which required Secretary to prescribe regulations relating to the order in which medical services were to be furnished to veterans.

Subsec. (j). Pub. L. 104–262, §101(c)(1)(B), redesignated subsec. (j) as (e).

1994—Subsec. (a)(1)(D). Pub. L. 103–452, §103(a)(2), substituted “December 31, 1995” for “December 31, 1994”.

Subsec. (i)(1). Pub. L. 103–452, §101(e)(1), inserted “(A)” after “To a veteran” and inserted before period at end “, or (B) who is eligible for counseling and care and services under section 1720D of this title, for the purposes of such counseling and care and services”.

Subsec. (i)(2). Pub. L. 103–452, §101(e)(2), substituted “or (B)” for “, (B)” and struck out before period at end “, or (C) who is eligible for counseling under section 1720D of this title, for the purposes of such counseling”.

Subsec. (i)(5). Pub. L. 103–446, §1201(d)(3)(A), substituted “section 1722(a)(3)” for “section 1722(a)(1)(C)”.

Subsec. (j). Pub. L. 103–446, §1201(d)(3)(B), substituted “Section 7316” for “Section 4116”.

1993—Subsec. (a)(1)(D). Pub. L. 103–210, §1(b)(1), added subpar. (D).

Subsec. (a)(7). Pub. L. 103–210, §1(b)(2), added par. (7).

1992—Subsec. (i)(2)(C). Pub. L. 102–585 added cl. (C).

1991—Pub. L. 102–83, §5(a), renumbered section 612 of this title as this section.

Subsec. (a). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Subsec. (a)(1)(C). Pub. L. 102–83, §5(c)(1), substituted “1151” for “351”.

Subsec. (a)(2)(B). Pub. L. 102–83, §5(c)(1), substituted “1710(a)” for “610(a)”, “1503” for “503”, and “1521(d)” for “521(d)”.

Subsec. (a)(4). Pub. L. 102–83, §5(c)(1), substituted “1710” for “610”.

Subsec. (a)(6). Pub. L. 102–83, §5(c)(1), substituted “1703” for “603”.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Subsec. (b)(1)(B)(ii). Pub. L. 102–25, §334(a), inserted “or, in the case of a veteran who served on active duty during the Persian Gulf War, 90 days” after “180 days”.

Subsec. (b)(1)(H). Pub. L. 102–86, §301, amended subsec. (b)(1) of this section as in effect before the redesignations made by Pub. L. 102–83, §5, by adding subpar. (H).

Subsec. (b)(2). Pub. L. 102–25, §334(a), inserted “or, in the case of a veteran who served on active duty during the Persian Gulf War, 90 days” after “180 days”.

Subsec. (b)(3). Pub. L. 102–86, §302, amended subsec. (b) of this section as in effect before the redesignations made by Pub. L. 102–83, §5, by substituting “$1,000” for “$500”.

Pub. L. 102–83, §5(c)(1), substituted “1703(a)” for “603(a)”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Subsec. (b)(4). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Subsec. (b)(4)(A). Pub. L. 102–83, §5(c)(1), substituted in two places “1703” for “603” and “1710(c)” for “610(c)”.

Subsec. (b)(4)(B). Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in introductory provisions.

Subsec. (d). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Subsec. (f). Pub. L. 102–83, §5(c)(1), substituted “1717” for “617” and “1710(a)(2)” for “610(a)(2)” in par. (1) and “1717” for “617” in par. (3).

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in pars. (1) and (2).

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in pars. (2) and (4).

Subsec. (h). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

Pub. L. 102–25, §334(c), substituted “a period of war” for “the Mexican border period, World War I, World War II, the Korean conflict, or the Vietnam era”.

Subsec. (i). Pub. L. 102–83, §5(c)(1), substituted “1710(e)” for “610(e)” in par. (3) and “1722(a)(1)(C)” for “622(a)(1)(C)” in par. (5).

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in introductory provisions.

Subsec. (j). Pub. L. 102–83, §4(b)(5), substituted “the Secretary of Health and Human Services” for “the Secretary” in second and third sentences.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in first sentence.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” wherever appearing.

1990—Subsec. (f)(1). Pub. L. 101–508, §8013(b)(1), substituted “section 610(a)(2)” for “section 610(a)(2)(B)”.

Subsec. (f)(3) to (7). Pub. L. 101–508, §8013(b)(2), (3), redesignated pars. (5) and (7) as (3) and (4), respectively, and struck out former pars. (3), (4), and (6) which read as follows:

“(3) A veteran may not be required to make a payment under this subsection for services furnished under subsection (a) of this section during any 90-day period to the extent that such payment would cause the total amount paid by the veteran under this subsection for medical services furnished during that period and under section 610(f) of this title for hospital and nursing home care furnished during that period to exceed the amount of the inpatient Medicare deductible in effect on the first day of such 90-day period.

“(4) A veteran may not be required to make a payment under this subsection if such payment would result in the veteran paying, under this subsection and section 610(f) of this title, a total amount greater than four times the amount of the inpatient Medicare deductible for care or services, or any combination thereof, furnished under this chapter during any 365-calendar-day period.

“(6) For the purposes of this subsection, the term ‘inpatient Medicare deductible’ means the amount of the inpatient hospital deductible in effect under section 1813(b) of the Social Security Act (42 U.S.C. 1395e(b)).”

1988—Pub. L. 100–322, §101(h)(1), substituted “Eligibility for outpatient services” for “Eligibility for medical treatment” in section catchline.

Subsec. (a)(1). Pub. L. 100–322, §101(a), substituted “shall furnish on an ambulatory or outpatient basis” for “may furnish” in introductory provisions and added subpar. (C).

Subsec. (a)(2). Pub. L. 100–322, §101(b)(1), (3), added par. (2) and struck out former par. (2) which read as follows: “Subject to subsection (k) of this section, as part of medical services furnished to a veteran under paragraph (1) of this subsection, the Administrator may furnish to the veteran such home health services as the Administrator finds to be necessary or appropriate for the effective and economical treatment of such disability (including only such improvements and structural alterations the cost of which does not exceed $2,500 (or reimbursement up to such amount) as are necessary to assure the continuation of treatment for such disability or to provide access to the home or to essential lavatory and sanitary facilities).”

Subsec. (a)(3) to (6). Pub. L. 100–322, §101(b)(2), (3), added pars. (3) to (5) and redesignated former par. (3) as (6).

Subsec. (b)(1)(B)(i). Pub. L. 100–322, §101(f)(1), substituted “at the time of the veteran's” for “at time of”.

Subsec. (b)(1)(B)(ii). Pub. L. 100–322, §101(f)(2), substituted “180 days” for “one hundred and eighty days”.

Subsec. (b)(1)(B)(iii). Pub. L. 100–322, §101(f)(3), substituted “90 days” for “ninety days” in four places.

Subsec. (b)(1)(B)(iv). Pub. L. 100–322, §101(f)(4), substituted “90-day” for “ninety-day”.

Subsec. (b)(1)(F). Pub. L. 100–322, §§101(g)(1)(A), 106, redesignated subpar. (G) as (F), substituted “90 days” for “six months”, and struck out former subpar. (F) which read as follows: “from which a veteran of the Spanish-American War or Indian wars is suffering;”.

Subsec. (b)(1)(G), (H). Pub. L. 100–322, §101(g)(1)(A), redesignated subpar. (H) as (G). Former subpar. (G) redesignated (F).

Subsec. (b)(4)(A). Pub. L. 100–322, §101(e)(2)(A), substituted “subsection (a) of this section (other than paragraphs (3)(B) and (3)(C) of that subsection)” for “subsections (a) and (f) of this section”.

Subsec. (e). Pub. L. 100–322, §101(g)(1)(B), struck out subsec. (e) which read as follows: “Any disability of a veteran of the Spanish-American War or Indian Wars, upon application for the benefits of this section or outpatient medical services under section 624 of this title, shall be considered for the purposes thereof to be a service-connected disability incurred or aggravated in a period of war.”

Subsec. (f)(1). Pub. L. 100–322, §101(e)(1)(A)–(C), redesignated par. (4)(A) as par. (1), substituted “under subsection (a) of this section (including home health services under section 617 of this title)” for “under this subsection (including home health services under paragraph (2) of this subsection)” and “paragraph (2) of this subsection” for “subparagraph (B) of this paragraph”, and struck out former par. (1) which read as follows: “Except as provided in paragraph (4) of this subsection, the Administrator may furnish medical services for any disability on an outpatient or ambulatory basis—

“(A) to any veteran eligible for hospital care under section 610 of this title (i) if such services are reasonably necessary in preparation for, or (to the extent that facilities are available) to obviate the need of, hospital admission, or (ii) if such a veteran has been furnished hospital care, nursing home care, or domiciliary care and such medical services are reasonably necessary to complete treatment incident to such care (for a period not in excess of twelve months after discharge from such treatment, except where the Administrator finds that a longer period is required by virtue of the disability being treated); and

“(B) to any veteran who is a former prisoner of war.”

Subsec. (f)(2). Pub. L. 100–322, §101(e)(1)(D)–(F), redesignated par. (4)(B) as (2), substituted “subsection (a) of this section and who is required under paragraph (1) of this subsection” for “this subsection and who is required under subparagraph (A) of this paragraph”, and struck out former par. (2) which read as follows: “Subject to subsection (k) of this section, as part of medical services furnished to a veteran under paragraph (1) of this subsection, the Administrator may furnish to the veteran such home health services as the Administrator determines to be necessary or appropriate for the effective and economical treatment of a disability of a veteran (including only such improvements and structural alterations the cost of which does not exceed $600 (or reimbursement up to such amount) as are necessary to assure the continuation of treatment or provide access to the home or to essential lavatory and sanitary facilities).”

Subsec. (f)(3). Pub. L. 100–322, §101(e)(1)(A), (D), (E), (G), redesignated par. (4)(C) as (3), substituted “under this subsection for services furnished under subsection (a) of this section” for “under this paragraph for services furnished under this subsection” and “veteran under this subsection” for “veteran under this paragraph”, and struck out former par. (3) which read as follows: “In addition to furnishing medical services under this subsection through Veterans’ Administration facilities, the Administrator may furnish such services in accordance with section 603 of this title.”

Subsec. (f)(4). Pub. L. 100–322, §101(e)(1)(D), redesignated par. (4)(D) as (4).

Subsec. (f)(5). Pub. L. 100–322, §101(e)(1)(D), (H), redesignated par. (4)(E) as (5) and substituted “under section 617 of this title” for “under this subsection”.

Subsec. (f)(6). Pub. L. 100–322, §101(e)(1)(D), (E), redesignated par. (4)(F) as (6) and substituted “this subsection” for “this paragraph”.

Subsec. (f)(7). Pub. L. 100–322, §101(e)(1)(D), (E), redesignated par. (4)(G) as (7) and substituted “this subsection” for “this paragraph”.

Subsec. (g). Pub. L. 100–322, §101(e)(2)(B), struck out subsec. (g) which read as follows:

“(1) The Administrator may furnish medical services which the Administrator determines are needed to a veteran—

“(A) who is a veteran of the Mexican border period or of World War I; or

“(B) who is in receipt of increased pension or additional compensation or allowances based on the need of regular aid and attendance or by reason of being permanently housebound (or who, but for the receipt of retired pay, would be in receipt of such pension, compensation, or allowance).

“(2) As part of medical services furnished to a veteran under paragraph (1) of this subsection, the Administrator may furnish to the veteran home health services under the terms and conditions set forth in subsection (f) of this section.

“(3) In addition to furnishing medical services under this subsection through Veterans’ Administration facilities, the Administrator may furnish such services in accordance with section 603 of this title.”

Subsec. (i). Pub. L. 100–322, §101(c), added pars. (1) to (5) and struck out former pars. (1) to (6) which read as follows:

“(1) To any veteran for a service-connected disability.

“(2) To any veteran described in subsection (f)(2) of this section.

“(3) To any veteran with a disability rated as service-connected (including any veteran being examined to determine the existence or rating of a service-connected disability).

“(4) To any veteran (A) who is a former prisoner of war, or (B) who is eligible for care under section 610(a)(5) of this title.

“(5) To any veteran being furnished medical services under subsection (g) of this section.

“(6) To any veteran who is in receipt of pension under section 521 of this title.”

Subsec. (k). Pub. L. 100–322, §101(d)(2), transferred subsec. (k) to section 617(a)(3) of this title.

1986—Subsec. (a). Pub. L. 99–272, §19011(b)(1), substituted par. (1) for “Except as provided in subsection (b) of this section, the Administrator, within the limits of Veterans’ Administration facilities, may furnish such medical services as the Administrator finds to be reasonably necessary to any veteran for a service-connected disability.”, designated second sentence of existing provision as par. (2), substituted “As part of medical services furnished to a veteran under paragraph (1) of this subsection, the Administrator may furnish to the veteran” for “The Administrator may also furnish to any such veteran”, struck out provision that in the case of a veteran discharged or released from active military, naval, or air service for a disability incurred or aggravated in the line of duty, services may be provided for that disability, whether or not service-connected for the purposes of this chapter, and added par. (3).

Subsec. (a)(2). Pub. L. 99–576, §202(1), substituted “Subject to subsection (k) of this section, as” for “As”.

Subsec. (b)(3). Pub. L. 99–272, §19012(c)(1), substituted “clause (1), (2), or (5) of section 603(a)” for “clause (i), (ii), or (v) of section 601(4)(C)”.

Subsec. (b)(4). Pub. L. 99–576, §231(b), designated existing provisions as subpar. (A), substituted “Except as provided in subparagraph (B) of this paragraph, in” for “In”, and added subpar. (B).

Pub. L. 99–272, §19012(c)(2), substituted “section 603” for “section 601(4)(C)” in two places.

Subsec. (f). Pub. L. 99–272, §19011(b)(2), designated existing first sentence as par. (1), substituted “Except as provided in paragraph (4) of this subsection, the Administrator may” for “The Administrator, within the limits of Veterans’ Administration facilities, may”, redesignated former cl. (1) as cl. (A) and subcls. (A) and (B) as subcls. (i) and (ii), inserted “and” after “being treated);”, struck out par. (2), which related to any veteran who had a service-connected disability rated at 50 percent or more, and redesignated cl. (3) as cl. (B); designated existing second sentence as par. (2) and substituted “As part of medical services furnished to a veteran under paragraph (1) of this subsection, the Administrator may furnish to the veteran” for “The Administrator may also furnish to any such veteran”; struck out provision authorizing the Administrator to furnish outpatient dental services and treatment, and related appliances, to any veteran described in subsec. (b)(1)(G) of this section; and added pars. (3) and (4).

Subsec. (f)(2). Pub. L. 99–576, §202(1), substituted “Subject to subsection (k) of this section, as” for “As”.

Subsec. (f)(4)(D) to (G). Pub. L. 99–576, §237(b)(2), added subpar. (D) and redesignated former subpars. (D) to (F) as (E) to (G), respectively.

Subsec. (g). Pub. L. 99–272, §19011(b)(3), amended subsec. (g) generally. Prior to amendment, subsec. (g) read as follows: “In the case of any veteran who is a veteran of the Mexican border period or of World War I or who is in receipt of increased pension or additional compensation or allowance based on the need of regular aid and attendance or by reason of being permanently housebound, or who, but for the receipt of retired pay, would be in receipt of such pension, compensation, or allowance, the Administrator, within the limits of Veterans’ Administration facilities, may furnish the veteran such medical services as the Administrator finds to be reasonably necessary. The Administrator may also furnish to any such veteran home health services under the terms and conditions set forth in subsection (f) of this section.”

Subsec. (i)(6). Pub. L. 99–272, §19011(b)(4), added par. (6).

Subsec. (j). Pub. L. 99–576, §702(5), substituted “programs under other provisions” for “programs pursuant to other provisions”, “veterans who voluntarily request such immunizations” for “veterans (voluntarily requesting such immunizations)”, “facility. Any such immunization shall be made using” for “facility, utilizing”, “Administration. For such purpose, notwithstanding any other provision of law, the Secretary may provide” for “Administration, and for such purpose, notwithstanding any other provision of law, the Secretary is authorized to provide”, and “cost. Section 4116” for “cost and the provisions of section 4116”.

Subsec. (k). Pub. L. 99–576, §202(2), added subsec. (k).

1985—Subsec. (f)(1). Pub. L. 99–166 substituted “if” for “where” after “(A)” and “(B)”, inserted “, nursing home care, or domiciliary care”, struck out “hospital” after “treatment incident to such”, and substituted “from such treatment” for “from in-hospital treatment”.

1982—Subsec. (a). Pub. L. 97–295, §4(17)(A), (B), inserted “of this section” after “subsection (b)”, and substituted “facilities)” for “facilities” after “sanitary”.

Subsec. (f)(2). Pub. L. 97–295, §4(17)(C), substituted “percent” for “per centum”.

Subsec. (h). Pub. L. 97–295, §4(17)(D), inserted “of this title” after “chapter 11”.

Subsec. (i). Pub. L. 97–295, §4(17)(E), substituted “The” for “Not later than ninety days after the effective date of this subsection, the” at the beginning.

Subsec. (j). Pub. L. 97–295, §4(95)(A), substituted “Health and Human Services” for “Health, Education, and Welfare”.

1981—Subsec. (b). Pub. L. 97–72, §103(a), divided existing provisions into pars. (1), (2), (3), and (4), redesignated cls. (1) through (8) as subpars. (A) through (H) of par. (1) as redesignated, made internal substitutions reflecting new number and letter designations, and, in par. (1)(B) as redesignated, inserted provisions set out in par. (1)(B)(ii), (iii)(I), and (iv).

Pub. L. 97–37, §3(b), in cl. (7) substituted “from which a veteran who is a former prisoner of war and who was detained or interned for a period of not less than six months is suffering” for “from which any veteran of World War I, World War II, the Korean conflict, or the Vietnam era who was held as a prisoner of war for a period of not less than six months is suffering”.

Pub. L. 97–35 inserted provisions requiring the Secretary concerned to furnish a discharged or released member of the Armed Forces a written explanation concerning the provisions of cl. (2) of this subsection, and in cl. (2) added subcl. (B) and (D), and redesignated former subcl. (B) as (C) and, as so redesignated, substituted “90 days” for “one year” in two places.

Subsec. (c). Pub. L. 97–72, §103(b)(1), substituted “paragraph (1)(B)” for “clause (2)”.

Subsec. (f). Pub. L. 97–72, §103(b)(2), substituted “clause (G) of subsection (b)(1)” for “subsection (b)(7)”.

Subsec. (f)(3). Pub. L. 97–37, §5(b), added cl. (3).

Subsec. (i)(4). Pub. L. 97–72, §102(b), designated existing provisions relating to former prisoners of war as cl. (A) and added cl. (B) relating to veterans who are eligible for care under section 610(a)(5) of this title.

Pub. L. 97–37, §5(c), added cl. (4). Former cl. (4) redesignated (5).

Subsec. (i)(5). Pub. L. 97–37, §5(c)(1), redesignated former cl. (4) as (5).

1979—Subsec. (b). Pub. L. 96–151, §203, inserted provisions relating to the total amount the Administrator may expend.

Pub. L. 96–22, §102(b)(1), added pars. (7) and (8) and inserted provisions following par. (8).

Subsec. (f). Pub. L. 96–22, §102(b)(2), authorized the Administrator to furnish outpatient dental services and treatment, and related appliances, to any veteran described in subsec. (b)(7) of this section.

Subsec. (g). Pub. L. 96–151, §204, inserted provisions relating to particular applicability to Mexican border period or World War I veterans, and provisions relating to furnishing by the Administrator of home health care services.

Subsec. (i)(3). Pub. L. 96–22, §101, inserted “(including any veteran being examined to determine the existence or rating of a service-connected disability)” after “with a disability rated as service connected”.

1978—Subsec. (h). Pub. L. 95–588 substituted “$1,000” for “$500”.

1976—Subsec. (a). Pub. L. 94–581, §§103(a)(1), 210(a)(3)(A), inserted provisions which authorized the Administrator to furnish such home health services as the Administrator finds to be necessary or appropriate for the effective and economical treatment of the disability (including only such improvements and structural alterations the cost of which does not exceed $2,500 (or reimbursement up to such amount) as are necessary to assure the continuation of treatment for the disability or to provide access to the home or to essential lavatory and sanitary facilities), and in the existing provisions substituted “as the Administrator finds” for “as he finds”.

Subsec. (b). Pub. L. 94–581, §103(a)(2), added par. (5) and redesignated former par. (5) as (6).

Subsec. (d). Pub. L. 94–581, §210(a)(3)(B), substituted “procured by the Administrator” for “procured by him” and “whichever the Administrator determines” for “whichever he determines”.

Subsec. (e). Pub. L. 94–581, §202(f)(1), substituted “Indian Wars” for “Indian wars”.

Subsec. (f). Pub. L. 94–581, §§103(a)(3)–(7), 202(f)(2), substituted “within the limits of Veterans’ Administration facilities, may furnish” for “may also furnish” in provisions preceding par. (1), substituted “or (to the extent that facilities are available) to obviate” for “or to obviate” in cl. (A) of par. (1), substituted “furnished” for “granted” in existing provisions of cl. (B) of par. (1) and inserted “(for a period not in excess of twelve months after discharge from in-hospital treatment, except where the Administrator finds that a longer period is required by virtue of the disability being treated)” at end, substituted “50 per centum” for “80 per centum” in par. (2), and inserted, after par. (2), provision authorizing the Administrator to furnish to the veteran such home health services as the Administrator determines to be necessary or appropriate for the effective and economical treatment of a disability of the veteran (including only such improvements and structural alterations the cost of which does not exceed $600 (or reimbursement up to such amount) as are necessary to assure the continuation of treatment or provide access to the home or to essential lavatory and sanitary facilities).

Subsec. (g). Pub. L. 94–581, §§202(f)(3), 210(a)(3)(C), inserted “, within the limits of Veterans’ Administration facilities,” after “the Administrator” and substituted “as the Administrator finds” for “as he finds”.

Subsec. (h). Pub. L. 94–581, §210(a)(3)(D), substituted “such veteran's annual income is greater” for “his annual income is greater” and “such veteran's annual income does not exceed” for “his annual income does not exceed”.

Subsecs. (i), (j). Pub. L. 94–581, §103(a)(8), added subsecs. (i) and (j).

1973—Subsec. (f). Pub. L. 93–82 substituted provisions relating to the furnishing of medical services for any disability on an outpatient or ambulatory basis to veterans eligible for hospital care where such services are necessary in preparation for, or to obviate the need of, hospital admission, or where such veteran has been granted hospital care and such medical services are reasonably necessary to complete treatment incident to such hospital care and to veterans who have a service-connected disability rated at 80 per centum or more for provisions relating to the furnishing of medical services for a non-service connected disability where such care is reasonably necessary in preparation for admission of a veteran who has been determined to need hospital care and who has been scheduled for admission, where a veteran has been granted hospital care, and outpatient care is reasonably necessary to complete treatment incident to such hospital care, and where a veteran of any war has a total disability permanent in nature resulting from a service-connected disability.

1970—Subsec. (g). Pub. L. 91–500, §2, extended the authority of the Administrator to furnish medical services as he finds necessary to veterans permanently housebound or receiving pension or compensation based on need of regular aid and attendance and struck out conditions limiting such medical care to veterans hospitalized or suffering from one or more of the six specific conditions or diseases enumerated.

Subsec. (h). Pub. L. 91–588 inserted reference to Mexican border period and authorized the Administrator to continue furnishing drugs and medicine so ordered by any veteran in need of regular aid and attendance whose pension payments have been discontinued solely because his annual income is greater than the applicable maximum annual income limitation, but only so long as his annual income does not exceed such maximum annual income limitation by more than $500.

Pub. L. 91–500, §3, authorized furnishing of drugs and medicines to veterans receiving additional compensation or allowance or increased pension by reason of being “permanently housebound”.

1969—Subsec. (f)(3). Pub. L. 91–102 added par. (3).

1967—Subsec. (h). Pub. L. 90–77 imposed the obligation of furnishing drugs and medicines on the Administrator and extended such medical benefits to veterans receiving additional compensation under chapter 11 and veterans of the Vietnam era.

1964—Subsec. (b)(2). Pub. L. 88–430 permitted an application for treatment to be made within one year after a disqualifying discharge or release has been corrected, or the date of enactment of this exception, whichever is later.

Subsec. (g). Pub. L. 88–450 added subsec. (g).

Subsec. (h). Pub. L. 88–664 added subsec. (h).

1962—Subsec. (a). Pub. L. 87–583 provided for medical service to any veteran for a service-connected disability instead of to a veteran of any war, to a veteran discharged or released from the active military, naval, or air service for a disability incurred or aggravated in line of duty, or to a person who is in receipt of, but for the receipt of retirement pay would be entitled to, disability compensation.

1961—Subsecs. (b)(5), (e). Pub. L. 87–377 inserted “or Indian wars” after “Spanish-American War”.

1960—Subsec. (f). Pub. L. 86–639 added subsec. (f).

Effective Date of 1993 Amendment

Amendment by Pub. L. 103–210 effective as of Aug. 2, 1990, see section 1(c)(1) of Pub. L. 103–210, set out as a note under section 1710 of this title.

Effective Date of 1990 Amendment

Amendment by Pub. L. 101–508 to remain in effect through the period covered by Pub. L. 102–145, see section 111 of Pub. L. 102–145, set out as a note under section 1710 of this title.

Amendment by Pub. L. 101–508 to remain in effect through the period covered by Pub. L. 102–109, see section 111 of Pub. L. 102–109, set out as a note under section 1710 of this title.

Amendment by Pub. L. 101–508 applicable with respect to hospital care and medical services received after Nov. 5, 1990, see section 8013(d) of Pub. L. 101–508, as amended, set out as a note under section 1710 of this title.

Effective Date of 1988 Amendment

Amendment by section 101(a)–(c), (d)(2), (e)(1), (2), (f), (g)(1), (h)(1) of Pub. L. 100–322 applicable with respect to furnishing of medical services to veterans who apply for such services after June 30, 1988, see section 101(i) of Pub. L. 100–322, set out as a note under section 1703 of this title.

Effective Date of 1986 Amendments

Amendment by section 237(b)(2) of Pub. L. 99–576 effective Apr. 7, 1986, see section 237(c) of Pub. L. 99–576, set out as a note under section 1710 of this title.

Amendment by section 19011(b) of Pub. L. 99–272 applicable to hospital care, nursing home care, and medical services furnished on or after July 1, 1986, see section 19011(f) of Pub. L. 99–272, set out as a note under section 1710 of this title.

Effective Date of 1981 Amendments

Amendment by section 5(b), (c) of Pub. L. 97–37 effective Oct. 1, 1981, see section 5(d) of Pub. L. 97–37, set out as a note under section 1710 of this title.

Section 2002(b) of Pub. L. 97–35 provided that:

“(b)(1) The amendments made by clauses (1)(A), (1)(C), and (2) of subsection (a) [amending this section] shall take effect on October 1, 1981.

“(2) The amendment made by clause (1)(B) of subsection (a) [amending this section] shall apply only to veterans discharged or released from active military, naval, or air service after September 30, 1981.”

Effective Date of 1979 Amendments

Amendment by Pub. L. 96–151 effective Jan. 1, 1980, see section 206 of Pub. L. 96–151, set out as a note under section 111 of this title.

Amendment by section 102(b) of Pub. L. 96–22 effective Oct. 1, 1979, see section 107 of Pub. L. 96–22, set out as a note under section 1701 of this title.

Effective Date of 1978 Amendment

Amendment by Pub. L. 95–588 effective Jan. 1, 1979, see section 401 of Pub. L. 95–588, set out as a note under section 101 of this title.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Effective Date of 1973 Amendment

Amendment by Pub. L. 93–82 effective Sept. 1, 1973, see section 501 of Pub. L. 93–82, set out as a note under section 1701 of this title.

Effective Date of 1970 Amendment

Amendment by Pub. L. 91–588 effective Jan. 1, 1971, see section 10(a) of Pub. L. 91–588, set out as a note under section 1521 of this title.

Effective Date of 1967 Amendment

Amendment by Pub. L. 90–77 effective first day of first calendar month which begins more than ten days after Aug. 31, 1967, see section 405 of Pub. L. 90–77, set out as a note under section 101 of this title.

Effective Date of 1964 Amendment

Amendment by Pub. L. 88–664 effective Jan. 1, 1965, see section 11 of Pub. L. 88–664, set out as a note under section 1503 of this title.

Savings Provision

Provisions of subsec. (a) of this section, as in effect on Oct. 8, 1996, to continue to apply on and after such date with respect to furnishing of hospital care, nursing home care, and medical services for any veteran who was furnished such care before Oct. 9, 1996, on the basis of presumed exposure to a substance of radiation, but only for treatment for disability for which such care or services were furnished before Oct. 9, 1996, see section 102(b) of Pub. L. 104–262, set out as a note under section 1710 of this title.

Pilot Program on Provision of Dental Insurance Plans to Veterans and Survivors and Dependents of Veterans

Pub. L. 111–163, title V, §510, May 5, 2010, 124 Stat. 1162, provided that:

“(a) Pilot Program Required.—The Secretary of Veterans Affairs shall carry out a pilot program to assess the feasibility and advisability of providing a dental insurance plan to veterans and survivors and dependents of veterans described in subsection (b).

“(b) Covered Veterans and Survivors and Dependents.—The veterans and survivors and dependents of veterans described in this subsection are as follows:

“(1) Any veteran who is enrolled in the system of annual patient enrollment under section 1705 of title 38, United States Code.

“(2) Any survivor or dependent of a veteran who is eligible for medical care under section 1781 of such title.

“(c) Duration of Program.—The pilot program shall be carried out during the 3-year period beginning on the date that is 270 days after the date of the enactment of this Act [May 5, 2010].

“(d) Locations.—The pilot program shall be carried out in such Veterans Integrated Services Networks as the Secretary considers appropriate for purposes of the pilot program.

“(e) Administration.—The Secretary shall contract with a dental insurer to administer the dental insurance plan provided under the pilot program.

“(f) Benefits.—The dental insurance plan under the pilot program shall provide such benefits for dental care and treatment as the Secretary considers appropriate for the dental insurance plan, including diagnostic services, preventative services, endodontics and other restorative services, surgical services, and emergency services.

“(g) Enrollment.—

“(1) Voluntary.—Enrollment in the dental insurance plan under the pilot program shall be voluntary.

“(2) Minimum period.—Enrollment in the dental insurance plan shall be for such minimum period as the Secretary shall prescribe for purposes of this section.

“(h) Premiums.—

“(1) In general.—Premiums for coverage under the dental insurance plan under the pilot program shall be in such amount or amounts as the Secretary shall prescribe to cover all costs associated with the pilot program.

“(2) Annual adjustment.—The Secretary shall adjust the premiums payable under the pilot program for coverage under the dental insurance plan on an annual basis. Each individual covered by the dental insurance plan at the time of such an adjustment shall be notified of the amount and effective date of such adjustment.

“(3) Responsibility for payment.—Each individual covered by the dental insurance plan shall pay the entire premium for coverage under the dental insurance plan, in addition to the full cost of any copayments.

“(i) Voluntary Disenrollment.—

“(1) In general.—With respect to enrollment in the dental insurance plan under the pilot program, the Secretary shall—

“(A) permit the voluntary disenrollment of an individual in the dental insurance plan if the disenrollment occurs during the 30-day period beginning on the date of the enrollment of the individual in the dental insurance plan; and

“(B) permit the voluntary disenrollment of an individual in the dental insurance plan for such circumstances as the Secretary shall prescribe for purposes of this subsection, but only to the extent such disenrollment does not jeopardize the fiscal integrity of the dental insurance plan.

“(2) Allowable circumstances.—The circumstances prescribed under paragraph (1)(B) shall include the following:

“(A) If an individual enrolled in the dental insurance plan relocates to a location outside the jurisdiction of the dental insurance plan that prevents use of the benefits under the dental insurance plan.

“(B) If an individual enrolled in the dental insurance plan is prevented by a serious medical condition from being able to obtain benefits under the dental insurance plan.

“(C) Such other circumstances as the Secretary shall prescribe for purposes of this subsection.

“(3) Establishment of procedures.—The Secretary shall establish procedures for determinations on the permissibility of voluntary disenrollments under paragraph (1)(B). Such procedures shall ensure timely determinations on the permissibility of such disenrollments.

“(j) Relationship to Dental Care Provided by Secretary.—Nothing in this section shall affect the responsibility of the Secretary to provide dental care under section 1712 of title 38, United States Code, and the participation of an individual in the dental insurance plan under the pilot program shall not affect the individual's entitlement to outpatient dental services and treatment, and related dental appliances, under that section.

“(k) Regulations.—The dental insurance plan under the pilot program shall be administered under such regulations as the Secretary shall prescribe.”

Ratification of Actions During Period of Expired Authority

Any action taken by Secretary of Veterans Affairs before Feb. 13, 1996, under provision of law amended by title I of Pub. L. 104–110 that was taken during period beginning on date on which authority of Secretary under such provision of law expired and ending on Feb. 13, 1996, considered to have same force and effect as if such amendment had been in effect at time of that action, see section 103 of Pub. L. 104–110, set out as a note under section 1710 of this title.

Disability of Veterans of Spanish-American War

Section 101(g)(2) of Pub. L. 100–322, as amended by Pub. L. 102–83, §5(c)(2), Aug. 6, 1991, 105 Stat. 406, provided that: “Any disability of a veteran of the Spanish-American War, upon application for outpatient medical services under section 1712 or 1724 of title 38, United States Code, shall be considered for the purposes thereof to be a service-connected disabilty [sic] and, for the purposes of section 1712(b) of such title, to be compensable in degree.”

Pilot Program of Mobile Health-Care Clinics

Section 113 of Pub. L. 100–322 authorized Administrator of Veterans’ Affairs to conduct a pilot program under which eligible veterans residing in areas which are at least 100 miles from the nearest Veterans’ Administration health-care facility are furnished health-care services at a location convenient to their residences by Veterans’ Administration employees furnishing such services through the use of appropriately equipped mobile health-care clinics, provided that the pilot program be conducted for a period of not less than 24 months, and required Administrator to submit to Committees on Veterans’ Affairs of Senate and House of Representatives interim and final reports on the project.

Pilot Program of Community-Based Residential Care for Homeless Chronically Mentally Ill and Other Veterans

Section 115(a)–(f) of Pub. L. 100–322, as amended by Pub. L. 101–237, title II, §201(c), Dec. 18, 1989, 103 Stat. 2066; Pub. L. 102–83, §§5(c)(2), 6(j)(1), Aug. 6, 1991, 105 Stat. 406, 409; Pub. L. 102–405, title I, §107(h), Oct. 9, 1992, 106 Stat. 1978; Pub. L. 103–452, title I, §103(e), Nov. 2, 1994, 108 Stat. 4787; Pub. L. 104–110, title I, §102(a), Feb. 13, 1996, 110 Stat. 769; Pub. L. 104–275, title VI, §601(a), Oct. 9, 1996, 110 Stat. 3344, provided for a pilot program to provide care and treatment in community-based facilities to homeless veterans suffering from chronic mental illness, prior to repeal by Pub. L. 105–114, title II, §202(c)(4), Nov. 21, 1997, 111 Stat. 2287.

Report on Treatment and Services for Chronically Mentally Ill Veterans

Section 114 of Pub. L. 100–322 directed that the report required by section 235 of Pub. L. 99–576 [see below] include additional information about veterans being treated by the Veterans’ Administration for mental illness disabilities who were furnished hospital, domiciliary, or nursing home care by the Administrator during fiscal years 1986, 1987, and 1988, and extended the deadline for submission of the report to not later than Dec. 15, 1988.

Section 235 of Pub. L. 99–576 directed Administrator to submit to Committees on Veterans’ Affairs of Senate and House of Representatives not later than Dec. 15, 1987, a report on Administrator's current use of authority to contract for care and treatment, and for rehabilitative services, for chronically mentally ill veterans through various types of facilities and to furnish home health services to such veterans in such veterans’ homes or in other settings in which they reside.

Veterans Discharged or Released From Active Service Who Reentered Such Service Within One Year, and Were Discharged or Released Before August 13, 1981

Section 103(c) of Pub. L. 97–72, as amended by Pub. L. 102–83, §5(c)(2), Aug. 6, 1991, 105 Stat. 406, provided that:

“(1) Section 1712(b)(1)(B)(iii)(I) [now 1712(a)(1)(B)(iii)(I), formerly 612(b)(1)(B)(iii)(I)] of title 38, United States Code, shall apply only to veterans discharged or released from active military, naval, or air service after August 12, 1981.

“(2) A veteran who before August 13, 1981—

“(A) was discharged or released from active military, naval, or air service,

“(B) reentered such service within one year after the date of such discharge or release, and

“(C) was discharged or released from such subsequent service,

may be provided dental services and treatment in the same manner as provided for in section 1712(b) [now 1712(a), formerly 612(b)] of title 38, United States Code, if the veteran is otherwise eligible for such services and treatment and if application for such services and treatment is or was made within one year from the date of such subsequent discharge or release.”

Study of Home Modifications for Totally Blinded Service-Connected Veterans; Report Not Later Than October 1, 1979

Section 505 of Pub. L. 96–22 directed Administrator of Veterans’ Affairs to submit a report to Committees on Veterans’ Affairs of Senate and House of Representatives not later than Oct. 1, 1979, on needs of veterans who are totally blind from service-connected causes for home modifications the cost of which would exceed the amount allowable for such purposes under subsec. (a) of this section and on reasons why such veterans have not applied for home health services.

Annual Report to Congress on Results of Regulations Prescribed To Carry Out Special Priorities in Furnishing Medical Services

Section 103(b) of Pub. L. 94–581, as amended by Pub. L. 100–527, §10(1), Oct. 25, 1988, 102 Stat. 2640; Pub. L. 102–83, §5(c)(2), Aug. 6, 1991, 105 Stat. 406, provided that not later than one year after Oct. 21, 1976, and annually thereafter, the Secretary of Veterans Affairs was to report to the Congress on the results of the regulations prescribed to carry out former subsec. (i) of this section.

Notification to Eligible Individuals of Expanded Care and Services Available as Result of Amendments by Veterans Omnibus Health Care Act of 1976

Section 117(b) of Pub. L. 94–581 directed Administrator, not later than ninety days after Oct. 21, 1976, to take all appropriate steps to ensure that each individual eligible for new or expanded services as a result of amendments made by Veterans Omnibus Health Care Act of 1976 (Pub. L. 94–581) was personally notified about his or her eligibility and the way to secure care and services and directed Administrator to send copies of all notification forms to appropriate House and Senate committees, along with a description of how the forms were distributed.

§1712A. Eligibility for readjustment counseling and related mental health services

(a)(1)(A) Upon the request of any veteran referred to in subparagraph (B), the Secretary shall furnish counseling to the veteran to assist the veteran in readjusting to civilian life. Such counseling may include a general mental and psychological assessment of the veteran to ascertain whether such veteran has mental or psychological problems associated with readjustment to civilian life.

(B) Subparagraph (A) applies to the following veterans:

(i) Any veteran who served on active duty—

(I) in a theater of combat operations (as determined by the Secretary in consultation with the Secretary of Defense) during the Vietnam era; or

(II) after May 7, l975, in an area at a time during which hostilities occurred in that area.


(ii) Any veteran (other than a veteran covered by clause (i)) who served on active duty during the Vietnam era who seeks or is furnished such counseling before January 1, 2004.

(iii) Any veteran who served on active duty—

(I) in a theater of combat operations (as determined by the Secretary in consultation with the Secretary of Defense) during a period of war after the Persian Gulf War; or

(II) in combat against a hostile force during a period of hostilities (as defined in paragraph (2)(B)) after November 11, 1998.


(2)(A) Upon the request of any veteran (other than a veteran covered by paragraph (1)) who served in the active military, naval, or air service in a theater of combat operations (as so determined) during a period of war, or in any other area during a period in which hostilities (as defined in subparagraph (B)) occurred in such area, the Secretary may furnish counseling to the veteran to assist the veteran in readjusting to civilian life.

(B) For the purposes of subparagraph (A), the term “hostilities” means an armed conflict in which the members of the Armed Forces are subjected to danger comparable to the danger to which members of the Armed Forces have been subjected in combat with enemy armed forces during a period of war, as determined by the Secretary in consultation with the Secretary of Defense.

(3) Upon request of a veteran described in paragraph (1)(B)(iii), the Secretary shall provide the veteran a preliminary general mental health assessment as soon as practicable after receiving the request, but not later than 30 days after receiving the request.

(b)(1) If, on the basis of the assessment furnished under subsection (a) of this section, a physician or psychologist employed by the Department (or, in areas where no such physician or psychologist is available, a physician or psychologist carrying out such function under a contract or fee arrangement with the Secretary) determines that the provision of mental health services to such veteran is necessary to facilitate the successful readjustment of the veteran to civilian life, such veteran shall, within the limits of Department facilities, be furnished such services on an outpatient basis. For the purposes of furnishing such mental health services, the counseling furnished under subsection (a) of this section shall be considered to have been furnished by the Department as a part of hospital care. Any hospital care and other medical services considered necessary on the basis of the assessment furnished under subsection (a) of this section shall be furnished only in accordance with the eligibility criteria otherwise set forth in this chapter (including the eligibility criteria set forth in section 1784 of this title).

(2) Mental health services furnished under paragraph (1) of this subsection may, if determined to be essential to the effective treatment and readjustment of the veteran, include such consultation, counseling, training, services, and expenses as are described in sections 1782 and 1783 of this title.

(c) Upon receipt of a request for counseling under this section from any individual who has been discharged or released from active military, naval, or air service but who is not otherwise eligible for such counseling, the Secretary shall—

(1) provide referral services to assist such individual, to the maximum extent practicable, in obtaining mental health care and services from sources outside the Department; and

(2) if pertinent, advise such individual of such individual's rights to apply to the appropriate military, naval, or air service, and to the Department, for review of such individual's discharge or release from such service.


(d) The Under Secretary for Health may provide for such training of professional, paraprofessional, and lay personnel as is necessary to carry out this section effectively, and, in carrying out this section, may utilize the services of paraprofessionals, individuals who are volunteers working without compensation, and individuals who are veteran-students (as described in section 3485 of this title) in initial intake and screening activities.

(e)(1) In furnishing counseling and related mental health services under subsections (a) and (b) of this section, the Secretary shall have available the same authority to enter into contracts with private facilities that is available to the Secretary (under sections 1703(a)(2) and 1710(a)(1)(B) of this title) in furnishing medical services to veterans suffering from total service-connected disabilities.

(2) Before furnishing counseling or related mental health services described in subsections (a) and (b) of this section through a contract facility, as authorized by this subsection, the Secretary shall approve (in accordance with criteria which the Secretary shall prescribe by regulation) the quality and effectiveness of the program operated by such facility for the purpose for which the counseling or services are to be furnished.

(3) The authority of the Secretary to enter into contracts under this subsection shall be effective for any fiscal year only to such extent or in such amounts as are provided in appropriation Acts.

(f) The Secretary, in cooperation with the Secretary of Defense, shall take such action as the Secretary considers appropriate to notify veterans who may be eligible for assistance under this section of such potential eligibility.

(g) For the purposes of this section:

(1) The term “center” means a facility which is operated by the Department for the provision of services under this section and which (A) is situated apart from Department general health-care facilities, or (B) was so situated but has been relocated to a Department general health-care facility.

