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

Editorial Notes

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, air, or space 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, who was awarded the medal of honor under section 7271, 8291, or 9271 of title 10 or section 491 ¹ of title 14, or who was awarded the Purple Heart;

(E) who is a veteran of—

(i) the Mexican border period;

(ii) World War I; or

(iii) World War II;

(F) who is a toxic-exposed veteran, in accordance with 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 (including any veteran who, in connection with service during such period, received the Armed Forces Expeditionary Medal, Service Specific Expeditionary Medal, Combat Era Specific Expeditionary Medal, Campaign Specific Medal, or any other combat theater award established by a Federal statute or an Executive order), or in combat against a hostile force during a period of hostilities 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.

(F) Subject to paragraph (2), a veteran who served on active duty in the Armed Forces at Camp Lejeune, North Carolina, for not fewer than 30 days during the period beginning on August 1, 1953, and ending on December 31, 1987, is eligible for hospital care and medical services under subsection (a)(2)(F) for any of the following illnesses or conditions, notwithstanding that there is insufficient medical evidence to conclude that such illnesses or conditions are attributable to such service:

(i) Esophageal cancer.

(ii) Lung cancer.

(iii) Breast cancer.

(iv) Bladder cancer.

(v) Kidney cancer.

(vi) Leukemia.

(vii) Multiple myeloma.

(viii) Myelodysplastic syndromes.

(ix) Renal toxicity.

(x) Hepatic steatosis.

(xi) Female infertility.

(xii) Miscarriage.

(xiii) Scleroderma.

(xiv) Neurobehavioral effects.

(xv) Non-Hodgkin's lymphoma.

(G) Beginning not later than the applicable date specified in paragraph (6), and subject to paragraph (2), a veteran who participated in a toxic exposure risk activity while serving on active duty, active duty for training, or inactive duty training is eligible for hospital care (including mental health services and counseling), medical services, and nursing home care under subsection (a)(2)(F) for any illness.

(H) Beginning not later than the applicable date specified in paragraph (6), and subject to paragraph (2), a covered veteran (as defined in section 1119(c) of this title) is eligible for hospital care (including mental health services and counseling), medical services, and nursing home care under subsection (a)(2)(F) for any illness.

(I)(i) Beginning not later than the applicable date specified in paragraph (6), and subject to paragraph (2), a veteran who deployed in support of a contingency operation specified in clause (ii) is eligible for hospital care (including mental health services and counseling), medical services, and nursing home care under subsection (a)(2)(F) for any illness.

(ii) A contingency operation specified in this clause is any of the following:

(I) Operation Enduring Freedom.

(II) Operation Freedom's Sentinel.

(III) Operation Iraqi Freedom.

(IV) Operation New Dawn.

(V) Operation Inherent Resolve.

(VI) Resolute Support Mission.

(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), (E), (F), (G), (H), or (I) 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, testing, or activity described in such subparagraph.

(3) In the case of care for a veteran described in paragraph (1)(D), hospital care, medical services, and nursing home care may be provided under or by virtue of subsection (a)(2)(F) only during the following periods:

(A) Except as provided by subparagraph (B), with respect to a veteran described in paragraph (1)(D) who is discharged or released from the active military, naval, air, or space service after September 11, 2001, the 10-year period beginning on the date of such discharge or release.

(B) With respect to a veteran described in paragraph (1)(D) who was discharged or released from the active military, naval, air, or space service after September 11, 2001, and before October 1, 2013, but did not enroll to receive such hospital care, medical services, or nursing home care under such paragraph pursuant to subparagraph (A) before October 1, 2022, the one-year period beginning on October 1, 2022.

(4) For purposes of this subsection—

(A) The term "Vietnam-era herbicide-exposed veteran" means a veteran who—

(i) performed covered service, as defined in section 1116(d) of this title; or

(ii) the Secretary finds may have been exposed during active military, naval, air, or space service to dioxin during the Vietnam era, regardless of the geographic area of such service, or was exposed during such service to a toxic substance found in a herbicide or defoliant used for military purposes during such era, regardless of the geographic area of such service.

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

(C) The term "toxic exposure risk activity" means any activity—

(i) that requires a corresponding entry in an exposure tracking record system (as defined in section 1119(c) of this title) for the veteran who carried out the activity; or

(ii) that the Secretary determines qualifies for purposes of this subsection when taking into account what is reasonably prudent to protect the health of veterans.

(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.

(6)(A) The Secretary shall determine the dates in subparagraphs (G), (H), and (I) of paragraph (1) as follows:

(i) October 1, 2024, with respect to a veteran described in such subparagraph (G) or (H) who was discharged or released from the active military, naval, air, or space service during the period beginning on August 2, 1990, and ending on September 11, 2001.

(ii) October 1, 2026, with respect to a veteran described in such subparagraph (G) or (H) who was discharged or released from the active military, naval, air, or space service during the period beginning on September 12, 2001, and ending on December 31, 2006.