(2) The term “Department general health-care facility” means a health-care facility which is operated by the Department for the furnishing of health-care services under this chapter, not limited to services provided through the program established under this section.

(Added Pub. L. 96–22, title I, §103(a)(1), June 13, 1979, 93 Stat. 48, §612A; amended Pub. L. 96–128, title V, §501(b), Nov. 28, 1979, 93 Stat. 987; Pub. L. 97–72, title I, §104(a)(1), (b), Nov. 3, 1981, 95 Stat. 1049; Pub. L. 98–160, title I, §101, Nov. 21, 1983, 97 Stat. 993; Pub. L. 99–166, title I, §§105, 106, Dec. 3, 1985, 99 Stat. 944, 945; Pub. L. 99–272, title XIX, §§19011(d)(4), 19012(c)(3), Apr. 7, 1986, 100 Stat. 379, 382; Pub. L. 99–576, title II, §204, title VII, §702(6), Oct. 28, 1986, 100 Stat. 3255, 3302; Pub. L. 100–322, title I, §107(a)–(e), May 20, 1988, 102 Stat. 494–496; Pub. L. 100–687, div. B, title XV, §1501(a), Nov. 18, 1988, 102 Stat. 4132; Pub. L. 102–25, title III, §334(d), Apr. 6, 1991, 105 Stat. 89; Pub. L. 102–54, §14(b)(11), June 13, 1991, 105 Stat. 283; renumbered §1712A and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), (6), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–405, title III, §302(c)(1), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 104–262, title I, §101(d)(5), title III, §331, Oct. 9, 1996, 110 Stat. 3180, 3197; Pub. L. 106–117, title II, §205(a), Nov. 30, 1999, 113 Stat. 1563; Pub. L. 107–135, title II, §208(e)(3)(A), Jan. 23, 2002, 115 Stat. 2463; Pub. L. 110–181, div. A, title XVII, §1708(b), Jan. 28, 2008, 122 Stat. 494; Pub. L. 110–387, title IX, §901(a)(1), Oct. 10, 2008, 122 Stat. 4142; Pub. L. 111–163, title IV, §402, May 5, 2010, 124 Stat. 1156.)

Amendments

2010—Subsecs. (c) to (g). Pub. L. 111–163 added subsec. (c) and redesignated former subsecs. (c) to (f) as (d) to (g), respectively.

2008—Subsec. (a)(1)(B)(iii). Pub. L. 110–181, §1708(b)(1), added cl. (iii).

Subsec. (a)(3). Pub. L. 110–181, §1708(b)(2), added par. (3).

Subsecs. (c) to (e). Pub. L. 110–387, §901(a)(1)(B), redesignated subsecs. (d) to (f) as (c) to (e), respectively.

Subsec. (f). Pub. L. 110–387, §901(a)(1)(B), (C), redesignated subsec. (i) as (f) and struck out “(including a Resource Center designated under subsection (h)(3)(A) of this section)” after “means a facility” in par. (1). Former subsec. (f) redesignated (e).

Subsec. (g). Pub. L. 110–387, §901(a)(1)(A), struck out subsec. (g) which related to criteria for the closure or relocation of a center for readjustment counseling and related mental health services in existence on Jan. 1, 1988, and the submission of reports by the Secretary on the effectiveness of such services provided to Vietnam veterans and on a national plan for all centers in existence on Jan. 1, 1988.

Subsec. (i). Pub. L. 110–387, §901(a)(1)(B), redesignated subsec. (i) as (f).

2002—Subsec. (b). Pub. L. 107–135 substituted “section 1784” for “section 1711(b)” in par. (1) and “sections 1782 and 1783” for “section 1701(6)(B)” in par. (2).

1999—Subsec. (a)(1)(B)(ii). Pub. L. 106–117 substituted “January 1, 2004” for “January 1, 2000”.

1996—Subsec. (a). Pub. L. 104–262, §331(a), amended subsec. (a) generally. Prior to amendment, subsec. (a) read as follows:

“(a)(1) Upon the request of any veteran who served on active duty during the Vietnam era, the Secretary shall, within the limits of Department facilities, furnish counseling to such veteran to assist such veteran in readjusting to civilian life. Such counseling shall include a general mental and psychological assessment to ascertain whether such veteran has mental or psychological problems associated with readjustment to civilian life.

“(2)(A) The Secretary shall furnish counseling as described in paragraph (1), upon request, to any veteran who served on active duty after May 7, 1975, in an area at a time during which hostilities occurred in such area.

“(B) For the purposes of subparagraph (A) of this paragraph, the term ‘hostilities’ means an armed conflict in which members of the Armed Forces are subjected to danger comparable to the danger to which members of the Armed Forces have been subjected in combat with enemy armed forces during a period of war, as determined by the Secretary in consultation with the Secretary of Defense.”

Subsec. (b)(1). Pub. L. 104–262, §101(d)(5)(A), struck out “under the conditions specified in section 1712(a)(5)(B) of this title” after “furnished such services on an outpatient basis”.

Subsec. (c). Pub. L. 104–262, §331(b), struck out subsec. (c) which read as follows: “Upon receipt of a request for counseling under this section from any individual who has been discharged or released from active military, naval, or air service but who is not eligible for such counseling, the Secretary shall—

“(1) provide referral services to assist such individual, to the maximum extent practicable, in obtaining mental health care and services from sources outside the Department; and

“(2) if pertinent, advise such individual of such individual's rights to apply to the appropriate military, naval, or air service and the Department for review of such individual's discharge or release from such service.”

Subsec. (e)(1). Pub. L. 104–262, §101(d)(5)(B), substituted “sections 1703(a)(2) and 1710(a)(1)(B)” for “sections 1712(a)(1)(B) and 1703(a)(2)”.

1992—Subsecs. (d), (g)(3)(A). Pub. L. 102–405 substituted “Under Secretary for Health” for “Chief Medical Director”.

1991—Pub. L. 102–83, §5(a), renumbered section 612A of this title as this section.

Subsec. (a). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in par. (1).

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in par. (1).

Pub. L. 102–25 designated existing provisions as par. (1) and added par. (2).

Subsec. (b)(1). Pub. L. 102–83, §5(c)(1), substituted “1712(a)(5)(B)” for “612(a)(5)(B)” and “1711(b)” for “611(b)”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” wherever appearing.

Pub. L. 102–54 substituted “section 612(a)(5)(B)” for “paragraph (1)(A)(ii) of section 612(f)”.

Subsec. (b)(2). Pub. L. 102–83, §5(c)(1), substituted “1701(6)(B)” for “601(6)(B)”.

Subsec. (c). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in introductory provisions.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in pars. (1) and (2).

Subsec. (d). Pub. L. 102–83, §5(c)(1), substituted “3485” for “1685”.

Subsec. (e). Pub. L. 102–83, §5(c)(1), substituted “1712(a)(1)(B) and 1703(a)(2)” for “612(a)(1)(B) and 603(a)(2)” in par. (1).

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Subsec. (f). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

Subsec. (g). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” and “Secretary's” for “Administrator's” wherever appearing.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” wherever appearing.

Subsec. (h). Pub. L. 102–83, §4(b)(6), struck out subsec. (h) which related to carrying out a pilot program to provide and coordinate services to meet the readjustment needs of veterans on active duty during the Vietnam era.

Subsec. (i). Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” wherever appearing.

1988—Subsec. (g)(1). Pub. L. 100–322, §107(a), amended par. (1) generally. Prior to amendment, par. (1) read as follows: “During the 24-month period ending on September 30, 1989, the Administrator shall take appropriate steps to ensure—

“(A) the orderly, gradual transition, by October 1, 1989, of that part of the program established under this section for the provision of readjustment counseling services by Veterans’ Administration personnel from a program providing such services primarily through centers located in facilities situated apart from the health-care facilities operated by the Veterans’ Administration for the provision of other health-care services under other provisions of this chapter to a program providing readjustment counseling services primarily through such health-care facilities; and

“(B) the continued availability after such date of readjustment counseling and related mental health services under this section to veterans eligible for the provision of such counseling and services who request such counseling.”

Subsec. (g)(1)(A). Pub. L. 100–687, §1501(a)(1), substituted “Except as provided in subparagraph (C) of this paragraph, the” for “The”.

Subsec. (g)(1)(C). Pub. L. 100–687, §1501(a)(2), added subpar. (C).

Subsec. (g)(2)(A). Pub. L. 100–322, §107(b), substituted “April 1, 1988” for “April 1, 1987” and struck out “(or, if the study is not then completed, whatever information from it is then available)” after “(Public Law 98–160)”.

Subsec. (g)(2)(B)(i). Pub. L. 100–322, §107(e)(1)(A), substituted “in centers is needed” for “in a program providing such services through facilities situated apart from Veterans’ Administration health-care facilities is needed”.

Subsec. (g)(2)(B)(ii). Pub. L. 100–322, §107(e)(1)(B), substituted “this subsection” for “paragraph (1) of this subsection”.

Subsec. (g)(3) to (5). Pub. L. 100–322, §107(c), added pars. (3) to (5) and struck out former pars. (3) and (4) which read as follows:

“(3) Not later than July 1, 1987, the Administrator shall submit to such committees a report containing a description of the plans made and timetable for carrying out paragraph (1) of this subsection. Such report shall be prepared taking into consideration the results of the study referred to in paragraph (2)(A) of this subsection (or, if the study is not then completed, whatever information from it is then available).

“(4) Not later than February 1, 1989, the Administrator shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the experience under as much of the transition as was carried out pursuant to paragraph (1) of this subsection before September 30, 1988, including such recommendations for legislative and administrative action as the Administrator considers appropriate in light of such experience.”

Subsec. (h)(3)(B). Pub. L. 100–322, §107(e)(2)(A), substituted “referred to as ‘Resource Centers’)” for “referred to as ‘Centers’)”.

Subsec. (h)(4), (5). Pub. L. 100–322, §107(e)(2)(B), substituted “Resource Center” for “Center” wherever appearing.

Subsec. (i). Pub. L. 100–322, §107(d), added subsec. (i).

1986—Subsec. (b)(1). Pub. L. 99–272, §19011(d)(4)(A), substituted “paragraph (1)(A)(ii)” for “clause (1)(B)”.

Subsec. (e)(1). Pub. L. 99–272, §19012(c)(3), substituted “603(a)(2)” for “601(4)(C)(ii)”.

Pub. L. 99–272, §19011(d)(4)(B), substituted “612(a)(1)(B)” for “612(f)(2)”.

Subsec. (g)(1). Pub. L. 99–576, §204(a), substituted “the 24-month period ending on September 30, 1989” for “the twelve-month period ending on September 30, 1988” in introductory provision, and substituted “orderly, gradual transition by October 1, 1989” for “orderly transition, by October 1, 1988” in subpar. (A).

Subsec. (g)(2)(A). Pub. L. 99–576, §204(b)(1), inserted “(Pub. L. 98–160) (or, if the study is not then completed, whatever information from it is then available)” after “the Veterans’ Health Care Amendments of 1983”.

Subsec. (g)(3). Pub. L. 99–576, §204(b)(2), inserted at end “Such report shall be prepared taking into consideration the results of the study referred to in paragraph (2)(A) of this subsection (or, if the study is not then completed, whatever information from it is then available).”

Subsec. (g)(4). Pub. L. 99–576, §204(c), added par. (4).

Subsec. (h)(3)(A)(i). Pub. L. 99–576, §702(6), substituted “December 3, 1985,” for “the date of the enactment of this section”.

1985—Subsec. (g)(1)(B). Pub. L. 99–166, §106, which directed the substitution of “who request such counseling” for “who requested counseling before such date”, was executed by making the substitution for the phrase “who requested such counseling before such date” to reflect the probable intent of Congress.

Subsec. (h). Pub. L. 99–166, §105, added subsec. (h).

1983—Subsec. (a). Pub. L. 98–160, §101(a), struck out “if such veteran requests such counseling within two years after the date of such veteran's discharge or release from active duty, or by September 30, 1984, whichever is later” after “to assist such veteran in readjusting to civilian life”.

Subsec. (g)(1). Pub. L. 98–160, §101(b)(1), substituted “September 30, 1988” for “September 30, 1984” in provisions preceding subpar. (A).

Subsec. (g)(1)(A). Pub. L. 98–160, §101(b)(1), substituted “October 1, 1988” for “October 1, 1984”.

Subsec. (g)(2). Pub. L. 98–160, §101(b)(2), amended par. (2) generally, designating existing provisions as subpar. (A), substituting “Not later than April 1, 1987, the Administrator shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the Administrator's evaluation of the effectiveness in helping to meet the readjustment needs of veterans who served on active duty during the Vietnam era of the readjustment counseling and mental health services provided pursuant to this section (and of outreach efforts with respect to such counseling and services). Such report shall give particular attention, in light of the results of the study required by section 102 of the Veterans’ Health Care Amendments of 1983, to the provision of such counseling and services to veterans with post-traumatic stress disorder and to the diagnosis and treatment of such disorder” for “Not later than April 1, 1984, the Administrator shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report on the plans made and actions taken to carry out this subsection”, and adding subpar. (B).

Subsec. (g)(3). Pub. L. 98–160, §101(b)(2), added par. (3).

1981—Subsec. (a). Pub. L. 97–72, §104(a)(1), substituted “or by September 30, 1984” for “or two years after the effective date of this section”.

Subsec. (g). Pub. L. 97–72, §104(b), added subsec. (g).

1979—Subsec. (d). Pub. L. 96–128 substituted “title)” for “title),”.

Effective Date of 1986 Amendment

Amendment by section 19011(d)(4) of Pub. L. 99–272 applicable to hospital care, nursing home care, and medical services furnished on or after July 1, 1986, see section 19011(f) of Pub. L. 99–272, set out as a note under section 1710 of this title.

Effective Date of 1981 Amendment

Section 104(a)(2) of Pub. L. 97–72 provided that: “The amendment made by paragraph (1) [amending this section] shall take effect as of October 1, 1981.”

Effective Date of 1979 Amendment

Amendment by Pub. L. 96–128 effective Nov. 28, 1979, see section 601(b) of Pub. L. 96–128, set out as a note under section 1114 of this title.

Effective Date

Section effective Oct. 1, 1979, see section 107 of Pub. L. 96–22, set out as an Effective Date of 1979 Amendment note under section 1701 of this title.

Pilot Program on Counseling in Retreat Settings for Women Veterans Newly Separated From Service

Pub. L. 111–163, title II, §203, May 5, 2010, 124 Stat. 1143, provided that:

“(a) Pilot Program Required.—

“(1) In general.—Commencing not later than 180 days after the date of the enactment of this Act [May 5, 2010], the Secretary of Veterans Affairs shall carry out, through the Readjustment Counseling Service of the Veterans Health Administration, a pilot program to evaluate the feasibility and advisability of providing reintegration and readjustment services described in subsection (b) in group retreat settings to women veterans who are recently separated from service in the Armed Forces after a prolonged deployment.

“(2) Participation at election of veteran.—The participation of a veteran in the pilot program under this section shall be at the election of the veteran.

“(b) Covered Services.—The services provided to a woman veteran under the pilot program shall include the following:

“(1) Information on reintegration into the veteran's family, employment, and community.

“(2) Financial counseling.

“(3) Occupational counseling.

“(4) Information and counseling on stress reduction.

“(5) Information and counseling on conflict resolution.

“(6) Such other information and counseling as the Secretary considers appropriate to assist a woman veteran under the pilot program in reintegration into the veteran's family, employment, and community.

“(c) Locations.—The Secretary shall carry out the pilot program at not fewer than three locations selected by the Secretary for purposes of the pilot program.

“(d) Duration.—The pilot program shall be carried out during the 2-year period beginning on the date of the commencement of the pilot program.

“(e) Report.—Not later than 180 days after the completion of the pilot program, the Secretary shall submit to Congress a report on the pilot program. The report shall contain the findings and conclusions of the Secretary as a result of the pilot program, and shall include such recommendations for the continuation or expansion of the pilot program as the Secretary considers appropriate.

“(f) Authorization of Appropriations.—There is authorized to be appropriated to the Secretary of Veterans Affairs for each of fiscal years 2010 and 2011, $2,000,000 to carry out the pilot program.”

Program on Readjustment and Mental Health Care Services for Veterans Who Served in Operation Enduring Freedom and Operation Iraqi Freedom

Pub. L. 111–163, title III, §304, May 5, 2010, 124 Stat. 1150, provided that:

“(a) Program Required.—Not later than 180 days after the date of the enactment of this Act [May 5, 2010], the Secretary of Veterans Affairs shall establish a program to provide—

“(1) to veterans of Operation Enduring Freedom and Operation Iraqi Freedom, particularly veterans who served in such operations while in the National Guard and the Reserves—

“(A) peer outreach services;

“(B) peer support services;

“(C) readjustment counseling and services described in section 1712A of title 38, United States Code; and

“(D) mental health services; and

“(2) to members of the immediate family of veterans described in paragraph (1), during the 3-year period beginning on the date of the return of such veterans from deployment in Operation Enduring Freedom or Operation Iraqi Freedom, education, support, counseling, and mental health services to assist in—

“(A) the readjustment of such veterans to civilian life;

“(B) in the case such veterans have an injury or illness incurred during such deployment, the recovery of such veterans from such injury or illness; and

“(C) the readjustment of the family following the return of such veterans.

“(b) Contracts With Community Mental Health Centers and Other Qualified Entities.—In carrying out the program required by subsection (a), the Secretary may contract with community mental health centers and other qualified entities to provide the services required by such subsection only in areas the Secretary determines are not adequately served by other health care facilities or vet centers of the Department of Veterans Affairs. Such contracts shall require each contracting community health center or entity—

“(1) to the extent practicable, to use telehealth services for the delivery of services required by subsection (a);

“(2) to the extent practicable, to employ veterans trained under subsection (c) in the provision of services covered by that subsection;

“(3) to participate in the training program conducted in accordance with subsection (d);

“(4) to comply with applicable protocols of the Department before incurring any liability on behalf of the Department for the provision of services required by subsection (a);

“(5) for each veteran for whom a community mental health center or other qualified entity provides mental health services under such contract, to provide the Department with such clinical summary information as the Secretary shall require;

“(6) to submit annual reports to the Secretary containing, with respect to the program required by subsection (a) and for the last full calendar year ending before the submittal of such report—

“(A) the number of the veterans served, veterans diagnosed, and courses of treatment provided to veterans as part of the program required by subsection (a); and

“(B) demographic information for such services, diagnoses, and courses of treatment; and

“(7) to meet such other requirements as the Secretary shall require.

“(c) Training of Veterans for Provision of Peer-outreach and Peer-support Services.—In carrying out the program required by subsection (a), the Secretary shall contract with a national not-for-profit mental health organization to carry out a national program of training for veterans described in subsection (a) to provide the services described in subparagraphs (A) and (B) of paragraph (1) of such subsection.

“(d) Training of Clinicians for Provision of Services.—The Secretary shall conduct a training program for clinicians of community mental health centers or entities that have contracts with the Secretary under subsection (b) to ensure that such clinicians can provide the services required by subsection (a) in a manner that—

“(1) recognizes factors that are unique to the experience of veterans who served on active duty in Operation Enduring Freedom or Operation Iraqi Freedom (including their combat and military training experiences); and

“(2) uses best practices and technologies.

“(e) Vet Center Defined.—In this section, the term ‘vet center’ means a center for readjustment counseling and related mental health services for veterans under section 1712A of title 38, United States Code.”

Eligibility of Members of the Armed Forces Who Serve in Operation Enduring Freedom or Operation Iraqi Freedom for Counseling and Services Through Readjustment Counseling Service

Pub. L. 111–163, title IV, §401, May 5, 2010, 124 Stat. 1156, provided that:

“(a) In General.—Any member of the Armed Forces, including a member of the National Guard or Reserve, who serves on active duty in the Armed Forces in Operation Enduring Freedom or Operation Iraqi Freedom is eligible for readjustment counseling and related mental health services under section 1712A of title 38, United States Code, through the Readjustment Counseling Service of the Veterans Health Administration.

“(b) No Requirement for Current Active Duty Service.—A member of the Armed Forces who meets the requirements for eligibility for counseling and services under subsection (a) is entitled to counseling and services under that subsection regardless of whether or not the member is currently on active duty in the Armed Forces at the time of receipt of counseling and services under that subsection.

“(c) Regulations.—The eligibility of members of the Armed Forces for counseling and services under subsection (a) shall be subject to such regulations as the Secretary of Defense and the Secretary of Veterans Affairs shall jointly prescribe for purposes of this section.

“(d) Subject to Availability of Appropriations.—The provision of counseling and services under subsection (a) shall be subject to the availability of appropriations for such purpose.”

Pilot Program on Peer Outreach and Support for Veterans and Use of Community Mental Health Centers and Indian Health Service Facilities

Pub. L. 110–387, title I, §107, Oct. 10, 2008, 122 Stat. 4116, provided that:

“(a) Pilot Program Required.—Commencing not later than 180 days after the date of the enactment of this Act [Oct. 10, 2008], the Secretary of Veterans Affairs shall carry out a pilot program to assess the feasability [sic] and advisability of providing to veterans of Operation Iraqi Freedom and Operation Enduring Freedom, and, in particular, veterans who served in such operations as a member of the National Guard or Reserve, the following:

“(1) Peer outreach services.

“(2) Peer support services provided by licensed providers of peer support services or veterans who have personal experience with mental illness.

“(3) Readjustment counseling services described in section 1712A of title 38, United States Code.

“(4) Other mental health services.

“(b) Provision of Certain Services.—In providing services described in paragraphs (3) and (4) of subsection (a) under the pilot program to veterans who reside in rural areas and do not have adequate access through the Department of Veterans Affairs to the services described in such paragraphs, the Secretary shall, acting through the Office of Mental Health Services and the Office of Rural Health, provide such services as follows:

“(1) Through community mental health centers under contracts or other agreements if entered into by the Secretary of Veterans Affairs and the Secretary of Health and Human Services for the provision of such services for purposes of the pilot program.

“(2) Through the Indian Health Service, or an Indian tribe or tribal organization that has entered into an agreement with the Indian Health Service pursuant to the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.), if a memorandum of understanding is entered into by the Secretary of Veterans Affairs and the Secretary of Health and Human Services for purposes of the pilot program.

“(3) Through other appropriate entities under contracts or other agreements entered into by the Secretary of Veterans Affairs for the provision of such services for purposes of the pilot program.

“(c) Duration.—The pilot program shall be carried out during the three-year period beginning on the date of the commencement of the pilot program.

“(d) Program Locations.—

“(1) In general.—The pilot program shall be carried out within areas selected by the Secretary for the purpose of the pilot program in at least three Veterans Integrated Service Networks (VISNs).

“(2) Rural geographic locations.—The locations selected shall be in rural geographic locations that, as determined by the Secretary, lack access to comprehensive mental health services through the Department of Veterans Affairs.

“(3) Qualified providers.—In selecting locations for the pilot program, the Secretary shall select locations in which an adequate number of licensed mental health care providers with credentials equivalent to those of Department mental health care providers are available in Indian Health Service facilities, community mental health centers, and other entities for participation in the pilot program.

“(e) Participation in Program.—Each community mental health center, facility of the Indian Health Service, or other entity participating in the pilot program under subsection (b) shall—

“(1) provide the services described in paragraphs (3) and (4) of subsection (a) to eligible veterans, including, to the extent practicable, telehealth services that link the center or facility with Department of Veterans Affairs clinicians;

“(2) use the clinical practice guidelines of the Veterans Health Administration or the Department of Defense in the provision of such services; and

“(3) meet such other requirements as the Secretary shall require.

“(f) Compliance With Department Protocols.—Each community mental health center, facility of the Indian Health Service, or other entity participating in the pilot program under subsection (b) shall comply with—

“(1) applicable protocols of the Department before incurring any liability on behalf of the Department for the provision of services as part of the pilot program; and

“(2) access and quality standards of the Department relevant to the provision of services as part of the pilot program.

“(g) Provision of Clinical Information.—Each community mental health center, facility of the Indian Health Service, or other entity participating in the pilot program under subsection (b) shall, in a timely fashion, provide the Secretary with such clinical information on each veteran for whom such health center or facility provides mental health services under the pilot program as the Secretary shall require.

“(h) Training.—

“(1) Training of veterans.—As part of the pilot program, the Secretary shall carry out a program of training for veterans described in subsection (a) to provide the services described in paragraphs (1) and (2) of such subsection.

“(2) Training of clinicians.—

“(A) In general.—The Secretary shall conduct a training program for clinicians of community mental health centers, Indian Health Service facilities, or other entities participating in the pilot program under subsection (b) to ensure that such clinicians can provide the services described in paragraphs (3) and (4) of subsection (a) in a manner that accounts for factors that are unique to the experiences of veterans who served on active duty in Operation Iraqi Freedom or Operation Enduring Freedom (including their combat and military training experiences).

“(B) Participation in training.—Personnel of each community mental health center, facility of the Indian Health Service, or other entity participating in the pilot program under subsection (b) shall participate in the training program conducted pursuant to subparagraph (A).

“(i) Annual Reports.—Each community mental health center, facility of the Indian Health Service, or other entity participating in the pilot program under subsection (b) shall submit to the Secretary on an annual basis a report containing, with respect to the provision of services under subsection (b) and for the last full calendar year ending before the submission of such report—

“(1) the number of—

“(A) veterans served; and

“(B) courses of treatment provided; and

“(2) demographic information for such services, diagnoses, and courses of treatment.

“(j) Program Evaluation.—

“(1) In general.—The Secretary shall, through Department of Veterans Affairs Mental Health Services investigators and in collaboration with relevant program offices of the Department, design and implement a strategy for evaluating the pilot program.

“(2) Elements.—The strategy implemented under paragraph (1) shall assess the impact that contracting with community mental health centers, the Indian Health Service, and other entities participating in the pilot program under subsection (b) has on the following:

“(A) Access to mental health care by veterans in need of such care.

“(B) The use of telehealth services by veterans for mental health care needs.

“(C) The quality of mental health care and substance use disorder treatment services provided to veterans in need of such care and services.

“(D) The coordination of mental health care and other medical services provided to veterans.

“(k) Definitions.—In this section:

“(1) The term ‘community mental health center’ has the meaning given such term in section 410.2 of title 42, Code of Federal Regulations (as in effect on the day before the date of the enactment of this Act [Oct. 10, 2008]).

“(2) The term ‘eligible veteran’ means a veteran in need of mental health services who—

“(A) is enrolled in the Department of Veterans Affairs health care system; and

“(B) has received a referral from a health professional of the Veterans Health Administration to a community mental health center, a facility of the Indian Health Service, or other entity for purposes of the pilot program.

“(3) The term ‘Indian Health Service’ means the organization established by section 601(a) of the Indian Health Care Improvement Act (25 U.S.C. 1661(a)).

“(l) Authorization of Appropriations.—There is authorized to be appropriated such sums as may be necessary to carry out the provisions of this section.”

Research Program on Comorbid Post-Traumatic Stress Disorder and Substance Use Disorders

Pub. L. 110–387, title II, §201, Oct. 10, 2008, 122 Stat. 4119, provided that:

“(a) Program Required.—The Secretary of Veterans Affairs shall, through the Office of Research and Development, carry out a program of research into comorbid post-traumatic stress disorder (PTSD) and substance use disorder.

“(b) Discharge Through National Center for Posttraumatic Stress Disorder.—The research program required by subsection (a) shall be carried out by the National Center for Posttraumatic Stress Disorder. In carrying out the program, the Center shall—

“(1) develop protocols and goals with respect to research under the program; and

“(2) coordinate research, data collection, and data dissemination under the program.

“(c) Research.—The program of research required by subsection (a) shall address the following:

“(1) Comorbid post-traumatic stress disorder and substance use disorder.

“(2) The systematic integration of treatment for post-traumatic stress disorder with treatment for substance use disorder.

“(3) The development of protocols to evaluate care of veterans with comorbid post-traumatic stress disorder and substance use disorder.

“(d) Funding.—

“(1) Authorization of appropriations.—There is authorized to be appropriated for the Department of Veterans Affairs for each of fiscal years 2009 through 2012, $2,000,000 to carry out this section.

“(2) Availability.—Amounts authorized to be appropriated by paragraph (1) shall be made available to the National Center on Posttraumatic Stress Disorder for the purpose specified in that paragraph.

“(3) Supplement not supplant.—Any amount made available to the National Center on Posttraumatic Stress Disorder for a fiscal year under paragraph (2) is in addition to any other amounts made available to the National Center on Posttraumatic Stress Disorder for such year under any other provision of law.”

Pilot Program on Provision of Readjustment and Transition Assistance to Veterans and Their Families in Cooperation With Vet Centers

Pub. L. 110–387, title III, §302, Oct. 10, 2008, 122 Stat. 4120, provided that:

“(a) Pilot Program.—The Secretary of Veterans Affairs shall carry out, through a non-Department of Veterans Affairs entity, a pilot program to assess the feasability [sic] and advisability of providing readjustment and transition assistance described in subsection (b) to veterans and their families in cooperation with centers under section 1712A of title 38, United States Code (commonly referred to as ‘Vet Centers’).

“(b) Readjustment and Transition Assistance.—Readjustment and transition assistance described in this subsection is assistance as follows:

“(1) Readjustment and transition assistance that is preemptive, proactive, and principle-centered.

“(2) Assistance and training for veterans and their families in coping with the challenges associated with making the transition from military to civilian life.

“(c) Non-Department of Veterans Affairs Entity.—

“(1) In general.—The Secretary shall carry out the pilot program through any for-profit or non-profit organization selected by the Secretary for purposes of the pilot program that has demonstrated expertise and experience in the provision of assistance and training described in subsection (b).

“(2) Contract or agreement.—The Secretary shall carry out the pilot program through a non-Department entity described in paragraph (1) pursuant to a contract or other agreement entered into by the Secretary and the entity for purposes of the pilot program.

“(d) Commencement of Pilot Program.—The pilot program shall commence not later than 180 days after the date of the enactment of this Act [Oct. 10, 2008].

“(e) Duration of Pilot Program.—The pilot program shall be carried out during the three-year period beginning on the date of the commencement of the pilot program, and may be carried out for additional one-year periods thereafter.

“(f) Location of Pilot Program.—

“(1) In general.—The Secretary shall provide assistance under the pilot program in cooperation with 10 centers described in subsection (a) designated by the Secretary for purposes of the pilot program.

“(2) Designations.—In designating centers described in subsection (a) for purposes of the pilot program, the Secretary shall designate centers so as to provide a balanced geographical representation of such centers throughout the United States, including the District of Columbia, the Commonwealth of Puerto Rico, tribal lands, and other territories and possessions of the United States.

“(g) Participation of Centers.—A center described in subsection (a) that is designated under subsection (f) for participation in the pilot program shall participate in the pilot program by promoting awareness of the assistance and training available to veterans and their families through—

“(1) the facilities and other resources of such center;

“(2) the non-Department of Veterans Affairs entity selected pursuant to subsection (c); and

“(3) other appropriate mechanisms.

“(h) Additional Support.—In carrying out the pilot program, the Secretary may enter into contracts or other agreements, in addition to the contract or agreement described in subsection (c), with such other non-Department of Veterans Affairs entities meeting the requirements of subsection (c) as the Secretary considers appropriate for purposes of the pilot program.

“(i) Report on Pilot Program.—

“(1) Report required.—Not later than three years after the date of the enactment of this Act [Oct. 10, 2008], the Secretary shall submit to the congressional veterans affairs committees a report on the pilot program.

“(2) Elements.—Each report under paragraph (1) shall include the following:

“(A) A description of the activities under the pilot program as of the date of such report, including the number of veterans and families provided assistance under the pilot program and the scope and nature of the assistance so provided.

“(B) A current assessment of the effectiveness of the pilot program.

“(C) Any recommendations that the Secretary considers appropriate for the extension or expansion of the pilot program.

“(3) Congressional veterans affairs committees defined.—In this subsection, the term ‘congressional veterans affairs committees’ means—

“(A) the Committees on Veterans’ Affairs and Appropriations of the Senate; and

“(B) the Committees on Veterans’ Affairs and Appropriations of the House of Representatives.

“(j) Authorization of Appropriations.—

“(1) In general.—There is authorized to be appropriated for the Department of Veterans Affairs for each of fiscal years 2009 through 2011 $1,000,000 to carry out this section.

“(2) Availability.—Amounts authorized to be appropriated by paragraph (1) shall remain available until expended.”

Improvement and Expansion of Mental Health Services

Pub. L. 109–461, title II, §203, Dec. 22, 2006, 120 Stat. 3410, provided that:

“(a) Required Capacity for Community-Based Outpatient Clinics.—

“(1) In general.—The Secretary of Veterans Affairs shall ensure that each community-based outpatient clinic of the Department of Veterans Affairs has the capacity to provide, or monitor the provision of, mental health services to enrolled veterans who, as determined by the Secretary, are in need of such services.

“(2) Settings.—In carrying out paragraph (1), the Secretary shall ensure that mental health services are provided through—

“(A) a community-based outpatient clinic of the Department by an employee of the Department;

“(B) referral to another facility of the Department;

“(C) contract with an appropriate mental health professional in the community; or

“(D) telemental health services.

“(b) Clinical Training and Protocols.—

“(1) Collaboration.—The National Center on Post-Traumatic Stress Disorder of the Department of Veterans Affairs shall collaborate with the Secretary of Defense—

“(A) to enhance the clinical skills of military clinicians on matters relating to post-traumatic stress disorder through training, treatment protocols, web-based interventions, and the development of evidence-based interventions; and

“(B) to promote pre-deployment resilience and post-deployment readjustment among members of the Armed Forces serving in Operation Iraqi Freedom and Operation Enduring Freedom.

“(2) Authorization of appropriations.—There are authorized to be appropriated for the Department of Veterans Affairs for fiscal year 2007 $2,000,000 to carry out this subsection.

“(c) Mental Health Outreach.—The Secretary of Veterans Affairs shall—

“(1) develop additional educational materials on post-traumatic stress disorder; and

“(2) undertake additional efforts to educate veterans about post-traumatic stress disorder.

“(d) Review of PTSD Clinical Guidelines.—The Secretary of Veterans Affairs shall—

“(1) review the clinical guidelines of the Department of Veterans Affairs on post-traumatic stress disorder and all appropriate protocols related to post-traumatic stress disorder;

“(2) revise such guidelines and protocols as the Secretary considers appropriate to ensure that clinicians are able to effectively distinguish between diagnoses with similar symptoms that may manifest as post-traumatic stress disorder, including traumatic brain injury; and

“(3) develop performance measures for the treatment of post-traumatic stress disorder among veterans.”

Expansion of Telehealth Services

Pub. L. 109–461, title II, §205, Dec. 22, 2006, 120 Stat. 3411, provided that:

“(a) In General.—The Secretary of Veterans Affairs shall increase the number of facilities of the Readjustment Counseling Service that are capable of providing health services and counseling through telehealth linkages with facilities of the Veterans Health Administration.

“(b) Plan.—Not later than July 1, 2007, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a plan to implement the requirement in subsection (a). The plan shall specify which facilities of the Readjustment Counseling Service will have the capabilities described in subsection (a) as of the end of each of fiscal years 2007, 2008, and 2009.”

Expansion of Outreach Activities of Vet Centers

Pub. L. 109–461, title II, §215, Dec. 22, 2006, 120 Stat. 3424, provided that:

“(a) Additional Outreach Workers.—The Secretary of Veterans Affairs shall employ not fewer than 100 veterans for the purpose of providing outreach to veterans on the availability of readjustment counseling and related mental health services for veterans under section 1712A of title 38, United States Code.

“(b) Construction With Current Outreach Program.—The veterans employed under subsection (a) are in addition to any veterans employed by the Secretary for the purpose described in that subsection under the February 2004 program of the Department of Veterans Affairs to provide outreach described in that subsection.

“(c) Assignment to Vet Centers.—The Secretary may assign any veteran employed under subsection (a) to any center for the provision of readjustment counseling and related mental health services under section 1712A of title 38, United States Code, that the Secretary considers appropriate in order to meet the purpose described in that subsection.

“(d) Inapplicability and Termination of Limitation on Duration of Employment.—Any limitation on the duration of employment of veterans under the program described in subsection (b) is hereby terminated and shall not apply to veterans employed under such program or under this section.

“(e) Employment Status.—Veterans employed under subsection (a) shall be employed in career conditional status, which is the employment status in which veterans are employed under the program described in subsection (b).”

Study of Post-Traumatic Stress Disorder in Vietnam Veterans

Pub. L. 106–419, title II, §212, Nov. 1, 2000, 114 Stat. 1843, provided that:

“(a) Study on Post-Traumatic Stress Disorder.—Not later than 10 months after the date of the enactment of this Act [Nov. 1, 2000], the Secretary of Veterans Affairs shall enter into a contract with an appropriate entity to carry out a study on post-traumatic stress disorder.

“(b) Follow-Up Study.—The contract under subsection (a) shall provide for a follow-up study to the study conducted in accordance with section 102 of the Veterans Health Care Amendments of 1983 (Public Law 98–160) [set out as a note below]. Such follow-up study shall use the data base and sample of the previous study.

“(c) Information To Be Included.—The study conducted pursuant to this section shall be designed to yield information on—

“(1) the long-term course of post-traumatic stress disorder;

“(2) any long-term medical consequences of post-traumatic stress disorder;

“(3) whether particular subgroups of veterans are at greater risk of chronic or more severe problems with such disorder; and

“(4) the services used by veterans who have post-traumatic stress disorder and the effect of those services on the course of the disorder.

“(d) Report.—The Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the results of the study under this section. The report shall be submitted no later than October 1, 2004.”

Specialized Mental Health Services

Pub. L. 106–117, title I, §116, Nov. 30, 1999, 113 Stat. 1559, as amended by Pub. L. 108–170, title I, §108, Dec. 6, 2003, 117 Stat. 2046, provided that:

“(a) Improvement to Specialized Mental Health Services.—The Secretary [of Veterans Affairs], in furtherance of the responsibilities of the Secretary under section 1706(b) of title 38, United States Code, shall carry out a program to expand and improve the provision of specialized mental health services to veterans. The Secretary shall establish the program in consultation with the Committee on Care of Severely Chronically Mentally Ill Veterans established pursuant to section 7321 of title 38, United States Code.

“(b) Covered Programs.—For purposes of this section, the term ‘specialized mental health services’ includes programs relating to—

“(1) the treatment of post-traumatic stress disorder; and

“(2) substance use disorders.

“(c) Funding.—(1) In carrying out the program described in subsection (a), the Secretary shall identify, from funds available to the Department [of Veterans Affairs] for medical care, an amount of not less than $25,000,000 in each of fiscal years 2004, 2005, and 2006 to be available to carry out the program and to be allocated to facilities of the Department pursuant to subsection (d).

“(2) In identifying available amounts pursuant to paragraph (1), the Secretary shall ensure that, after the allocation of those funds under subsection (d), the total expenditure for programs relating to (A) the treatment of post-traumatic stress disorder, and (B) substance use disorders is not less than $25,000,000 in excess of the baseline amount.

“(3)(A) For purposes of paragraph (2), the baseline amount is the amount of the total expenditures on such programs for the most recent fiscal year for which final expenditure amounts are known, adjusted to reflect any subsequent increase in applicable costs to deliver such services in the Veterans Health Administration, as determined by the Committee on Care of Severely Chronically Mentally Ill Veterans.

“(B) For purposes of this paragraph, in fiscal years 2004, 2005, and 2006, the fiscal year used to determine the baseline amount shall be fiscal year 2003.

“(d) Allocation of Funds to Department Facilities.—(1) In each of fiscal years 2004, 2005, and 2006, the Secretary shall allocate funds identified pursuant to subsection (c)(1) to individual medical facilities of the Department as the Secretary determines appropriate based upon proposals submitted by those facilities for the use of those funds for improvements to specialized mental health services.

“(2) In allocating funds to facilities in a fiscal year under paragraph (1), the Secretary shall ensure that—

“(A) not less than $10,000,000 is allocated by direct grants to programs that are identified by the Mental Health Strategic Health Care Group and the Committee on Care of Severely Chronically Mentally Ill Veterans;

“(B) not less than $5,000,000 is allocated for programs on post-traumatic stress disorder; and

“(C) not less than $5,000,000 is allocated for programs on substance use disorder.

“(3) The Secretary shall provide that the funds to be allocated under this section during each of fiscal years 2004, 2005, and 2006 are funds for a special purpose program for which funds are not allocated through the Veterans Equitable Resource Allocation system.

“(e) Report.—Not later than 12 months after the date of the enactment of this Act [Nov. 30, 1999], the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report describing the implementation of this section. The Secretary shall include in the report information on the allocation of funds to facilities of the Department under the program and a description of the improvements made with those funds to specialized mental health services for veterans.”

Marriage and Family Counseling for Persian Gulf War Veterans

Section 121 of Pub. L. 102–405 provided that:

“(a) Requirement.—Subject to the availability of funds appropriated pursuant to the authorization in subsection (g), the Secretary shall conduct a program to furnish to the persons referred to in subsection (b) the marriage and family counseling services referred to in subsection (c). The authority to conduct the program shall expire on September 30, 1994.

“(b) Persons Eligible for Counseling.—The persons eligible to receive marriage and family counseling services under the program are—

“(1) veterans who were awarded a campaign medal for active-duty service during the Persian Gulf War and the spouses and children of such veterans; and

“(2) veterans who are or were members of the reserve components who were called or ordered to active duty during the Persian Gulf War and the spouses and children of such members.

“(c) Counseling Services.—Under the program, the Secretary may provide marriage and family counseling that the Secretary determines, based on an assessment by a mental-health professional employed by the Department and designated by the Secretary (or, in an area where no such professional is available, a mental-health professional designated by the Secretary and performing services under a contract or fee arrangement with the Secretary), is necessary for the amelioration of psychological, marital, or familial difficulties that result from the active duty service referred to in subsection (b)(1) or (2).

“(d) Manner of Furnishing Services.—(1) Marriage and family counseling services shall be furnished under the program—

“(A) by personnel of the Department of Veterans Affairs who are qualified to provide such counseling services;

“(B) by appropriately certified marriage and family counselors employed by the Department; and

“(C) by qualified mental health professionals pursuant to contracts with the Department, when Department facilities are not capable of furnishing economical medical services because of geographical inaccessibility or are not capable of furnishing the services required.

“(2) The Secretary shall establish the qualifications required of personnel under subparagraphs (A) and (C) of paragraph (1) and shall prescribe the training, experience, and certification required of appropriately certified marriage and family counselors under subparagraph (B) of such paragraph.

“(3) The Secretary may employ licensed or certified marriage and family counselors to provide counseling under paragraph (1)(B) and may classify the positions in which they are employed at levels determined appropriate by the Secretary, taking into consideration the training, experience, and licensure or certification required of such counselors.

“(e) Contract Counseling Services.—(1) Subject to paragraphs (2) and (4), a mental health professional referred to in subsection (d)(1)(C) may furnish marriage and family counseling services to a person under the program as follows:

“(A) For a period of not more than 15 days beginning on the date of the commencement of the furnishing of such services to the person.

“(B) For a 90-day period beginning on such date if—

“(i) the mental health professional submits to the Secretary a treatment plan with respect to the person not later than 15 days after such date; and

“(ii) the treatment plan and the assessment made under subsection (c) are approved by an appropriate mental health professional of the Department designated for that purpose by the Under Secretary for Health.

“(C) For an additional 90-day period beginning on the date of the expiration of the 90-day period referred to in subparagraph (B) (or any subsequent 90-day period) if—

“(i) not more than 30 days before the expiration of the 90-day period referred to in subparagraph (B) (or any subsequent 90-day period), the mental health professional submits to the Secretary a revised treatment plan containing a justification of the need of the person for additional counseling services; and

“(ii) the plan is approved in accordance with the provisions of subparagraph (B)(ii).

“(2)(A) A mental health professional referred to in paragraph (1) who assesses the need of any person for services for the purposes of subsection (c) may not furnish counseling services to that person.

“(B) The Secretary may waive the prohibition referred to in subparagraph (A) for locations (as determined by the Secretary) in which the Secretary is unable to obtain the assessment referred to in that subparagraph from a mental health professional other than the mental health professional with whom the Secretary enters into contracts under subsection (d)(1)(C) for the furnishing of counseling services.

“(3) The Secretary shall reimburse mental health professionals for the reasonable cost (as determined by the Secretary) of furnishing counseling services under paragraph (1). In the event of the disapproval of a treatment plan of a person submitted by a mental health professional under paragraph (1)(B)(i), the Secretary shall reimburse the mental health professional for the reasonable cost (as so determined) of furnishing counseling services to the person for the period beginning on the date of the commencement of such services and ending on the date of the disapproval.

“(4) The Secretary may authorize the furnishing of counseling in an individual case for a period shorter than the 90-day period specified in subparagraph (B) or (C) of paragraph (1) and, upon further consideration, extend the shorter period to the full 90 days.

“(5)(A) For the purposes of this subsection, the term ‘treatment plan’, with respect to a person entitled to counseling services under the program, must include—

“(i) an assessment by the mental health professional submitting the plan of the counseling needs of the person described in the plan on the date of the submittal of the plan; and

“(ii) a description of the counseling services to be furnished to the person by the mental health professional during the 90-day period covered by the plan, including the number of counseling sessions proposed as part of such services.

“(B) The Secretary shall prescribe an appropriate form for the treatment plan.

“(f) Cost Recovery.—For the purposes of section 1729 of title 38, United States Code, marriage and family counseling services furnished under the program shall be deemed to be care and services furnished by the Department under chapter 17 of such title, and the United States shall be entitled to recover or collect the reasonable cost of such services in accordance with that section.

“(g) Authorization of Appropriations.—There is authorized to be appropriated $10,000,000 for each of fiscal years 1993 and 1994 to carry out this section.

“(h) Report.—Not later than July 1, 1994, the Secretary shall submit to Congress a report on the program conducted pursuant to this section. The report shall contain information regarding the persons furnished counseling services under the program, including—

“(1) the number of such persons, stated as a total number and separately for each eligibility status referred to in subsection (b);

“(2) the age and gender of such persons;

“(3) the manner in which such persons were furnished such services under the program; and

“(4) the number of counseling sessions furnished to such persons.

“(i) Definitions.—For the purposes of this section, the terms ‘veteran’, ‘child’, ‘active duty’, ‘reserve component’, ‘spouse’, and ‘Persian Gulf War’ have the meanings given such terms in paragraphs 101(2), (4), (21), (27), (31), and (33) of section 101 of title 38, United States Code, respectively.”

Post-Traumatic Stress Disorder Program Planning

Section 123 of Pub. L. 102–405 provided that:

“(a) Plan.—The Secretary shall develop a plan—

“(1) to ensure, to the maximum extent practicable, that veterans suffering from post-traumatic stress disorder related to active duty are provided appropriate treatment and rehabilitative services for that condition in a timely manner;

“(2) to expand and improve the services available for veterans suffering from post-traumatic stress disorder related to active duty;

“(3) to eliminate waiting lists for inpatient treatment and other modes of treatment for post-traumatic stress disorder;

“(4) to enhance outreach activities carried out to inform combat-area veterans of the availability of treatment for post-traumatic stress disorder; and

“(5) to ensure, to the extent practicable, that there are Department post-traumatic stress disorder treatment units in locations that are readily accessible to veterans residing in rural areas of the United States.

“(b) Considerations.—In developing the plan referred to in subsection (a), the Secretary shall consider—

“(1) the numbers of veterans suffering from post-traumatic stress disorder related to active duty, as indicated by relevant studies, scientific and clinical reports, and other pertinent information;

“(2) the numbers of veterans who would likely seek post-traumatic stress disorder treatment from the Department if waiting times for treatment were eliminated and outreach activities to combat-area veterans with post-traumatic stress disorder were enhanced;

“(3) the current and projected capacity of the Department to provide appropriate treatment and rehabilitative services for post-traumatic stress disorder;

“(4) the level and geographic accessibility of inpatient and outpatient care available through the Department for veterans suffering from post-traumatic stress disorder across the United States;

“(5) the desirability of providing that inpatient and outpatient post-traumatic stress disorder care be furnished in facilities of the Department that are physically independent of general psychiatric wards of the medical facilities of the Department;

“(6) the treatment needs of veterans suffering from post-traumatic stress disorder who are women, of such veterans who are ethnic minorities (including Native Americans, Native Hawaiians, Asian-Pacific Islanders, and Native Alaskans), and of such veterans who suffer from substance abuse problems in addition to post-traumatic stress disorder; and

“(7) the recommendations of the Special Committee on Post-Traumatic-Stress Disorder with respect to (A) specialized inpatient and outpatient programs of the Department for the treatment of post-traumatic stress disorder, and (B) with respect to the establishment of educational programs that are designed for each of the various levels of education, training, and experience of the various mental health professionals involved in the treatment of veterans suffering from post-traumatic stress disorder.

“(c) Report.—Not later than six months after the date of the enactment of this Act [Oct. 9, 1992], the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the plan developed pursuant to subsection (a). The report shall include specific information relating to the consideration given to the matters described in subsection (b).

“(d) Definitions.—For the purposes of this section:

“(1) The term ‘active duty’ has the meaning given that term in section 101(21) of title 38, United States Code.

“(2) The term ‘veteran’ has the meaning given that term in section 101(2) of such title.

“(3) The term ‘combat-area veteran’ means a veteran who served on active duty in an area at a time during which hostilities (as defined in section 1712A(a)(2)(B) of such title) occurred in such area.”

Updates of Reports on Post-Traumatic Stress Disorder

Section 122(b) of Pub. L. 102–405 directed Special Committee on Post-Traumatic-Stress Disorder, not later than Oct. 1, 1992, and Oct. 1, 1993, to concurrently submit to Secretary and Committees on Veterans’ Affairs of Senate and House of Representatives a report containing information updating the reports submitted to the Secretary under section 110(e) of the Veterans’ Health Care Act of 1984, together with any additional information the Special Committee considers appropriate regarding the overall efforts of the Department of Veterans Affairs to meet the needs of veterans with post-traumatic stress disorder and other psychological problems in readjusting to civilian life, and directed Secretary, not later than 90 days after receiving each of the reports to submit to the committees any comments concerning the report that the Secretary considered appropriate. Similar provisions were contained in Pub. L. 101–237, title II, §201(e), Dec. 18, 1989, 103 Stat. 2066, as amended by Pub. L. 101–366, title II, §204, Aug. 15, 1990, 104 Stat. 439.

Authorization for Relocation of Certain Facilities

Section 1501(b) of Pub. L. 100–687 related to relocation of 17 Veterans’ Administration Readjustment Counseling Service Vet Centers from their locations away from general Veterans’ Administration health-care facilities to other such locations.

Prohibition of Delegation of Duties

Pub. L. 100–322, title I, §107(f), May 20, 1988, 102 Stat. 496, as amended by Pub. L. 100–527, §10(4), Oct. 25, 1988, 102 Stat. 2641; Pub. L. 102–40, §2(b), May 7, 1991, 105 Stat. 187; Pub. L. 102–83, §5(c)(2), Aug. 6, 1991, 105 Stat. 406, provided that: “The Chief Medical Director [now Under Secretary for Health] of the Department of Veterans Affairs may not delegate the function of making recommendations under [former] section 1712A(g)(3)(A) of title 38, United States Code, as amended by subsection (c).”

Post-Traumatic-Stress Disorder; Diagnosis and Treatment; Education and Training of Health-Care Personnel; Coordination With Readjustment Counseling; Special Committee; National Center; Compilation and Publication of Research Results; Reports to Congressional Committees

Pub. L. 98–528, title I, §110, Oct. 19, 1984, 98 Stat. 2691, as amended by Pub. L. 106–117, title II, §206, Nov. 30, 1999, 113 Stat. 1563; Pub. L. 108–170, title IV, §405(e), Dec. 6, 2003, 117 Stat. 2063; Pub. L. 110–387, §202, Oct. 10, 2008, 122 Stat. 4120, provided that:

“(a)(1) The Under Secretary for Health of the Department of Veterans Affairs may designate special programs within the Veterans Health Administration for the diagnosis and treatment of post-traumatic-stress disorder (hereinafter in this section referred to as ‘PTSD’).

“(2) The Under Secretary for Health shall direct (A) that (in addition to providing diagnostic and treatment services for PTSD) Department programs designated under paragraph (1) (hereinafter in this section referred to as ‘designated PTSD programs’) carry out activities to promote the education and training of health-care personnel (including health-care personnel not working for the Department or the Federal Government) in the causes, diagnosis, and treatment of PTSD, and (B) that (when appropriate) the provision of treatment services under such program be coordinated with the provision of readjustment counseling services under section 1712A of title 38, United States Code.

“(b)(1) The Under Secretary for Health shall establish in the Veterans Health Administration a Special Committee on Post-Traumatic-Stress Disorder (hereinafter in this section referred to as the ‘Special Committee’). The Under Secretary for Health shall appoint qualified employees of the Veterans Health Administration to serve on the Special Committee.

“(2) The Special Committee shall assess, and carry out a continuing assessment of, the capacity of the Department to provide diagnostic and treatment services for PTSD to veterans eligible for health care furnished by the Department.

“(3) The Special Committee shall also advise the Under Secretary for Health regarding the development of policies, the provision of guidance, and the coordination of services for the diagnosis and treatment of PTSD (A) in designated PTSD programs, (B) in inpatient psychiatric programs and outpatient mental health programs other than designated PTSD programs, and (C) in readjustment counseling programs of the Department.

“(4) The Special Committee shall also make recommendations to the Under Secretary for Health for guidance with respect to PTSD regarding—

“(A) appropriate diagnostic and treatment methods;

“(B) referral for and coordination of followup care;

“(C) the evaluation of PTSD treatment programs;

“(D) the conduct of research concerning such diagnosis and treatment (taking into account the provisions of subsection (c));

“(E) special programs of education and training for employees of the Veterans Health Administration and the Veterans Benefits Administration (also taking into account such provisions);

“(F) the appropriate allocation of resources for all such activities; and

“(G) any specific steps that should be taken to improve such diagnosis and treatment and to correct any deficiencies in the operations of designated PTSD programs.

“(c) The Under Secretary for Health shall establish and operate in the Veterans Health Administration a National Center on Post-Traumatic-Stress Disorder. The National Center (1) shall carry out and promote the training of health care and related personnel in, and research into, the causes and diagnosis of PTSD and the treatment of veterans for PTSD, and (2) shall serve as a resource center for, and promote and seek to coordinate the exchange of information regarding, all research and training activities carried out by the Department, and by other Federal and non-Federal entities, with respect to PTSD.

“(d) The Under Secretary for Health shall regularly compile and publish the results of research that has been conducted relating to PTSD.

“(e)(1) Not later than March 1, 2000, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the implementation of this section. The report shall include the following:

“(A) A list of the members of the Special Committee.

“(B) A list of all designated PTSD programs and other programs providing treatment for PTSD, together with a description of the resources that have been allocated for the development and operation of each such program, a description of the education and training that has been provided for Department health-care personnel in such programs and elsewhere within the Department in the diagnosis and treatment of PTSD, and specification of the funding that has been allocated to each such program and elsewhere within the Department to support research relating to PTSD.

“(C) The assessment of the Under Secretary for Health of the Department, after consultation with the Special Committee, regarding the capability of the Department to meet the needs for inpatient and outpatient PTSD diagnosis and treatment (both through designated PTSD programs and otherwise) of veterans who served in the Republic of Vietnam during the Vietnam era, former prisoners of war, and other veterans eligible for health care from the Department and the efficacy of the treatment so provided, as well as a description of the results of any evaluations that have been made of PTSD treatment programs.

“(D) The plans of the Special Committee for further assessments of the capability of the Department to diagnose and treat veterans with PTSD.

“(E) The recommendations made by the Special Committee to the Under Secretary for Health and the views of the Under Secretary for Health on such recommendations.

“(F) A summary of the results of research conducted by the Department relating to PTSD.

“(G) A description of the steps taken, plans made (and a timetable for their execution), and resources to be applied to implement subsections (b) and (c).

“(H) The assessment of the Administrator [now Secretary] of the capacity of the Department to meet in all geographic areas of the United States the needs described in subparagraph (C) and any plans and timetable for increasing that capacity (including the costs of such action).

“(2) Not later than February 1, 2001, and May 1 of each year through 2012, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report containing information updating the reports submitted under this subsection since the enactment of the Veterans’ Millennium Health Care and Benefits Act [Nov. 30, 1999].”

Study of Post-Traumatic Stress Disorder and Other Post-War Psychological Problems

Section 102 of Pub. L. 98–160, as amended by Pub. L. 99–576, title II, §216, Oct. 28, 1986, 100 Stat. 3259, directed Administrator of Veterans’ Affairs to provide for the conducting of a comprehensive study of prevalence and incidence in population of Vietnam veterans of post-traumatic stress disorder and other psychological problems of readjusting to civilian life and effects of such problems on such veterans and directed Administrator to submit to Committees on Veterans’ Affairs of Senate and House of Representatives not later than Oct. 1, 1986, a report on results of study.

Readjustment Counseling and Related Mental Health Services for Veterans of War Declared After June 13, 1979

Section 103(b) of Pub. L. 96–22, as amended by Pub. L. 102–83, §§5(c)(2), 6(d), Aug. 6, 1991, 105 Stat. 406, 407, provided that: “In the event of a declaration of war by the Congress after June 13, 1979, the Secretary of Veterans Affairs, not later than six months after the date of such declaration, shall determine and recommend to the Congress whether eligibility for the readjustment counseling and related mental health services provided for in section 1712A [formerly 612A] of title 38, United States Code (as added by subsection (a) of this section) should be extended to the veterans of such war.”

§1712B. Counseling for former prisoners of war

The Secretary may establish a program under which, upon the request of a veteran who is a former prisoner of war, the Secretary, within the limits of Department facilities, furnishes counseling to such veteran to assist such veteran in overcoming the psychological effects of the veteran's detention or internment as a prisoner of war.

(Added Pub. L. 99–166, title I, §107(a), Dec. 3, 1985, 99 Stat. 945, §612B; renumbered §1712B and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.)

Amendments

1991—Pub. L. 102–83, §5(a), renumbered section 612B of this title as this section.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

[§1713. Renumbered §1781]

Prior Provisions

A prior section 1713 was renumbered section 3513 of this title.

§1714. Fitting and training in use of prosthetic appliances; guide dogs; service dogs

(a) Any veteran who is entitled to a prosthetic appliance shall be furnished such fitting and training, including institutional training, in the use of such appliance as may be necessary, whether in a Department facility or other training institution, or by outpatient treatment, including such service under contract, and including travel and incidental expenses (under the terms and conditions set forth in section 111 of this title) to and from such veteran's home to such hospital or training institution.

(b) The Secretary may provide guide dogs trained for the aid of the blind to veterans who are enrolled under section 1705 of this title. The Secretary may also provide such veterans with mechanical or electronic equipment for aiding them in overcoming the disability of blindness.

(c) The Secretary may, in accordance with the priority specified in section 1705 of this title, provide—

(1) service dogs trained for the aid of the hearing impaired to veterans who are hearing impaired and are enrolled under section 1705 of this title;

(2) service dogs trained for the aid of persons with spinal cord injury or dysfunction or other chronic impairment that substantially limits mobility to veterans with such injury, dysfunction, or impairment who are enrolled under section 1705 of this title; and

(3) service dogs trained for the aid of persons with mental illnesses, including post-traumatic stress disorder, to veterans with such illnesses who are enrolled under section 1705 of this title.


(d) In the case of a veteran provided a dog under subsection (b) or (c), the Secretary may pay travel and incidental expenses for that veteran under the terms and conditions set forth in section 111 of this title to and from the veteran's home for expenses incurred in becoming adjusted to the dog.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1143, §614; Pub. L. 93–82, title I, §103(b), Aug. 2, 1973, 87 Stat. 181; Pub. L. 94–581, title II, §210(a)(5), Oct. 21, 1976, 90 Stat. 2862; Pub. L. 96–151, title II, §201(c), Dec. 20, 1979, 93 Stat. 1093; renumbered §1714 and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 107–135, title II, §201(a), (b)(1), Jan. 23, 2002, 115 Stat. 2456, 2457; Pub. L. 111–117, div. E, title II, §229, Dec. 16, 2009, 123 Stat. 3307.)

Prior Provisions

Prior section 1714 was renumbered section 3514 of this title.

Provisions similar to those comprising subsec. (a) of this section were classified to section 613 of this title prior to repeal by section 103(b) of Pub. L. 93–82.

Amendments

2009—Subsec. (c)(3). Pub. L. 111–117 added par. (3).

2002—Pub. L. 107–135, §201(b)(1), substituted “guide dogs; service dogs” for “seeing-eye dogs” in section catchline.

Subsec. (b). Pub. L. 107–135, §201(a)(1), struck out “seeing-eye or” after “may provide”, substituted “who are enrolled under section 1705 of this title” for “who are entitled to disability compensation, and may pay travel and incidental expenses (under the terms and conditions set forth in section 111 of this title) to and from their homes and incurred in becoming adjusted to such seeing-eye or guide dogs”, and substituted “disability” for “handicap”.

Subsecs. (c), (d). Pub. L. 107–135, §201(a)(2), added subsecs. (c) and (d).

1991—Pub. L. 102–83, §5(a), renumbered section 614 of this title as this section.

Subsec. (a). Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Subsec. (b). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

1979—Subsec. (a). Pub. L. 96–151, §201(c)(1), substituted provisions respecting travel and incidental expenses for provisions respecting necessary travel expenses.

Subsec. (b). Pub. L. 96–151, §201(c)(2), substituted provisions respecting travel and incidental expenses for provisions respecting all necessary travel expenses.

1976—Subsec. (a). Pub. L. 94–581, §210(a)(5)(A), substituted “such veteran's home” for “his home”.

Subsec. (b). Pub. L. 94–581, §210(a)(5)(B), substituted “and may pay” for “and he may pay”.

1973—Pub. L. 93–82 designated existing provisions as subsec. (b) and added subsec. (a).

Effective Date of 1979 Amendment

Amendment by Pub. L. 96–151 effective Jan. 1, 1980, see section 206 of Pub. L. 96–151, set out as a note under section 111 of this title.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Effective Date

Section effective Sept. 1, 1973, see section 501 of Pub. L. 93–82, set out as an Effective Date of 1973 Amendment note under section 1701 of this title.

§1715. Tobacco for hospitalized veterans

The Secretary may furnish tobacco to veterans receiving hospital or domiciliary care.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1143, §615; renumbered §1715 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.)

Amendments

1991—Pub. L. 102–83, §5(a), renumbered section 615 of this title as this section.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Use of Tobacco Products in Department of Veterans Affairs Facilities

Pub. L. 102–585, title V, §526, Nov. 4, 1992, 106 Stat. 4961, provided that:

“(a) In General.—The Secretary of Veterans Affairs shall take appropriate actions to ensure that, consistent with medical requirements and limitations, each facility of the Department described in subsection (b)—

“(1) establishes and maintains—

“(A) a suitable indoor area in which patients or residents may smoke and which is ventilated in a manner that, to the maximum extent feasible, prevents smoke from entering other areas of the facility; or

“(B) an area in a building that—

“(i) is detached from the facility;

“(ii) is accessible to patients or residents of the facility; and

“(iii) has appropriate heating and air conditioning; and

“(2) provides access to an area established and maintained under paragraph (1), consistent with medical requirements and limitations, for patients or residents of the facility who are receiving care or services and who desire to smoke tobacco products.

“(b) Covered Facilities.—A Department facility referred to in subsection (a) is any Department of Veterans Affairs medical center, nursing home, or domiciliary care facility.

“(c) Reports.—(1) Not later than 180 days after the date of the enactment of this Act [Nov. 4, 1992], the Comptroller General shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the feasibility of the establishment and maintenance of areas for smoking in Department facilities under this section. The report shall include information on—

“(A) the cost of, and a proposed schedule for, the establishment of such an area at each Department facility covered by this section;

“(B) the extent to which the ventilating system of each facility is adequate to ensure that use of the area for smoking does not result in health problems for other patients or residents of the facility; and

“(C) the effect of the establishment and maintenance of an area for smoking in each facility on the accreditation score issued for the facility by the Joint Commission on the Accreditation of Health Organizations.

“(2) Not later than 120 days after the effective date of this section, the Secretary shall submit to the committees referred to in paragraph (1) a report on the implementation of this section. The report shall include a description of the actions taken at each covered facility to ensure compliance with this section.

“(d) Effective Date.—The requirement to establish and maintain areas for smoking under subsection (a) shall take effect 60 days after the date on which the Comptroller General submits to the committees referred to in subsection (c)(1) that report required under that subsection.”

§1716. Hospital care by other agencies of the United States

When so specified in an appropriation or other Act, the Secretary may make allotments and transfers to the Departments of Health and Human Services (Public Health Service), the Army, Navy, Air Force, or Interior, for disbursement by them under the various headings of their appropriations, of such amounts as are necessary for the care and treatment of veterans entitled to hospitalization from the Department under this chapter. The amounts to be charged the Department for care and treatment of veterans in hospitals shall be calculated on the basis of a per diem rate approved by the Office of Management and Budget.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1143, §616; Pub. L. 94–581, title II, §202(g), Oct. 21, 1976, 90 Stat. 2856; Pub. L. 97–295, §4(95)(A), Oct. 12, 1982, 96 Stat. 1313; renumbered §1716 and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.)

Amendments

1991—Pub. L. 102–83, §5(a), renumbered section 616 of this title as this section.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in two places.

1982—Pub. L. 97–295 substituted “Health and Human Services” for “Health, Education, and Welfare”.

1976—Pub. L. 94–581 substituted “Office of Management and Budget” for “Bureau of the Budget”.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

§1717. Home health services; invalid lifts and other devices

(a)(1) As part of medical services furnished to a veteran under section 1710(a) of this title, the Secretary may furnish such home health services as the Secretary finds to be necessary or appropriate for the effective and economical treatment of the veteran.

(2) Improvements and structural alterations may be furnished as part of such home health services only as necessary to assure the continuation of treatment for the veteran's disability or to provide access to the home or to essential lavatory and sanitary facilities. The cost of such improvements and structural alterations (or the amount of reimbursement therefor) under this subsection may not exceed—

(A) in the case of medical services furnished under section 1710(a)(1) of this title, or for a disability described in section 1710(a)(2)(C) of this title—

(i) in the case of a veteran who first applies for benefits under this paragraph before May 5, 2010, $4,100; or

(ii) in the case of a veteran who first applies for benefits under this paragraph on or after May 5, 2010, $6,800; and


(B) in the case of medical services furnished under any other provision of section 1710(a) of this title—

(i) in the case of a veteran who first applies for benefits under this paragraph before May 5, 2010, $1,200; or

(ii) in the case of a veteran who first applies for benefits under this paragraph on or after May 5, 2010, $2,000.


(3) The Secretary may furnish home health services to a veteran in any setting in which the veteran is residing. The Secretary may not furnish such services in such a manner as to relieve any other person or entity of a contractual obligation to furnish services to the veteran. When home health services are furnished in a setting other than the veteran's home, such services may not include any structural improvement or alteration.

(b) The Secretary may furnish an invalid lift, or any type of therapeutic or rehabilitative device, as well as other medical equipment and supplies (excluding medicines), if medically indicated, to any veteran who is receiving (1) compensation under section 1114(l)–(p) of this title (or the comparable rates provided pursuant to section 1134 of this title), or (2) pension under chapter 15 of this title by reason of being in need of regular aid and attendance.

(c) The Secretary may furnish devices for assisting in overcoming the handicap of deafness (including telecaptioning television decoders) to any veteran who is profoundly deaf and is entitled to compensation on account of hearing impairment.

(d)(1) In the case of a member of the Armed Forces who, as determined by the Secretary, has a disability permanent in nature incurred or aggravated in the line of duty in the active military, naval, or air service, the Secretary may furnish improvements and structural alterations for such member for such disability or as otherwise described in subsection (a)(2) while such member is hospitalized or receiving outpatient medical care, services, or treatment for such disability if the Secretary determines that such member is likely to be discharged or released from the Armed Forces for such disability.

(2) The furnishing of improvements and alterations under paragraph (1) in connection with the furnishing of medical services described in subparagraph (A) or (B) of subsection (a)(2) shall be subject to the limitation specified in the applicable subparagraph.

(Added Pub. L. 86–211, §5, Aug. 29, 1959, 73 Stat. 435, §617; amended Pub. L. 88–450, §6(a), (c), Aug. 19, 1964, 78 Stat. 504; Pub. L. 90–77, title I, §109, Aug. 31, 1967, 81 Stat. 180; Pub. L. 90–493, §3(a), Aug. 19, 1968, 82 Stat. 809; Pub. L. 97–295, §4(18), Oct. 12, 1982, 96 Stat. 1306; Pub. L. 98–528, title I, §107, Oct. 19, 1984, 98 Stat. 2690; Pub. L. 99–576, title II, §202(2), Oct. 28, 1986, 100 Stat. 3254; Pub. L. 100–322, title I, §101(d), May 20, 1988, 102 Stat. 491; renumbered §1717 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–405, title I, §101(a), Oct. 9, 1992, 106 Stat. 1973; Pub. L. 104–262, title I, §101(d)(6), Oct. 9, 1996, 110 Stat. 3180; Pub. L. 105–114, title IV, §402(b), Nov. 21, 1997, 111 Stat. 2294; Pub. L. 110–289, div. B, title VI, §2601, July 30, 2008, 122 Stat. 2858; Pub. L. 111–163, title V, §516(a), May 5, 2010, 124 Stat. 1166; Pub. L. 111–275, title X, §1001(c)(1), Oct. 13, 2010, 124 Stat. 2896.)

Amendments

2010—Subsec. (a)(2)(A), (B). Pub. L. 111–275 substituted “May 5, 2010” for “the date of the Caregivers and Veterans Omnibus Health Services Act of 2010” wherever appearing.

Pub. L. 111–163 added subpars. (A) and (B) and struck out former subpars. (A) and (B) which read as follows:

“(A) $4,100 in the case of medical services furnished under section 1710(a)(1) of this title, or for a disability described in section 1710(a)(2)(C) of this title; or

“(B) $1,200 in the case of medical services furnished under any other provision of section 1710(a) of this title.”

2008—Subsec. (d). Pub. L. 110–289 added subsec. (d).

1997—Subsec. (a)(1). Pub. L. 105–114, §402(b)(1), substituted “treatment of the veteran” for “treatment of the veteran's disability”.

Subsec. (a)(2)(B). Pub. L. 105–114, §402(b)(2), substituted “section 1710(a)” for “section 1710(a)(2)”.

1996—Subsec. (a)(1). Pub. L. 104–262, §101(d)(6)(A), substituted “section 1710(a)” for “section 1712(a)”.

Subsec. (a)(2)(A). Pub. L. 104–262, §101(d)(6)(B)(i), substituted “section 1710(a)(1) of this title, or for a disability described in section 1710(a)(2)(C) of this title” for “paragraph (1) of section 1712(a) of this title”.

Subsec. (a)(2)(B). Pub. L. 104–262, §101(d)(6)(B)(ii), substituted “section 1710(a)(2)” for “section 1712”.

1992—Subsec. (a)(2). Pub. L. 102–405 substituted “$4,100” for “$2,500” in subpar. (A) and “$1,200” for “$600” in subpar. (B).

1991—Pub. L. 102–83, §5(a), renumbered section 617 of this title as this section.

Subsec. (a). Pub. L. 102–83, §5(c)(1), substituted “1712(a)” for “612(a)” in pars. (1) and (2)(A) and “1712” for “612” in par. (2)(B).

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing in pars. (1) and (3).

Subsec. (b). Pub. L. 102–83, §5(c)(1), substituted “1114(l)–(p)” for “314(l)–(p)” and “1134” for “334”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Subsec. (c). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

1988—Pub. L. 100–322, §101(d)(3), substituted “Home health services; invalid” for “Invalid” in section catchline.

Subsec. (a). Pub. L. 100–322, §101(d)(1)(B), added subsec. (a). Former subsec. (a) redesignated (b).

Subsec. (a)(3). Pub. L. 100–322, §101(d)(2), transferred subsec. (k) of section 612 of this title to subsec. (a) of this section and redesignated it as par. (3).

Subsecs. (b), (c). Pub. L. 100–322, §101(d)(1)(A), redesignated subsecs. (a) and (b) as (b) and (c), respectively.

1986—Subsec. (a)(3) [formerly §612(k)]. Pub. L. 99–576 added subsec. (k). See 1988 Amendment note above.

1984—Pub. L. 98–528 designated existing provision as subsec. (a) and added subsec. (b).

1982—Pub. L. 97–295 substituted “section 314(l)–(p) of this title (or the comparable rates provided pursuant to section 334 of this title)” for “subsections 314(l)–(p) (or the comparable rates provided pursuant to section 334) of this title”.

1968—Pub. L. 90–493 substituted “Invalid lifts and other devices” for “Invalid lifts and other devices for pensioners” in section catchline, and inserted provisions authorizing the Administrator to furnish lifts and other devices to any veteran who is receiving compensation under subsections 314(l)–(p) (or the comparable rates provided pursuant to section 334) of this title.

1967—Subsec. (b). Pub. L. 90–77 substituted “to any veteran in receipt of pension under chapter 15 of this title based on need of regular aid and attendance” for “to any veteran who is eligible to receive an invalid lift under subsection (a) of this section, or who would be so eligible, but for the fact that he has such a lift”.

1964—Pub. L. 88–450 inserted “and other devices” in section catchline, designated existing provisions of section as subsec. (a), and added subsec. (b).

Effective Date of 1992 Amendment

Section 101(b) of Pub. L. 102–405 provided that: “The amendments made by subsection (a) [amending this section] shall apply with respect to a veteran who first applies for benefits under section 1717(a)(2) of title 38, United States Code, after December 31, 1989.”

Effective Date of 1988 Amendment

Amendment by Pub. L. 100–322 applicable with respect to furnishing of medical services to veterans who apply for such services after June 30, 1988, see section 101(i) of Pub. L. 100–322, set out as a note under section 1703 of this title.

Effective Date of 1967 Amendment

Amendment by Pub. L. 90–77 effective first day of first calendar month which begins more than ten days after Aug. 31, 1967, see section 405 of Pub. L. 90–77, set out as a note under section 101 of this title.

Effective Date

Section effective July 1, 1960, see section 10 of Pub. L. 86–211, set out as an Effective Date of 1959 Amendment note under section 1521 of this title.

Applicability of Increase in Grant Limits

Pub. L. 111–163, title V, §516(b), May 5, 2010, 124 Stat. 1167, provided that: “A veteran who exhausts such veteran's eligibility for benefits under section 1717(a)(2) of such title [probably means 38 U.S.C. 1717(a)(2)] before the date of the enactment of this Act [May 5, 2010], is not entitled to additional benefits under such section by reason of the amendments made by subsection (a) [amending this section].”

Section 101(c) of Pub. L. 102–405 provided that: “A veteran who exhausts such veteran's eligibility for benefits under section 1717(a)(2) of title 38, United States Code, before January 1, 1990, is not entitled to additional benefits under such section by reason of the amendments made by subsection (a) [amending this section].”

§1718. Therapeutic and rehabilitative activities

(a) In providing rehabilitative services under this chapter, the Secretary, upon the recommendation of the Under Secretary for Health, may use the services of patients and members in Department health care facilities for therapeutic and rehabilitative purposes. Such patients and members shall not under these circumstances be held or considered as employees of the United States for any purpose. The Secretary shall prescribe the conditions for the use of such services.

(b)(1) In furnishing rehabilitative services under this chapter, the Secretary, upon the recommendation of the Under Secretary for Health, may enter into a contract or other arrangement with any appropriate source (whether or not an element of the Department of Veterans Affairs or of any other Federal entity) to provide for therapeutic work for patients and members in Department health care facilities.

(2) Notwithstanding any other provision of law, the Secretary may also furnish rehabilitative services under this subsection through contractual arrangements with nonprofit entities to provide for such therapeutic work for such patients. The Secretary shall establish appropriate fiscal, accounting, management, recordkeeping, and reporting requirements with respect to the activities of any such nonprofit entity in connection with such contractual arrangements.

(c)(1) There is hereby established in the Treasury of the United States a revolving fund known as the Department of Veterans Affairs Special Therapeutic and Rehabilitation Activities Fund (hereinafter in this section referred to as the “fund”) for the purpose of furnishing rehabilitative services authorized in subsection (b) or (d). Such amounts of the fund as the Secretary may determine to be necessary to establish and maintain operating accounts for the various rehabilitative services activities may be deposited in checking accounts in other depositaries selected or established by the Secretary.

(2) All funds received by the Department under contractual arrangements made under subsection (b) or (d), or by nonprofit entities described in subsection (b)(2), shall be deposited in or credited to the fund, and the Secretary shall distribute out of the fund moneys to participants at rates not less than the wage rates specified in the Fair Labor Standards Act of 1938 (29 U.S.C. 201 et seq.) and regulations prescribed thereunder for work of similar character.

(3) The Under Secretary for Health shall prepare, for inclusion in the annual report submitted to Congress under section 529 of this title, a description of the scope and achievements of activities carried out under this section (including pertinent data regarding productivity and rates of distribution) during the prior twelve months and an estimate of the needs of the program of therapeutic and rehabilitation activities to be carried out under this section for the ensuing fiscal year.

(d) In providing to a veteran rehabilitative services under this chapter, the Secretary may furnish the veteran with the following:

(1) Work skills training and development services.

(2) Employment support services.

(3) Job development and placement services.


(e) In providing rehabilitative services under this chapter, the Secretary shall take appropriate action to make it possible for the patient to take maximum advantage of any benefits to which such patient is entitled under chapter 31, 34, or 35 of this title, and, if the patient is still receiving treatment of a prolonged nature under this chapter, the provision of rehabilitative services under this chapter shall be continued during, and coordinated with, the pursuit of education and training under such chapter 31, 34, or 35.

(f) The Secretary shall prescribe regulations to ensure that the priorities set forth in section 1705 of this title shall be applied, insofar as practicable, to participation in therapeutic and rehabilitation activities carried out under this section.

(g)(1) The Secretary may not consider any of the matters stated in paragraph (2) as a basis for the denial or discontinuance of a rating of total disability for purposes of compensation or pension based on the veteran's inability to secure or follow a substantially gainful occupation as a result of disability.

(2) Paragraph (1) applies to the following:

(A) A veteran's participation in an activity carried out under this section.

(B) A veteran's receipt of a distribution as a result of participation in an activity carried out under this section.

(C) A veteran's participation in a program of rehabilitative services that (i) is provided as part of the veteran's care furnished by a State home and (ii) is approved by the Secretary as conforming appropriately to standards for activities carried out under this section.

(D) A veteran's receipt of payment as a result of participation in a program described in subparagraph (C).


(3) A distribution of funds made under this section and a payment made to a veteran under a program of rehabilitative services described in paragraph (2)(C) shall be considered for the purposes of chapter 15 of this title to be a donation from a public or private relief or welfare organization.

(Added Pub. L. 87–574, §2(1), Aug. 6, 1962, 76 Stat. 308, §618; amended Pub. L. 94–581, title I, §105(a), Oct. 21, 1976, 90 Stat. 2845; Pub. L. 98–543, title III, §303, Oct. 24, 1984, 98 Stat. 2748; Pub. L. 99–576, title II, §205, Oct. 28, 1986, 100 Stat. 3256; Pub. L. 102–54, §§10, 14(b)(12), June 13, 1991, 105 Stat. 273, 284; renumbered §1718 and amended Pub. L. 102–83, §§2(c)(3), 4(a)(3), (4), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 402, 404–406; Pub. L. 102–86, title V, §506(a)(1), Aug. 14, 1991, 105 Stat. 426; Pub. L. 102–405, title III, §302(c)(1), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 102–585, title IV, §401, Nov. 4, 1992, 106 Stat. 4953; Pub. L. 103–446, title XII, §1201(i)(1), Nov. 2, 1994, 108 Stat. 4688; Pub. L. 104–262, title I, §101(d)(7), Oct. 9, 1996, 110 Stat. 3180; Pub. L. 108–170, title I, §104(b), Dec. 6, 2003, 117 Stat. 2045; Pub. L. 109–444, §8(a)(1), Dec. 21, 2006, 120 Stat. 3313; Pub. L. 109–461, title X, §§1004(a)(1), 1006(b), Dec. 22, 2006, 120 Stat. 3465, 3468.)

References in Text

The Fair Labor Standards Act of 1938, referred to in subsec. (c)(2), is act June 25, 1938, ch. 676, 52 Stat. 1060, as amended, which is classified generally to chapter 8 (§201 et seq.) of Title 29, Labor. For complete classification of this Act to the Code, see section 201 of Title 29 and Tables.

Amendments

2006—Subsec. (c)(2). Pub. L. 109–461, §1006(b), provided that as of the enactment of Pub. L. 109–461, the amendments made by Pub. L. 109–444 were deemed for all purposes not to have taken effect and that Pub. L. 109–444 ceased to be in effect. See Amendment notes below and section 1006(b) of Pub. L. 109–461, set out as a Coordination of Provisions With Pub. L. 109–444 note under section 101 of this title.

Pub. L. 109–461, §1004(a)(1), inserted “of 1938” after “Act”.

Pub. L. 109–444, which inserted “of 1938” after “Act”, was terminated by Pub. L. 109–461, §1006(b). See Amendment notes above.

2003—Subsec. (c)(1). Pub. L. 108–170, §104(b)(2)(A), substituted “subsection (b) or (d)” for “subsection (b) of this section”.

Subsec. (c)(2). Pub. L. 108–170, §104(b)(2)(B), substituted “subsection (b) or (d)” for “subsection (b) of this section” and “subsection (b)(2)” for “paragraph (2) of such subsection”.

Subsecs. (d) to (g). Pub. L. 108–170, §104(b)(1), added subsec. (d) and redesignated former subsecs. (d) to (f) as (e) to (g), respectively.

1996—Subsec. (e). Pub. L. 104–262 substituted “section 1705” for “section 1712(i)”.

1994—Subsec. (c)(1). Pub. L. 103–446 substituted “Department of Veterans Affairs” for “Department”.

1992—Subsecs. (a), (b)(1), (c)(3). Pub. L. 102–405 substituted “Under Secretary for Health” for “Chief Medical Director”.

Subsec. (f). Pub. L. 102–585 amended subsec. (f) generally. Prior to amendment, subsec. (f) read as follows:

“(1) Neither a veteran's participation in an activity carried out under this section nor a veteran's receipt of a distribution as a result of such participation may be considered as a basis for the denial or discontinuance of a rating of total disability for purposes of compensation or pension based on the veteran's inability to secure or follow a substantially gainful occupation as a result of disability.

“(2) A distribution of funds made under this section shall be considered for purposes of chapter 15 of this title to be a donation from a public or private relief or welfare organization.”

1991—Pub. L. 102–83, §5(a), renumbered section 618 of this title as this section.

Subsec. (a). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Subsec. (b)(1). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Pub. L. 102–54, §10(a), substituted “a contract or other arrangement with any appropriate source (whether or not an element of the Department of Veterans Affairs or of any other Federal entity)” for “contractual arrangements with private industry or other sources outside the Veterans’ Administration”.

Subsec. (b)(2). Pub. L. 102–86 amended subsec. (b)(2) of this section as in effect before the redesignations made by Pub. L. 102–83, §5, by substituting “arrangements” for “arangements” in first sentence.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

Subsec. (c)(1). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Pub. L. 102–54, §10(b), substituted “furnishing rehabilitative services authorized in” for “carrying out the provisions of”.

Subsec. (c)(2). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Subsec. (c)(3). Pub. L. 102–83, §2(c)(3), substituted “section 529” for “section 214”.

Pub. L. 102–54, §14(b)(12), inserted “and” after “productivity”.

Subsec. (d). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Subsec. (e). Pub. L. 102–83, §5(c)(1), substituted “1712(i)” for “612(i)”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

1986—Subsec. (a). Pub. L. 99–576, §205(1), substituted “may use” for “may utilize”, “purposes. Such” for “purposes, at nominal remuneration, and such”, and “use” for “utilization”.

Subsec. (b)(1). Pub. L. 99–576, §205(2), struck out “for remuneration” after “therapeutic work”.

Subsec. (c)(2), (3). Pub. L. 99–576, §205(3), substituted “distribute” for “pay” in par. (2), and substituted “rates of distribution” for “and wage rates” in par. (3).

Subsec. (f). Pub. L. 99–576, §205(4), designated existing provisions as par. (1), substituted “a distribution” for “remuneration”, and added par. (2).

1984—Subsec. (f). Pub. L. 98–543 added subsec. (f).

1976—Subsec. (a). Pub. L. 94–581, §105(a)(1), (2), designated existing provisions as subsec. (a) and substituted “In providing rehabilitative services under this chapter, the” for “The” and “health care facilities” for “hospitals and domiciliaries”.

Subsecs. (b) to (e). Pub. L. 94–581, §105(a)(3), added subsecs. (b) to (e).

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Demonstration Program of Compensated Work Therapy and Therapeutic Transitional Housing

Section 7 of Pub. L. 102–54, as amended by Pub. L. 102–83, §5(c)(2), Aug. 6, 1991, 105 Stat. 406; Pub. L. 102–86, title V, §501, Aug. 14, 1991, 105 Stat. 424; Pub. L. 103–452, title I, §103(f), Nov. 2, 1994, 108 Stat. 4787; Pub. L. 104–110, title I, §102(b), Feb. 13, 1996, 110 Stat. 769, authorized Secretary of Veterans’ Affairs, between Oct. 1, 1991, and Dec. 31, 1997, to carry out compensated work therapy and therapeutic transitional housing demonstration program, prior to repeal by Pub. L. 105–114, title II, §202(c)(1), Nov. 21, 1997, 111 Stat. 2287.

Settlement of Claims

Section 105(b) of Pub. L. 94–581, as amended by Pub. L. 97–258, §4(b), Sept. 13, 1982, 96 Stat. 1067; Pub. L. 102–83, §6(a), Aug. 6, 1991, 105 Stat. 407, provided that:

“(1) The Secretary of Veterans Affairs may settle claims made by the Department of Veterans Affairs against any private nonprofit corporation organized under the laws of any State, for the use of facilities and personnel of the Department in work projects as a part of a therapeutic or rehabilitation program for patients and members in health care facilities of the Department, and to execute a binding release of all claims by the United States against any such corporation, in such amounts, and upon such terms and conditions as the Secretary considers appropriate.