(iii) October 1, 2028, with respect to a veteran described in such subparagraph (G) or (H) who was discharged or released from the active military, naval, air, or space service during the period beginning on January 1, 2007, and ending on December 31, 2012.

(iv) October 1, 2030, with respect to a veteran described in such subparagraph (G) or (H) who was discharged or released from the active military, naval, air, or space service during the period beginning on January 1, 2013, and ending on December 31, 2018.

(v) October 1, 2032, with respect to a veteran described in such subparagraph (I).

(B)(i) The Secretary may modify a date specified in subparagraph (A) to an earlier date, as the Secretary determines appropriate based on the number of veterans receiving hospital care, medical services, and nursing home care under subparagraphs (G), (H), and (I) of paragraph (1) and the resources available to the Secretary.

(ii) If the Secretary determines to modify a date under clause (i), the Secretary shall—

(I) notify the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives of the proposed modification; and

(II) publish such modified date in the Federal Register.

(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, 2025, 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 the following:

(A) Home health services under section 1717 of this title to the extent that such services are for improvements and structural alterations.

(B) Education on the use of opioid antagonists to reverse the effects of overdoses of specific medications or substances.

(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; Pub. L. 112–154, title I, §§102(a), 112, Aug. 6, 2012, 126 Stat. 1167, 1176; Pub. L. 113–37, §2(c), Sept. 30, 2013, 127 Stat. 524; Pub. L. 113–175, title I, §107, Sept. 26, 2014, 128 Stat. 1903; Pub. L. 113–235, div. I, title II, §243, Dec. 16, 2014, 128 Stat. 2568; Pub. L. 114–2, §7, Feb. 12, 2015, 129 Stat. 36; Pub. L. 114–58, title I, §101, title VI, §601(4), Sept. 30, 2015, 129 Stat. 532, 538; Pub. L. 114–198, title IX, §915(b), July 22, 2016, 130 Stat. 765; Pub. L. 114–223, div. A, title II, §243(b), Sept. 29, 2016, 130 Stat. 884; Pub. L. 114–228, title I, §101, Sept. 29, 2016, 130 Stat. 936; Pub. L. 114–315, title VI, §603(b), title VIII, §802(3), Dec. 16, 2016, 130 Stat. 1570, 1591; Pub. L. 115–62, title I, §101, Sept. 29, 2017, 131 Stat. 1160; Pub. L. 115–232, div. A, title VIII, §809(n)(1)(B), Aug. 13, 2018, 132 Stat. 1843; Pub. L. 115–251, title I, §101, Sept. 29, 2018, 132 Stat. 3168; Pub. L. 116–23, §2(f), June 25, 2019, 133 Stat. 969; Pub. L. 116–159, div. E, title I, §5101, Oct. 1, 2020, 134 Stat. 748; Pub. L. 116–283, div. A, title IX, §926(a)(21), Jan. 1, 2021, 134 Stat. 3830; Pub. L. 117–168, title I, §§102(a), (c), 103(a), 111(a), (b), title IV, §403(c), Aug. 10, 2022, 136 Stat. 1761, 1762, 1765, 1766, 1781; Pub. L. 117–180, div. E, title I, §101, Sept. 30, 2022, 136 Stat. 2136; Pub. L. 117–328, div. U, title I, §101(a), Dec. 29, 2022, 136 Stat. 5407; Pub. L. 118–83, div. B, title III, §301, Sept. 26, 2024, 138 Stat. 1539.)

Editorial Notes

References in Text

Section 491 of title 14, referred to in subsec. (a)(2)(D), was redesignated section 2732 of title 14 by Pub. L. 115–282, title I, §116(b), Dec. 4, 2018, 132 Stat. 4226, and references to section 491 of title 14 deemed to refer to such redesignated section, see section 123(b)(1) of Pub. L. 115–282, set out as a References to Redesignated Sections of Title 14 note preceding section 101 of Title 14, Coast Guard.

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.

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

2024—Subsec. (f)(2)(B). Pub. L. 118–83 substituted "September 30, 2025" for "September 30, 2024".

2022—Subsec. (a)(2)(E). Pub. L. 117–328 designated existing provisions as introductory provisions, substituted "of—" for "of the Mexican border period or of World War I;", and added cls. (i) to (iii).

Subsec. (a)(2)(F). Pub. L. 117–168, §102(a), substituted "who is a toxic-exposed veteran, in accordance with subsection (e)" for "who was exposed to a toxic substance, radiation, or other conditions, as provided in subsection (e)".

Subsec. (e)(1)(D). Pub. L. 117–168, §111(b), inserted "(including any veteran who, in connection with service during such period, received the Armed Forces Expeditionary Medal, Service Specific Expeditionary Medal, Combat Era Specific Expeditionary Medal, Campaign Specific Medal, or any other combat theater award established by a Federal statute or an Executive order)" after "Persian Gulf War".

Subsec. (e)(1)(G) to (I). Pub. L. 117–168, §103(a)(1)(A), added subpars. (G) to (I).