“(2) For the purposes of this subsection, notwithstanding section 3302 of title 31, or any other provision of law, the Secretary may utilize any funds received under any settlement made pursuant to paragraph (1) of this subsection for any purpose agreed upon by the Secretary and such corporation.”

§1719. Repair or replacement of certain prosthetic and other appliances

The Secretary may repair or replace any artificial limb, truss, brace, hearing aid, spectacles, or similar appliance (not including dental appliances) reasonably necessary to a veteran and belonging to such veteran which was damaged or destroyed by a fall or other accident caused by a service-connected disability for which such veteran is in receipt of, or but for the receipt of retirement pay would be entitled to, disability compensation.

(Added Pub. L. 87–850, §1(a), Oct. 23, 1962, 76 Stat. 1126, §619; amended Pub. L. 94–581, title II, §210(a)(6), Oct. 21, 1976, 90 Stat. 2862; renumbered §1719 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.)

Amendments

1991—Pub. L. 102–83, §5(a), renumbered section 619 of this title as this section.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

1976—Pub. L. 94–581 substituted “belonging to such veteran” for “belonging to him”.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Effective Date

Section 2 of Pub. L. 87–850 provided that: “The amendment made by this Act [enacting this section] shall apply only with respect to the repair or replacement of artificial limbs, trusses, braces, hearing aids, spectacles, and similar devices damaged or destroyed after the date of enactment of this Act [Oct. 23, 1962].”

§1720. Transfers for nursing home care; adult day health care

(a)(1) Subject to subsection (b) of this section, the Secretary may transfer to a non-Department nursing home, for care at the expense of the United States—

(A) a veteran—

(i) who has been furnished care by the Secretary in a facility under the direct jurisdiction of the Secretary; and

(ii) who the Secretary determines—

(I) requires a protracted period of nursing home care which can be furnished in the non-Department nursing home; and

(II) in the case of a veteran who has been furnished hospital care in a facility under the direct jurisdiction of the Secretary, has received maximum benefits from such care; and


(B) a member of the Armed Forces—

(i) who has been furnished care in a hospital of the Armed Forces;

(ii) who the Secretary concerned determines has received maximum benefits from such care but requires a protracted period of nursing home care; and

(iii) who upon discharge from the Armed Forces will become a veteran.


(2) The Secretary may transfer a person to a nursing home under this subsection only if the Secretary determines that the cost to the United States of the care of such person in the nursing home will not exceed—

(A) the amount equal to 45 percent of the cost of care furnished by the Department in a general hospital under the direct jurisdiction of the Secretary (as such cost may be determined annually by the Secretary); or

(B) the amount equal to 50 percent of such cost, if such higher amount is determined to be necessary by the Secretary (upon the recommendation of the Under Secretary for Health) to provide adequate care.


(3) Nursing home care may not be furnished under this subsection at the expense of the United States for more than six months in the aggregate in connection with any one transfer except—

(A) in the case of a veteran—

(i) who is transferred to a non-Department nursing home from a hospital under the direct jurisdiction of the Secretary; and

(ii) whose hospitalization was primarily for a service-connected disability;


(B) in a case in which the nursing home care is required for a service-connected disability; or

(C) in a case in which, in the judgment of the Secretary, a longer period of nursing home care is warranted.


(4) A veteran who is furnished care by the Secretary in a hospital or domiciliary facility in Alaska or Hawaii may be furnished nursing home care at the expense of the United States under this subsection even if such hospital or domiciliary facility is not under the direct jurisdiction of the Secretary.

(b) No veteran may be transferred or admitted to any institution for nursing home care under this section, unless such institution is determined by the Secretary to meet such standards as the Secretary may prescribe. The standards prescribed and any report of inspection of institutions furnishing care to veterans under this section made by or for the Secretary shall, to the extent possible, be made available to all Federal, State, and local agencies charged with the responsibility of licensing or otherwise regulating or inspecting such institutions.

(c)(1)(A) In furnishing nursing home care, adult day health care, or other extended care services under this section, the Secretary may enter into agreements for furnishing such care or services with—

(i) in the case of the medicare program, a provider of services that has entered into a provider agreement under section 1866(a) of the Social Security Act (42 U.S.C. 1395cc(a)); and

(ii) in the case of the medicaid program, a provider participating under a State plan under title XIX of such Act (42 U.S.C. 1396 et seq.).


(B) In entering into an agreement under subparagraph (A) with a provider of services described in clause (i) of that subparagraph or a provider described in clause (ii) of that subparagraph, the Secretary may use the procedures available for entering into provider agreements under section 1866(a) of the Social Security Act.

(2) In applying the provisions of section 6704(a) of title 41 with respect to any contract entered into under this section to provide nursing home care of veterans, the payment of wages not less than those specified in section 6(b) of the Fair Labor Standards Act of 1938 (29 U.S.C. 206(b)) shall be deemed to constitute compliance with such provisions.

(d)(1) Subject to subsection (b) of this section, the Secretary may authorize for any veteran requiring nursing home care for a service-connected disability direct admission for such care at the expense of the United States to any non-Department nursing home. The Secretary may also authorize a direct admission to such a nursing home for nursing home care for any veteran who has been discharged from a hospital under the direct jurisdiction of the Secretary and who is currently receiving medical services as part of home health services from the Department.

(2) Direct admission authorized by paragraph (1) of this subsection may be authorized upon determination of need therefor—

(A) by a physician employed by the Department; or

(B) in areas where no such physician is available, by a physician carrying out such function under contract or fee arrangement,


based on an examination by such physician.

(3) The amount which may be paid for such care and the length of care available under this subsection shall be the same as authorized under subsection (a) of this section.

(e)(1) The cost of intermediate care for purposes of payment by the United States pursuant to subsection (a)(2)(B) of this section shall be determined by the Secretary except that the rate of reimbursement shall be commensurately less than that provided for nursing home care.

(2) For the purposes of this section, the term “non-Department nursing home” means a public or private institution not under the direct jurisdiction of the Secretary which furnishes nursing home care.

(f)(1)(A) The Secretary may furnish adult day health care services to a veteran enrolled under section 1705(a) of this title who would otherwise require nursing home care.

(B) The Secretary may provide in-kind assistance (through the services of Department employees and the sharing of other Department resources) to a facility furnishing care to veterans under subparagraph (A) of this paragraph. Any such in-kind assistance shall be provided under a contract or agreement between the Secretary and the facility concerned. The Secretary may provide such assistance only for use solely in the furnishing of adult day health care and only if, under such contract or agreement, the Department receives reimbursement for the full cost of such assistance, including the cost of services and supplies and normal depreciation and amortization of equipment. Such reimbursement may be made by reduction in the charges to the United States or by payment to the United States. Any funds received through such reimbursement shall be credited to funds allotted to the Department facility that provided the assistance.

(2) The Secretary may conduct, at facilities over which the Secretary has direct jurisdiction, programs for the furnishing of adult day health care to veterans who are eligible for such care under paragraph (1) of this subsection, except that necessary travel and incidental expenses (or transportation in lieu thereof) may be furnished under such a program only under the terms and conditions set forth in section 111 of this title. The furnishing of care under any such program shall be subject to the limitations that are applicable to the duration of adult day health care furnished under paragraph (1) of this subsection.

(g) The Secretary may contract with appropriate entities to provide specialized residential care and rehabilitation services to a veteran of Operation Enduring Freedom or Operation Iraqi Freedom who the Secretary determines suffers from a traumatic brain injury, has an accumulation of deficits in activities of daily living and instrumental activities of daily living, and because of these deficits, would otherwise require admission to a nursing home even though such care would generally exceed the veteran's nursing needs.

(Added Pub. L. 88–450, §2(a), Aug. 19, 1964, 78 Stat. 500, §620; amended Pub. L. 90–429, July 26, 1968, 82 Stat. 446; Pub. L. 90–612, §§1, 3, Oct. 21, 1968, 82 Stat. 1202; Pub. L. 91–101, Oct. 30, 1969, 83 Stat. 167; Pub. L. 93–82, title I, §104, Aug. 2, 1973, 87 Stat. 182; Pub. L. 94–581, title I, §106, title II, §§202(h), 210(a)(7), Oct. 21, 1976, 90 Stat. 2847, 2856, 2863; Pub. L. 97–295, §4(19), Oct. 12, 1982, 96 Stat. 1306; Pub. L. 98–160, title I, §103(a)(1), (2), Nov. 21, 1983, 97 Stat. 995; Pub. L. 99–166, title I, §108(a)–(c), Dec. 3, 1985, 99 Stat. 946, 947; Pub. L. 99–272, title XIX, §19011(d)(5), Apr. 7, 1986, 100 Stat. 379; Pub. L. 100–322, title I, §§103(b), 111(a), May 20, 1988, 102 Stat. 493, 499; renumbered §1720 and amended Pub. L. 102–83, §§4(a)(2)(A)(ii), (3)–(5), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 403–406; Pub. L. 102–405, title III, §302(c)(1), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 104–262, title I, §101(d)(8), Oct. 9, 1996, 110 Stat. 3180; Pub. L. 105–114, title IV, §402(c), Nov. 21, 1997, 111 Stat. 2294; Pub. L. 106–117, title I, §101(d), Nov. 30, 1999, 113 Stat. 1549; Pub. L. 108–170, title I, §105, Dec. 6, 2003, 117 Stat. 2045; Pub. L. 111–163, title V, §507, May 5, 2010, 124 Stat. 1161; Pub. L. 111–350, §5(j)(1), Jan. 4, 2011, 124 Stat. 3850.)

References in Text

The Social Security Act, referred to in subsec. (c)(1)(A)(ii), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XIX of the Act is classified generally to subchapter XIX (§1396 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.

Prior Provisions

Prior section 1720 was renumbered section 3520 of this title.

Amendments

2011—Subsec. (c)(2). Pub. L. 111–350 substituted “section 6704(a) of title 41” for “section 2(b)(1) of the Service Contract Act of 1965 (41 U.S.C. 351(b)(1))”.

2010—Subsec. (g). Pub. L. 111–163 added subsec. (g).

2003—Subsec. (c). Pub. L. 108–170, §105(a), designated existing provisions as par. (2) and added par. (1).

Subsec. (f)(1)(B). Pub. L. 108–170, §105(b), inserted “or agreement” after “contract” in two places.

1999—Subsec. (f)(1)(A). Pub. L. 106–117 amended subpar. (A) generally. Prior to amendment, subpar. (A) read as follows: “The Secretary is authorized to furnish adult day health care as provided for in this subsection. For the purpose only of authorizing the furnishing of such care and specifying the terms and conditions under which it may be furnished to veterans needing such care—

“(i) references to ‘nursing home care’ in subsections (a) through (d) of this section shall be deemed to be references to ‘adult day health care’; and

“(ii) a veteran who is eligible for medical services under paragraph (1), (2), or (3) of section 1710(a) of this title shall be deemed to be a veteran described in subsection (a)(1) of this section.”

1997—Subsec. (a)(1)(A)(i). Pub. L. 105–114 substituted “care” for “hospital care, nursing home care, or domiciliary care”.

1996—Subsec. (f)(1)(A)(ii). Pub. L. 104–262, §101(d)(8)(A), substituted “paragraph (1), (2), or (3) of section 1710(a)” for “section 1712(a)(1)(B)”.

Subsec. (f)(3). Pub. L. 104–262, §101(d)(8)(B), struck out par. (3) which read as follows: “Adult day health care may not be furnished under this section after September 30, 1991.”

1992—Subsec. (a)(2)(B). Pub. L. 102–405 substituted “Under Secretary for Health” for “Chief Medical Director”.

1991—Pub. L. 102–83, §5(a), renumbered section 620 of this title as this section.

Subsec. (a). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing in par. (1) introductory provisions and subpar. (A) and pars. (2) to (4).

Pub. L. 102–83, §4(a)(5), substituted “non-Department” for “non-Veterans’ Administration” wherever appearing in pars. (1) and (3)(A)(i).

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in par. (2)(A).

Subsec. (b). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Subsec. (d)(1). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Pub. L. 102–83, §4(a)(5), substituted “non-Department” for “non-Veterans’ Administration”.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Subsec. (d)(2)(A). Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Subsec. (e). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in pars. (1) and (2).

Pub. L. 102–83, §4(a)(5), substituted “non-Department” for “non-Veterans’ Administration” in par. (2).

Subsec. (f)(1)(A). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in introductory provisions.

Subsec. (f)(1)(A)(ii). Pub. L. 102–83, §5(c)(1), substituted “1712(a)(1)(B)” for “612(a)(1)(B)”.

Subsec. (f)(1)(B). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” before “may” in two places.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” wherever appearing.

Pub. L. 102–83, §4(a)(2)(A)(ii), substituted “Secretary” for “Veterans’ Administration” in second sentence.

Subsec. (f)(2). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

1988—Subsec. (e)(1). Pub. L. 100–322, §103(b), struck out “For the purposes of this section, the term ‘nursing home care’ includes intermediate care, as determined by the Administrator in accordance with regulations which the Administrator shall prescribe.” at beginning and struck out “(as defined in section 101(28) of this title)” after “provided for nursing home care”.

Subsec. (f)(3). Pub. L. 100–322, §111(a), substituted “September 30, 1991” for “September 30, 1988”.

1986—Subsec. (f)(1)(A)(ii). Pub. L. 99–272 substituted “612(a)(1)(B)” for “612(f)(2)”.

1985—Subsec. (a). Pub. L. 99–166, §108(a), amended subsec. (a) generally. Prior to amendment, subsec. (a) read as follows: “Subject to subsection (b) and except as provided in subsection (e) of this section, the Administrator may transfer—

“(1) Any veteran who has been furnished care by the Administrator in a hospital under the direct jurisdiction of the Administrator, and

“(2) Any person (A) who has been furnished care in any hospital of any of the Armed Forces, (B) who the appropriate Secretary concerned has determined has received maximum hospital benefits but requires a protracted period of nursing home care, and (C) who upon discharge therefrom will become a veteran

to any public or private institution not under the jurisdiction of the Administrator which furnishes nursing home care, for care at the expense of the United States, only if the Administrator determines that—

“(i) such veteran has received maximum benefits from such care in such hospital, but will require a protracted period of nursing home care which can be furnished in such institution, and

“(ii) the cost of such nursing home care in such institution will not exceed 45 percent of the cost of care furnished by the Veterans’ Administration in a general hospital under the direct and exclusive jurisdiction of the Administrator, as such cost may be determined annually by the Administrator, or not to exceed 50 percent of such cost where determined necessary by the Administrator, upon recommendation of the Chief Medical Director, to provide adequate care.

Nursing home care may not be furnished pursuant to this section at the expense of the United States for more than six months in the aggregate in connection with any one transfer, except (I) in the case of the veteran whose hospitalization was primarily for a service-connected disability, or (II) where in the judgment of the Administrator a longer period is warranted in the case of any other veteran. Any veteran who is furnished care by the Administrator in a hospital in Alaska or Hawaii may be furnished nursing home care under the provisions of this section even if such hospital is not under the direct jurisdiction of the Administrator.”

Subsec. (d). Pub. L. 99–166, §108(b), designated existing first sentence as par. (1), substituted “to any non-Veterans’ Administration nursing home” for “to any public or private institution not under the jurisdiction of the Administrator which furnishes nursing home care”, inserted “The Administrator may also authorize a direct admission to such a nursing home for nursing home care for any veteran who has been discharged from a hospital under the direct jurisdiction of the Administrator and who is currently receiving medical services as part of home health services from the Veterans’ Administration.”, substituted par. (2) for “Such admission may be authorized upon determination of need therefor by a physician employed by the Veterans’ Administration or, in areas where no such physician is available, carrying out such function under contract or fee arrangement based on an examination by such physician.”, and designated existing last sentence as par. (3).

Subsec. (e). Pub. L. 99–166, §108(c), designated existing provisions as par. (1), substituted “subsection (a)(2)(B)” for “subsection (a)(ii)” in second sentence, and added par. (2).

1983—Pub. L. 98–160, §103(a)(2), inserted “; adult day health care” in section catchline.

Subsec. (f). Pub. L. 98–160, §103(a)(1), added subsec. (f).

1982—Subsec. (a)(ii) Pub. L. 97–295, §4(19)(A), substituted “percent” for “per centum” wherever appearing.

Subsec. (c). Pub. L. 97–295, §4(19)(B), inserted “(41 U.S.C. 351(b)(1))” after “the Service Contract Act of 1965” and substituted “(29 U.S.C. 206(b))” for “, as amended,”.

1976—Subsec. (a). Pub. L. 94–581, §§106(1)–(3), 202(h), inserted “and except as provided in subsection (e)” after “subsection (b)” in provisions preceding par. (1), substituted “direct jurisdiction” for “direct and exclusive jurisdiction” in par. (1), substituted “45 per centum” for “40 per centum” and “annually” for “from time to time” in cl. (ii) and inserted “, or not to exceed 50 per centum of such cost where determined necessary by the Administrator, upon recommendation of the Chief Medical Director, to provide adequate care” at the end thereof, and substituted “direct jurisdiction” for “direct and exclusive jurisdiction” in provisions following cl. (ii).

Subsec. (b). Pub. L. 94–581, §210(a)(7), substituted “such standards as the Administrator may prescribe” for “such standards as he may prescribe”.

Subsec. (e). Pub. L. 94–581, §106(4), added subsec. (e).

1973—Subsec. (a). Pub. L. 93–82, §104(a), (b), designated cls. (1) and (2) as (i) and (ii), respectively, and in provisions preceding cl. (i) as so designated, substituted authority of the Administrator to transfer veterans and other persons under pars. (1) and (2), for authority of the Administrator to transfer veterans who have been furnished care by the Administrator in a hospital under the direct and exclusive jurisdiction of the Administrator, to any public or private institution not under the jurisdiction of the Administrator which furnishes nursing home care for care at the expense of the United States, and in the provisions following cl. (ii) as so designated, substituted designations (I) and (II) for designations (A) and (B).

Subsec. (b). Pub. L. 93–82, §104(c), inserted provisions relating to the admissions of veterans to institutions for nursing home care and for the furnishing of standards and reports to Federal, State and local agencies charged with the responsibility of licensing or otherwise regulating or inspecting such institutions.

Subsec. (d). Pub. L. 93–82, §104(d), added subsec. (d).

1969—Subsec. (a). Pub. L. 91–101 inserted provision authorizing the furnishing of nursing home care for more than six months in the aggregate in connection with any one transfer in the case of a veteran whose hospitalization was primarily for a service-connected disability.

1968—Subsec. (a). Pub. L. 90–612, §1, authorized furnishing of nursing home care to veterans who are being furnished care by the Administrator in hospitals in Alaska or Hawaii even if the hospitals involved are not under the direct and exclusive jurisdiction of the Administrator.

Subsec. (a)(2). Pub. L. 90–429 substituted “40 per centum” for “one-third”.

Subsec. (c). Pub. L. 90–612, §3, added subsec. (c).

Effective Date of 1986 Amendment

Amendment by Pub. L. 99–272 applicable to hospital care, nursing home care, and medical services furnished on or after July 1, 1986, see section 19011(f) of Pub. L. 99–272, set out as a note under section 1710 of this title.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Effective Date of 1973 Amendment

Amendment by Pub. L. 93–82 effective Sept. 1, 1973, see section 501 of Pub. L. 93–82, set out as a note under section 1701 of this title.

Comparison Study Between Adult Day Health Care and Nursing Home Care

Section 111(b), (c) of Pub. L. 100–322 directed Administrator to conduct a study of medical efficacy and cost-effectiveness of furnishing adult day health care under subsec. (f) of this section as an alternative to nursing home care and the comparative advantages and disadvantages of providing such care through facilities that are not under direct jurisdiction of Administrator and through facilities that are under direct jurisdiction of Administrator, with Administrator to submit to Committees on Veterans’ Affairs of Senate and House of Representatives an interim report on the study not later than Feb. 1, 1988, a final report on such study not later than Feb. 1, 1991.

Section 103(b), (c) of Pub. L. 98–160, which provided for a study and report, not later than Feb. 1, 1988, of the medical efficacy and cost-effectiveness of furnishing adult day health care as an alternative for nursing home care and of the comparative advantages and disadvantages of providing such care in Veterans’ Administration or in other facilities, was repealed by Pub. L. 100–322, title I, §111(d), May 20, 1988, 102 Stat. 499.

§1720A. Treatment and rehabilitative services for persons with drug or alcohol dependency

(a) The Secretary, in consultation with the Secretary of Labor and the Director of the Office of Personnel Management, may take appropriate steps to (1) urge all Federal agencies and appropriate private and public firms, organizations, agencies, and persons to provide appropriate employment and training opportunities for veterans who have been provided treatment and rehabilitative services under this title for alcohol or drug dependence or abuse disabilities and have been determined by competent medical authority to be sufficiently rehabilitated to be employable, and (2) provide all possible assistance to the Secretary of Labor in placing such veterans in such opportunities.

(b) Upon receipt of an application for treatment and rehabilitative services under this title for an alcohol or drug dependence or abuse disability from any individual who has been discharged or released from active military, naval, or air service but who is not eligible for such treatment and services, the Secretary shall—

(1) provide referral services to assist such individual, to the maximum extent practicable, in obtaining treatment and rehabilitative services from sources outside the Department; and

(2) if pertinent, advise such individual of such individual's rights to apply to the appropriate military, naval, or air service and the Department for review of such individual's discharge or release from such service.


(c)(1) Any person serving in the active military, naval, or air service who is determined by the Secretary concerned to have an alcohol or drug dependence or abuse disability may be transferred to any facility in order for the Secretary to furnish care or treatment and rehabilitative services for such disability. Care and services provided to a member so transferred shall be provided as if such member were a veteran. Any transfer of any such member for such care and services shall be made pursuant to such terms as may be agreed upon by the Secretary concerned and the Secretary, subject to the provisions of sections 1535 and 1536 of title 31.

(2) No person serving in the active military, naval, or air service may be transferred pursuant to an agreement made under paragraph (1) of this subsection unless such person requests such transfer in writing for a specified period of time. No such person transferred pursuant to such a request may be furnished such care and services by the Secretary beyond the period of time specified in such request unless such person requests in writing an extension for a further specified period of time and such request is approved by the Secretary.

(d)(1) The Secretary shall ensure that each medical center of the Department develops and carries out a plan to provide treatment for substance use disorders, either through referral or direct provision of services, to veterans who require such treatment.

(2) Each plan under paragraph (1) shall make available clinically proven substance abuse treatment methods, including opioid substitution therapy, to veterans with respect to whom a qualified medical professional has determined such treatment methods to be appropriate.

(Added Pub. L. 96–22, title I, §104(a), June 13, 1979, 93 Stat. 50, §620A; amended Pub. L. 96–128, title V, §501(c), Nov. 28, 1979, 93 Stat. 987; Pub. L. 97–251, §6, Sept. 8, 1982, 96 Stat. 716; Pub. L. 97–258, §3(k)(1), Sept. 13, 1982, 96 Stat. 1065; Pub. L. 99–108, §3, Sept. 30, 1985, 99 Stat. 481; Pub. L. 99–166, title I, §101(a), (b)(1), Dec. 3, 1985, 99 Stat. 942, 943; Pub. L. 100–687, div. B, title XV, §1509, Nov. 18, 1988, 102 Stat. 4137; Pub. L. 100–689, title V, §502(a)(1), (b), Nov. 18, 1988, 102 Stat. 4179; Pub. L. 102–54, §14(b)(13), June 13, 1991, 105 Stat. 284; renumbered §1720A and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–86, title III, §303, Aug. 14, 1991, 105 Stat. 416; Pub. L. 103–452, title I, §103(b), Nov. 2, 1994, 108 Stat. 4786; Pub. L. 104–110, title I, §101(b), Feb. 13, 1996, 110 Stat. 768; Pub. L. 105–114, title II, §202(b), Nov. 21, 1997, 111 Stat. 2287; Pub. L. 106–117, title I, §114, Nov. 30, 1999, 113 Stat. 1558; Pub. L. 106–419, title IV, §404(a)(4), Nov. 1, 2000, 114 Stat. 1864; Pub. L. 107–95, §8(c), Dec. 21, 2001, 115 Stat. 920.)

Amendments

2001—Subsec. (d). Pub. L. 107–95 added subsec. (d).

2000—Subsec. (c)(1). Pub. L. 106–419 substituted “for such disability. Care and services provided to a member so transferred” for “for such disability unless such transfer is during the last thirty days of such member's enlistment period or tour of duty, in which case such care and services provided to such member”.

1999—Subsec. (c)(1). Pub. L. 106–117, §114(a), substituted “may be transferred” for “may not be transferred” in first sentence.

Pub. L. 106–117, §114(a)(2), which directed the amendment of first sentence of par. (1) by striking out “unless such transfer is during the last thirty days of such member's enlistment or tour of duty”, could not be executed because that phrase did not appear.

Subsec. (c)(2). Pub. L. 106–117, §114(b), struck out “during the last thirty days of such person's enlistment period or tour of duty” before period at end of first sentence.

1997—Pub. L. 105–114, §202(b)(2), substituted “Treatment and rehabilitative services for persons with drug and alcohol dependency” for “Treatment and rehabilitation for alcohol or drug dependence or abuse disabilities” in section catchline.

Subsecs. (a) to (d). Pub. L. 105–114, §202(b)(1), redesignated subsecs. (b) to (d) as (a) to (c), respectively, and struck out former subsec. (a) which read as follows:

“(a)(1) The Secretary, in furnishing hospital, nursing home, and domiciliary care and medical and rehabilitative services under this chapter, may contract for care and treatment and rehabilitative services in halfway houses, therapeutic communities, psychiatric residential treatment centers, and other community-based treatment facilities for eligible veterans suffering from alcohol or drug dependence or abuse disabilities.

“(2) Before furnishing such care and services to any veteran through a contract facility as authorized by paragraph (1) of this subsection, the Secretary shall approve (in accordance with criteria which the Secretary shall prescribe by regulation) the quality and effectiveness of the program operated by such facility for the purpose for which such veteran is to be furnished such care and services.”

Subsecs. (e) to (g). Pub. L. 105–114, §202(b)(1)(B), struck out subsecs. (e) to (g) which read as follows:

“(e) The Secretary may not furnish care and treatment and rehabilitative services under subsection (a) of this section after December 31, 1997.

“(f)(1) During the period beginning on December 1, 1988, and ending on October 1, 1997, the Secretary shall conduct an ongoing clinical evaluation in order to determine the long-term results of drug and alcohol abuse treatment furnished to veterans in contract residential treatment facilities under this section.

“(2) The evaluation shall include an assessment of the following:

“(A) The long-term results of treatment referred to in paragraph (1) of this subsection on drug and alcohol use by veterans who may have received such treatment.

“(B) The need for hospitalization of such veterans for drug and alcohol abuse after completion of the residential treatment.

“(C) The employment status and income of such veterans.

“(D) The extent of any criminal activity of such veterans.

“(E) Whether certain models and methods of residential treatment for drug and alcohol abuse are more successful for veterans with specific abuses, specific levels of resources available to them, and specific needs than are other models and methods.

“(3) To the extent feasible, the Secretary shall select for consideration in the evaluation veterans whose treatment for drug and alcohol abuse in contract residential treatment facilities under such section represents a variety of models and methods of residential drug and alcohol abuse treatment.

“(4) The Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives the following reports on the evaluation under this subsection:

“(A) Not later than February 1, 1993, an interim report containing information obtained during the first four years of the evaluation and any conclusions that the Secretary has drawn on the basis of that information.

“(B) Not later than March 31, 1998, a final report containing information obtained during the evaluation and the determinations and conclusions of the Secretary based on that information.

“(g) The authority of the Secretary to enter into contracts under this section shall be effective for any fiscal year only to such extent or in such amounts as are provided in appropriation Acts.”

1996—Subsec. (e). Pub. L. 104–110 substituted “December 31, 1997” for “December 31, 1995”.

1994—Subsec. (e). Pub. L. 103–452 substituted “December 31, 1995” for “December 31, 1994”.

1991—Pub. L. 102–83, §5(a), renumbered section 620A of this title as this section.

Subsecs. (a), (b). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Subsec. (c). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in introductory provisions.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in pars. (1) and (2).

Subsec. (d). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Subsec. (e). Pub. L. 102–86 amended subsec. (e) of this section as in effect before the redesignations made by Pub. L. 102–83, §5, by substituting “December 31, 1994” for “September 30, 1991”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Subsec. (f). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Pub. L. 102–54 struck out “during the period” before “beginning” in par. (1).

Subsec. (g). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

1988—Subsec. (e). Pub. L. 100–689, §502(a)(1), substituted “1991” for “1988”.

Subsec. (f). Pub. L. 100–689, §502(b), amended subsec. (f) generally. Prior to amendment, subsec. (f) read as follows:

“(1) The Administrator shall monitor the performance of each contract facility furnishing care and services under the program carried out under subsection (a) of this section.

“(2) The Administrator shall use the results of such monitoring to determine—

“(A) with respect to the program, the medical advantages and cost-effectiveness that result from furnishing such care and services; and

“(B) with respect to such contract facilities generally, the level of success under the program, considering—

“(i) the rate of successful rehabilitation for veterans furnished care and services under the program;

“(ii) the rate of readmission to contract facilities under the program or to Veterans’ Administration health-care facilities by such veterans for care or services for disabilities referred to in subsection (a) of this section;

“(iii) whether the care and services furnished under the program obviated the need of such veterans for hospitalization for such disabilities;

“(iv) the average duration of the care and services furnished such veterans under the program;

“(v) the ability of the program to aid in the transition of such veterans back into their communities; and

“(vi) any other factor that the Administrator considers appropriate.

“(3) The Administrator shall maintain records of—

“(A) the total cost for the care and services furnished by each contract facility under the program;

“(B) the average cost per veteran for the care and services furnished under the program; and

“(C) the appropriateness of such costs, by comparison to—

“(i) the average charges for the same types of care and services furnished generally by other comparable halfway houses, therapeutic communities, psychiatric residential treatment centers, and other community-based treatment facilities; and

“(ii) the historical costs for such care and services for the period of time that the program carried out under subsection (a) of this section was a pilot program, taking into account economic inflation.

“(4) Not later than February 1, 1988, the Administrator shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the experience under the program carried out under this section during fiscal years 1984 through 1987. The report shall include—

“(A) a description of the care and services furnished;

“(B) the matters referred to in paragraphs (1), (2), and (3) of this subsection; and

“(C) the Administrator's findings, assessment, and recommendations regarding the program under this section.”

Subsec. (f)(1). Pub. L. 100–687 substituted “during the period beginning on December 1, 1988, and ending on October 1, 1997” for “before October 1, 1997” in par. (1) as amended by Pub. L. 100–689 above.

1985—Pub. L. 99–166, §101(b)(1), struck out “; pilot program” after “disabilities” in section catchline.

Subsec. (a)(1). Pub. L. 99–166, §101(a)(1), struck out “may conduct a pilot program under which the Administrator” before “may contract” in first sentence, and struck out second sentence relating to the planning, designing, and conducting of a pilot program by the Chief Medical Director so as to demonstrate any medical advantages and cost effectiveness that might result from furnishing care and services to disabled veterans in contract facilities as authorized by this section, rather than in facilities over which the Administrator had jurisdiction.

Subsec. (e). Pub. L. 99–166, §101(a)(2), substituted “September 30, 1988” for “October 31, 1985”.

Pub. L. 99–108 substituted “October 31, 1985” for “the last day of the fifth fiscal year following the fiscal year in which the pilot program authorized by such subsection is initiated”.

Subsec. (f). Pub. L. 99–166, §101(a)(3), amended subsec. (f) generally. Prior to amendment, subsec. (f) read as follows: “Not later than March 31, 1984, the Administrator shall report to the Committee on Veterans’ Affairs of the Senate and House of Representatives on the findings and recommendations of the Administrator pertaining to the operation through September 30, 1983, of the pilot program authorized by this section.”

1982—Subsec. (d)(1). Pub. L. 97–258 substituted “sections 1535 and 1536 of title 31” for “the Act of March 4, 1915 (31 U.S.C 686)” after “provisions of”.

Subsec. (f). Pub. L. 97–251 substituted “March 31, 1984” and “September 30, 1983” for “March 31, 1983” and “September 30, 1982”, respectively.

1979—Subsec. (a)(1). Pub. L. 96–128, §501(c)(1), substituted “treatment facilities for” for “treatment facilities of”.

Subsec. (d)(2). Pub. L. 96–128, §501(c)(2), substituted “such request unless” for “such request, unless”.

Effective Date of 1979 Amendment

Amendment by Pub. L. 96–128 effective Nov. 28, 1979, see section 601(b) of Pub. L. 96–128, set out as a note under section 1114 of this title.

Effective Date

Section effective Oct. 1, 1979, see section 107 of Pub. L. 96–22, set out as an Effective Date of 1979 Amendment note under section 1701 of this title.

Substance Use Disorders and Mental Health Care

Pub. L. 110–387, title I, §§102–105, Oct. 10, 2008, 122 Stat. 4112–4114, provided that:

“SEC. 102. FINDINGS ON SUBSTANCE USE DISORDERS AND MENTAL HEALTH.

“Congress makes the following findings:

“(1) More than 1,500,000 members of the Armed Forces have been deployed in Operation Iraqi Freedom and Operation Enduring Freedom. The 2005 Department of Defense Survey of Health Related Behaviors Among Active Duty Personnel reports that 23 percent of members of the Armed Forces on active duty acknowledge a significant problem with alcohol use disorder, with similar rates of acknowledged problems with alcohol use disorder among members of the National Guard.

“(2) The effects of substance use disorder are wide ranging, including significantly increased risk of suicide, exacerbation of mental and physical health disorders, breakdown of family support, and increased risk of unemployment and homelessness.

“(3) While veterans suffering from mental health conditions, chronic physical illness, and polytrauma may be at increased risk for development of a substance use disorder, treatment for these veterans is complicated by the need to address adequately the physical and mental symptoms associated with these conditions through appropriate medical intervention.

“(4) While the Veterans Health Administration has dramatically increased health services for veterans from 1996 through 2006, the number of veterans receiving specialized substance use disorder treatment services decreased 18 percent during that time. No comparable decrease in the national rate of substance use disorder has been observed during that time.

“(5) While some facilities of the Veterans Health Administration provide exemplary substance use disorder treatment services, the availability of such treatment services throughout the health care system of the Veterans Health Administration is inconsistent.

“(6) According to a 2006 report by the Government Accountability Office, the Department of Veterans Affairs significantly reduced its substance use disorder treatment and rehabilitation services between 1996 and 2006, and the Fiscal Year 2007 National Mental Health Program Monitoring System report shows that little progress has been made in restoring these services to their pre-1996 levels.

“SEC. 103. EXPANSION OF SUBSTANCE USE DISORDER TREATMENT SERVICES PROVIDED BY DEPARTMENT OF VETERANS AFFAIRS.

“(a) In General.—The Secretary of Veterans Affairs shall ensure the provision of such services and treatment to each veteran enrolled in the health care system of the Department of Veterans Affairs who is in need of services and treatments for a substance use disorder as follows:

“(1) Screening for substance use disorder in all settings, including primary care settings.

“(2) Short term motivational counseling services.

“(3) Marital and family counseling.

“(4) Intensive outpatient or residential care services.

“(5) Relapse prevention services.

“(6) Ongoing aftercare and outpatient counseling services.

“(7) Opiate substitution therapy services.

“(8) Pharmacological treatments aimed at reducing craving for drugs and alcohol.

“(9) Detoxification and stabilization services.

“(10) Coordination with groups providing peer to peer counseling.

“(11) Such other services as the Secretary considers appropriate.

“(b) Provision of Services.—

“(1) Allocation of resources for provision of services.—The Secretary shall ensure that amounts made available for care, treatment, and services provided under this section are allocated in such a manner that a full continuum of care, treatment, and services described in subsection (a) is available to veterans seeking such care, treatment, or services, without regard to the location of the residence of any such veterans.

“(2) Manner of provision.—The services and treatment described in subsection (a) may be provided to a veteran described in such subsection—

“(A) at Department of Veterans Affairs medical centers or clinics;

“(B) by referral to other facilities of the Department that are accessible to such veteran; or

“(C) by contract or fee-for-service payments with community-based organizations for the provision of such services and treatments.

“(c) Alternatives in Case of Services Denied Due to Clinical Necessity.—If the Secretary denies the provision to a veteran of services or treatment for a substance use disorder due to clinical necessity, the Secretary shall provide the veteran such other services or treatment as are medically appropriate.

“SEC. 104. CARE FOR VETERANS WITH MENTAL HEALTH AND SUBSTANCE USE DISORDERS.

“(a) In General.—If the Secretary of Veterans Affairs provides a veteran inpatient or outpatient care for a substance use disorder and a comorbid mental health disorder, the Secretary shall ensure that treatment for such disorders is provided concurrently—

“(1) through a service provided by a clinician or health professional who has training and expertise in treatment of substance use disorders and mental health disorders;

“(2) by separate substance use disorder and mental health disorder treatment services when there is appropriate coordination, collaboration, and care management between such treatment services; or

“(3) by a team of clinicians with appropriate expertise.

“(b) Team of Clinicians With Appropriate Expertise Defined.—In this section, the term ‘team of clinicians with appropriate expertise’ means a team consisting of the following:

“(1) Clinicians and health professionals with expertise in treatment of substance use disorders and mental health disorders who act in coordination and collaboration with each other.

“(2) Such other professionals as the Secretary considers appropriate for the provision of treatment to veterans for substance use and mental health disorders.

“SEC. 105. PILOT PROGRAM FOR INTERNET-BASED SUBSTANCE USE DISORDER TREATMENT FOR VETERANS OF OPERATION IRAQI FREEDOM AND OPERATION ENDURING FREEDOM.

“(a) Findings.—Congress makes the following findings:

“(1) Stigma associated with seeking treatment for mental health disorders has been demonstrated to prevent some veterans from seeking such treatment at a medical facility operated by the Department of Defense or the Department of Veterans Affairs.

“(2) There is a significant incidence among veterans of post-deployment mental health problems, especially among members of a reserve component who return as veterans to civilian life.

“(3) Computer-based self-guided training has been demonstrated to be an effective strategy for supplementing the care of psychological conditions.

“(4) Younger veterans, especially those who served in Operation Enduring Freedom or Operation Iraqi Freedom, are comfortable with and proficient at computer-based technology.

“(5) Veterans living in rural areas may find access to treatment for substance use disorder limited.

“(6) Self-assessment and treatment options for substance use disorders through an Internet website may reduce stigma and provides additional access for individuals seeking care and treatment for such disorders.

“(b) In General.—Not later than October 1, 2009, the Secretary of Veterans Affairs shall carry out a pilot program to assess the feasibility and advisability of providing veterans who seek treatment for substance use disorders access to a computer-based self-assessment, education, and specified treatment program through a secure Internet website operated by the Secretary. Participation in the pilot program shall be available on a voluntary basis for those veterans who have served in Operation Enduring Freedom or Operation Iraqi Freedom.

“(c) Elements of Pilot Program.—

“(1) In general.—In carrying out the pilot program under this section, the Secretary shall ensure that—

“(A) access to the Internet website and the programs available on the website by a veteran (or family member) does not involuntarily generate an identifiable medical record of that access by that veteran in any medical database maintained by the Department of Veterans Affairs;

“(B) the Internet website is accessible from remote locations, especially rural areas; and

“(C) the Internet website includes a self-assessment tool for substance use disorders, self-guided treatment and educational materials for such disorders, and appropriate information and materials for family members of veterans.

“(2) Consideration of similar projects.—In designing the pilot program under this section, the Secretary shall consider similar pilot projects of the Department of Defense for the early diagnosis and treatment of post-traumatic stress disorder and other mental health conditions established under section 741 of the John Warner National Defense Authorization Act of [for] Fiscal Year 2007 (Public Law 109–364; 120 Stat. 2304) [10 U.S.C. 1074 note].

“(3) Location of pilot program.—The Secretary shall carry out the pilot program through those medical centers of the Department of Veterans Affairs that have established Centers for Excellence for Substance Abuse Treatment and Education or that have established a Substance Abuse Program Evaluation and Research Center.

“(4) Contract authority.—The Secretary may enter into contracts with qualified entities or organizations to carry out the pilot program required under this section.

“(d) Duration of Pilot Program.—The pilot program required by subsection (a) shall be carried out during the two-year period beginning on the date of the commencement of the pilot program.

“(e) Report.—Not later than six months after the completion of the pilot program, the Secretary shall submit to Congress a report on the pilot program, and shall include in that report—an assessment of the feasibility and advisability of continuing or expanding the pilot program, of any cost savings or other benefits associated with the pilot program, and any other recommendations.

“(f) Authorization of Appropriations.—There are authorized to be appropriated to the Secretary of Veterans Affairs $1,500,000 for each of fiscal years 2010 and 2011 to carry out the pilot program under this section.”

Ratification of Actions During Period of Expired Authority

Any action taken by Secretary of Veterans Affairs before Feb. 13, 1996, under provision of law amended by title I of Pub. L. 104–110 that was taken during period beginning on date on which authority of Secretary under such provision of law expired and ending on Feb. 13, 1996, considered to have same force and effect as if such amendment had been in effect at time of that action, see section 103 of Pub. L. 104–110, set out as a note under section 1710 of this title.

Report on Consolidation of Certain Programs

Section 202(a) of Pub. L. 104–110 provided that: “The Secretary of Veterans Affairs shall submit to Congress, not later than March 1, 1997, a report on the advantages and disadvantages of consolidating into one program the following three programs:

“(1) The alcohol and drug abuse contract care program under section 1720A of title 38, United States Code.

“(2) The program to provide community-based residential care to homeless chronically mentally ill veterans under section 115 of the Veterans’ Benefits and Services Act of 1988 [Pub. L. 100–322] (38 U.S.C. 1712 note).

“(3) The demonstration program under section 7 of Public Law 102–54 (38 U.S.C. 1718 note).”

Loans to Organizations Providing Transitional Housing for Substance Abusers

Section 8 of Pub. L. 102–54 provided that:

“(a) Loan Program.—The Secretary of Veterans Affairs may make loans in accordance with this section to assist in the provision of transitional housing exclusively to veterans who are in (or who recently have been in) a program for the treatment of substance abuse.

“(b) Loan Recipients.—A loan under this section may only be made to a nonprofit organization under selection criteria promulgated by the Secretary and only to assist that organization in leasing housing units for use as a group residence for the purposes described in subsection (a). The amount of such a loan that is used with respect to any single residential unit may not exceed $4,500. In making loans under this subsection, the Secretary shall, except to the extent that the Secretary determines that it is infeasible to do so, ensure that—

“(1) each loan is repaid within two years after the date on which the loan is made;

“(2) each loan is repaid through monthly installments and that a reasonable penalty is assessed for each failure to pay an installment by the date specified in the loan agreement involved; and

“(3) each loan is made only to a nonprofit private entity which agrees that, in the operation of each residence established with the assistance of the loan—

“(A) the use of alcohol or any illegal drug in the residence will be prohibited;

“(B) any resident who violates the prohibition in subclause (A) of this clause will be expelled from the residence;

“(C) the costs of maintaining the residence, including fees for rent and utilities, will be paid by the residents;

“(D) the residents will, through a majority vote of the residents, otherwise establish policies governing the conditions of residence, including the manner in which applications for residence are approved; and

“(E) the residence will be operated solely as a residence for not less than six veterans.

“(c) Funding.—Loans under this section shall be made from the special account of the General Post Fund of the Department of Veterans Affairs established for purposes of this section. The amount of such loans outstanding at any time may not exceed $100,000. Amounts received as payment of principal and interest on such loans shall be deposited in that account. The operation of the loan program under this section shall be separately accounted for, and shall be separately stated in the documents accompanying the President's budget for each fiscal year.

“(d) Terms and Conditions.—Loans under this section shall be made on such terms and conditions, including interest, as the Secretary prescribes.

“(e) Report.—After the end of the 15-month period beginning on the date the first loan is extended under this section, the Secretary shall issue a report on the Department's experience under the section. The report shall include the following information:

“(1) The default rate on loans extended under this section.

“(2) The manner in which loan payments are collected.

“(3) The number of facilities at which loans have been extended.

“(4) The adequacy of the amount of funds in the special account referred to in subsection (c).”

Evaluation of Veterans’ Administration Inpatient and Outpatient Drug and Alcohol Treatment Programs

Pub. L. 100–690, title II, §2501, Nov. 18, 1988, 102 Stat. 4232, directed Administrator of Veterans’ Affairs to conduct an evaluation of inpatient and outpatient drug and alcohol treatment programs operated by the Veterans’ Administration, such evaluation to include a determination of medical advantages and cost-effectiveness of such programs, taking into consideration rates of readmission and the rate of successful rehabilitation, and authorized appropriations for this purpose for fiscal years 1989, 1990, and 1991.

Ratification for Lapsed Period

Section 502(a)(2) of Pub. L. 100–689 ratified actions by the Administrator of Veterans’ Affairs in providing, during the period beginning Oct. 1, 1988, and ending Nov. 18, 1988, for care and treatment and rehabilitative services under this section.

§1720B. Respite care

(a) The Secretary may furnish respite care services to a veteran who is enrolled to receive care under section 1710 of this title.

(b) For the purpose of this section, the term “respite care services” means care and services which—

(1) are of limited duration;

(2) are furnished on an intermittent basis to a veteran who is suffering from a chronic illness and who resides primarily at home; and

(3) are furnished for the purpose of helping the veteran to continue residing primarily at home.


(c) In furnishing respite care services, the Secretary may enter into contract arrangements.

(Added Pub. L. 99–576, title II, §201(a)(1), Oct. 28, 1986, 100 Stat. 3254, §620B; amended Pub. L. 101–237, title II, §201(a), Dec. 18, 1989, 103 Stat. 2066; renumbered §1720B and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–585, title V, §502, Nov. 4, 1992, 106 Stat. 4955; Pub. L. 106–117, title I, §101(e), Nov. 30, 1999, 113 Stat. 1549.)

Amendments

1999—Subsec. (a). Pub. L. 106–117, §101(e)(1), substituted “enrolled” for “eligible”.

Subsec. (b). Pub. L. 106–117, §101(e)(2), in introductory provisions, substituted “the term ‘respite care services’ means care and services” for “the term ‘respite care’ means hospital or nursing home care”, in par. (1) substituted “are” for “is”, in par. (2) substituted “are” for “is” and struck out “in a Department facility” after “furnished”, and in par. (3) substituted “are” for “is”.

Subsec. (c). Pub. L. 106–117, §101(e)(3), added subsec. (c).

1992—Subsec. (c). Pub. L. 102–585 struck out subsec. (c) which read as follows: “The authority provided by this section terminates on September 30, 1992.”

1991—Pub. L. 102–83, §5(a), renumbered section 620B of this title as this section.

Subsec. (a). Pub. L. 102–83, §5(c)(1), substituted “1710” for “610”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Subsec. (b)(2). Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

1989—Subsec. (c). Pub. L. 101–237 substituted “September 30, 1992” for “September 30, 1989”.

Ratification of Actions of Secretary of Veterans Affairs During Transition Periods

Section 604 of Pub. L. 101–237 ratified actions of the Secretary of Veterans Affairs in carrying out this section, section 115 of Pub. L. 100–322 [38 U.S.C. 1712 note], section 618 of Pub. L. 100–440 [5 U.S.C. 6302 note], or section 1829 [now 3729] of this title, by contract or otherwise, during the period beginning Dec. 1, 1989, and ending Dec. 18, 1989.

Pub. L. 101–110, §3(b), Oct. 6, 1989, 103 Stat. 682, ratified actions of the Secretary of Veterans Affairs in carrying out this section, section 115 of Pub. L. 100–322 [38 U.S.C. 1712 note], section 618 of Pub. L. 100–440 [5 U.S.C. 6302 note], or section 1829 [now 3729] of this title, by contract or otherwise, during the period beginning Oct. 1, 1989, and ending Oct. 6, 1989.

Interim Extension of Respite Care Program

Pub. L. 101–110, §1(a), Oct. 6, 1989, 103 Stat. 682, provided that: “Notwithstanding the provisions of subsection (c) of section 620B [now 1720B] of title 38, United States Code, the authority provided by such section shall terminate on November 30, 1989.”

Report

Section 201(b) of Pub. L. 99–576 provided that if the Administrator of Veterans’ Affairs furnished respite care under this section, the Administrator was to conduct an evaluation of the health efficacy and cost-effectiveness of furnishing such care and submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives not later than Feb. 1, 1989, a report containing the results of such evaluation and appropriate recommendations.

§1720C. Noninstitutional alternatives to nursing home care

(a) The Secretary may furnish medical, rehabilitative, and health-related services in noninstitutional settings for veterans who are eligible under this chapter for, and are in need of, nursing home care. The Secretary shall give priority for participation in such program to veterans who—

(1) are in receipt of, or are in need of, nursing home care primarily for the treatment of a service-connected disability; or

(2) have a service-connected disability rated at 50 percent or more.


(b)(1) Under the program conducted pursuant to subsection (a), the Secretary shall (A) furnish appropriate health-related services solely through contracts with appropriate public and private agencies that provide such services, and (B) designate Department health-care employees to furnish case management services to veteran furnished services under the program.

(2) For the purposes of paragraph (1), the term “case management services” includes the coordination and facilitation of all services furnished to a veteran by the Department of Veterans Affairs, either directly or through contract, including assessment of needs, planning, referral (including referral for services to be furnished by the Department, either directly or through a contract, or by an entity other than the Department), monitoring, reassessment, and followup.

(c) The Secretary may provide in-kind assistance (through the services of Department of Veterans Affairs employees and the sharing of other Department resources) to a facility furnishing services to veterans under subsection (b)(1)(A). Any such in-kind assistance shall be provided under a contract between the Department and the facility concerned. The Secretary may provide such assistance only for use solely in the furnishing of appropriate services under this section and only if, under such contract, the Department receives reimbursement for the full cost of such assistance (including the cost of services and supplies and normal depreciation and amortization of equipment). Such reimbursement may be made by reduction in the charges to the United States or by payment to the United States. Any funds received through such reimbursement shall be credited to funds allotted to the Department facility that provided the assistance.

(d) The total cost of providing services or in-kind assistance in the case of any veteran for any fiscal year under the program may not exceed 65 percent of the cost that would have been incurred by the Department during that fiscal year if the veteran had been furnished, instead, nursing home care under section 1710 of this title during that fiscal year.

(e) The authority of the Secretary to enter into contracts under this section shall be effective for any fiscal year only to the extent that appropriations are available.

(Added Pub. L. 101–366, title II, §201(a)(1), Aug. 15, 1990, 104 Stat. 437, §620C; renumbered §1720C and amended Pub. L. 102–83, §5(a), (c)(1), Aug. 6, 1991, 105 Stat. 406; Pub. L. 103–452, title I, §103(c), Nov. 2, 1994, 108 Stat. 4786; Pub. L. 104–110, title I, §101(c), Feb. 13, 1996, 110 Stat. 768; Pub. L. 105–114, title II, §206(a)–(b)(2), Nov. 21, 1997, 111 Stat. 2289.)

Amendments

1997—Pub. L. 105–114, §206(b)(2), struck out “: pilot program” after “home care” in section catchline.

Subsec. (a). Pub. L. 105–114, §206(a), substituted “The Secretary may furnish” for “During the period through December 31, 1997, the Secretary may conduct a pilot program for the furnishing of”.

Subsec. (b)(1). Pub. L. 105–114, §206(b)(1), substituted “Under the program” for “Under the pilot program”.

Subsec. (d). Pub. L. 105–114, §206(b)(1), substituted “under the program” for “under the pilot program”.

1996—Subsec. (a). Pub. L. 104–110 substituted “December 31, 1997” for “September 30, 1995” in introductory provisions.

1994—Subsec. (a). Pub. L. 103–452, in introductory provisions, substituted “During the period through September 30, 1995,” for “During the four-year period beginning on October 1, 1990,” and “care. The Secretary shall give priority for participation in such program to veterans who” for “care and who”.

1991—Pub. L. 102–83, §5(a), renumbered section 620C of this title as this section.

Subsec. (d). Pub. L. 102–83, §5(c)(1), substituted “1710” for “610”.

Effective Date of 1994 Amendment

Section 103(c)(1) of Pub. L. 103–452 provided that the amendment made by that section is effective Oct. 1, 1994.

Ratification of Actions During Period of Expired Authority

Any action taken by Secretary of Veterans Affairs before Feb. 13, 1996, under provision of law amended by title I of Pub. L. 104–110 that was taken during period beginning on date on which authority of Secretary under such provision of law expired and ending on Feb. 13, 1996, considered to have same force and effect as if such amendment had been in effect at time of that action, see section 103 of Pub. L. 104–110, set out as a note under section 1710 of this title.

Report to Congressional Committees

Section 201(b) of Pub. L. 101–366, as amended by Pub. L. 102–83, §5(c)(2), Aug. 6, 1991, 105 Stat. 406; Pub. L. 103–452, title I, §103(g), Nov. 2, 1994, 108 Stat. 4787, provided that: “Not later than February 1, 1995, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report setting forth the Secretary's evaluation, findings, and conclusions regarding the conduct, through September 30, 1993, of the pilot program required by section 1720C [formerly 620C] of title 38, United States Code (as added by subsection (a)), and the results of the furnishing of care under such pilot program for the participating veterans. The report shall include a description of the conduct of the pilot program (including a description of the veterans furnished services and of the services furnished under the pilot program), and any plans for administrative action, and any recommendations for legislation, that the Secretary considers appropriate to include in the report.”

§1720D. Counseling and treatment for sexual trauma

(a)(1) The Secretary shall operate a program under which the Secretary provides counseling and appropriate care and services to veterans who the Secretary determines require such counseling and care and services to overcome psychological trauma, which in the judgment of a mental health professional employed by the Department, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the veteran was serving on active duty or active duty for training.

(2) In furnishing counseling to a veteran under this subsection, the Secretary may provide such counseling pursuant to a contract with a qualified mental health professional if (A) in the judgment of a mental health professional employed by the Department, the receipt of counseling by that veteran in facilities of the Department would be clinically inadvisable, or (B) Department facilities are not capable of furnishing such counseling to that veteran economically because of geographical inaccessibility.

(b)(1) The Secretary shall give priority to the establishment and operation of the program to provide counseling and care and services under subsection (a). In the case of a veteran eligible for counseling and care and services under subsection (a), the Secretary shall ensure that the veteran is furnished counseling and care and services under this section in a way that is coordinated with the furnishing of such care and services under this chapter.

(2) In establishing a program to provide counseling under subsection (a), the Secretary shall—

(A) provide for appropriate training of mental health professionals and such other health care personnel as the Secretary determines necessary to carry out the program effectively;

(B) seek to ensure that such counseling is furnished in a setting that is therapeutically appropriate, taking into account the circumstances that resulted in the need for such counseling; and

(C) provide referral services to assist veterans who are not eligible for services under this chapter to obtain those from sources outside the Department.


(c) The Secretary shall provide information on the counseling and treatment available to veterans under this section. Efforts by the Secretary to provide such information—

(1) shall include availability of a toll-free telephone number (commonly referred to as an 800 number);

(2) shall ensure that information about the counseling and treatment available to veterans under this section—

(A) is revised and updated as appropriate;

(B) is made available and visibly posted at appropriate facilities of the Department; and

(C) is made available through appropriate public information services; and


(3) shall include coordination with the Secretary of Defense seeking to ensure that individuals who are being separated from active military, naval, or air service are provided appropriate information about programs, requirements, and procedures for applying for counseling and treatment under this section.


(d)(1) The Secretary shall carry out a program to provide graduate medical education, training, certification, and continuing medical education for mental health professionals who provide counseling, care, and services under subsection (a).

(2) In carrying out the program required by paragraph (1), the Secretary shall ensure that—

(A) all mental health professionals described in such paragraph have been trained in a consistent manner; and

(B) training described in such paragraph includes principles of evidence-based treatment and care for sexual trauma and post-traumatic stress disorder.


(e) Each year, the Secretary shall submit to Congress an annual report on the counseling, care, and services provided to veterans pursuant to this section. Each report shall include data for the year covered by the report with respect to each of the following:

(1) The number of mental health professionals, graduate medical education trainees, and primary care providers who have been certified under the program required by subsection (d) and the amount and nature of continuing medical education provided under such program to such professionals, trainees, and providers who are so certified.

(2) The number of women veterans who received counseling and care and services under subsection (a) from professionals and providers who received training under subsection (d).

(3) The number of graduate medical education, training, certification, and continuing medical education courses provided by reason of subsection (d).

(4) The number of trained full-time equivalent employees required in each facility of the Department to meet the needs of veterans requiring treatment and care for sexual trauma and post-traumatic stress disorder.

(5) Such recommendations for improvements in the treatment of women veterans with sexual trauma and post-traumatic stress disorder as the Secretary considers appropriate.

(6) Such other information as the Secretary considers appropriate.


(f) In this section, the term “sexual harassment” means repeated, unsolicited verbal or physical contact of a sexual nature which is threatening in character.

(Added Pub. L. 102–585, title I, §102(a)(1), Nov. 4, 1992, 106 Stat. 4945; amended Pub. L. 103–452, title I, §101(a)–(d), (f)(1), (2)(A), (g)(1), Nov. 2, 1994, 108 Stat. 4783, 4784; Pub. L. 105–368, title IX, §902, Nov. 11, 1998, 112 Stat. 3360; Pub. L. 106–117, title I, §115(a)–(c), Nov. 30, 1999, 113 Stat. 1558; Pub. L. 108–422, title III, §301, Nov. 30, 2004, 118 Stat. 2382; Pub. L. 111–163, title II, §202, May 5, 2010, 124 Stat. 1142.)

Amendments

2010—Subsecs. (d) to (f). Pub. L. 111–163 added subsecs. (d) and (e) and redesignated former subsec. (d) as (f).

2004—Subsec. (a)(1). Pub. L. 108–422, §301(a)(1), (b), substituted “The” for “During the period through December 31, 2004, the” and inserted “or active duty for training” before period at end.

Subsec. (a)(2). Pub. L. 108–422, §301(a)(2), struck out “, during the period through December 31, 2004,” after “the Secretary may”.

1999—Subsec. (a)(1). Pub. L. 106–117, §115(a)(1), (b)(1), substituted “December 31, 2004” for “December 31, 2001” and “shall operate a program under which the Secretary provides counseling and appropriate care and services to veterans who the Secretary determines require such counseling and care and services” for “may provide counseling to a veteran who the Secretary determines requires such counseling”.

Subsec. (a)(2), (3). Pub. L. 106–117, §115(a)(2), (b)(2), redesignated par. (3) as (2), substituted “December 31, 2004” for “December 31, 2001”, and struck out former par. (2) which read as follows: “During the period referred to in paragraph (1), the Secretary may provide appropriate care and services to a veteran for an injury, illness, or other psychological condition that the Secretary determines to be the result of a physical assault, battery, or harassment referred to in that paragraph.”

Subsec. (c). Pub. L. 106–117, §115(c)(1), inserted “and treatment” after “counseling” in first sentence.

Subsec. (c)(2), (3). Pub. L. 106–117, §115(c), added par. (2), redesignated former par. (2) as (3), and inserted “and treatment” after “counseling”.

1998—Subsec. (a)(1), (3). Pub. L. 105–368 substituted “December 31, 2001” for “December 31, 1998”.

1994—Pub. L. 103–452, §101(f)(2)(A), substituted “and treatment” for “to women veterans” in section catchline.

Subsec. (a)(1). Pub. L. 103–452, §101(b)(1), (f)(1)(A), substituted “December 31, 1998,” for “December 31, 1995,” and struck out “woman” after “counseling to a”.

Subsec. (a)(2). Pub. L. 103–452, §101(a), added par. (2) and struck out former par. (2) which read as follows: “To be eligible to receive counseling under this subsection, a veteran must seek such counseling from the Secretary within two years after the date of the veteran's discharge or release from active military, naval, or air service.”

Subsec. (a)(3). Pub. L. 103–452, §101(b)(2), substituted “December 31, 1998,” for “December 31, 1994,”.

Subsec. (b). Pub. L. 103–452, §101(c), redesignated subsec. (c) as (b) and struck out former subsec. (b) which read as follows: “In providing services to a veteran under subsection (a), the period for which counseling is provided may not exceed one year from the date of the commencement of the furnishing of such counseling to the veteran. However, the Secretary may authorize a longer period in any case if, in the judgment of the Secretary, a longer period of counseling is required.”

Subsec. (b)(1). Pub. L. 103–452, §101(d), amended par. (1) generally. Prior to amendment, par. (1) read as follows: “The Secretary shall give priority to the establishment and operation of the program to provide counseling under subsection (a). In the case of a veteran eligible for such counseling who requires other care or services under this chapter for trauma described in subsection (a)(1), the Secretary shall ensure that the veteran is furnished counseling under this section in a way that is coordinated with the furnishing of such other care and services under this chapter.”

Subsec. (b)(2)(C). Pub. L. 103–452, §101(f)(1)(B), struck out “women” after “assist”.

Subsec. (c). Pub. L. 103–452, §101(f)(1)(B), struck out “women” after “available to” in introductory provisions.

Pub. L. 103–452, §101(c)(2), redesignated subsec. (d) as (c). Former subsec. (c) redesignated (b).

Subsec. (c)(1). Pub. L. 103–452, §101(g)(1), amended par. (1) generally. Prior to amendment, par. (1) read as follows: “may include establishment of an information system involving the use of a toll-free telephone number (commonly referred to as an 800 number), and”.

Subsec. (c)(2). Pub. L. 103–452, §101(f)(1)(C), substituted “individuals” for “women”.

Subsecs. (d), (e). Pub. L. 103–452, §101(c)(2), redesignated subsec. (e) as (d). Former subsec. (d) redesignated (c).

Information on Telephone Counseling Availability; Personnel Training; Client Confidentiality; Publicity; Report

Section 101(g)(2) to (5) of Pub. L. 103–452 provided that:

“(2) In providing information on counseling available to veterans as required under section 1720D(c)(1) of title 38, United States Code (as amended by paragraph (1)), the Secretary of Veterans Affairs shall ensure that the Department of Veterans Affairs personnel who provide assistance under such section are trained in the provision to persons who have experienced sexual trauma of information about the care and services relating to sexual trauma that are available to veterans in the communities in which such veterans reside, including care and services available under programs of the Department (including the care and services available under section 1720D of such title) and from non-Department agencies or organizations.

“(3) The telephone assistance service shall be operated in a manner that protects the confidentiality of persons who place calls to the system.

“(4) The Secretary shall ensure that information about the availability of the telephone assistance service is visibly posted in Department medical facilities and is advertised through public service announcements, pamphlets, and other means.

“(5) Not later than 18 months after the date of the enactment of this Act [Nov. 2, 1994], the Secretary shall submit to Congress a report on the operation of the telephone assistance service required under section 1720D(c)(1) of title 38, United States Code (as amended by paragraph (1)). The report shall set forth the following:

“(A) The number of persons who sought information during the period covered by the report through a toll-free telephone number regarding services available to veterans relating to sexual trauma, with a separate display of the number of such persons arrayed by State (as such term is defined in section 101(20) of title 38, United States Code).

“(B) A description of the training provided to the personnel who provide such assistance.

“(C) The recommendations and plans of the Secretary for the improvement of the service.”

Transition Period for Eligibility for Counseling

Section 102(b) of Pub. L. 102–585, as amended by Pub. L. 103–210, §2(b), Dec. 20, 1993, 107 Stat. 2497, provided that in the case of a veteran who was discharged or released from active military, naval, or air service before Dec. 31, 1992, the two-year period specified in 38 U.S.C. 1720D(a)(2) was to be treated as ending on Dec. 31, 1994, prior to repeal by Pub. L. 103–452, title I, §101(h), Nov. 2, 1994, 108 Stat. 4785.

Commencement of Provision of Information on Services

Section 104 of Pub. L. 102–585 directed Secretary of Veterans Affairs, not later than 90 days after Nov. 4, 1992, to commence the provision of information on the counseling relating to sexual trauma that is available to women veterans under 38 U.S.C. 1720D.

Report on Implementation of Sexual Trauma Counseling Program

Section 105 of Pub. L. 102–585 directed Secretary of Veterans Affairs, not later than Mar. 31, 1994, to submit to Congress a comprehensive report on the Secretary's actions under 38 U.S.C. 1720D.

§1720E. Nasopharyngeal radium irradiation

(a) The Secretary may provide any veteran a medical examination, and hospital care, medical services, and nursing home care, which the Secretary determines is needed for the treatment of any cancer of the head or neck which the Secretary finds may be associated with the veteran's receipt of nasopharyngeal radium irradiation treatments in active military, naval, or air service.

(b) The Secretary shall provide care and services to a veteran under subsection (a) only on the basis of evidence in the service records of the veteran which document nasopharyngeal radium irradiation treatment in service, except that, notwithstanding the absence of such documentation, the Secretary may provide such care to a veteran who—

(1) served as an aviator in the active military, naval, or air service before the end of the Korean conflict; or

(2) underwent submarine training in active naval service before January 1, 1965.

(Added Pub. L. 105–368, title IX, §901(a), Nov. 11, 1998, 112 Stat. 3360.)

§1720F. Comprehensive program for suicide prevention among veterans

(a) Establishment.—The Secretary shall develop and carry out a comprehensive program designed to reduce the incidence of suicide among veterans incorporating the components described in this section.

(b) Staff Education.—In carrying out the comprehensive program under this section, the Secretary shall provide for mandatory training for appropriate staff and contractors (including all medical personnel) of the Department who interact with veterans. This training shall cover information appropriate to the duties being performed by such staff and contractors. The training shall include information on—

(1) recognizing risk factors for suicide;

(2) proper protocols for responding to crisis situations involving veterans who may be at high risk for suicide; and

(3) best practices for suicide prevention.


(c) Health Assessments of Veterans.—In carrying out the comprehensive program, the Secretary shall direct that medical staff offer mental health in their overall health assessment when veterans seek medical care at a Department medical facility (including a center established under section 1712A of this title) and make referrals, at the request of the veteran concerned, to appropriate counseling and treatment programs for veterans who show signs or symptoms of mental health problems.

(d) Designation of Suicide Prevention Counselors.—In carrying out the comprehensive program, the Secretary shall designate a suicide prevention counselor at each Department medical facility other than centers established under section 1712A of this title. Each counselor shall work with local emergency rooms, police departments, mental health organizations, and veterans service organizations to engage in outreach to veterans and improve the coordination of mental health care to veterans.

(e) Best Practices Research.—In carrying out the comprehensive program, the Secretary shall provide for research on best practices for suicide prevention among veterans. Research shall be conducted under this subsection in consultation with the heads of the following entities:

(1) The Department of Health and Human Services.

(2) The National Institute of Mental Health.

(3) The Substance Abuse and Mental Health Services Administration.

(4) The Centers for Disease Control and Prevention.


(f) Sexual Trauma Research.—In carrying out the comprehensive program, the Secretary shall provide for research on mental health care for veterans who have experienced sexual trauma while in military service. The research design shall include consideration of veterans of a reserve component.

(g) 24-Hour Mental Health Care.—In carrying out the comprehensive program, the Secretary shall provide for mental health care availability to veterans on a 24-hour basis.

(h) Hotline.—In carrying out the comprehensive program, the Secretary may provide for a toll-free hotline for veterans to be staffed by appropriately trained mental health personnel and available at all times.

(i) Outreach and Education for Veterans and Families.—In carrying out the comprehensive program, the Secretary shall provide for outreach to and education for veterans and the families of veterans, with special emphasis on providing information to veterans of Operation Iraqi Freedom and Operation Enduring Freedom and the families of such veterans. Education to promote mental health shall include information designed to—

(1) remove the stigma associated with mental illness;

(2) encourage veterans to seek treatment and assistance for mental illness;

(3) promote skills for coping with mental illness; and

(4) help families of veterans with—

(A) understanding issues arising from the readjustment of veterans to civilian life;

(B) identifying signs and symptoms of mental illness; and

(C) encouraging veterans to seek assistance for mental illness.


(j) Peer Support Counseling Program.—(1) In carrying out the comprehensive program, the Secretary may establish and carry out a peer support counseling program, under which veterans shall be permitted to volunteer as peer counselors—

(A) to assist other veterans with issues related to mental health and readjustment; and

(B) to conduct outreach to veterans and the families of veterans.


(2) In carrying out the peer support counseling program under this subsection, the Secretary shall provide adequate training for peer counselors.

(k) Other Components.—In carrying out the comprehensive program, the Secretary may provide for other actions to reduce the incidence of suicide among veterans that the Secretary considers appropriate.

(Added Pub. L. 110–110, §3(a)(1), Nov. 5, 2007, 121 Stat. 1031.)

Codification

Section 3(a)(1) of Pub. L. 110–110, which directed that this section be added at the end of this chapter, was executed by adding this section at the end of this subchapter, to reflect the probable intent of Congress.

Sense of Congress

Pub. L. 110–110, §2, Nov. 5, 2007, 121 Stat. 1031, provided that: “It is the sense of Congress that—

“(1) suicide among veterans suffering from post-traumatic stress disorder (in this section referred to as ‘PTSD’) is a serious problem; and

“(2) the Secretary of Veterans Affairs should take into consideration the special needs of veterans suffering from PTSD and the special needs of elderly veterans who are at high risk for depression and experience high rates of suicide in developing and implementing the comprehensive program under this Act [enacting this section and provisions set out as a note under section 101 of this title].”

§1720G. Assistance and support services for caregivers

(a) Program of Comprehensive Assistance for Family Caregivers.—(1)(A) The Secretary shall establish a program of comprehensive assistance for family caregivers of eligible veterans.

(B) The Secretary shall only provide support under the program required by subparagraph (A) to a family caregiver of an eligible veteran if the Secretary determines it is in the best interest of the eligible veteran to do so.

(2) For purposes of this subsection, an eligible veteran is any individual who—

(A) is a veteran or member of the Armed Forces undergoing medical discharge from the Armed Forces;

(B) has a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, or air service on or after September 11, 2001; and

(C) is in need of personal care services because of—

(i) an inability to perform one or more activities of daily living;

(ii) a need for supervision or protection based on symptoms or residuals of neurological or other impairment or injury; or

(iii) such other matters as the Secretary considers appropriate.


(3)(A) As part of the program required by paragraph (1), the Secretary shall provide to family caregivers of eligible veterans the following assistance:

(i) To each family caregiver who is approved as a provider of personal care services for an eligible veteran under paragraph (6)—

(I) such instruction, preparation, and training as the Secretary considers appropriate for the family caregiver to provide personal care services to the eligible veteran;

(II) ongoing technical support consisting of information and assistance to address, in a timely manner, the routine, emergency, and specialized caregiving needs of the family caregiver in providing personal care services to the eligible veteran;

(III) counseling; and

(IV) lodging and subsistence under section 111(e) of this title.


(ii) To each family caregiver who is designated as the primary provider of personal care services for an eligible veteran under paragraph (7)—

(I) the assistance described in clause (i);

(II) such mental health services as the Secretary determines appropriate;

(III) respite care of not less than 30 days annually, including 24-hour per day care of the veteran commensurate with the care provided by the family caregiver to permit extended respite;

(IV) medical care under section 1781 of this title; and

(V) a monthly personal caregiver stipend.


(B) Respite care provided under subparagraph (A)(ii)(III) shall be medically and age-appropriate and include in-home care.

(C)(i) The amount of the monthly personal caregiver stipend provided under subparagraph (A)(ii)(V) shall be determined in accordance with a schedule established by the Secretary that specifies stipends based upon the amount and degree of personal care services provided.

(ii) The Secretary shall ensure, to the extent practicable, that the schedule required by clause (i) specifies that the amount of the monthly personal caregiver stipend provided to a primary provider of personal care services for the provision of personal care services to an eligible veteran is not less than the monthly amount a commercial home health care entity would pay an individual in the geographic area of the eligible veteran to provide equivalent personal care services to the eligible veteran.

(iii) If personal care services are not available from a commercial home health entity in the geographic area of an eligible veteran, the amount of the monthly personal caregiver stipend payable under the schedule required by clause (i) with respect to the eligible veteran shall be determined by taking into consideration the costs of commercial providers of personal care services in providing personal care services in geographic areas other than the geographic area of the eligible veteran with similar costs of living.

(4) An eligible veteran and a family member of the eligible veteran seeking to participate in the program required by paragraph (1) shall jointly submit to the Secretary an application therefor in such form and in such manner as the Secretary considers appropriate.

(5) For each application submitted jointly by an eligible veteran and family member, the Secretary shall evaluate—

(A) the eligible veteran—

(i) to identify the personal care services required by the eligible veteran; and

(ii) to determine whether such requirements could be significantly or substantially satisfied through the provision of personal care services from a family member; and


(B) the family member to determine the amount of instruction, preparation, and training, if any, the family member requires to provide the personal care services required by the eligible veteran—

(i) as a provider of personal care services for the eligible veteran; and

(ii) as the primary provider of personal care services for the eligible veteran.


(6)(A) The Secretary shall provide each family member of an eligible veteran who makes a joint application under paragraph (4) the instruction, preparation, and training determined to be required by such family member under paragraph (5)(B).

(B) Upon the successful completion by a family member of an eligible veteran of instruction, preparation, and training under subparagraph (A), the Secretary shall approve the family member as a provider of personal care services for the eligible veteran.

(C) The Secretary shall, subject to regulations the Secretary shall prescribe, provide for necessary travel, lodging, and per diem expenses incurred by a family member of an eligible veteran in undergoing instruction, preparation, and training under subparagraph (A).

(D) If the participation of a family member of an eligible veteran in instruction, preparation, and training under subparagraph (A) would interfere with the provision of personal care services to the eligible veteran, the Secretary shall, subject to regulations as the Secretary shall prescribe and in consultation with the veteran, provide respite care to the eligible veteran during the provision of such instruction, preparation, and training to the family member so that the family member can participate in such instruction, preparation, and training without interfering with the provision of such services to the eligible veteran.

(7)(A) For each eligible veteran with at least one family member who is described by subparagraph (B), the Secretary shall designate one family member of such eligible veteran as the primary provider of personal care services for such eligible veteran.

(B) A primary provider of personal care services designated for an eligible veteran under subparagraph (A) shall be selected from among family members of the eligible veteran who—

(i) are approved under paragraph (6) as a provider of personal care services for the eligible veteran;

(ii) elect to provide the personal care services to the eligible veteran that the Secretary determines the eligible veteran requires under paragraph (5)(A)(i);

(iii) has 1 the consent of the eligible veteran to be the primary provider of personal care services for the eligible veteran; and

(iv) are considered by the Secretary as competent to be the primary provider of personal care services for the eligible veteran.


(C) An eligible veteran receiving personal care services from a family member designated as the primary provider of personal care services for the eligible veteran under subparagraph (A) may, in accordance with procedures the Secretary shall establish for such purposes, revoke consent with respect to such family member under subparagraph (B)(iii).

(D) If a family member designated as the primary provider of personal care services for an eligible veteran under subparagraph (A) subsequently fails to meet any requirement set forth in subparagraph (B), the Secretary—

(i) shall immediately revoke the family member's designation under subparagraph (A); and

(ii) may designate, in consultation with the eligible veteran, a new primary provider of personal care services for the eligible veteran under such subparagraph.


(E) The Secretary shall take such actions as may be necessary to ensure that the revocation of a designation under subparagraph (A) with respect to an eligible veteran does not interfere with the provision of personal care services required by the eligible veteran.

(8) If an eligible veteran lacks the capacity to make a decision under this subsection, the Secretary may, in accordance with regulations and policies of the Department regarding appointment of guardians or the use of powers of attorney, appoint a surrogate for the eligible veteran who may make decisions and take action under this subsection on behalf of the eligible veteran.

(9)(A) The Secretary shall monitor the well-being of each eligible veteran receiving personal care services under the program required by paragraph (1).

(B) The Secretary shall document each finding the Secretary considers pertinent to the appropriate delivery of personal care services to an eligible veteran under the program.

(C) The Secretary shall establish procedures to ensure appropriate follow-up regarding findings described in subparagraph (B). Such procedures may include the following:

(i) Visiting an eligible veteran in the eligible veteran's home to review directly the quality of personal care services provided to the eligible veteran.

(ii) Taking such corrective action with respect to the findings of any review of the quality of personal care services provided an eligible veteran as the Secretary considers appropriate, which may include—

(I) providing additional training to a family caregiver; and

(II) suspending or revoking the approval of a family caregiver under paragraph (6) or the designation of a family caregiver under paragraph (7).


(10) The Secretary shall carry out outreach to inform eligible veterans and family members of eligible veterans of the program required by paragraph (1) and the benefits of participating in the program.

(b) Program of General Caregiver Support Services.—(1) The Secretary shall establish a program of support services for caregivers of covered veterans who are enrolled in the health care system established under section 1705(a) of this title (including caregivers who do not reside with such veterans).

(2) For purposes of this subsection, a covered veteran is any individual who needs personal care services because of—

(A) an inability to perform one or more activities of daily living;

(B) a need for supervision or protection based on symptoms or residuals of neurological or other impairment or injury; or

(C) such other matters as the Secretary shall specify.


(3)(A) The support services furnished to caregivers of covered veterans under the program required by paragraph (1) shall include the following:

(i) Services regarding the administering of personal care services, which, subject to subparagraph (B), shall include—

(I) educational sessions made available both in person and on an Internet website;

(II) use of telehealth and other available technologies; and

(III) teaching techniques, strategies, and skills for caring for a disabled veteran;


(ii) Counseling and other services under section 1782 of this title.

(iii) Respite care under section 1720B of this title that is medically and age appropriate for the veteran (including 24-hour per day in-home care).

(iv) Information concerning the supportive services available to caregivers under this subsection and other public, private, and nonprofit agencies that offer support to caregivers.


(B) If the Secretary certifies to the Committees on Veterans’ Affairs of the Senate and the House of Representatives that funding available for a fiscal year is insufficient to fund the provision of services specified in one or more subclauses of subparagraph (A)(i), the Secretary shall not be required under subparagraph (A) to provide the services so specified in the certification during the period beginning on the date that is 180 days after the date the certification is received by the Committees and ending on the last day of the fiscal year.

(4) In providing information under paragraph (3)(A)(iv), the Secretary shall collaborate with the Assistant Secretary for Aging of the Department of Health and Human Services in order to provide caregivers access to aging and disability resource centers under the Administration on Aging of the Department of Health and Human Services.

(5) In carrying out the program required by paragraph (1), the Secretary shall conduct outreach to inform covered veterans and caregivers of covered veterans about the program. The outreach shall include an emphasis on covered veterans and caregivers of covered veterans living in rural areas.

(c) Construction.—(1) A decision by the Secretary under this section affecting the furnishing of assistance or support shall be considered a medical determination.

(2) Nothing in this section shall be construed to create—

(A) an employment relationship between the Secretary and an individual in receipt of assistance or support under this section; or

(B) any entitlement to any assistance or support provided under this section.


(d) Definitions.—In this section:

(1) The term “caregiver”, with respect to an eligible veteran under subsection (a) or a covered veteran under subsection (b), means an individual who provides personal care services to the veteran.

(2) The term “family caregiver”, with respect to an eligible veteran under subsection (a), means a family member who is a caregiver of the veteran.

(3) The term “family member”, with respect to an eligible veteran under subsection (a), means an individual who—

(A) is a member of the family of the veteran, including—

(i) a parent;

(ii) a spouse;

(iii) a child;

(iv) a step-family member; and

(v) an extended family member; or


(B) lives with the veteran but is not a member of the family of the veteran.


(4) The term “personal care services”, with respect to an eligible veteran under subsection (a) or a covered veteran under subsection (b), means services that provide the veteran the following:

(A) Assistance with one or more independent activities of daily living.

(B) Any other non-institutional extended care (as such term is used in section 1701(6)(E) of this title).


(e) Authorization of Appropriations.—There are authorized to be appropriated to carry out the programs required by subsections (a) and (b)—

(1) $60,000,000 for fiscal year 2010; and

(2) $1,542,000,000 for the period of fiscal years 2011 through 2015.

(Added Pub. L. 111–163, title I, §101(a)(1), May 5, 2010, 124 Stat. 1132.)

Effective Date

Pub. L. 111–163, title I, §101(a)(3), May 5, 2010, 124 Stat. 1137, provided that:

“(A) In general.—The amendments made by this subsection [enacting this section] shall take effect on the date that is 270 days after the date of the enactment of this Act [May 5, 2010].

“(B) Implementation.—The Secretary of Veterans Affairs shall commence the programs required by subsections (a) and (b) of section 1720G of title 38, United States Code, as added by paragraph (1) of this subsection, on the date on which the amendments made by this subsection take effect.”

Annual Evaluation Report

Pub. L. 111–163, title I, §101(c), May 5, 2010, 124 Stat. 1138, provided that:

“(1) In general.—Not later than 2 years after the date described in subsection (a)(3)(A) [see Effective Date note above] and annually thereafter, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a comprehensive report on the implementation of section 1720G of title 38, United States Code, as added by subsection (a)(1).

“(2) Contents.—The report required by paragraph (1) shall include the following:

“(A) With respect to the program of comprehensive assistance for family caregivers required by subsection (a)(1) of such section 1720G and the program of general caregiver support services required by subsection (b)(1) of such section—

“(i) the number of caregivers that received assistance under such programs;

“(ii) the cost to the Department of providing assistance under such programs;

“(iii) a description of the outcomes achieved by, and any measurable benefits of, carrying out such programs;

“(iv) an assessment of the effectiveness and the efficiency of the implementation of such programs; and

“(v) such recommendations, including recommendations for legislative or administrative action, as the Secretary considers appropriate in light of carrying out such programs.

“(B) With respect to the program of comprehensive assistance for family caregivers required by such subsection (a)(1)—

“(i) a description of the outreach activities carried out by the Secretary under such program; and

“(ii) an assessment of the manner in which resources are expended by the Secretary under such program, particularly with respect to the provision of monthly personal caregiver stipends under paragraph (3)(A)(ii)(v) of such subsection (a).

“(C) With respect to the provision of general caregiver support services required by such subsection (b)(1)—

“(i) a summary of the support services made available under the program;

“(ii) the number of caregivers who received support services under the program;

“(iii) the cost to the Department of providing each support service provided under the program; and

“(iv) such other information as the Secretary considers appropriate.”

1 So in original. Probably should be “have”.

SUBCHAPTER III—MISCELLANEOUS PROVISIONS RELATING TO HOSPITAL AND NURSING HOME CARE AND MEDICAL TREATMENT OF VETERANS

Amendments

1976—Pub. L. 94–581, title II, §202(i), Oct. 21, 1976, 90 Stat. 2856, inserted “AND NURSING HOME” in subchapter heading.

§1721. Power to make rules and regulations

Rules and regulations prescribed under section 501(a) of this title shall include rules and regulations to promote good conduct on the part of persons who are receiving hospital, nursing home, and domiciliary care and medical services in Department facilities. The Secretary may prescribe in rules and regulations under such section limitations in connection with the furnishing of such care and services during a period of national emergency (other than a period of war or an emergency described in section 8111A of this title).

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1143, §621; Pub. L. 94–581, title II, §§202(j), 210(a)(8), Oct. 21, 1976, 90 Stat. 2856, 2863; Pub. L. 100–322, title I, §133, May 20, 1988, 102 Stat. 507; Pub. L. 102–40, title IV, §402(d)(1), May 7, 1991, 105 Stat. 239; renumbered §1721 and amended Pub. L. 102–83, §§2(c)(1), 4(a)(3), (4), (b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 402, 404–406.)

Prior Provisions

Prior section 1721 was renumbered section 3521 of this title.

Amendments

1991—Pub. L. 102–83, §5(a), renumbered section 621 of this title as this section.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Pub. L. 102–83, §2(c)(1), substituted “501(a)” for “210(c)(1)”.

Pub. L. 102–40 substituted “8111A” for “5011A”.

1988—Pub. L. 100–322 amended section generally. Prior to amendment, section read as follows: “The Administrator shall prescribe—

“(1) such rules and procedure governing the furnishing of hospital, nursing home, and domiciliary care as the Administrator may deem proper and necessary;

“(2) limitations in connection with the furnishing of hospital, nursing home, and domiciliary care; and

“(3) such rules and regulations as the Administrator deems necessary in order to promote good conduct on the part of persons who are receiving hospital, nursing home, or domiciliary care in Veterans’ Administration facilities.”

1976—Cl. (1). Pub. L. 94–581, §§202(j), 210(a)(8), substituted “hospital, nursing home, and domiciliary care as the Administrator may deem” for “hospital and domiciliary care as he may deem”.

Cl. (2). Pub. L. 94–581, §202(j), substituted “hospital, nursing home, and domiciliary care” for “hospital and domiciliary care”.

Cl. (3). Pub. L. 94–581, §§202(j), 210(a)(8), substituted “as the Administrator deems” for “as he deems” and “hospital, nursing home, or domiciliary care” for “hospital or domiciliary care”.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

§1722. Determination of inability to defray necessary expenses; income thresholds

(a) For the purposes of section 1710(a)(2)(G) of this title, a veteran shall be considered to be unable to defray the expenses of necessary care if—

(1) the veteran is eligible to receive medical assistance under a State plan approved under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.);

(2) the veteran is in receipt of pension under section 1521 of this title; or

(3) the veteran's attributable income is not greater than the amount set forth in subsection (b).


(b)(1) For purposes of subsection (a)(3), the income threshold for the calendar year beginning on January 1, 1990, is—

(A) $17,240 in the case of a veteran with no dependents; and

(B) $20,688 in the case of a veteran with one dependent, plus $1,150 for each additional dependent.


(2) For a calendar year beginning after December 31, 1990, the amounts in effect for purposes of this subsection shall be the amounts in effect for the preceding calendar year as adjusted under subsection (c) of this section.

(c) Effective on January 1 of each year, the amounts in effect under subsection (b) of this section shall be increased by the percentage by which the maximum rates of pension were increased under section 5312(a) of this title during the preceding calendar year.

(d)(1) Notwithstanding the attributable income of a veteran, the Secretary may refuse to make a determination described in paragraph (2) of this subsection if the corpus of the estate of the veteran is such that under all the circumstances it is reasonable that some part of the corpus of the estate of the veteran be consumed for the veteran's maintenance.

(2) A determination described in this paragraph is a determination that for purposes of subsection (a)(3) of this section a veteran's attributable income is not greater than the amount determined under subsection (b) of this section.

(3) For the purposes of paragraph (1) of this subsection, the corpus of the estate of a veteran shall be determined in the same manner as the manner in which determinations are made of the corpus of the estates of persons under section 1522 of this title.

(e)(1) In order to avoid a hardship to a veteran described in paragraph (2) of this subsection, the Secretary may deem the veteran to have an attributable income during the previous year not greater than the amount determined under subsection (b) of this section.

(2) A veteran is described in this paragraph for the purposes of subsection (a) of this section if—

(A) the veteran has an attributable income greater than the amount determined under subsection (b) of this section; and

(B) the current projections of such veteran's income for the current year are that the veteran's income for such year will be substantially below the amount determined under subsection (b).


(f) For purposes of this section:

(1) The term “attributable income” means the income of a veteran for the previous year determined in the same manner as the manner in which a determination is made of the total amount of income by which the rate of pension for such veteran under section 1521 of this title would be reduced if such veteran were eligible for pension under that section.

(2) The term “corpus of the estate of the veteran” includes the corpus of the estates of the veteran's spouse and dependent children, if any.

(3) The term “previous year” means the calendar year preceding the year in which the veteran applies for care or services under section 1710(a) of this title.


(g) For the purposes of section 1724(c) of this title, the fact that a veteran is—

(1) eligible to receive medical assistance under a State plan approved under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.);

(2) a veteran with a service-connected disability; or

(3) in receipt of pension under any law administered by the Secretary,


shall be accepted as sufficient evidence of such veteran's inability to defray necessary expenses.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1144, §622; Pub. L. 89–612, §1, Sept. 30, 1966, 80 Stat. 859; Pub. L. 91–500, §1, Oct. 22, 1970, 84 Stat. 1096; Pub. L. 94–581, title II, §§202(k), 210(a)(9), Oct. 21, 1976, 90 Stat. 2856, 2863; Pub. L. 96–330, title IV, §401(a), Aug. 26, 1980, 94 Stat. 1051; Pub. L. 99–272, title XIX, §19011(c)(1), Apr. 7, 1986, 100 Stat. 376; Pub. L. 100–322, title I, §102(b), May 20, 1988, 102 Stat. 493; Pub. L. 101–508, title VIII, §8013(c), Nov. 5, 1990, 104 Stat. 1388–346; Pub. L. 102–40, title IV, §402(d)(1), May 7, 1991, 105 Stat. 239; renumbered §1722 and amended Pub. L. 102–83, §§4(a)(1), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 403–406; Pub. L. 104–262, title I, §101(d)(9), Oct. 9, 1996, 110 Stat. 3180.)

References in Text

The Social Security Act, referred to in subsecs. (a)(1) and (g)(1), is act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Title XIX of the Social Security Act is classified generally to subchapter XIX (§1396 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.

Prior Provisions

Prior section 1722, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1196, related to change of program by eligible person, prior to repeal by Pub. L. 92–540, title IV, §402(2), Oct. 24, 1972, 86 Stat. 1090. See section 3691 of this title.

Amendments

1996—Subsec. (a). Pub. L. 104–262, §101(d)(9)(A), substituted “section 1710(a)(2)(G)” for “section 1710(a)(1)(I)” in introductory provisions.

Subsec. (f)(3). Pub. L. 104–262, §101(d)(9)(B), struck out “or 1712(f)” before “of this title”.

1991—Pub. L. 102–83, §5(a), renumbered section 622 of this title as this section.

Subsec. (a). Pub. L. 102–83, §5(c)(1), substituted “1710(a)(1)(I)” for “610(a)(1)(I)” in introductory provisions and “1521” for “521” in par. (2).

Subsec. (c). Pub. L. 102–40 substituted “5312(a)” for “3112(a)”.

Subsec. (d)(1). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Subsec. (d)(3). Pub. L. 102–83, §5(c)(1), substituted “1522” for “522”.

Subsec. (e)(1). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Subsec. (f). Pub. L. 102–83, §5(c)(1), substituted “1521” for “521” in par. (1) and “1710(a) or 1712(f)” for “610(a) or 612(f)” in par. (3).

Subsec. (g). Pub. L. 102–83, §5(c)(1), substituted “1724(c)” for “624(c)” in introductory provisions.

Pub. L. 102–83, §4(a)(1), substituted “administered by the Secretary” for “administered by the Veterans’ Administration” in par. (3).

1990—Subsec. (a). Pub. L. 101–508, §8013(c)(1), designated par. (1) as entire subsec. (a), redesignated cls. (A) to (C) as pars. (1) to (3), respectively, substituted “amount set forth in subsection (b)” for “Category A threshold” in par. (3), and struck out former par. (2) which read as follows: “For the purposes of section 610(a)(2)(A) of this title, a veteran's income level is described in this paragraph if the veteran's attributable income is not greater than the Category B threshold.”

Subsec. (b). Pub. L. 101–508, §8013(c)(2), amended subsec. (b) generally. Prior to amendment, subsec. (b) read as follows: “For the purposes of this section:

“(1) The Category A threshold—

“(A) for the calendar year beginning on January 1, 1986, is—

“(i) $15,000 in the case of a veteran with no dependents; and

“(ii) $18,000 in the case of a veteran with one dependent, plus $1,000 for each additional dependent; and

“(B) for a calendar year beginning after December 31, 1986, is the amount in effect for purposes of this paragraph for the preceding calendar year as adjusted under subsection (c) of this subsection.

“(2) The Category B threshold—

“(A) for the calendar year beginning on January 1, 1986, is—

“(i) $20,000 in the case of a veteran with no dependents; and

“(ii) $25,000 in the case of a veteran with one dependent, plus $1,000 for each additional dependent; and

“(B) for a calendar year beginning after December 31, 1986, is the amount in effect for purposes of this paragraph for the preceding calendar year as adjusted under subsection (c) of this subsection.”

Subsec. (c). Pub. L. 101–508, §8013(c)(3), struck out “paragraphs (1) and (2) of” before “subsection (b) of this section”.

Subsec. (d)(2). Pub. L. 101–508, §8013(c)(4), amended par. (2) generally. Prior to amendment, par. (2) read as follows: “A determination described in this paragraph is a determination—

“(A) that for the purposes of subsection (a)(1)(C) of this section a veteran's attributable income is not greater than the Category A threshold; or

“(B) that for the purposes of subsection (a)(2) of this section a veteran's attributable income is not greater than the Category B threshold.”

Subsec. (e)(1). Pub. L. 101–508, §8013(c)(5)(A), substituted “the amount determined under subsection (b) of this section” for “the Category A threshold or the Category B threshold, as appropriate”.

Subsec. (e)(2). Pub. L. 101–508, §8013(c)(5)(B), added par. (2) and struck out former par. (2) which read as follows:

“(A) A veteran is described in this paragraph for the purposes of subsection (a)(1) of this section if—

“(i) the veteran has an attributable income greater than the Category A threshold; and

“(ii) the current projections of such veteran's income for the current year are that the veteran's income for such year will be substantially below such threshold.

“(B) A veteran is described in this paragraph for the purposes of subsection (a)(2) of this section if—

“(i) the veteran has an attributable income greater than the Category B threshold; and

“(ii) the current projections of such veteran's income for the current year are that the veteran's income for such year will be substantially below such threshold.”

1988—Subsec. (g). Pub. L. 100–322 substituted “section” for “sections 610(b)(2) and”.

1986—Pub. L. 99–272 amended section generally, revising and restating existing provisions as subsec. (g) and adding subsecs. (a) to (f).

1980—Pub. L. 96–330 substituted provisions relating to the facts that will be accepted as sufficient evidence of an individual's inability to defray necessary expenses for provisions relating to the use of statements under oath to establish the inability to defray necessary expenses.

1976—Subsec. (a). Pub. L. 94–581, §202(k), substituted “610(a)(1)(B)” for “610(a)(1)” and “632(a)(2)” for “632(b)”.

Subsec. (b). Pub. L. 94–581, §210(a)(9), substituted “such veteran's inability” for “his inability”.

1970—Pub. L. 91–500 designated existing provisions as subsec. (a) and added subsec. (b).

1966—Pub. L. 89–612 inserted reference to section 632(b) of this title.

Effective Date of 1990 Amendment

Amendment by Pub. L. 101–508 to remain in effect through the period covered by Pub. L. 102–145, see section 111 of Pub. L. 102–145, set out as a note under section 1710 of this title.

Amendment by Pub. L. 101–508 to remain in effect through the period covered by Pub. L. 102–109, see section 111 of Pub. L. 102–109, set out as a note under section 1710 of this title.

Amendment by Pub. L. 101–508 applicable with respect to hospital care and medical services received after Nov. 5, 1990, see section 8013(d) of Pub. L. 101–508, as amended, set out as a note under section 1710 of this title.

Effective Date of 1986 Amendment

Provisions of this section as in effect on the day before Apr. 7, 1986, applicable with respect to hospital and nursing home care furnished on or after July 1, 1986, to veterans furnished such care or services on June 30, 1986, but only to the extent that such care is furnished with respect to the same episode of care for which it was furnished on June 30, 1986, see section 19011(f) of Pub. L. 99–272, set out as a note under section 1710 of this title.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Initial Increase Under Subsection (c)

Section 19011(c)(3) of Pub. L. 99–272 provided that the first increase under subsection (c) of this section, as added by section 19011(c)(1) of Pub. L. 99–272, was to take effect on Jan. 1, 1987.”

§1722A. Copayment for medications

(a)(1) Subject to paragraph (2), the Secretary shall require a veteran to pay the United States $2 for each 30-day supply of medication furnished such veteran under this chapter on an outpatient basis for the treatment of a non-service-connected disability or condition. If the amount supplied is less than a 30-day supply, the amount of the charge may not be reduced.

(2) The Secretary may not require a veteran to pay an amount in excess of the cost to the Secretary for medication described in paragraph (1).

(3) Paragraph (1) does not apply—

(A) to a veteran with a service-connected disability rated 50 percent or more;

(B) to a veteran who is a former prisoner of war; or

(C) to a veteran whose annual income (as determined under section 1503 of this title) does not exceed the maximum annual rate of pension which would be payable to such veteran if such veteran were eligible for pension under section 1521 of this title.


(b) The Secretary, pursuant to regulations which the Secretary shall prescribe, may—

(1) increase the copayment amount in effect under subsection (a); and

(2) establish a maximum monthly and a maximum annual pharmaceutical copayment amount under subsection (a) for veterans who have multiple outpatient prescriptions.


(c) Amounts collected under this section shall be deposited in the Department of Veterans Affairs Medical Care Collections Fund.

(Added Pub. L. 101–508, title VIII, §8012(a)(1), Nov. 5, 1990, 104 Stat. 1388–345, §622A; renumbered §1722A, Pub. L. 102–83, §5(a), Aug. 6, 1991, 105 Stat. 406; amended Pub. L. 102–139, title V, §518(a), Oct. 28, 1991, 105 Stat. 779; Pub. L. 102–229, title I, Dec. 12, 1991, 105 Stat. 1709; Pub. L. 102–568, title VI, §§605(a), 606(a), Oct. 29, 1992, 106 Stat. 4343; Pub. L. 103–66, title XII, §12002(b), Aug. 10, 1993, 107 Stat. 414; Pub. L. 103–446, title XII, §1201(e)(7), Nov. 2, 1994, 108 Stat. 4685; Pub. L. 105–33, title VIII, §§8021(b), 8023(b)(3), Aug. 5, 1997, 111 Stat. 665, 667; Pub. L. 106–117, title II, §201(a), Nov. 30, 1999, 113 Stat. 1560; Pub. L. 108–7, div. K, title I, §113(c), Feb. 20, 2003, 117 Stat. 482; Pub. L. 108–170, title I, §101(b), Dec. 6, 2003, 117 Stat. 2043.)

Amendments

2003—Subsec. (a)(3)(B), (C). Pub. L. 108–170 added subpar. (B) and redesignated former subpar. (B) as (C).

Subsec. (c). Pub. L. 108–7, §113(c)(1), substituted “under this section” for “under subsection (a)” in first sentence and struck out second sentence which read as follows: “Amounts collected through use of the authority under subsection (b) shall be deposited in the Department of Veterans Affairs Health Services Improvement Fund.”

Subsec. (d). Pub. L. 108–7, §113(c)(2), struck out subsec. (d) which read as follows: “The provisions of subsection (a) expire on September 30, 2002.”

1999—Subsec. (b). Pub. L. 106–117, §201(a)(1), (2), added subsec. (b). Former subsec. (b) redesignated (c).

Subsec. (c). Pub. L. 106–117, §201(a)(1), (3), redesignated subsec. (b) as (c), substituted “subsection (a)” for “this section”, and inserted at end “Amounts collected through use of the authority under subsection (b) shall be deposited in the Department of Veterans Affairs Health Services Improvement Fund.” Former subsec. (c) redesignated (d).

Subsec. (d). Pub. L. 106–117, §201(a)(1), redesignated subsec. (c) as (d).

1997—Subsec. (b). Pub. L. 105–33, §8023(b)(3), substituted “Medical Care Collections Fund” for “Medical-Care Cost Recovery Fund”.

Subsec. (c). Pub. L. 105–33, §8021(b), substituted “September 30, 2002” for “September 30, 1998”.

1994—Subsec. (a)(1). Pub. L. 103–446 substituted “veteran to pay” for “veteran) to pay”.

1993—Subsec. (c). Pub. L. 103–66 substituted “1998” for “1992” in first sentence and struck out at end “Notwithstanding the preceding sentence, the provisions of subsection (a) shall be in effect through September 30, 1997.”

1992—Subsec. (a)(1). Pub. L. 102–568, §605(a)(1), struck out “(other than a veteran with a service-connected disability rated 50 percent or more” after “require a veteran”.

Subsec. (a)(3). Pub. L. 102–568, §605(a)(2), added par. (3).

Subsec. (c). Pub. L. 102–568, §606(a), inserted at end “Notwithstanding the preceding sentence, the provisions of subsection (a) shall be in effect through September 30, 1997.”

1991—Pub. L. 102–83 renumbered section 622A of this title as this section.

Subsec. (c). Pub. L. 102–139, as amended by Pub. L. 102–229, substituted “September 30, 1992” for “September 30, 1991”.

Effective Date of 1997 Amendment

Amendment by section 8023(b)(3) of Pub. L. 105–33 effective Oct. 1, 1997, see section 8023(g) of Pub. L. 105–33, set out as a note under section 1710 of this title.

Effective Date of 1992 Amendment

Section 605(b) of Pub. L. 102–568 provided that: “The amendments made by subsection (a) [amending this section] shall apply with respect to medication furnished after the date of the enactment of this Act [Oct. 29, 1992].”

Effective and Termination Dates

Section to remain in effect through the period covered by Pub. L. 102–145, see section 111 of Pub. L. 102–145, set out as an Effective and Termination Dates of 1990 Amendment note under section 1710 of this title.

Section to remain in effect through the period covered by Pub. L. 102–109, see section 111 of Pub. L. 102–109, set out as an Effective and Termination Dates of 1990 Amendment note under section 1710 of this title.

Section 8012(b) of Pub. L. 101–508 provided that: “The amendments made by subsection (a) [enacting this section] shall take effect with respect to medication furnished to a veteran after October 31, 1990, or the date of the enactment of this Act [Nov. 5, 1990], whichever is later.”

§1723. Furnishing of clothing

The Secretary shall not furnish clothing to persons who are in Department facilities, except (1) where the furnishing of such clothing to indigent persons is necessary to protect health or sanitation, and (2) where the Secretary furnishes veterans with special clothing made necessary by the wearing of prosthetic appliances.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1144, §623; Pub. L. 94–581, title II, §210(a)(10), Oct. 21, 1976, 90 Stat. 2863; renumbered §1723 and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.)

Prior Provisions

Prior section 1723 was renumbered section 3523 of this title.

Amendments

1991—Pub. L. 102–83, §5(a), renumbered section 623 of this title as this section.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

1976—Pub. L. 94–581 substituted “the Administrator furnishes” for “he furnishes”.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

§1724. Hospital care, medical services, and nursing home care abroad

(a) Except as provided in subsections (b) and (c), the Secretary shall not furnish hospital or domiciliary care or medical services outside any State.

(b)(1) The Secretary may furnish hospital care and medical services outside a State to a veteran who is otherwise eligible to receive hospital care and medical services if the Secretary determines that such care and services are needed for the treatment of a service-connected disability of the veteran or as part of a rehabilitation program under chapter 31 of this title.

(2) Care and services for a service-connected disability of a veteran who is not a citizen of the United States may be furnished under this subsection only—

(A) if the veteran is in the Republic of the Philippines or in Canada; or

(B) if the Secretary determines, as a matter of discretion and pursuant to regulations which the Secretary shall prescribe, that it is appropriate and feasible to furnish such care and services.


(c) Within the limits of those facilities of the Veterans Memorial Medical Center at Manila, Republic of the Philippines, for which the Secretary may contract, the Secretary may furnish necessary hospital care to a veteran for any non-service-connected disability if such veteran is unable to defray the expenses of necessary hospital care. The Secretary may enter into contracts to carry out this section.

(d) The Secretary may furnish nursing home care, on the same terms and conditions set forth in section 1720(a) of this title, to any veteran who has been furnished hospital care in the Philippines pursuant to this section, but who requires a protracted period of nursing home care.

(e) Within the limits of an outpatient clinic in the Republic of the Philippines that is under the direct jurisdiction of the Secretary, the Secretary may furnish a veteran who has a service-connected disability with such medical services as the Secretary determines to be needed.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1144, §624; Pub. L. 86–152, Aug. 11, 1959, 73 Stat. 332; Pub. L. 86–624, §25(a), July 12, 1960, 74 Stat. 418; Pub. L. 87–815, §4, Oct. 15, 1962, 76 Stat. 927; Pub. L. 93–82, title I, §108, Aug. 2, 1973, 87 Stat. 186; Pub. L. 94–581, title II, §§202(l), 210(a)(11), Oct. 21, 1976, 90 Stat. 2856, 2863; Pub. L. 95–520, §3(a), Oct. 26, 1978, 92 Stat. 1820; Pub. L. 97–72, title I, §107(a), Nov. 3, 1981, 95 Stat. 1051; Pub. L. 97–295, §4(20), Oct. 12, 1982, 96 Stat. 1306; Pub. L. 100–322, title I, §105, May 20, 1988, 102 Stat. 493; renumbered §1724 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 106–377, §1(a)(1) [title V, §501(c)], Oct. 27, 2000, 114 Stat. 1441, 1441A–58.)

Prior Provisions

Prior section 1724 was renumbered section 3524 of this title.

Prior section 1725, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1197, related to period of operation for approval by Administrator, prior to repeal by Pub. L. 92–540, title IV, §402(2), Oct. 24, 1972, 86 Stat. 1090. See section 3689 of this title.

Amendments

2000—Subsec. (e). Pub. L. 106–377 added subsec. (e).

1991—Pub. L. 102–83, §5(a), renumbered section 624 of this title as this section.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Subsec. (d). Pub. L. 102–83, §5(c)(1), substituted “1720(a)” for “620(a)”.

1988—Subsec. (b). Pub. L. 100–322 amended subsec. (b) generally. Prior to amendment, subsec. (b) read as follows: “The Administrator may furnish necessary hospital care and medical services to any otherwise eligible veteran for any service-connected disability if the veteran (1) is a citizen of the United States sojourning or residing abroad, or (2) is in the Republic of the Philippines.”

1982—Pub. L. 97–295 substituted “Hospital care, medical services, and nursing home care abroad” for “Hospital care and medical services abroad” in section catchline, without regard to a prior amendment by Pub. L. 93–82, which had substituted “Hospital care, medical services and nursing home care abroad” for “Hospital care and medical services abroad”. See 1973 Amendment note below.

1981—Subsec. (d). Pub. L. 97–72 struck out “and at the same rate as specified in section 632(a)(4) of this title” after “on the same terms and conditions set forth in section 620(a) of this title”.

1978—Subsec. (c). Pub. L. 95–520 substituted “Veterans Memorial Medical Center” for “Veterans Memorial Hospital”.

1976—Subsec. (c). Pub. L. 94–581 substituted “the Administrator may furnish” for “he may furnish” and “hospital care to a veteran for any” for “hospital care to a veteran of any war for any”.

1973—Pub. L. 93–82, §108(b), substituted “Hospital care, medical services and nursing home care abroad” for “Hospital care and medical services abroad” in section catchline.

Subsec. (d). Pub. L. 93–82, §108(a), added subsec. (d).

1962—Subsec. (b). Pub. L. 87–815 struck out “temporarily” before “sojourning”.

1960—Subsec. (a). Pub. L. 86–624 substituted “outside any State” for “outside the continental limits of the United States, or a Territory, Commonwealth, or possession of the United States”.

1959—Subsec. (b). Pub. L. 86–152 extended authority to provide hospital and medical care for veterans who are United States citizens temporarily residing abroad to include those with peacetime service-incurred disabilities.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Effective Date of 1973 Amendment

Amendment by Pub. L. 93–82 effective Sept. 1, 1973, see section 501 of Pub. L. 93–82, set out as a note under section 1701 of this title.

§1725. Reimbursement for emergency treatment

(a) General Authority.—(1) Subject to subsections (c) and (d), the Secretary shall reimburse a veteran described in subsection (b) for the reasonable value of emergency treatment furnished the veteran in a non-Department facility.

(2) In any case in which reimbursement is authorized under subsection (a)(1), the Secretary, in the Secretary's discretion, may, in lieu of reimbursing the veteran, make payment of the reasonable value of the furnished emergency treatment directly—

(A) to a hospital or other health care provider that furnished the treatment; or

(B) to the person or organization that paid for such treatment on behalf of the veteran.


(b) Eligibility.—(1) A veteran referred to in subsection (a)(1) is an individual who is an active Department health-care participant who is personally liable for emergency treatment furnished the veteran in a non-Department facility.

(2) A veteran is an active Department health-care participant if—

(A) the veteran is enrolled in the health care system established under section 1705(a) of this title; and

(B) the veteran received care under this chapter within the 24-month period preceding the furnishing of such emergency treatment.


(3) A veteran is personally liable for emergency treatment furnished the veteran in a non-Department facility if the veteran—

(A) is financially liable to the provider of emergency treatment for that treatment;

(B) has no entitlement to care or services under a health-plan contract (determined, in the case of a health-plan contract as defined in subsection (f)(2)(B) or (f)(2)(C), without regard to any requirement or limitation relating to eligibility for care or services from any department or agency of the United States);

(C) has no other contractual or legal recourse against a third party that would, in whole, extinguish such liability to the provider; and

(D) is not eligible for reimbursement for medical care or services under section 1728 of this title.


(c) Limitations on Reimbursement.—(1) The Secretary, in accordance with regulations prescribed by the Secretary, shall—

(A) establish the maximum amount payable under subsection (a);

(B) delineate the circumstances under which such payments may be made, to include such requirements on requesting reimbursement as the Secretary shall establish; and

(C) provide that in no event may a payment under that subsection include any amount for which the veteran is not personally liable.


(2) Subject to paragraph (1), the Secretary may provide reimbursement under this section only after the veteran or the provider of emergency treatment has exhausted without success all claims and remedies reasonably available to the veteran or provider against a third party for payment of such treatment.

(3) Payment by the Secretary under this section on behalf of a veteran to a provider of emergency treatment shall, unless rejected and refunded by the provider within 30 days of receipt, extinguish any liability on the part of the veteran for that treatment. Neither the absence of a contract or agreement between the Secretary and the provider nor any provision of a contract, agreement, or assignment to the contrary shall operate to modify, limit, or negate the requirement in the preceding sentence.

(4)(A) If the veteran has contractual or legal recourse against a third party that would only, in part, extinguish the veteran's liability to the provider of the emergency treatment, and payment for the treatment may be made both under subsection (a) and by the third party, the amount payable for such treatment under such subsection shall be the amount by which the costs for the emergency treatment exceed the amount payable or paid by the third party, except that the amount payable may not exceed the maximum amount payable established under paragraph (1)(A).

(B) In any case in which a third party is financially responsible for part of the veteran's emergency treatment expenses, the Secretary shall be the secondary payer.

(C) A payment in the amount payable under subparagraph (A) shall be considered payment in full and shall extinguish the veteran's liability to the provider.

(D) The Secretary may not reimburse a veteran under this section for any copayment or similar payment that the veteran owes the third party or for which the veteran is responsible under a health-plan contract.

(d) Independent Right of Recovery.—(1) In accordance with regulations prescribed by the Secretary, the United States shall have the independent right to recover any amount paid under this section when, and to the extent that, a third party subsequently makes a payment for the same emergency treatment.

(2) Any amount paid by the United States to the veteran (or the veteran's personal representative, successor, dependents, or survivors) or to any other person or organization paying for such treatment shall constitute a lien in favor of the United States against any recovery the payee subsequently receives from a third party for the same treatment.

(3) Any amount paid by the United States to the provider that furnished the veteran's emergency treatment shall constitute a lien against any subsequent amount the provider receives from a third party for the same emergency treatment for which the United States made payment.

(4) The veteran (or the veteran's personal representative, successor, dependents, or survivors) shall ensure that the Secretary is promptly notified of any payment received from any third party for emergency treatment furnished to the veteran. The veteran (or the veteran's personal representative, successor, dependents, or survivors) shall immediately forward all documents relating to such payment, cooperate with the Secretary in the investigation of such payment, and assist the Secretary in enforcing the United States right to recover any payment made under subsection (c)(3).

(e) Waiver.—The Secretary, in the Secretary's discretion, may waive recovery of a payment made to a veteran under this section that is otherwise required by subsection (d)(1) when the Secretary determines that such waiver would be in the best interest of the United States, as defined by regulations prescribed by the Secretary.

(f) Definitions.—For purposes of this section:

(1) The term “emergency treatment” means medical care or services furnished, in the judgment of the Secretary—

(A) when Department or other Federal facilities are not feasibly available and an attempt to use them beforehand would not be reasonable;

(B) when such care or services are rendered in a medical emergency of such nature that a prudent layperson reasonably expects that delay in seeking immediate medical attention would be hazardous to life or health; and

(C) until—

(i) such time as the veteran can be transferred safely to a Department facility or other Federal facility and such facility is capable of accepting such transfer; or

(ii) such time as a Department facility or other Federal facility accepts such transfer if—

(I) at the time the veteran could have been transferred safely to a Department facility or other Federal facility, no Department facility or other Federal facility agreed to accept such transfer; and

(II) the non-Department facility in which such medical care or services was furnished made and documented reasonable attempts to transfer the veteran to a Department facility or other Federal facility.


(2) The term “health-plan contract” includes any of the following:

(A) An insurance policy or contract, medical or hospital service agreement, membership or subscription contract, or similar arrangement under which health services for individuals are provided or the expenses of such services are paid.

(B) An insurance program described in section 1811 of the Social Security Act (42 U.S.C. 1395c) or established by section 1831 of that Act (42 U.S.C. 1395j).

(C) A State plan for medical assistance approved under title XIX of such Act (42 U.S.C. 1396 et seq.).

(D) A workers’ compensation law or plan described in section 1729(a)(2)(A) of this title.


(3) The term “third party” means any of the following:

(A) A Federal entity.

(B) A State or political subdivision of a State.

(C) An employer or an employer's insurance carrier.

(D) An automobile accident reparations insurance carrier.

(E) A person or entity obligated to provide, or to pay the expenses of, health services under a health-plan contract.

(Added Pub. L. 106–117, title I, §111(a), Nov. 30, 1999, 113 Stat. 1553; amended Pub. L. 110–387, title IV, §402(a), Oct. 10, 2008, 122 Stat. 4123; Pub. L. 111–137, §1(a), (b), Feb. 1, 2010, 123 Stat. 3495.)

References in Text

The Social Security Act, referred to in subsec. (f)(2), is act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Title XIX of the Act is classified generally to subchapter XIX (§1396 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.

Amendments

2010—Subsec. (b)(3)(C). Pub. L. 111–137, §1(a)(1), struck out “or in part” after “in whole”.

Subsec. (c)(4). Pub. L. 111–137, §1(b), added par. (4).

Subsec. (f)(2)(E). Pub. L. 111–137, §1(a)(2), struck out subpar. (E) which read as follows: “A law of a State or political subdivision described in section 1729(a)(2)(B) of this title.”

2008—Subsec. (a)(1). Pub. L. 110–387, §402(a)(1), substituted “shall reimburse” for “may reimburse”.

Subsec. (f)(1)(C). Pub. L. 110–387, §402(a)(2), added subpar. (C) and struck out former subpar. (C) which read as follows: “until such time as the veteran can be transferred safely to a Department facility or other Federal facility”.

Effective Date of 2010 Amendment

Pub. L. 111–137, §1(c), Feb. 1, 2010, 123 Stat. 3495, provided that:

“(1) In general.—The amendments made by subsections (a) and (b) [amending this section] shall take effect on the date of the enactment of this Act [Feb. 1, 2010], and shall apply with respect to emergency treatment furnished on or after the date of the enactment of this Act.

“(2) Reimbursement for treatment provided before effective date.—The Secretary may provide reimbursement under section 1725 of title 38, United States Code, as amended by subsections (a) and (b), for emergency treatment furnished to a veteran before the date of the enactment of this Act [Feb. 1, 2010], if the Secretary determines that, under the circumstances applicable with respect to the veteran, it is appropriate to do so.”

Effective Date

Pub. L. 106–117, title I, §111(c), Nov. 30, 1999, 113 Stat. 1556, provided that: “The amendments made by this section [enacting this section and amending section 1729A of this title] shall take effect 180 days after the date of the enactment of this Act [Nov. 30, 1999].”

Implementation Reports

Pub. L. 106–117, title I, §111(d), Nov. 30, 1999, 113 Stat. 1556, provided that: “The Secretary [of Veterans Affairs] shall include with the budget justification materials submitted to Congress in support of the Department of Veterans Affairs budget for fiscal year 2002 and for fiscal year 2003 a report on the implementation of section 1725 of title 38, United States Code, as added by subsection (a). Each such report shall include information on the experience of the Department under that section and the costs incurred, and expected to be incurred, under that section.”

§1726. Reimbursement for loss of personal effects by natural disaster

The Secretary shall, under regulations which the Secretary shall prescribe, reimburse veterans in Department hospitals and domiciliaries for any loss of personal effects sustained by fire, earthquake, or other natural disaster while such effects were stored in designated locations in Department hospitals or domiciliaries.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1144, §627; Pub. L. 93–82, title I, §105, Aug. 2, 1973, 87 Stat. 183; Pub. L. 94–581, title II, §210(a)(12), Oct. 21, 1976, 90 Stat. 2863; renumbered §1726 and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.)

Prior Provisions

Prior section 1726, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1197, provided for control by agencies of United States, prior to repeal by Pub. L. 89–358, §3(a)(3), Mar. 3, 1966, 80 Stat. 20. See section 3689 of this title.

Amendments

1991—Pub. L. 102–83, §5(a), renumbered section 626 of this title as this section.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in two places.

1976—Pub. L. 94–581 substituted “the Administrator shall prescribe” for “he shall prescribe”.

1973—Pub. L. 93–82 substituted “natural disaster” for “fire” in section catchline and extended reimbursement provisions to earthquake and other natural disasters also.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Effective Date of 1973 Amendment

Amendment by Pub. L. 93–82 effective Jan. 1, 1971, see section 501 of Pub. L. 93–82, set out as a note under section 1701 of this title.

§1727. Persons eligible under prior law

Persons who have a status which would, under the laws in effect on December 31, 1957, entitle them to the medical services, hospital and domiciliary care, and other benefits, provided for in this chapter, but who do not meet the service requirements contained in this chapter, shall be entitled to such benefits notwithstanding failure to meet such service requirements.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1144, §627; Pub. L. 94–581, title II, §202(m), Oct. 21, 1976, 90 Stat. 2856; renumbered §1727 Pub. L. 102–83, §5(a), Aug. 6, 1991, 105 Stat. 406.)

Amendments

1991—Pub. L. 102–83 renumbered section 627 of this title as this section.

1976—Pub. L. 94–581 substituted “1957” for “1958”.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

§1728. Reimbursement of certain medical expenses

(a) The Secretary shall, under such regulations as the Secretary prescribes, reimburse veterans eligible for hospital care or medical services under this chapter for the customary and usual charges of emergency treatment (including travel and incidental expenses under the terms and conditions set forth in section 111 of this title) for which such veterans have made payment, from sources other than the Department, where such emergency treatment was rendered to such veterans in need thereof for any of the following:

(1) An adjudicated service-connected disability.

(2) A non-service-connected disability associated with and held to be aggravating a service-connected disability.

(3) Any disability of a veteran if the veteran has a total disability permanent in nature from a service-connected disability.

(4) Any illness, injury, or dental condition of a veteran who—

(A) is a participant in a vocational rehabilitation program (as defined in section 3101(9) of this title); and

(B) is medically determined to have been in need of care or treatment to make possible the veteran's entrance into a course of training, or prevent interruption of a course of training, or hasten the return to a course of training which was interrupted because of such illness, injury, or dental condition.


(b) In any case where reimbursement would be in order under subsection (a) of this section, the Secretary may, in lieu of reimbursing such veteran, make payment of the reasonable value of emergency treatment directly—

(1) to the hospital or other health facility furnishing the emergency treatment; or

(2) to the person or organization making such expenditure on behalf of such veteran.


(c) In this section, the term “emergency treatment” has the meaning given such term in section 1725(f)(1) of this title.

(Added Pub. L. 93–82, title I, §106(a), Aug. 2, 1973, 87 Stat. 183, §628; amended Pub. L. 94–581, title II, §§202(n), 210(a)(13), Oct. 21, 1976, 90 Stat. 2856, 2863; Pub. L. 96–151, title II, §201(d), Dec. 20, 1979, 93 Stat. 1093; Pub. L. 101–237, title II, §202(a), Dec. 18, 1989, 103 Stat. 2066; Pub. L. 102–54, §14(b)(14), June 13, 1991, 105 Stat. 284; renumbered §1728 and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 110–387, title IV, §402(b), Oct. 10, 2008, 122 Stat. 4123.)

Amendments

2008—Subsec. (a). Pub. L. 110–387, §402(b)(1), added subsec. (a) and struck out former subsec. (a) which authorized the Secretary to reimburse veterans entitled to hospital care or medical services for the reasonable value of such care or services for which such veterans made payment from sources other than the Department under certain conditions.

Subsec. (b). Pub. L. 110–387, §402(b)(2), substituted “emergency treatment” for “care or services” in introductory provisions and in par. (1).

Subsec. (c). Pub. L. 110–387, §402(b)(3), added subsec. (c).

1991—Pub. L. 102–83, §5(a), renumbered section 628 of this title as this section.

Subsec. (a). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places in introductory provisions.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in introductory provisions and in par. (3).

Subsec. (a)(2)(D). Pub. L. 102–83, §5(c)(1), substituted “3101(9)” for “1501(9)”.

Pub. L. 102–54 substituted “(i) is” for “is (i)”.

Subsec. (b). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in introductory provisions.

1989—Subsec. (a)(2)(D). Pub. L. 101–237 substituted “(i) a participant in a vocational rehabilitation program (as defined in section 1501(9) of this title), and (ii)” for “found to be (i) in need of vocational rehabilitation under chapter 31 of this title and for whom an objective had been selected or (ii) pursuing a course of vocational rehabilitation training and”.

1979—Subsec. (a). Pub. L. 96–151 substituted provisions relating to travel and incidental expenses for provisions relating to necessary travel.

1976—Subsec. (a). Pub. L. 94–581 substituted “as the Administrator shall prescribe” for “as he shall prescribe” in provisions preceding par. (1), substituted “delay” for “they” in par. (1), and substituted “make possible such veteran's entrance” for “make possible his entrance” in par. (2)(D)(ii).

Effective Date of 1989 Amendment

Section 202(b) of Pub. L. 101–237 provided that: “The amendment made by subsection (a) [amending this section] shall apply with respect to hospital care and medical services received on or after the date of the enactment of this Act [Dec. 18, 1989].”

Effective Date of 1979 Amendment

Amendment by Pub. L. 96–151 effective Jan. 1, 1980, see section 206 of Pub. L. 96–151, set out as a note under section 111 of this title.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Effective Date

Section effective Jan. 1, 1971, see section 501 of Pub. L. 93–82, set out as an Effective Date of 1973 Amendment note under section 1701 of this title.

§1729. Recovery by the United States of the cost of certain care and services

(a)(1) Subject to the provisions of this section, in any case in which a veteran is furnished care or services under this chapter for a non-service-connected disability described in paragraph (2) of this subsection, the United States has the right to recover or collect reasonable charges for such care or services (as determined by the Secretary) from a third party to the extent that the veteran (or the provider of the care or services) would be eligible to receive payment for such care or services from such third party if the care or services had not been furnished by a department or agency of the United States.

(2) Paragraph (1) of this subsection applies to a non-service-connected disability—

(A) that is incurred incident to the veteran's employment and that is covered under a workers’ compensation law or plan that provides for payment for the cost of health care and services provided to the veteran by reason of the disability;

(B) that is incurred as the result of a motor vehicle accident to which applies a State law that requires the owners or operators of motor vehicles registered in that State to have in force automobile accident reparations insurance;

(C) that is incurred as the result of a crime of personal violence that occurred in a State, or a political subdivision of a State, in which a person injured as the result of such a crime is entitled to receive health care and services at such State's or subdivision's expense for personal injuries suffered as the result of such crime;

(D) that is incurred by a veteran—

(i) who does not have a service-connected disability; and

(ii) who is entitled to care (or payment of the expenses of care) under a health-plan contract; or


(E) for which care and services are furnished before October 1, 2012, under this chapter to a veteran who—

(i) has a service-connected disability; and

(ii) is entitled to care (or payment of the expenses of care) under a health-plan contract.


(3) In the case of a health-plan contract that contains a requirement for payment of a deductible or copayment by the veteran—

(A) the veteran's not having paid such deductible or copayment with respect to care or services furnished under this chapter shall not preclude recovery or collection under this section; and

(B) the amount that the United States may collect or recover under this section shall be reduced by the appropriate deductible or copayment amount, or both.


(b)(1) As to the right provided in subsection (a) of this section, the United States shall be subrogated to any right or claim that the veteran (or the veteran's personal representative, successor, dependents, or survivors) may have against a third party.

(2)(A) In order to enforce any right or claim to which the United States is subrogated under paragraph (1) of this subsection, the United States may intervene or join in any action or proceeding brought by the veteran (or the veteran's personal representative, successor, dependents, or survivors) against a third party.

(B) The United States may institute and prosecute legal proceedings against the third party if—

(i) an action or proceeding described in subparagraph (A) of this paragraph is not begun within 180 days after the first day on which care or services for which recovery is sought are furnished to the veteran by the Secretary under this chapter;

(ii) the United States has sent written notice by certified mail to the veteran at the veteran's last-known address (or to the veteran's personal representative or successor) of the intention of the United States to institute such legal proceedings; and

(iii) a period of 60 days has passed following the mailing of such notice.


(C) A proceeding under subparagraph (B) of this paragraph may not be brought after the end of the six-year period beginning on the last day on which the care or services for which recovery is sought are furnished.

(c)(1) The Secretary may compromise, settle, or waive any claim which the United States has under this section.

(2)(A) The Secretary, after consultation with the Comptroller General of the United States, shall prescribe regulations for the purpose of determining reasonable charges for care or services under subsection (a)(1) of this section. Any determination of such charges shall be made in accordance with such regulations.

(B) Such regulations shall provide that reasonable charges for care or services sought to be recovered or collected from a third-party liable under a health-plan contract may not exceed the amount that such third party demonstrates to the satisfaction of the Secretary it would pay for the care or services if provided by facilities (other than facilities of departments or agencies of the United States) in the same geographic area.

(C) Not later than 45 days after the date on which the Secretary prescribes such regulations (or any amendment to such regulations), the Comptroller General shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives the Comptroller General's comments on and recommendations regarding such regulations (or amendment).

(d) Any contract or agreement into which the Secretary enters with a person under section 3718 of title 31 for collection services to recover indebtedness owed the United States under this section shall provide, with respect to such services, that such person is subject to sections 5701 and 7332 of this title.

(e) A veteran eligible for care or services under this chapter—

(1) may not be denied such care or services by reason of this section; and

(2) may not be required by reason of this section to make any copayment or deductible payment in order to receive such care.


(f) No law of any State or of any political subdivision of a State, and no provision of any contract or other agreement, shall operate to prevent recovery or collection by the United States under this section or with respect to care or services furnished under section 1784 of this title.

[(g) Repealed. Pub. L. 105–33, title VIII, §8023(b)(4), Aug. 5, 1997, 111 Stat. 667.]

(h)(1) Subject to paragraph (3) of this subsection, the Secretary shall make available medical records of a veteran described in paragraph (2) of this subsection for inspection and review by representatives of the third party concerned for the sole purposes of permitting the third party to verify—

(A) that the care or services for which recovery or collection is sought were furnished to the veteran; and

(B) that the provision of such care or services to the veteran meets criteria generally applicable under the health-plan contract involved.


(2) A veteran described in this paragraph is a veteran who is a beneficiary of a health-plan contract under which recovery or collection is sought under this section from the third party concerned for the cost of the care or services furnished to the veteran.

(3) Records shall be made available under this subsection under such conditions to protect the confidentiality of such records as the Secretary shall prescribe in regulations.

(i) For purposes of this section—

(1)(A) The term “health-plan contract” means an insurance policy or contract, medical or hospital service agreement, membership or subscription contract, or similar arrangement, under which health services for individuals are provided or the expenses of such services are paid.

(B) Such term does not include—

(i) an insurance program described in section 1811 of the Social Security Act (42 U.S.C. 1395c) or established by section 1831 of such Act (42 U.S.C. 1395j);

(ii) a State plan for medical assistance approved under title XIX of such Act (42 U.S.C. 1396 et seq.);

(iii) a workers’ compensation law or plan described in subparagraph (A) of subsection (a)(2) of this section; or

(iv) a program, plan, or policy under a law described in subparagraph (B) or (C) of such subsection.


(2) The term “payment” includes reimbursement and indemnification.

(3) The term “third party” means—

(A) a State or political subdivision of a State;

(B) an employer or an employer's insurance carrier;

(C) an automobile accident reparations insurance carrier; or

(D) a person obligated to provide, or to pay the expenses of, health services under a health-plan contract.

(Added Pub. L. 97–72, title I, §106(a)(1), Nov. 3, 1981, 95 Stat. 1050, §629; amended Pub. L. 99–272, title XIX, §19013(a), Apr. 7, 1986, 100 Stat. 382; Pub. L. 100–322, title II, §202, May 20, 1988, 102 Stat. 509; Pub. L. 101–508, title VIII, §8011(a)–(c), Nov. 5, 1990, 104 Stat. 1388–344; Pub. L. 102–40, title IV, §402(d)(1), May 7, 1991, 105 Stat. 239; renumbered §1729 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–568, title VI, §604, Oct. 29, 1992, 106 Stat. 4343; Pub. L. 103–66, title XII, §12003, Aug. 10, 1993, 107 Stat. 414; Pub. L. 104–262, title I, §101(d)(10), Oct. 9, 1996, 110 Stat. 3180; Pub. L. 105–33, title VIII, §§8022, 8023(b)(4), (d), Aug. 5, 1997, 111 Stat. 665, 667; Pub. L. 107–135, title II, §§208(e)(4), 209(b), Jan. 23, 2002, 115 Stat. 2463, 2464; Pub. L. 110–161, div. I, title II, §232, Dec. 26, 2007, 121 Stat. 2273; Pub. L. 110–329, div. E, title II, §225, Sept. 30, 2008, 122 Stat. 3713; Pub. L. 110–387, title VIII, §804(b), Oct. 10, 2008, 122 Stat. 4141; Pub. L. 111–163, title V, §518, May 5, 2010, 124 Stat. 1167.)

References in Text

The Social Security Act, referred to in subsec. (i)(1)(B)(ii), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XIX of the Social Security Act is classified generally to subchapter XIX (§1396 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.

Amendments

2010—Subsec. (a)(2)(E). Pub. L. 111–163 amended subpar. (E) generally. Prior to amendment, subpar. (E) read as follows: “for which care and services are furnished before October 1, 2010, under this chapter to a veteran who—

“(i) has a service-connected disability; and

“(ii) is entitled to care (or payment of the expenses of care) under a health-plan contract.”

2008—Subsec. (a)(2)(E). Pub. L. 110–387, which directed substitution of “October 1, 2010” for “October 1, 2008”, was executed by making the substitution for “October 1, 2009” in introductory provisions to reflect the probable intent of Congress and the amendment by Pub. L. 110–329. See below.

Pub. L. 110–329 substituted “October 1, 2009,” for “October 1, 2008,” in introductory provisions.

2007—Subsec. (a)(2)(E). Pub. L. 110–161 substituted “October 1, 2008” for “October 1, 2007”.

2002—Subsec. (a)(2)(E). Pub. L. 107–135, §209(b), substituted “October 1, 2007” for “October 1, 2002”.

Subsec. (f). Pub. L. 107–135, §208(e)(4), substituted “section 1784” for “section 1711(b)”.

1997—Subsec. (a)(1). Pub. L. 105–33, §8023(d)(1), substituted “reasonable charges for” for “the reasonable cost of”.

Subsec. (a)(2)(E). Pub. L. 105–33, §8022, substituted “October 1, 2002” for “October 1, 1998”.

Subsec. (c)(2)(A). Pub. L. 105–33, §8023(d)(2), substituted “reasonable charges for” for “the reasonable cost of” and “such charges” for “such cost”.

Subsec. (c)(2)(B). Pub. L. 105–33, §8023(d)(2)(A), substituted “reasonable charges for” for “the reasonable cost of”.

Subsec. (g). Pub. L. 105–33, §8023(b)(4), struck out subsec. (g) which established in the Treasury a fund known as the Department of Veterans Affairs Medical-Care Cost Recovery Fund and provided for deposits to and payments from the Fund.

1996—Subsec. (g)(3)(A). Pub. L. 104–262 substituted “under subsection (f) or (g) of section 1710 of this title for hospital care, medical services, or nursing home care” for “under section 1710(f) of this title for hospital care or nursing home care, under section 1712(f) of this title for medical services,”.

1993—Subsec. (a)(2)(E). Pub. L. 103–66 substituted “October 1, 1998” for “August 1, 1994”.

1992—Subsec. (a)(2)(E). Pub. L. 102–568 substituted “August 1, 1994” for “October 1, 1993”.

1991—Pub. L. 102–83, §5(a), renumbered section 629 of this title as this section.

Subsecs. (a) to (c). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Subsec. (d). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Pub. L. 102–40 substituted “5701” for “3301” and “7332” for “4132”.

Subsec. (f). Pub. L. 102–83, §5(c)(1), substituted “1711(b)” for “611(b)”.

Subsec. (g)(3)(A). Pub. L. 102–83, §5(c)(1), substituted “1710(f)” for “610(f)”, “1712(f)” for “612(f)”, and “1722A” for “622A” in introductory provisions.

Subsec. (h)(1), (3). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

1990—Subsec. (a)(2)(E). Pub. L. 101–508, §8011(a), added subpar. (E).

Subsec. (c)(2)(B). Pub. L. 101–508, §8011(b), substituted “if provided by” for “in accordance with the prevailing rates at which the third party makes payments under comparable health-plan contracts with”.

Subsec. (g). Pub. L. 101–508, §8011(c), amended subsec. (g) generally. Prior to amendment, subsec. (g) read as follows: “Amounts collected or recovered on behalf of the United States under this section shall be deposited into the Treasury as miscellaneous receipts.”

1988—Subsec. (b)(2)(C). Pub. L. 100–322 added subpar. (C).

1986—Pub. L. 99–272 amended section generally, inserting authority to recover from a third party under a health-plan contract the reasonable costs of a non-service-connected disability, to require the Administrator to prescribe regulations to govern determination of reasonable costs, to authorize the compromise, settlement or waiver of claims, and to provide for the deposit of money collected under this section in the Treasury.

Effective Date of 1997 Amendment

Amendment by section 8023(b)(4) of Pub. L. 105–33 effective Oct. 1, 1997, and amendment by section 8023(d) of Pub. L. 105–33 effective Aug. 5, 1997, see section 8023(g) of Pub. L. 105–33, set out as a note under section 1710 of this title.

Effective Date of 1990 Amendment

Section 8011(e) of Pub. L. 101–508 provided that: “The amendments made by this section [amending this section] shall take effect as of October 1, 1990.”

Effective Date of 1986 Amendment

Section 19013(b) of Pub. L. 99–272 provided that:

“(1) Except as provided in paragraph (2), section 629 [now 1729] of title 38, United States Code, as amended by subsection (a), shall apply to care and services provided on or after the date of the enactment of this Act [Apr. 7, 1986].

“(2)(A) Such section shall not apply so as to nullify any provision of a health-plan contract (as defined in subsection (i) of such section) that—

“(i) was entered into before the date of the enactment of this Act; and

“(ii) is not modified or renewed on or after such date.

“(B) In the case of a health-plan contract (as so defined) that was entered into before such date and which is modified or renewed on or after such date, the amendment made by subsection (a) [amending this section] shall apply—

“(i) with respect to such plan as of the day after the date that it is so modified or renewed; and

“(ii) with respect to care and services provided after such date of modification or renewal.

“(3) For purposes of paragraph (2), the term ‘modified’ includes any change in premium or coverage.”

Effective Date

Section 106(b) of Pub. L. 97–72 provided that: “Section 629 [now 1729] of title 38, United States Code, as added by subsection (a), shall apply with respect to care and services furnished under chapter 17 of title 38, United States Code, on or after the date of the enactment of this Act [Nov. 3, 1981].”

Healthcare Facilities Certified as Medicare and Medicaid Providers for Collection Purposes

Pub. L. 107–206, title I, Aug. 2, 2002, 116 Stat. 888, provided in part: “That for the purposes of enabling the collection from third-party insurance carriers for non-service related medical care of veterans, all Department of Veterans Affairs healthcare facilities are hereby certified as Medicare and Medicaid providers and the Centers for Medicare and Medicaid Services within the Department of Health and Human Services shall issue each Department of Veterans Affairs healthcare facility a provider number as soon as practicable after the date of enactment of this Act [Aug. 2, 2002]: Provided further, That nothing in the preceding proviso shall be construed to enable the Department of Veterans Affairs to bill Medicare or Medicaid for any medical services provided by the Veterans Health Administration or to require the Centers for Medicare and Medicaid Services to pay for any medical services provided by the Department of Veterans Affairs”.

Disposition of Funds in and Termination of Department of Veterans Affairs Medical-Care Cost Recovery Fund

Section 8023(c) of Pub. L. 105–33 provided that: “The amount of the unobligated balance remaining in the Department of Veterans Affairs Medical-Care Cost Recovery Fund (established pursuant to section 1729(g)(1) of title 38, United States Code) at the close of June 30, 1997, shall be deposited, not later than December 31, 1997, in the Treasury as miscellaneous receipts, and the Department of Veterans Affairs Medical-Care Cost Recovery Fund shall be terminated when the deposit is made.”

Transfers to Medical-Care Cost Recovery Fund

Section 8011(d) of Pub. L. 101–508, as amended by Pub. L. 102–83, §5(c)(2), Aug. 6, 1991, 105 Stat. 406, provided that the Secretary of the Treasury was to transfer $25,000,000 from the Department of Veterans Affairs Loan Guaranty Revolving Fund to the Department of Veterans Affairs Medical-Care Cost Recovery Fund and that the amount so transferred was to be available until the end of Sept. 30, 1991, for the support of the equivalent of 800 full-time employees and other expenses described in former subsec. (g)(3) of this section, and provided that the first $25,000,000 recovered or collected by the Department of Veterans Affairs during fiscal year 1991 as a result of third-party medical recovery activities was to be credited to the Department of Veterans Affairs Loan Guaranty Revolving Fund.

Reports on Implementation of 1986 Amendment

Section 19013(c) of Pub. L. 99–272 directed Administrator of Veterans’ Affairs, not later than six months after Apr. 7, 1986, to submit to Committees on Veterans’ Affairs of Senate and House of Representatives a report on the process for and results of implementation of this section, as amended by subsection (a), such report to show costs of administration (and a detailed breakdown of such costs) and the amount of receipts and collections under this section, and not later than Feb. 1, 1988, to submit to such Committees a report updating the information in the report previously submitted and providing information on the process and results of such implementation through at least the end of fiscal year 1987.

§1729A. Department of Veterans Affairs Medical Care Collections Fund

(a) There is in the Treasury a fund to be known as the Department of Veterans Affairs Medical Care Collections Fund.

(b) Amounts recovered or collected under any of the following provisions of law shall be deposited in the fund:

(1) Section 1710(f) of this title.

(2) Section 1710(g) of this title.

(3) Section 1711 of this title.

(4) Section 1722A of this title.

(5) Section 1725 of this title.

(6) Section 1729 of this title.

(7) Section 1784 of this title.

(8) Section 8165(a) of this title.

(9) Section 113 of the Veterans Millennium Health Care and Benefits Act (Public Law 106–117; 38 U.S.C. 8111 note).

(10) Public Law 87–693, popularly known as the “Federal Medical Care Recovery Act” (42 U.S.C. 2651 et seq.), to the extent that a recovery or collection under that law is based on medical care or services furnished under this chapter.


(c)(1) Subject to the provisions of appropriations Acts, amounts in the fund shall be available, without fiscal year limitation, to the Secretary for the following purposes:

(A) Furnishing medical care and services under this chapter, to be available during any fiscal year for the same purposes and subject to the same limitations (other than with respect to the period of availability for obligation) as apply to amounts appropriated from the general fund of the Treasury for that fiscal year for medical care.

(B) Expenses of the Department for the identification, billing, auditing, and collection of amounts owed the United States by reason of medical care and services furnished under this chapter.


(2) Amounts available under paragraph (1) may not be used for any purpose other than a purpose set forth in subparagraph (A) or (B) of that paragraph.

(d) Of the total amount recovered or collected by the Department during a fiscal year under the provisions of law referred to in subsection (b) and made available from the fund, the Secretary shall make available to each Department health care facility of the Department an amount that bears the same ratio to the total amount so made available as the amount recovered or collected by such facility during that fiscal year under such provisions of law bears to such total amount recovered or collected during that fiscal year. The Secretary shall make available to each facility the entirety of the amount specified to be made available to such facility by the preceding sentence.

(e) Amounts recovered or collected under the provisions of law referred to in subsection (b) shall be treated for the purposes of sections 251 and 252 of the Balanced Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 901, 902) as offsets to discretionary appropriations (rather than as offsets to direct spending) to the extent that such amounts are made available for expenditure in appropriations Acts for the purposes specified in subsection (c).

(Added Pub. L. 105–33, title VIII, §8023(a)(1), Aug. 5, 1997, 111 Stat. 665; amended Pub. L. 106–117, title I, §111(b)(1), title II, §203, Nov. 30, 1999, 113 Stat. 1556, 1561; Pub. L. 107–135, title II, §208(e)(5), Jan. 23, 2002, 115 Stat. 2463; Pub. L. 108–7, div. K, title I, §113(b), Feb. 20, 2003, 117 Stat. 482; Pub. L. 108–183, title VII, §708(a)(2), Dec. 16, 2003, 117 Stat. 2673.)

References in Text

Public Law 87–693, popularly known as the Federal Medical Care Recovery Act, referred to in subsec. (b)(10), is Pub. L. 87–693, Sept. 25, 1962, 76 Stat. 593, which is classified generally to chapter 32 (§2651 et seq.) of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Tables.

Amendments

2003—Subsec. (b). Pub. L. 108–183, §708(a)(2)(A), struck out “after June 30, 1997,” after “collected” in introductory provisions.

Subsec. (b)(8) to (10). Pub. L. 108–7 added pars. (8) and (9) and redesignated former par. (8) as (10).

Subsec. (c)(3). Pub. L. 108–183, §708(a)(2)(B), struck out par. (3) which related to duties of the Secretary for fiscal year 1998.

Subsecs. (e), (f). Pub. L. 108–183, §708(a)(2)(C), (D), redesignated subsec. (f) as (e) and struck out former subsec. (e) which required the Secretary to submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives quarterly reports on the operation of the section for fiscal years 1998, 1999, and 2000 and for the first quarter of fiscal year 2001.

2002—Subsec. (b)(7), (8). Pub. L. 107–135 added par. (7) and redesignated former par. (7) as (8).

1999—Subsec. (b)(5) to (7). Pub. L. 106–117, §111(b)(1), added par. (5) and redesignated former pars. (5) and (6) as (6) and (7), respectively.

Subsec. (d). Pub. L. 106–117, §203, struck out par. (1) designation, substituted “each Department health care facility” for “each designated health care region” and “each facility” for “each region”, substituted “such facility” for “such region” in two places, and struck out par. (2) which read as follows: “In this subsection, the term ‘designated health care regions of the Department’ means the geographic areas designated by the Secretary for purposes of the management of, and allocation of resources for, health care services provided by the Department.”

Effective Date of 1999 Amendment

Amendment by section 111(b)(1) of Pub. L. 106–117 effective 180 days after Nov. 30, 1999, see section 111(c) of Pub. L. 106–117, set out as an Effective Date note under section 1725 of this title.

Effective Date

Section effective Oct. 1, 1997, see section 8023(g) of Pub. L. 105–33, set out as an Effective Date of 1997 Amendment note under section 1710 of this title.

Medical Services Accounts

Pub. L. 108–447, div. I, title I, §115, Dec. 8, 2004, 118 Stat. 3293, provided that:

“(a) Hereafter receipts that would otherwise be credited to the accounts listed in subsection (c) shall be deposited into the Medical Care Collections Fund, and shall be transferred to and merged with the ‘Medical services’ account, in fiscal year 2005 and subsequent years, to remain available until expended, to carry out the purposes of the ‘Medical services’ account.

“(b) The unobligated balances in the accounts listed in subsection (c), shall be transferred to and merged with the ‘Medical services’ account in fiscal year 2005 and subsequent years, and remain available until expended, to carry out the purposes of the ‘Medical services’ account: Provided, That the obligated balances in these accounts may be transferred to the ‘Medical services’ account at the discretion of the Secretary of Veterans Affairs and shall remain available until expended.

“(c) Veterans Extended Care Revolving Fund; Medical Facilities Revolving Fund; Special Therapeutic and Rehabilitation Fund; Nursing Home Revolving Fund; Veterans Health Services Improvement Fund; and Parking Revolving Fund.”

Similar provisions were contained in the following prior appropriation act:

Pub. L. 108–199, div. G, title I, §115, Jan. 23, 2004, 118 Stat. 370.

Report on Implementation of Section 8023 of Pub. L. 105–33

Section 8023(f) of Pub. L. 105–33 provided that: “Not later than January 1, 1999, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the implementation of this section [enacting this section, amending sections 712, 1710, 1722A, and 1729 of this title, and enacting provisions set out as notes under sections 712 and 1729 of this title]. The report shall describe the collections under each of the provisions specified in section 1729A(b) of title 38, United States Code, as added by subsection (a). Information on such collections shall be shown for each of the health service networks (known as Veterans Integrated Service Networks) and, to the extent practicable for each facility within each such network. The Secretary shall include in the report an analysis of differences among the networks with respect to (A) the market in which the networks operates, (B) the effort expended to achieve collections, (C) the efficiency of such effort, and (D) any other relevant information.”

§1729B. Consolidated patient accounting centers

(a) In General.—Not later than five years after the date of the enactment of this section, the Secretary of Veterans Affairs shall establish not more than seven consolidated patient accounting centers for conducting industry-modeled regionalized billing and collection activities of the Department.

(b) Functions.—The centers shall carry out the following functions:

(1) Reengineer and integrate all business processes of the revenue cycle of the Department.

(2) Standardize and coordinate all activities of the Department related to the revenue cycle for all health care services furnished to veterans for non-service-connected medical conditions.

(3) Apply commercial industry standards for measures of access, timeliness, and performance metrics with respect to revenue enhancement of the Department.

(4) Apply other requirements with respect to such revenue cycle improvement as the Secretary may specify.

(Added Pub. L. 110–387, title IV, §406(a), Oct. 10, 2008, 122 Stat. 4129.)

References in Text

The date of the enactment of this section, referred to in subsec. (a), is the date of enactment of Pub. L. 110–387, which was approved Oct. 10, 2008.

Prior Provisions

A prior section 1729B, added Pub. L. 106–117, title II, §202(a), Nov. 30, 1999, 113 Stat. 1561; amended Pub. L. 107–103, title V, §509(c), Dec. 27, 2001, 115 Stat. 997; Pub. L. 107–330, title III, §308(g)(7), Dec. 6, 2002, 116 Stat. 2829, related to the Department of Veterans Affairs Health Services Improvement Fund, prior to repeal by Pub. L. 108–7, div. K, title I, §113(a)(1), Feb. 20, 2003, 117 Stat. 482.

Transfer of Balance

Pub. L. 108–7, div. K, title I, §113(a)(1), Feb. 20, 2003, 117 Stat. 482, repealed former section 1729B of this title and provided that any balance as of Feb. 20, 2003, in the Department of Veterans Affairs Health Services Improvement Fund established under former section 1729B was to be transferred to the Department of Veterans Affairs Medical Care Collections Fund established under section 1729A of this title.

§1730. Community residential care

(a) Subject to this section and regulations to be prescribed by the Secretary under this section, the Secretary may assist a veteran by referring such veteran for placement in, and aiding such veteran in obtaining placement in, a community residential-care facility if—

(1) at the time of initiating the assistance the Secretary—

(A) is furnishing the veteran medical services on an outpatient basis or hospital, domiciliary, or nursing home care; or

(B) has furnished the veteran such care or services within the preceding 12 months; and


(2) placement of the veteran in a community residential-care facility is appropriate.


(b)(1) The Secretary may not provide assistance under subsection (a) of this section with respect to a community residential-care facility unless such facility is approved by the Secretary for the purposes of this section.

(2) The Secretary's approval of a facility for the purposes of this section shall be based upon the Secretary's determination, after inspection of the facility, that the facility meets the standards established in regulations prescribed under this section. Such standards shall include the following:

(A) Health and safety criteria, including a requirement of compliance with applicable State laws and local ordinances relating to health and safety.

(B) A requirement that the costs charged for care by a facility be reasonable, as determined by the Secretary, giving consideration to such factors as (i) the level of care, supervision, and other services to be provided, (ii) the cost of goods and services in the geographic area in which the facility is located, and (iii) comparability with other facilities in such area providing similar services.

(C) Criteria for determining the resources that a facility needs in order to provide an appropriate level of services to veterans.

(D) Such other criteria as the Secretary determines are appropriate to protect the welfare of veterans placed in a facility under this section.


(3) Payment of the charges of a community residential-care facility for any care or service provided to a veteran whom the Secretary has referred to that facility under this section is not the responsibility of the United States or of the Department.

(c)(1) In order to determine continued compliance by community residential-care facilities that have been approved under subsection (b) of this section with the standards established in regulations prescribed under this section, the Secretary shall provide for periodic inspection of such facilities.

(2) If the Secretary determines that a facility is not in compliance with such standards, the Secretary (in accordance with regulations prescribed under this section)—

(A) shall cease to refer veterans to such facility; and

(B) may, with the permission of the veteran (or the person or entity authorized by law to give permission on behalf of the veteran), assist in removing a veteran from such facility.


Regulations prescribed to carry out this paragraph shall provide for reasonable notice and, upon request made on behalf of the facility, a hearing before any action authorized by this paragraph is taken.

(d) The Secretary shall prescribe regulations to carry out this section. Such regulations shall include the standards required by subsection (b) of this section.

(e)(1) To the extent possible, the Secretary shall make available each report of an inspection of a community residential-care facility under subsection (b)(2) or (c)(1) of this section to each Federal, State, and local agency charged with the responsibility of licensing or otherwise regulating or inspecting such facility.

(2) The Secretary shall make the standards prescribed in regulations under subsection (d) of this section available to all Federal, State, and local agencies charged with the responsibility of licensing or otherwise regulating or inspecting community residential-care facilities.

(f) For the purpose of this section, the term “community residential-care facility” means a facility that provides room and board and such limited personal care for and supervision of residents as the Secretary determines, in accordance with regulations prescribed under this section, are necessary for the health, safety, and welfare of residents.

(Added Pub. L. 98–160, title I, §104(a), Nov. 21, 1983, 97 Stat. 996, §630; amended Pub. L. 102–54, §14(b)(15), June 13, 1991, 105 Stat. 284; renumbered §1730 and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.)

Amendments

1991—Pub. L. 102–83, §5(a), renumbered section 630 of this title as this section.

Subsec. (a). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Pub. L. 102–54 struck out “(1)” after “(a)” and redesignated former subpar. (A) as par. (1), cls. (i) and (ii) as subpars. (A) and (B), respectively, and former subpar. (B) as par. (2).

Subsec. (b). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing and “Secretary's” for “Administrator's” in two places.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in par. (3).

Subsecs. (c) to (f). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

§1730A. Prohibition on collection of copayments from catastrophically disabled veterans

Notwithstanding subsections (f) and (g) of section 1710 and section 1722A(a) of this title or any other provision of law, the Secretary may not require a veteran who is catastrophically disabled, as defined by the Secretary, to make any copayment for the receipt of hospital care or medical services under the laws administered by the Secretary.

(Added Pub. L. 111–163, title V, §511(a), May 5, 2010, 124 Stat. 1164.)

SUBCHAPTER IV—HOSPITAL CARE AND MEDICAL TREATMENT FOR VETERANS IN THE REPUBLIC OF THE PHILIPPINES

Amendments

1981—Pub. L. 97–72, title I, §107(d)(1), Nov. 3, 1981, 95 Stat. 1053, substituted “HOSPITAL CARE AND MEDICAL TREATMENT FOR VETERANS IN THE REPUBLIC OF THE PHILIPPINES” for “HOSPITAL AND MEDICAL CARE FOR COMMONWEALTH OF THE PHILIPPINES ARMY VETERANS” in subchapter heading.

§1731. Assistance to the Republic of the Philippines

The President is authorized to assist the Republic of the Philippines in fulfilling its responsibility in providing medical care and treatment for Commonwealth Army veterans and new Philippine Scouts in need of such care and treatment for service-connected disabilities and non-service-connected disabilities under certain conditions.

(Added Pub. L. 93–82, title I, §107(a), Aug. 2, 1973, 87 Stat. 184, §631; amended Pub. L. 97–72, title I, §107(b), Nov. 3, 1981, 95 Stat. 1052; renumbered §1731, Pub. L. 102–83, §5(a), Aug. 6, 1991, 105 Stat. 406.)

Prior Provisions

Prior section 1731 was renumbered section 3531 of this title.

Amendments

1991—Pub. L. 102–83 renumbered section 631 of this title as this section.

1981—Pub. L. 97–72 inserted “in fulfilling its responsibility” after “The President is authorized to assist the Republic of the Philippines”.

Effective Date

Section effective July 1, 1973, see section 501 of Pub. L. 93–82, set out as an Effective Date of 1973 Amendment note under section 1701 of this title.

§1732. Contracts and grants to provide for the care and treatment of United States veterans by the Veterans Memorial Medical Center

(a) The President, with the concurrence of the Republic of the Philippines, may authorize the Secretary to enter into contracts with the Veterans Memorial Medical Center, with the approval of the appropriate department of the Government of the Republic of the Philippines, covering the period beginning on October 1, 1981, and ending on September 30, 1994, under which the United States—

(1) will provide for payments for hospital care and medical services (including nursing home care) in the Veterans Memorial Medical Center, as authorized by section 1724 of this title and on the terms and conditions set forth in such section, to eligible United States veterans at a per diem rate to be jointly determined for each fiscal year by the two Governments to be fair and reasonable; and

(2) may provide that payments for such hospital care and medical services provided to eligible United States veterans may consist in whole or in part of available medicines, medical supplies, and equipment furnished by the Secretary to the Veterans Memorial Medical Center at valuations therefor as determined by the Secretary, who may furnish such medicines, medical supplies, and equipment through the revolving supply fund pursuant to section 8121 of this title.


(b)(1) To further assure the effective care and treatment of United States veterans in the Veterans Memorial Medical Center, there is authorized to be appropriated for each fiscal year during the period beginning on October 1, 1981, and ending on September 30, 1990, the sum of $1,000,000 to be used by the Secretary for making grants to the Veterans Memorial Medical Center for the purpose of assisting the Republic of the Philippines in the replacement and upgrading of equipment and in rehabilitating the physical plant and facilities of such center.

(2) Grants under this subsection shall be made on such terms and conditions as prescribed by the Secretary. Such terms and conditions may include a requirement of prior approval by the Secretary of the uses of the funds provided by such grants.

(3) Funds for such grants may be provided only from appropriations made to the Department for the specific purpose of making such grants.

(c) The Secretary may stop payments under a contract or grant under this section upon reasonable notice as stipulated by the contract or grant if the Republic of the Philippines and the Veterans Memorial Medical Center do not maintain the medical center in a well-equipped and effective operating condition as determined by the Secretary.

(d)(1) The authority of the Secretary to enter into contracts and to make grants under this section is effective for any fiscal year only to the extent that appropriations are available for that purpose.

(2) Appropriations made for the purpose of this section shall remain available until expended.

(Added Pub. L. 93–82, title I, §107(a), Aug. 2, 1973, 87 Stat. 184, §632; amended Pub. L. 94–581, title II, §210(a)(14), Oct. 21, 1976, 90 Stat. 2863; Pub. L. 95–520, §3(b), Oct. 26, 1978, 92 Stat. 1820; Pub. L. 97–72, title I, §107(c)(1), Nov. 3, 1981, 95 Stat. 1052; Pub. L. 99–576, title II, §206(a)(1), Oct. 28, 1986, 100 Stat. 3256; Pub. L. 100–687, div. B, title XV, §1502(a), (b), Nov. 18, 1988, 102 Stat. 4132; Pub. L. 102–40, title IV, §402(d)(1), May 7, 1991, 105 Stat. 239; renumbered §1732 and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–86, title III, §304(a), Aug. 14, 1991, 105 Stat. 416; Pub. L. 102–585, title V, §503, Nov. 4, 1992, 106 Stat. 4955.)

Prior Provisions

Prior section 1732 was renumbered section 3532 of this title.

Amendments

1992—Subsec. (a). Pub. L. 102–585 substituted “September 30, 1994” for “September 30, 1992”.

1991—Pub. L. 102–83, §5(a), renumbered section 632 of this title as this section.

Subsec. (a). Pub. L. 102–86 amended subsec. (a) of this section as in effect before the redesignations made by Pub. L. 102–83, §5, by substituting “1992” for “1990”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Subsec. (a)(1). Pub. L. 102–83, §5(c)(1), substituted “1724” for “624”.

Subsec. (a)(2). Pub. L. 102–40, §402(d)(1), substituted “8121” for “5021”.

Subsec. (b)(1), (2). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Subsec. (b)(3). Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Subsecs. (c), (d)(1). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

1988—Subsecs. (a), (b)(1). Pub. L. 100–687 substituted “1990” for “1989” in subsec. (a) and substituted “1990” for “1989” and “$1,000,000” for “$500,000” in subsec. (b)(1).

1986—Subsecs. (a), (b)(1). Pub. L. 99–576 substituted “September 30, 1989” for “September 30, 1986”.

1981—Pub. L. 97–72 amended section generally, first by substituting Sept. 30, 1986, for Sept. 30, 1981, as the ending date for the period during which the President, with the concurrence of the Republic of the Philippines, may authorize the Administrator to enter into contracts with the Veterans Memorial Medical Center to provide for payments for hospital care and medical services, and by including nursing home care, for eligible United States veterans as authorized by and on the same conditions as set forth in section 624, with such care to consist in whole or in part of available medicines, medical supplies, and equipment furnished through the revolving supply fund, pursuant to section 5021, at valuations determined by the Administrator using available appropriations for payments and with the per diem rate for such care and services to be jointly determined annually by the two Governments as fair and reasonable, second by increasing from $50,000 to $500,000 per year the size of grants to replace and upgrade equipment and rehabilitate the Center's physical plant, third by continuing the Administrator's authority to stop payments in certain cases, and fourth by limiting the Administrator's authority to contract for hospital care and to make grants for any fiscal year, to the extent that appropriations are available for that purpose.

1978—Subsec. (a). Pub. L. 95–520, §3(b)(1), (2), substituted “Veterans Memorial Medical Center” for “Veterans Memorial Hospital” in introductory text and pars. (1), (2), (5), and (7), and in introductory text, substituted “enter into contracts” for “enter into a contract” and “September 30, 1981” for “June 30, 1978”.

Subsec. (b). Pub. L. 95–520, §3(b)(3), substituted “October 1, 1981” for “July 1, 1978”.

Subsec. (c). Pub. L. 95–520, §3(b)(1), substituted “Veterans Memorial Medical Center” for “Veterans Memorial Hospital”.

Subsec. (d). Pub. L. 95–520, §3(b)(1), (4), substituted “Veterans Memorial Medical Center” for “Veterans Memorial Hospital” in three places and “occurring during the period beginning July 1, 1973, and ending September 30, 1981” for “during the five years beginning July 1, 1973, and ending June 30, 1978”.

1976—Subsec. (d). Pub. L. 94–581 substituted “approval by the Administrator” for “approved by him”.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Effective Date

Section effective July 1, 1973, see section 501 of Pub. L. 93–82, set out as an Effective Date of 1973 Amendment note under section 1701 of this title.

Savings Provision

Section 107(c) of Pub. L. 93–82 provided that section 107(a) of Pub. L. 93–82, enacting this section and section 631 [now 1731] of this title, did not affect any right, cause, obligation, contract (including the contract executed Apr. 25, 1967, between the Government of the Republic of the Philippines and the Government of the United States resulting from Pub. L. 89–612, which was to remain in effect until modified or superseded by an agreement executed under authority of Pub. L. 93–82), authorization of appropriation, grant, function, power, or duty vested by law or otherwise under this section in effect on the day before Aug. 2, 1973.

Ratification of Actions of Secretary of Veterans Affairs in Carrying Out This Section

Section 304(b) of Pub. L. 102–86 provided that: “Any actions by the Secretary of Veterans Affairs in carrying out the provisions of section 632 [now 1732] of title 38, United States Code, by contract or otherwise, during the period beginning on October 1, 1990, and ending on the date of the enactment of this Act [Aug. 14, 1991] are hereby ratified.”

Ratification of Action of Administrator in Contracting

Section 206(a)(2) of Pub. L. 99–576 ratified actions by the Administrator of Veterans’ Affairs in contracting under subsec. (a) of this section with respect to the period beginning Oct. 1, 1986, and ending Oct. 28, 1986.

Reports on Use of Funds

Section 206(b) of Pub. L. 99–576 directed Administrator of Veterans’ Affairs, not later than Feb. 1, 1987, 1988, and 1989, to submit to Congress a report describing use of funds provided to Republic of the Philippines under subsec. (b) of this section during the preceding fiscal year.

§1733. Supervision of program by the President

The President, or any officer of the United States to whom the President may delegate authority under this section, may from time to time prescribe such rules and regulations and impose such conditions on the receipt of financial aid as may be necessary to carry out this subchapter.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1146, §633; Pub. L. 94–581, title II, §210(a)(15), Oct. 21, 1976, 90 Stat. 2863; renumbered §1733, Pub. L. 102–83, §5(a), Aug. 6, 1991, 105 Stat. 406.)

Prior Provisions

Prior section 1733 was renumbered section 3533 of this title.

Another prior section 1733, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1198, as amended by Pub. L. 91–219, title II, §206(b), Mar. 26, 1970, 84 Stat. 82; Pub. L. 91–584, §12, Dec. 24, 1970, 84 Stat. 1577, related to measurement of courses, prior to the general amendment of this section by Pub. L. 92–540, title III, §313, Oct. 24, 1972, 86 Stat. 1084. See section 3688 of this title.

Amendments

1991—Pub. L. 102–83 renumbered section 633 of this title as this section.

1976—Pub. L. 94–581 substituted “the President” for “he” and struck out “his” before “authority”.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Ex. Ord. No. 11762. Delegation of Authority to Administrator of Veterans’ Affairs Relating to Grants-in-Aid to Republic of the Philippines for Medical Care and Treatment of Veterans

Ex. Ord. No. 11762, Jan. 17, 1974, 39 F.R. 2347, provided:

By virtue of the authority vested in me by section 633 [now 1733] of title 38 and by section 301 of title 3 of the United States Code, and as President of the United States of America, it is hereby ordered as follows:

Section 1. (a) Subject to the provisions of subsections (b) and (c) of this section, the Administrator of Veterans’ Affairs is hereby designated and empowered to exercise, without the approval, ratification, or other action of the President, the authority vested in the President by sections 631, 632, 633, and 634 [now 1731, 1732, 1733, and 1734] of title 38 of the United States Code, as amended by section 107(a) of the Veterans Health Care Expansion Act of 1973 (Public Law 93–82; Stat. 184).

(b) The Secretary of State shall negotiate the agreement, and any modifications thereby with the Republic of the Philippines required by the provisions of sections 631, 632, 633, and 634 [now 1731, 1732, 1733, and 1734] of title 38 of the United States Code.

(c) All rules and regulations prescribed by the Administrator pursuant to the authority delegated to him by this order shall be subject to prior approval by the Director of the Office of Management and Budget.

Sec. 2. Nothing in this order shall be construed as modifying or terminating any other authority heretofore delegated by the President to the Administrator of Veterans’ Affairs.

Richard Nixon.      

§1734. Hospital and nursing home care and medical services in the United States

(a) The Secretary shall furnish hospital and nursing home care and medical services to any individual described in subsection (b) in the same manner, and subject to the same terms and conditions, as apply to the furnishing of such care and services to individuals who are veterans as defined in section 101(2) of this title. Any disability of an individual described in subsection (b) that is a service-connected disability for purposes of this subchapter (as provided for under section 1735(2) of this title) shall be considered to be a service-connected disability for purposes of furnishing care and services under the preceding sentence.

(b) Subsection (a) applies to any individual who is a Commonwealth Army veteran or new Philippine Scout and who—

(1) is residing in the United States; and

(2) is a citizen of the United States or an alien lawfully admitted to the United States for permanent residence.

(Added Pub. L. 96–22, title I, §106(a), June 13, 1979, 93 Stat. 53, §634; renumbered §1734 and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 106–377, §1(a)(1) [title V, §501(b)], Oct. 27, 2000, 114 Stat. 1441, 1441A–57; Pub. L. 108–170, title I, §103, Dec. 6, 2003, 117 Stat. 2044.)

Prior Provisions

Prior section 1734 was renumbered section 3534 of this title.

Another prior section 1734, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1199, as amended by Pub. L. 89–358, §4(m), Mar. 3, 1966, 80 Stat. 25, related to overcharging of eligible persons by educational institutions, prior to the general amendment of this section by Pub. L. 92–540, title III, §313, Oct. 24, 1972, 86 Stat. 1084. See section 3690 of this title.

Amendments

2003—Pub. L. 108–170 amended text generally. Prior to amendment, text read as follows:

“(a) The Secretary, within the limits of Department facilities, may furnish hospital and nursing home care and medical services to Commonwealth Army veterans and new Philippine Scouts for the treatment of the service-connected disabilities of such veterans and scouts.

“(b) An individual who is in receipt of benefits under subchapter II or IV of chapter 11 of this title paid by reason of service described in section 107(a) of this title who is residing in the United States and who is a citizen of, or an alien lawfully admitted for permanent residence in, the United States shall be eligible for hospital and nursing home care and medical services in the same manner as a veteran, and the disease or disability for which such benefits are paid shall be considered to be a service-connected disability for purposes of this chapter.”

2000—Pub. L. 106–377 designated existing provisions as subsec. (a) and added subsec. (b).

1991—Pub. L. 102–83, §5(a), renumbered section 634 of this title as this section.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Effective Date

Section effective Oct. 1, 1979, see section 107 of Pub. L. 96–22, set out as an Effective Date of 1979 Amendment note under section 1701 of this title.

§1735. Definitions

For the purposes of this subchapter—

(1) The term “Commonwealth Army veterans” means persons who served before July 1, 1946, in the organized military forces of the Government of the Philippines, while such forces were in the service of the Armed Forces pursuant to the military order of the President dated July 26, 1941, including among such military forces organized guerrilla forces under commanders appointed, designated, or subsequently recognized by the Commander in Chief, Southwest Pacific Area, or other competent authority in the Army of the United States, and who were discharged or released from such service under conditions other than dishonorable. The term “new Philippine Scouts” means persons who served in the Philippine Scouts under section 14 of the Armed Forces Voluntary Recruitment Act of 1945, and who were discharged or released from such service under conditions other than dishonorable.

(2) The term “service-connected disabilities” means disabilities determined by the Secretary under laws administered by the Secretary to have been incurred in or aggravated by the service described in paragraph (1) in line of duty.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1146, §634; Pub. L. 89–612, §3, Sept. 30, 1966, 80 Stat. 861; renumbered §635, Pub. L. 96–22, title I, §106(a), June 13, 1979, 93 Stat. 53; renumbered §1735 and amended Pub. L. 102–83, §§4(a)(1), (b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 403–406.)

References in Text

Section 14 of the Armed Forces Voluntary Recruitment Act of 1945, referred to in par. (1), is section 14 of act Oct. 6, 1945, ch. 393, 59 Stat. 543, which enacted section 637 of former Title 10, Army and Air Force, and was omitted from the Code in the revision and reenactment of Title 10, Armed Forces, by act Aug. 10, 1956, ch. 1041, 70A Stat. 1.

Prior Provisions

Prior sections 1735 and 1736 were renumbered sections 3535 and 3536 of this title, respectively.

Another prior section 1736, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1199; Pub. L. 88–126, §3, Sept. 23, 1963, 77 Stat. 162; Pub. L. 89–358, §4(o), Mar. 3, 1966, 80 Stat. 25, related to discontinuance of the educational assistance allowance by the Administrator, prior to repeal by Pub. L. 92–540, title IV, §402(2), Oct. 24, 1972, 86 Stat. 1090. See section 3690 of this title.

Prior section 1737 was renumbered section 3537 of this title.

Another prior section 1737, added Pub. L. 93–508, title III, §303(a), Dec. 3, 1974, 88 Stat. 1591; amended Pub. L. 97–35, title XX, §2005(c), Aug. 13, 1981, 95 Stat. 783, related to entitlement of any eligible person, before Oct. 1, 1981, to an education loan, prior to repeal by Pub. L. 100–689, title I, §124(a), Nov. 18, 1988, 102 Stat. 4174.

Another prior section 1737 was renumbered section 1736 of this title.

Prior section 1738, added Pub. L. 95–202, title II, §201(b), Nov. 23, 1977, 91 Stat. 1437, related to accelerated payment of educational assistance allowances, prior to repeal by Pub. L. 100–689, title I, §124(a), Nov. 18, 1988, 102 Stat. 4174.

Amendments

1991—Pub. L. 102–83, §5(a), renumbered section 635 of this title as this section.

Par. (2). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” before “under”.

Pub. L. 102–83, §4(a)(1), substituted “administered by the Secretary” for “administered by the Veterans’ Administration”.

1966—Par. (1). Pub. L. 89–612 inserted definition of “new Philippine Scouts”.

SUBCHAPTER V—PAYMENTS TO STATE HOMES

§1741. Criteria for payment

(a)(1) Except as provided in section 1745 of this title, the Secretary shall pay each State at the per diem rate of—

(A) $8.70 for domiciliary care; and

(B) $20.35 for nursing home care and hospital care,


for each veteran receiving such care in a State home, if such veteran is eligible for such care in a Department facility.

(2) The Secretary may pay each State per diem at a rate determined by the Secretary for each veteran receiving extended care services described in any of paragraphs (4) through (6) of section 1710B(a) of this title under a program administered by a State home, if such veteran is eligible for such care under laws administered by the Secretary.

(b) In no case shall the payments made with respect to any veteran under this section exceed one-half of the cost of the veterans’ care in such State home.

(c) Whenever the Secretary makes a determination pursuant to section 1720(a)(2)(A) of this title that the cost of care furnished by the Department in a general hospital under the direct jurisdiction of the Secretary has increased, the Secretary may, effective no earlier than the date of such determination, increase the rates paid under subsection (a) of this section by a percentage not greater than the percentage by which the Secretary has determined that such cost of care has increased.

(d) Subject to section 1743 of this title, the payment of per diem for care furnished in a State home facility shall commence on the date of the completion of the inspection for recognition of the facility under section 1742(a) of this title if the Secretary determines, as a result of that inspection, that the State home meets the standards described in such section.

(e) Payments to States pursuant to this section shall not be considered a liability of a third party, or otherwise be used to offset or reduce any other payment made to assist veterans.

(f) Any State home that requests payment or reimbursement for services provided to a veteran under this section shall provide to the Secretary such information as the Secretary considers necessary to identify each individual veteran eligible for payment under such section.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1146, §641; Pub. L. 86–625, July 12, 1960, 74 Stat. 424; Pub. L. 87–819, §1, Oct. 15, 1962, 76 Stat. 935; Pub. L. 88–450, §3(a), Aug. 19, 1964, 78 Stat. 500; Pub. L. 90–432, §1, July 26, 1968, 82 Stat. 448; Pub. L. 91–178, §1, Dec. 30, 1969, 83 Stat. 836; Pub. L. 93–82, title IV, §403(a), Aug. 2, 1973, 87 Stat. 196; Pub. L. 94–417, §1(a), Sept. 21, 1976, 90 Stat. 1277; Pub. L. 94–581, title II, §202(o), Oct. 21, 1976, 90 Stat. 2856; Pub. L. 96–151, title I, §101(b)(1), Dec. 20, 1979, 93 Stat. 1092; Pub. L. 98–160, title I, §105(a), Nov. 21, 1983, 97 Stat. 998; Pub. L. 100–322, title I, §134(a), May 20, 1988, 102 Stat. 507; renumbered §1741 and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–585, title IV, §406, Nov. 4, 1992, 106 Stat. 4954; Pub. L. 104–66, title I, §1141(a), Dec. 21, 1995, 109 Stat. 726; Pub. L. 104–262, title III, §342(a), Oct. 9, 1996, 110 Stat. 3206; Pub. L. 106–117, title I, §101(g), Nov. 30, 1999, 113 Stat. 1550; Pub. L. 108–422, title II, §202, Nov. 30, 2004, 118 Stat. 2382; Pub. L. 109–461, title II, §211(a)(3)(A), (b)(2), Dec. 22, 2006, 120 Stat. 3419, 3420.)

Prior Provisions

Prior sections 1740 and 1741 were renumbered sections 3540 and 3541 of this title, respectively.

Amendments

2006—Subsec. (a)(1). Pub. L. 109–461, §211(a)(3)(A), substituted “Except as provided in section 1745 of this title, the” for “The”.

Subsec. (f). Pub. L. 109–461, §211(b)(2), added subsec. (f).

2004—Subsec. (e). Pub. L. 108–422 added subsec. (e).

1999—Subsec. (a)(2). Pub. L. 106–117 substituted “extended care services described in any of paragraphs (4) through (6) of section 1710B(a) of this title under a program administered by a State home” for “adult day health care in a State home”.

1996—Subsec. (a). Pub. L. 104–262 designated existing provisions as par. (1), redesignated former pars. (1) and (2) as subpars. (A) and (B), respectively, and added par. (2).

1995—Subsecs. (c) to (e). Pub. L. 104–66 redesignated subsecs. (d) and (e) as (c) and (d), respectively, and struck out former subsec. (c) which read as follows: “The Secretary shall submit every three years to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the adequacy of the rates provided in subsection (a) of this section in light of projections over each of the following five years of the demand on the Department for the provision of nursing home care to veterans eligible for such care under this section and sections 1710 and 1720 of this title. The first such report shall be submitted not later than June 30, 1986.”

1992—Subsec. (e). Pub. L. 102–585 added subsec. (e).

1991—Pub. L. 102–83, §5(a), renumbered section 641 of this title as this section.

Subsec. (a). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in introductory provisions.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in concluding provisions.

Subsec. (c). Pub. L. 102–83, §5(c)(1), substituted “1710 and 1720” for “610 and 620”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Subsec. (d). Pub. L. 102–83, §5(c)(1), substituted “1720(a)(2)(A)” for “620(a)(2)(A)”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

1988—Subsec. (a). Pub. L. 100–322, §134(a)(1), added cls. (1) and (2) and struck out former cls. (1) to (3) which read as follows:

“(1) $7.30 for domiciliary care,

“(2) $17.05 for nursing home care, and

“(3) $15.25 for hospital care,”.

Subsec. (d). Pub. L. 100–322, §134(a)(2), added subsec. (d).

1983—Subsec. (a). Pub. L. 98–160, §105(a)(1), substituted “$7.30” for “$6.35” in par. (1), “$17.05” for “$12.10” in par. (2), and “$15.25” for “$13.25” in par. (3).

Subsec. (c). Pub. L. 98–160, §105(a)(2), added subsec. (c).

1979—Subsec. (a). Pub. L. 96–151 substituted “$6.35” for “$5.50”, “$12.10” for “$10.50”, and “$13.25” for “$11.50”.

1976—Pub. L. 94–581 struck out “of any war or of service after January 31, 1955” after “for each veteran” in provisions following par. (3).

Pub. L. 94–417 designated existing provisions as subsec. (a), increased from $4.50 to $5.50 the per diem rate for domiciliary care, from $6 to $10.50 the per diem rate for nursing home care, and from $10 to $11.50 the per diem rate for hospital care, struck out “of any war or of service after January 31, 1955” after “for each veteran”, “, in the case of such a veteran receiving domiciliary or hospital care,” after “if”, and provisions relating to the case of a veteran receiving nursing home care, and added subsec. (b).

1973—Pub. L. 93–82 increased from $3.50 to $4.50 the per diem rate for domiciliary care, from $5 to $6 the per diem rate for nursing home care, and from $7.50 to $10 the per diem rate for hospital care, and substituted “veteran of any war or of service after January 31, 1955” for “veteran of any war”.

1969—Pub. L. 91–178 increased from $3.50 to $7.50 the per diem payment for hospital care.

1968—Pub. L. 90–432 increased from $2.50 to $3.50 the per diem rate for hospital or domiciliary care and from $3.50 to $5.00 the per diem rate for nursing home care as the amounts the Administrator shall pay each State providing such services for veterans.

1964—Pub. L. 88–450 amended section generally and, among other changes, authorized payment at the per diem rate of $3.50 for each veteran receiving nursing care in a State home, if such veteran meets the requirements of paragraph (1), (2), or (3) of section 610(a) of this title, except that the requirement in clause (B) of such paragraph (1) shall, for this purpose, refer to the inability to defray the expenses of necessary nursing home care, and eliminated provisions which permitted reduction of the amount payable to the State homes under certain conditions and prohibited payments to State homes where a bar or canteen is maintained therein where intoxicating liquors are sold.

1962—Subsec. (b). Pub. L. 87–819 provided that no reduction shall be made by the retention or collection by a State home of amounts from the estate of a deceased veteran if such amounts are placed in a post or other special fund for the benefit of the State home or its inhabitants in providing the benefits enumerated in clauses (A) to (C).

1960—Subsec. (a). Pub. L. 86–625 substituted “at the per diem rate of $2.50 per diem for each veteran” for “at the annual rate of $700.00 for each veteran”.

Effective Date of 2006 Amendment

Amendment by section 211(a)(3)(A) of Pub. L. 109–461 effective 90 days after Dec. 22, 2006, see section 211(a)(5) of Pub. L. 109–461, set out as a note under section 1710 of this title.

Effective Date of 1988 Amendment

Section 134(b) of Pub. L. 100–322 provided that:

“(1) The amendment made by subsection (a)(1) [amending this section] shall take effect as of January 1, 1988.

“(2) The amendment made by subsection (a)(2) [amending this section] shall take effect on October 1, 1988.”

Effective Date of 1983 Amendment

Section 105(b) of Pub. L. 98–160 provided that: “The amendments made by subsection (a) [amending this section] shall take effect on April 1, 1984.”

Effective Date of 1979 Amendment

Section 101(b)(2) of Pub. L. 96–151 provided that: “The amendments made by paragraph (1) [amending this section] shall take effect on January 1, 1980, but, with respect to fiscal year 1980, shall take effect only to such extent and in such amounts as may be specifically provided for such purpose in appropriation Acts.”

Effective Date of 1976 Amendments

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Section 1(c) of Pub. L. 94–417 provided that:

“(1) The amendments made by subsection (a) of this section [amending this section] shall be effective on October 1, 1976.

“(2) At the time of the first payment to a State under section 641 [now 1741] of title 38, United States Code, as amended by subsection (a) of this section, the Administrator of Veterans’ Affairs shall pay such State, in a lump sum, an amount equal to the difference between the total amount paid each such State under such section 641 [now 1741] for care provided by such State in a State home from January 1, 1976, to October 1, 1976, and the amount such State would have been paid for providing such care if the amendment made by subsection (a) of this section had been effective on January 1, 1976.”

Effective Date of 1973 Amendment

Amendment by Pub. L. 93–82 effective Sept. 1, 1973, see section 501 of Pub. L. 93–82, set out as a note under section 1701 of this title.

Effective Date of 1964 Amendment

Section 3(c) of Pub. L. 88–450 provided that: “The amendment made by this section [amending this section] shall take effect on January 1, 1965; except that subsection (b) of section 641 [now 1741] of title 38, United States Code, as in effect immediately before such date, shall remain in effect with respect to any amounts retained or collected by any State home before such date.”

Payments to States for Nursing Home Care

Section 3(b) of Pub. L. 88–450 provided that: “No payment shall be made to any State home solely by reason of the amendment made by this section [amending this section] on account of nursing home care furnished any veteran except where such care is furnished the veteran by the State home for the first time after the effective date of this section [Jan. 1, 1965].”

§1742. Inspections of such homes; restrictions on beneficiaries

(a) The Secretary may inspect any State home at such times as the Secretary deems necessary. No payment or grant may be made to any home under this subchapter unless such home is determined by the Secretary to meet such standards as the Secretary shall prescribe, which standards with respect to nursing home care shall be no less stringent than those prescribed pursuant to section 1720(b) of this title.

(b) The Secretary may ascertain the number of persons on account of whom payments may be made under this subchapter on account of any State home, but shall have no authority over the management or control of any State home.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1146, §642; Pub. L. 94–581, title I, §107(a), title II, §210(a)(16), Oct. 21, 1976, 90 Stat. 2847, 2863; renumbered §1742 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406.)

Prior Provisions

Prior section 1742 was renumbered section 3542 of this title.

Amendments

1991—Pub. L. 102–83, §5(a), renumbered section 642 of this title as this section.

Subsec. (a). Pub. L. 102–83, §5(c)(1), substituted “1720(b)” for “620(b)”.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Subsec. (b). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator”.

1976—Subsec. (a). Pub. L. 94–581 substituted “as the Administrator deems necessary” for “as he deems necessary” in existing provisions and inserted provision that no payment or grant may be made to any home under this subchapter unless such home is determined by the Administrator to meet such standards as the Administrator shall prescribe, which standards with respect to nursing home care shall be no less stringent than those prescribed pursuant to section 620(b) of this title.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

§1743. Applications

Payments on account of any veteran cared for in a State home shall be made under this subchapter only from the date the Secretary receives a request for determination of such veteran's eligibility; however, if such request is received by the Secretary within ten days after care of such veteran begins, payments shall be made on account of such veteran from the date care began.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1147, §643; Pub. L. 97–251, §7, Sept. 8, 1982, 96 Stat. 716; renumbered §1743 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.)

Prior Provisions

Prior section 1743 was renumbered section 3543 of this title.

Amendments

1991—Pub. L. 102–83 renumbered section 643 of this title as this section and substituted “Secretary” for “Administrator” in two places.

1982—Pub. L. 97–251 struck out “of any war” after “Payments on account of any veteran”.

§1744. Hiring and retention of nurses: payments to assist States

(a) Payment Program.—The Secretary shall make payments to States under this section for the purpose of assisting State homes in the hiring and retention of nurses and the reduction of nursing shortages at State homes.

(b) Eligible Recipients.—Payments to a State for a fiscal year under this section shall, subject to submission of an application, be made to any State that during that fiscal year—

(1) receives per diem payments under this subchapter for that fiscal year; and

(2) has in effect an employee incentive scholarship program or other employee incentive program at a State home designed to promote the hiring and retention of nursing staff and to reduce nursing shortages at that home.


(c) Use of Funds Received.—A State may use an amount received under this section only to provide funds for a program described in subsection (b)(2). Any program shall meet such criteria as the Secretary may prescribe. In prescribing such criteria, the Secretary shall take into consideration the need for flexibility and innovation.

(d) Limitations on Amount of Payment.—(1) A payment under this section may not be used to provide more than 50 percent of the costs for a fiscal year of the employee incentive scholarship or other employee incentive program for which the payment is made.

(2) The amount of the payment to a State under this section for any fiscal year is, for each State home in that State with a program described in subsection (b)(2), the amount equal to 2 percent of the amount of payments estimated to be made to that State, for that State home, under section 1741 of this title for that fiscal year.

(e) Applications.—A payment under this section for any fiscal year with respect to any State home may only be made based upon an application submitted by the State seeking the payment with respect to that State home. Any such application shall describe the nursing shortage at the State home and the employee incentive scholarship program or other employee incentive program described in subsection (c) for which the payment is sought.

(f) Source of Funds.—Payments under this section shall be made from funds available for other payments under this subchapter.

(g) Disbursement.—Payments under this section to a State home shall be made as part of the disbursement of payments under section 1741 of this title with respect to that State home.

(h) Use of Certain Receipts.—The Secretary shall require as a condition of any payment under this section that, in any case in which the State home receives a refund payment made by an employee in breach of the terms of an agreement for employee assistance that used funds provided under this section, the payment shall be returned to the State home's incentive program account and credited as a non-Federal funding source.

(i) Annual Report From Payment Recipients.—Any State home receiving a payment under this section for any fiscal year, shall, as a condition of the payment, be required to agree to provide to the Secretary a report setting forth in detail the use of funds received through the payment, including a descriptive analysis of how effective the incentive program has been on nurse staffing in the State home during that fiscal year. The report for any fiscal year shall be provided to the Secretary within 60 days of the close of the fiscal year and shall be subject to audit by the Secretary. Eligibility for a payment under this section for any later fiscal year is contingent upon the receipt by the Secretary of the annual report under this subsection for the previous fiscal year in accordance with this subsection.

(j) Regulations.—The Secretary shall prescribe regulations to carry out this section. The regulations shall include the establishment of criteria for the award of payments under this section.

(Added Pub. L. 108–422, title II, §201(a)(1), Nov. 30, 2004, 118 Stat. 2380.)

Implementation

Pub. L. 108–422, title II, §201(b), Nov. 30, 2004, 118 Stat. 2382, provided that: “The Secretary of Veterans Affairs shall implement section 1744 of title 38, United States Code, as added by subsection (a), as expeditiously as possible. The Secretary shall establish such interim procedures as necessary so as to ensure that payments are made to eligible States under that section commencing not later than June 1, 2005, notwithstanding that regulations under subsection (j) of that section may not have become final.”

§1745. Nursing home care and medications for veterans with service-connected disabilities

(a)(1) The Secretary shall pay each State home for nursing home care at the rate determined under paragraph (2), in any case in which such care is provided to any veteran as follows:

(A) Any veteran in need of such care for a service-connected disability.

(B) Any veteran who—

(i) has a service-connected disability rated at 70 percent or more; and

(ii) is in need of such care.


(2) The rate determined under this paragraph with respect to a State home is the lesser of—

(A) the applicable or prevailing rate payable in the geographic area in which the State home is located, as determined by the Secretary, for nursing home care furnished in a non-Department nursing home (as that term is defined in section 1720(e)(2) of this title); or

(B) a rate not to exceed the daily cost of care, as determined by the Secretary, following a report to the Secretary by the director of the State home.


(3) Payment by the Secretary under paragraph (1) to a State home for nursing home care provided to a veteran described in that paragraph constitutes payment in full to the State home for such care furnished to that veteran.

(b) The Secretary shall furnish such drugs and medicines as may be ordered on prescription of a duly licensed physician as specific therapy in the treatment of illness or injury to any veteran as follows:

(1) Any veteran who—

(A) is not being provided nursing home care for which payment is payable under subsection (a); and

(B) is in need of such drugs and medicines for a service-connected disability.


(2) Any veteran who—

(A) has a service-connected disability rated at 50 percent or more;

(B) is not being provided nursing home care for which payment is payable under subsection (a); and

(C) is in need of such drugs and medicines.


(c) Any State home that requests payment or reimbursement for services provided to a veteran under this section shall provide to the Secretary such information as the Secretary considers necessary to identify each individual veteran eligible for payment under such section.

(Added and amended Pub. L. 109–461, title II, §211(a)(1), (2), (b)(1), Dec. 22, 2006, 120 Stat. 3418, 3419.)

Amendments

2006—Subsec. (b). Pub. L. 109–461, §211(a)(2), added subsec. (b).

Subsec. (c). Pub. L. 109–461, §211(b)(1), added subsec. (c).

Effective Date

Section and amendment by section 211(a)(2) of Pub. L. 109–461 effective 90 days after Dec. 22, 2006, see section 211(a)(5) of Pub. L. 109–461, set out as an Effective Date of 2006 Amendment note under section 1710 of this title.

SUBCHAPTER VI—SICKLE CELL ANEMIA

§1751. Screening, counseling, and medical treatment

The Secretary is authorized to carry out a comprehensive program of providing sickle cell anemia screening, counseling, treatment, and information under the provisions of this chapter.

(Added Pub. L. 93–82, title I, §109(a), Aug. 2, 1973, 87 Stat. 186, §651; renumbered §1751 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.)

Amendments

1991—Pub. L. 102–83 renumbered section 651 of this title as this section and substituted “Secretary” for “Administrator”.

Effective Date

Subchapter effective Sept. 1, 1973, see section 501 of Pub. L. 93–82, set out as an Effective Date of 1973 Amendment note under section 1701 of this title.

§1752. Research

The Secretary is authorized to carry out research and research training in the diagnosis, treatment, and control of sickle cell anemia based upon the screening examinations and treatment provided under this subchapter.

(Added Pub. L. 93–82, title I, §109(a), Aug. 2, 1973, 87 Stat. 186, §652; renumbered §1752 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.)

Amendments

1991—Pub. L. 102–83 renumbered section 652 of this title as this section and substituted “Secretary” for “Administrator”.

§1753. Voluntary participation; confidentiality

(a) The participation by any person in any program or portion thereof under this subchapter shall be wholly voluntary and shall not be a prerequisite to eligibility for or receipt of any other service or assistance from, or to participation in, any other program under this title.

(b) Patient records prepared or obtained under this subchapter shall be held confidential in the same manner and under the same conditions prescribed in section 7332 of this title.

(Added Pub. L. 93–82, title I, §109(a), Aug. 2, 1973, 87 Stat. 187, §653; amended Pub. L. 94–581, title I, §111(b), Oct. 21, 1976, 90 Stat. 2852; Pub. L. 102–40, title IV, §402(d)(1), May 7, 1991, 105 Stat. 239; renumbered §1753, Pub. L. 102–83, §5(a), Aug. 6, 1991, 105 Stat. 406.)

Amendments

1991—Pub. L. 102–83 renumbered section 653 of this title as this section.

Subsec. (b). Pub. L. 102–40 substituted “7332” for “4132”.

1976—Subsec. (b). Pub. L. 94–581 substituted “Patient records prepared or obtained under this subchapter shall be held confidential in the same manner and under the same conditions prescribed in section 4132 of this title” for “The Administrator shall promulgate rules and regulations to insure that all information and patient records prepared or obtained under this subchapter shall be held confidential except for (1) such information as the patient (or his guardian) requests in writing to be released or (2) statistical data compiled without reference to patient names or other identifying characteristics”.

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

§1754. Reports

The Secretary shall include in the annual report to the Congress required by section 529 of this title a comprehensive report on the administration of this subchapter, including such recommendations for additional legislation as the Secretary deems necessary.

(Added Pub. L. 93–82, title I, §109(a), Aug. 2, 1973, 87 Stat. 187, §654; renumbered §1754 and amended Pub. L. 102–83, §§2(c)(3), 4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 402, 404–406.)

Amendments

1991—Pub. L. 102–83, §5(a), renumbered section 654 of this title as this section.

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

Pub. L. 102–83, §2(c)(3), substituted “section 529” for “section 214”.

[§§1761 to 1764. Repealed. Pub. L. 102–585, title V, §514(a), Nov. 4, 1992, 106 Stat. 4958]

Section 1761, added Pub. L. 96–22, title I, §105(a), June 13, 1979, 93 Stat. 52, §661; amended Pub. L. 98–160, title I, §106(b), Nov. 21, 1983, 97 Stat. 998; renumbered §1761, Pub. L. 102–83, §5(a), Aug. 6, 1991, 105 Stat. 406, related to purpose of this subchapter, which established a preventive health-care services pilot program.

Prior section 1761 was renumbered section 3561 of this title.

Section 1762, added Pub. L. 96–22, title I, §105(a), June 13, 1979, 93 Stat. 52, §662; renumbered §1762 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–585, title V, §513(a), Nov. 4, 1992, 106 Stat. 4958, defined the term “preventive health-care services” for purposes of this subchapter. Section 1762 of this title was transferred to section 1701(9) of this title by Pub. L. 102–585.

Prior section 1762 was renumbered section 3562 of this title.

Section 1763, added Pub. L. 96–22, title I, §105(a), June 13, 1979, 93 Stat. 52, §663; amended Pub. L. 96–128, title V, §501(d), Nov. 28, 1979, 93 Stat. 987; Pub. L. 98–160, title I, §106(c), Nov. 21, 1983, 97 Stat. 998; Pub. L. 99–272, title XIX, §19011(d)(6), Apr. 7, 1986, 100 Stat. 379; renumbered §1763 and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406, related to provision of preventive health-care services under this subchapter.

Prior section 1763 was renumbered section 3563 of this title.

Another prior section 1763, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1201, provided for control by agencies of the United States, prior to repeal by Pub. L. 89–358, §3(a)(3), Mar. 3, 1966, 80 Stat. 20. See section 3682 of this title.

Section 1764, added Pub. L. 96–22, title I, §105(a), June 13, 1979, 93 Stat. 53, §664; amended Pub. L. 98–160, title I, §106(d), Nov. 21, 1983, 97 Stat. 999; renumbered §1764 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406, directed Secretary to include comprehensive reports on administration of this subchapter in annual reports to Congress for fiscal years 1984 through 1988.

Prior section 1764, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1201, provided for dismissal for conflict of interest, prior to repeal by Pub. L. 89–358, §§3(a)(3), 12(a), Mar. 3, 1966, 80 Stat. 20, 28, effective Mar. 3, 1966. See section 3683 of this title.

Prior section 1765 was renumbered section 3565 of this title.

Another prior section 1765, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1202, provided for reports by institutions, prior to repeal by Pub. L. 89–358, §3(a)(3), Mar. 3, 1966, 80 Stat. 20. See section 3684 of this title.

Prior section 1766 was renumbered section 3566 of this title.

Another prior section 1766, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1202, related to overpayments to eligible persons, prior to repeal by Pub. L. 89–358, §3(a)(3), Mar. 3, 1966, 80 Stat. 20. See section 3685 of this title.

Prior section 1767, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1202, related to examination of records, prior to repeal by Pub. L. 89–358, §3(a)(3), Mar. 3, 1966, 80 Stat. 20.

Prior section 1768, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1202, related to false or misleading statements, prior to repeal by Pub. L. 89–358, §3(a)(3), Mar. 3, 1966, 80 Stat. 20.

A prior section 1770 was renumbered section 3670 of this title.

[SUBCHAPTER VII—TRANSFERRED]

[§§1771 to 1774. Renumbered §§2031 to 2034]

Codification

Former subchapter VII of chapter 17, which consisted of sections 1771 to 1774, was renumbered subchapter IV of chapter 20 of this title and transferred to follow section 2023 of this title, and sections 1771 to 1774 were renumbered sections 2031 to 2034 of this title, respectively.

A prior subchapter VII of this chapter, consisting of sections 1761 to 1764 of this title, related to preventive health care services pilot program, prior to repeal by Pub. L. 102–585, title V, §514(a), Nov. 4, 1992, 106 Stat. 4958.

Other prior sections 1771 to 1774 were renumbered sections 3671 to 3674 of this title, respectively.

Prior sections 1775 to 1777 were renumbered sections 3675 to 3677 of this title, respectively.

Another prior section 1777 was renumbered section 1778 of this title.

Prior section 1778 was renumbered section 3678 of this title.

Another prior section 1778 was renumbered section 1779 of this title.

Prior sections 1779 and 1780 were renumbered sections 3679 and 3680 of this title, respectively.

SUBCHAPTER VIII—HEALTH CARE OF PERSONS OTHER THAN VETERANS

§1781. Medical care for survivors and dependents of certain veterans

(a) The Secretary is authorized to provide medical care, in accordance with the provisions of subsection (b) of this section, for—

(1) the spouse or child of a veteran who has a total disability, permanent in nature, resulting from a service-connected disability,

(2) the surviving spouse or child of a veteran who (A) died as a result of a service-connected disability, or (B) at the time of death had a total disability permanent in nature, resulting from a service-connected disability,

(3) the surviving spouse or child of a person who died in the active military, naval, or air service in the line of duty and not due to such person's own misconduct, and

(4) an individual designated as a primary provider of personal care services under section 1720G(a)(7)(A) of this title who is not entitled to care or services under a health-plan contract (as defined in section 1725(f) of this title); 1


who are not otherwise eligible for medical care under chapter 55 of title 10 (CHAMPUS).

(b) In order to accomplish the purposes of subsection (a) of this section, the Secretary shall provide for medical care in the same or similar manner and subject to the same or similar limitations as medical care is furnished to certain dependents and survivors of active duty and retired members of the Armed Forces under chapter 55 of title 10 (CHAMPUS), by—

(1) entering into an agreement with the Secretary of Defense under which that Secretary shall include coverage for such medical care under the contract, or contracts, that Secretary enters into to carry out such chapter 55, and under which the Secretary of Veterans Affairs shall fully reimburse the Secretary of Defense for all costs and expenditures made for the purposes of affording the medical care authorized pursuant to this section; or

(2) contracting in accordance with such regulations as the Secretary shall prescribe for such insurance, medical service, or health plans as the Secretary deems appropriate.


In cases in which Department medical facilities are equipped to provide the care and treatment, the Secretary is also authorized to carry out such purposes through the use of such facilities not being utilized for the care of eligible veterans. A dependent or survivor receiving care under the preceding sentence shall be eligible for the same medical services as a veteran, including services under sections 1782 and 1783 of this title.

(c) For the purposes of this section, a child between the ages of eighteen and twenty-three (1) who is eligible for benefits under subsection (a) of this section, (2) who is pursuing a full-time course of instruction at an educational institution approved under chapter 36 of this title, and (3) who, while pursuing such course of instruction, incurs a disabling illness or injury (including a disabling illness or injury incurred between terms, semesters, or quarters or during a vacation or holiday period) which is not the result of such child's own willful misconduct and which results in such child's inability to continue or resume such child's chosen program of education at an approved educational institution shall remain eligible for benefits under this section until the end of the six-month period beginning on the date the disability is removed, the end of the two-year period beginning on the date of the onset of the disability, or the twenty-third birthday of the child, whichever occurs first.

(d)(1)(A) An individual otherwise eligible for medical care under this section who is also entitled to hospital insurance benefits under part A of the medicare program is eligible for medical care under this section only if the individual is also enrolled in the supplementary medical insurance program under part B of the medicare program.

(B) The limitation in subparagraph (A) does not apply to an individual who—

(i) has attained 65 years of age as of June 5, 2001; and

(ii) is not enrolled in the supplementary medical insurance program under part B of the medicare program as of that date.


(2) Subject to paragraph (3), if an individual described in paragraph (1) receives medical care for which payment may be made under both this section and the medicare program, the amount payable for such medical care under this section shall be the amount by which (A) the costs for such medical care exceed (B) the sum of—

(i) the amount payable for such medical care under the medicare program; and

(ii) the total amount paid or payable for such medical care by third party payers other than the medicare program.


(3) The amount payable under this subsection for medical care may not exceed the total amount that would be paid under subsection (b) if payment for such medical care were made solely under subsection (b).

(4) In this subsection:

(A) The term “medicare program” means the program of health insurance administered by the Secretary of Health and Human Services under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).

(B) The term “third party” has the meaning given that term in section 1729(i)(3) of this title.


(e) Payment by the Secretary under this section on behalf of a covered beneficiary for medical care shall constitute payment in full and extinguish any liability on the part of the beneficiary for that care.

(Added Pub. L. 93–82, title I, §103(b), Aug. 2, 1973, 87 Stat. 181, §613; amended Pub. L. 94–581, title I, §104, title II, §210(a)(4), Oct. 21, 1976, 90 Stat. 2845, 2862; Pub. L. 96–151, title II, §205(a), Dec. 20, 1979, 93 Stat. 1094; Pub. L. 97–72, title I, §105, Nov. 3, 1981, 95 Stat. 1050; Pub. L. 97–251, §5(a), Sept. 8, 1982, 96 Stat. 716; renumbered §1713 and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(B), (E), 5(a), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–190, div. A, title VII, §704(b)(2), Dec. 5, 1991, 105 Stat. 1402; Pub. L. 107–14, §3, June 5, 2001, 115 Stat. 25; renumbered §1781 and amended Pub. L. 107–135, title II, §208(c), Jan. 23, 2002, 115 Stat. 2463; Pub. L. 107–330, title III, §308(g)(8), Dec. 6, 2002, 116 Stat. 2829; Pub. L. 111–163, title I, §102, title V, §503, May 5, 2010, 124 Stat. 1139, 1157.)

References in Text

The Social Security Act, referred to in subsec. (d)(4)(A), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XVIII of the Act is classified generally to subchapter XVIII (§1395 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.

Prior Provisions

A prior section 1781 was renumbered section 3681 of this title.

Amendments

2010—Subsec. (a)(4). Pub. L. 111–163, §102, added par. (4).

Subsec. (e). Pub. L. 111–163, §503, added subsec. (e).

2002—Pub. L. 107–135, §208(c)(1), (2), renumbered section 1713 of this title as this section.

Subsec. (b). Pub. L. 107–135, §208(c)(3), inserted at end “A dependent or survivor receiving care under the preceding sentence shall be eligible for the same medical services as a veteran, including services under sections 1782 and 1783 of this title.”

Subsec. (d)(1)(B)(i). Pub. L. 107–330, §308(g)(8)(A), substituted “as of June 5, 2001” for “as of the date of the enactment of the Veterans’ Survivor Benefits Improvements Act of 2001”.

Subsec. (d)(4). Pub. L. 107–330, §308(g)(8)(B), substituted “subsection” for “paragraph” in introductory provisions.

2001—Subsec. (d). Pub. L. 107–14 amended subsec. (d) generally. Prior to amendment, subsec. (d) read as follows: “Notwithstanding section 1086(d)(1) of title 10 or any other provision of law, any spouse, surviving spouse, or child who, after losing eligibility for medical care under this section by virtue of becoming entitled to hospital insurance benefits under part A of title XVIII of the Social Security Act (42 U.S.C. 1395c et seq.), has exhausted any such benefits shall become eligible for medical care under this section and shall not thereafter lose such eligibility under this section by virtue of becoming again eligible for such hospital insurance benefits.”

1991—Pub. L. 102–83, §5(a), renumbered section 613 of this title as this section.

Subsec. (a). Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in introductory provisions.

Subsec. (b). Pub. L. 102–83, §4(b)(2)(B), substituted “that Secretary” for second and third references to “the Secretary” and “the Secretary of Defense” for last reference to “the Secretary” in par. (1).

Pub. L. 102–83, §4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing in introductory and concluding provisions and in par. (2).

Pub. L. 102–83, §4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in concluding provisions.

Subsec. (d). Pub. L. 102–190 substituted “section 1086(d)(1)” for “the second sentence of section 1086(c)”.

1982—Subsec. (d). Pub. L. 97–251 added subsec. (d).

1981—Subsec. (b). Pub. L. 97–72 substituted “equipped to provide the care and treatment” for “particularly equipped to provide the most effective care and treatment” in provisions following par. (2).

1979—Subsec. (a). Pub. L. 96–151, §205(a)(1), in cl. (1) substituted reference to spouse for reference to wife, in cl. (2) substituted reference to surviving spouse for reference to widow, and added cl. (3).

Subsec. (c). Pub. L. 96–151, §205(a)(2), added subsec. (c).

1976—Subsec. (a)(2). Pub. L. 94–581, §104, designated existing provisions as cl. (A) and added cl. (B).

Subsec. (b)(1). Pub. L. 94–581, §210(a)(4)(A), substituted “the Secretary enters” for “he enters”.

Subsec. (b)(2). Pub. L. 94–581, §210(a)(4)(B), substituted “the Administrator” for “he” in two places.

Effective Date of 1982 Amendment

Section 5(b) of Pub. L. 97–251 provided that: “The amendment made by subsection (a) [amending this section] shall take effect on October 1, 1982.”

Effective Date of 1979 Amendment

Section 205(b) of Pub. L. 96–151 provided that: “The amendments made by subsection (a) [amending this section] shall take effect with respect to fiscal year 1980 only to such extent and for such amounts as may be specifically provided for such purpose in appropriation Acts.”

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Effective Date

Section effective Sept. 1, 1973, see section 501 of Pub. L. 93–82, set out as an Effective Date of 1973 Amendment note under section 1701 of this title.

1 So in original. The semicolon probably should be a comma.

§1782. Counseling, training, and mental health services for immediate family members and caregivers

(a) Counseling for Family Members of Veterans Receiving Service-Connected Treatment.—In the case of a veteran who is receiving treatment for a service-connected disability pursuant to paragraph (1) or (2) of section 1710(a) of this title, the Secretary shall provide to individuals described in subsection (c) such consultation, professional counseling, marriage and family counseling, training, and mental health services as are necessary in connection with that treatment.

(b) Counseling for Family Members of Veterans Receiving Non-Service-Connected Treatment.—In the case of a veteran who is eligible to receive treatment for a non-service-connected disability under the conditions described in paragraph (1), (2), or (3) of section 1710(a) of this title, the Secretary may, in the discretion of the Secretary, provide to individuals described in subsection (c) such consultation, professional counseling, marriage and family counseling, training, and mental health services as are necessary in connection with that treatment.

(c) Eligible Individuals.—Individuals who may be provided services under this subsection are—

(1) the members of the immediate family or the legal guardian of a veteran;

(2) a family caregiver of an eligible veteran or a caregiver of a covered veteran (as those terms are defined in section 1720G of this title); or

(3) the individual in whose household such veteran certifies an intention to live.


(d) Travel and Transportation Authorized.—Services provided under subsections (a) and (b) may include, under the terms and conditions set forth in section 111 of this title, travel and incidental expenses of individuals described in subsection (c) in the case of any of the following:

(1) A veteran who is receiving care for a service-connected disability.

(2) A dependent or survivor receiving care under the last sentence of section 1783(b) of this title.

(Added Pub. L. 107–135, title II, §208(b), Jan. 23, 2002, 115 Stat. 2462; amended Pub. L. 110–387, title III, §301(a)(2), Oct. 10, 2008, 122 Stat. 4120; Pub. L. 111–163, title I, §103(a), (b), May 5, 2010, 124 Stat. 1139, 1140.)

Prior Provisions

A prior section 1782 was renumbered section 3682 of this title.

Amendments

2010—Pub. L. 111–163, §103(b), inserted “and caregivers” after “members” in section catchline.

Subsec. (c)(2), (3). Pub. L. 111–163, §103(a), added par. (2) and redesignated former par. (2) as (3).

2008—Subsec. (a). Pub. L. 110–387, §301(a)(2)(A), inserted “marriage and family counseling,” after “professional counseling,”.

Subsec. (b). Pub. L. 110–387, §301(a)(2)(B), inserted “marriage and family counseling,” after “professional counseling,” and substituted period at end for “if—

“(1) those services were initiated during the veteran's hospitalization; and

“(2) the continued provision of those services on an outpatient basis is essential to permit the discharge of the veteran from the hospital.”

§1783. Bereavement counseling

(a) Deaths of Veterans.—In the case of an individual who was a recipient of services under section 1782 of this title at the time of the death of the veteran, the Secretary may provide bereavement counseling to that individual in the case of a death—

(1) that was unexpected; or

(2) that occurred while the veteran was participating in a hospice program (or a similar program) conducted by the Secretary.


(b) Deaths In Active Service.—(1) The Secretary may provide bereavement counseling to an individual who is a member of the immediate family of a member of the Armed Forces who dies in the active military, naval, or air service in the line of duty and under circumstances not due to the person's own misconduct.

(2) For purposes of this subsection, the members of the immediate family of a member of the Armed Forces described in paragraph (1) include the parents of such member.

(c) Provision of Counseling Through Vet Centers.—Bereavement counseling may be provided under this section through the facilities and personnel of centers for the provision of readjustment counseling and related mental health services under section 1712A of this title.

(d) Bereavement Counseling Defined.—For purposes of this section, the term “bereavement counseling” means such counseling services, for a limited period, as the Secretary determines to be reasonable and necessary to assist an individual with the emotional and psychological stress accompanying the death of another individual.

(Added Pub. L. 107–135, title II, §208(b), Jan. 23, 2002, 115 Stat. 2463; amended Pub. L. 109–461, title II, §216, Dec. 22, 2006, 120 Stat. 3424.)

Prior Provisions

A prior section 1783 was renumbered section 3683 of this title.

Amendments

2006—Subsec. (b). Pub. L. 109–461, §216(a), designated existing provisions as par. (1) and added par. (2).

Subsec. (c), (d). Pub. L. 109–461, §216(b), added subsec. (c) and redesignated former subsec. (c) as (d).

§1784. Humanitarian care

The Secretary may furnish hospital care or medical services as a humanitarian service in emergency cases, but the Secretary shall charge for such care and services at rates prescribed by the Secretary.

(Added Pub. L. 107–135, title II, §208(b), Jan. 23, 2002, 115 Stat. 2463.)

Prior Provisions

Prior section 1784 was renumbered section 3684 of this title.

§1785. Care and services during certain disasters and emergencies

(a) Authority To Provide Hospital Care and Medical Services.—During and immediately following a disaster or emergency referred to in subsection (b), the Secretary may furnish hospital care and medical services to individuals responding to, involved in, or otherwise affected by that disaster or emergency.

(b) Covered Disasters and Emergencies.—A disaster or emergency referred to in this subsection is any disaster or emergency as follows:

(1) A major disaster or emergency declared by the President under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.).

(2) A disaster or emergency in which the National Disaster Medical System established pursuant to section 2812 of the Public Health Service Act (42 U.S.C. 300hh) 1 is activated by the Secretary of Health and Human Services under that section or as otherwise authorized by law.


(c) Applicability to Eligible Individuals Who Are Veterans.—The Secretary may furnish care and services under this section to an individual described in subsection (a) who is a veteran without regard to whether that individual is enrolled in the system of patient enrollment under section 1705 of this title.

(d) Reimbursement From Other Federal Departments and Agencies.—(1) The cost of any care or services furnished under this section to an officer or employee of a department or agency of the United States other than the Department or to a member of the Armed Forces shall be reimbursed at such rates as may be agreed upon by the Secretary and the head of such department or agency or the Secretary concerned, in the case of a member of the Armed Forces, based on the cost of the care or service furnished.

(2) Amounts received by the Department under this subsection shall be credited to the Medical Care Collections Fund under section 1729A of this title.

(e) Report to Congressional Committees.—Within 60 days of the commencement of a disaster or emergency referred to in subsection (b) in which the Secretary furnishes care and services under this section (or as soon thereafter as is practicable), the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report on the Secretary's allocation of facilities and personnel in order to furnish such care and services.

(f) Regulations.—The Secretary shall prescribe regulations governing the exercise of the authority of the Secretary under this section.

(Added Pub. L. 107–287, §4(a)(1), Nov. 7, 2002, 116 Stat. 2028; amended Pub. L. 109–444, §8(a)(2), Dec. 21, 2006, 120 Stat. 3313; Pub. L. 109–461, title X, §§1004(a)(2), 1006(b), Dec. 22, 2006, 120 Stat. 3465, 3468; Pub. L. 111–275, title X, §1001(c)(2), Oct. 13, 2010, 124 Stat. 2896.)

References in Text

The Robert T. Stafford Disaster Relief and Emergency Assistance Act, referred to in subsec. (b)(1), is Pub. L. 93–288, May 22, 1974, 88 Stat. 143, which is classified principally to chapter 68 (§5121 et seq.) of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under section 5121 of Title 42 and Tables.

Section 2812 of the Public Health Service Act, referred to in subsec. (b)(2), is classified to section 300hh–11 of Title 42, The Public Health and Welfare.

Prior Provisions

A prior section 1785 was renumbered section 3685 of this title.

Amendments

2010—Subsec. (b)(2). Pub. L. 111–275 substituted “section 2812 of the Public Health Service Act (42 U.S.C. 300hh)” for “section 2811(b) of the Public Health Service Act (42 U.S.C. 300hh–11(b))” and struck out “paragraph (3)(A) of” before “that section”.

2006—Subsec. (b)(1). Pub. L. 109–461, §1006(b), provided that as of the enactment of Pub. L. 109–461, the amendments made by Pub. L. 109–444 were deemed for all purposes not to have taken effect and that Pub. L. 109–444 ceased to be in effect. See Amendment notes below and section 1006(b) of Pub. L. 109–461, set out as a Coordination of Provisions With Pub. L. 109–444 note under section 101 of this title.

Pub. L. 109–461, §1004(a)(2), substituted “Robert T.” for “Robert B.”.

Pub. L. 109–444, which substituted “Robert T.” for “Robert B.”, was terminated by Pub. L. 109–461, §1006(b). See Amendment notes above.

Transfer of Functions

For transfer of functions, personnel, assets, and liabilities of the National Disaster Medical System, including the functions of the Secretary of Homeland Security and the Under Secretary for Emergency Preparedness and Response relating thereto, to the Secretary of Health and Human Services, see title III of Pub. L. 109–295, set out in part as a note under section 300hh–11 of Title 42, The Public Health and Welfare, and section 301(b) of Pub. L. 109–417, set out as a note under section 300hh–11 of Title 42.

For transfer of functions, personnel, assets, and liabilities of the National Disaster Medical System of the Department of Health and Human Services, including the functions of the Secretary of Health and Human Services and the Assistant Secretary for Public Health Emergency Preparedness [now Assistant Secretary for Preparedness and Response] relating thereto, to the Secretary of Homeland Security, and for treatment of related references, see former section 313(5) and sections 551(d), 552(d), and 557 of Title 6, Domestic Security, and the Department of Homeland Security Reorganization Plan of November 25, 2002, as modified, set out as a note under section 542 of Title 6.

1 See References in Text note below.

§1786. Care for newborn children of women veterans receiving maternity care

(a) In General.—The Secretary may furnish health care services described in subsection (b) to a newborn child of a woman veteran who is receiving maternity care furnished by the Department for not more than seven days after the birth of the child if the veteran delivered the child in—

(1) a facility of the Department; or

(2) another facility pursuant to a Department contract for services relating to such delivery.


(b) Covered Health Care Services.—Health care services described in this subsection are all post-delivery care services, including routine care services, that a newborn child requires.

(Added Pub. L. 111–163, title II, §206(a), May 5, 2010, 124 Stat. 1145.)

Prior Provisions

A prior section 1786 was renumbered section 3686 of this title.

Another prior section 1786, added Pub. L. 89–358, §3(b), Mar. 3, 1966, 80 Stat. 23, related to the examination of records, prior to repeal by section 316(1) of Pub. L. 92–540. See section 3690 of this title.

Prior section 1787 was renumbered section 3687 of this title.

Another prior section 1787, added Pub. L. 89–358, §3(b), Mar. 3, 1966, 80 Stat. 23, related to the submission of false or misleading statements by educational institutions, persons or veterans, prior to repeal by section 316(1) of Pub. L. 92–540. See section 3690 of this title.

Prior section 1788 was renumbered section 3688 of this title.

Another prior section 1788 was renumbered section 3692 of this title.

Prior section 1789 was renumbered section 3689 of this title.

Another prior section 1789, which required the Administrator not to approve of enrollments in courses in institutions listed by the Attorney General under section 12 of Ex. Ord. No. 10450, was renumbered section 1793 of this title.

Prior section 1790 was renumbered section 3690 of this title.

Another prior section 1790 was renumbered section 3694 of this title.

Prior section 1791 was renumbered section 3691 of this title.

Another prior section 1791 was renumbered section 3695 of this title.

Prior sections 1792 and 1793 were renumbered sections 3692 and 3693 of this title, respectively.

Another prior section 1793, added Pub. L. 89–358, §3(b), Mar. 3, 1966, 80 Stat. 23, §1789; amended Pub. L. 91–24, §15, June 11, 1969, 83 Stat. 35; renumbered and amended Pub. L. 92–540, title III, §316(2), title IV, §403(12), Oct. 24, 1972, 86 Stat. 1086, 1090, required that the Administrator not to approve of enrollment in any course in an institution listed by the Attorney General under section 12 of Executive Order 10450, prior to repeal by section 511(1) of Pub. L. 94–502.

Prior sections 1794 to 1799 were renumbered sections 3694 to 3699 of this title, respectively, and sections 3698 and 3699 were subsequently repealed.