Subsec. (e)(2)(B). Pub. L. 117–168, §103(a)(1)(B), substituted "(F), (G), (H), or (I)" for "or (F)" and "service, testing, or activity" for "service or testing".

Subsec. (e)(3)(A). Pub. L. 117–168, §111(a)(1), substituted "September 11, 2001" for "January 27, 2003" and "10-year period" for "five-year period".

Subsec. (e)(3)(B). Pub. L. 117–168, §111(a)(2), amended subpar. (B) generally. Prior to amendment, subpar. (B) read as follows: "With respect to a veteran described in paragraph (1)(D) who is discharged or released from the active military, naval, air, or space service after January 1, 2009, and before January 1, 2011, but did not enroll to receive such hospital care, medical services, or nursing home care pursuant to such paragraph during the five-year period described in subparagraph (A), the one-year period beginning on the date of the enactment of the Clay Hunt Suicide Prevention for American Veterans Act."

Subsec. (e)(3)(C). Pub. L. 117–168, §111(a)(3), struck out subpar. (C) which read as follows: "With respect to a veteran described in paragraph (1)(D) who is discharged or released from the active military, naval, air, or space service on or before January 27, 2003, and did not enroll in the patient enrollment system under section 1705 of this title on or before such date, the three-year period beginning on January 27, 2008."

Subsec. (e)(4)(A). Pub. L. 117–168, §403(c), added subpar. (A) and struck out former subpar. (A) which read as follows: "The term 'Vietnam-era herbicide-exposed veteran' means a veteran (i) who served on active duty in the Republic of Vietnam (including offshore of such Republic as described in section 1116A(d) of this title) 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."

Subsec. (e)(4)(C). Pub. L. 117–168, §102(c), added subpar. (C).

Subsec. (e)(6). Pub. L. 117–168, §103(a)(2), added par. (6).

Subsec. (f)(2)(B). Pub. L. 117–180 substituted "September 30, 2024" for "September 30, 2022".

2021—Subsec. (a)(2)(B). Pub. L. 116–283 substituted "air, or space service" for "or air service".

Subsec. (e)(3). Pub. L. 116–283 substituted "air, or space service" for "or air service" in subpars. (A) to (C).

2020—Subsec. (f)(2)(B). Pub. L. 116–159 substituted "September 30, 2022" for "September 30, 2020".

2019—Subsec. (e)(4). Pub. L. 116–23 inserted "(including offshore of such Republic as described in section 1116A(d) of this title)" after "served on active duty in the Republic of Vietnam".

2018—Subsec. (a)(2)(D). Pub. L. 115–232 substituted "section 7271, 8291, or 9271 of title 10" for "section 3741, 6241, or 8741 of title 10".

Subsec. (f)(2)(B). Pub. L. 115–251 substituted "September 30, 2020" for "September 30, 2019".

2017—Subsec. (f)(2)(B). Pub. L. 115–62 substituted "September 30, 2019" for "September 30, 2017".

2016—Subsec. (a)(2)(D). Pub. L. 114–315, §603(b), inserted ", who was awarded the medal of honor under section 3741, 6241, or 8741 of title 10 or section 491 of title 14," after "war".

Subsec. (e)(1)(F). Pub. L. 114–315, §802(3), inserted comma after "1953" in introductory provisions.

Subsec. (f)(2)(B). Pub. L. 114–228 substituted "September 30, 2017" for "September 30, 2016".

Subsec. (g)(3). Pub. L. 114–198 and Pub. L. 114–223 amended par. (3) identically, substituting "with respect to the following:" for "with respect to home health services", inserting subpar. (A) designation and "Home health services" before "under section 1717 of this title", and adding subpar. (B).

2015—Subsec. (e)(1)(D). Pub. L. 114–58, §601(4)(A), struck out "(as defined in section 1712A(a)(2)(B) of this title)" after "hostilities".

Subsec. (e)(1)(F)(viii). Pub. L. 114–58, §601(4)(B), substituted "Myelodysplastic" for "Myleodysplasic".

Subsec. (e)(3). Pub. L. 114–2 amended par. (3) generally. Prior to amendment, par. (3) read as follows: "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."

Subsec. (f)(2)(B). Pub. L. 114–58, §101, substituted "September 30, 2016" for "September 30, 2015".

2014—Subsec. (e)(1)(F). Pub. L. 113–235, §243, substituted "August 1, 1953" for "January 1, 1957," in introductory provisions.

Subsec. (f)(2)(B). Pub. L. 113–175 substituted "September 30, 2015" for "September 30, 2014".

2013—Subsec. (f)(2)(B). Pub. L. 113–37 substituted "September 30, 2014" for "September 30, 2013".

2012—Subsec. (e)(1)(F). Pub. L. 112–154, §102(a)(1), added subpar. (F).

Subsec. (e)(2)(B). Pub. L. 112–154, §102(a)(2), substituted "(E), or (F)" for "or (E)".

Subsec. (f)(2)(B). Pub. L. 112–154, §112, substituted "September 30, 2013" for "September 30, 2012".

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).

Statutory Notes and Related Subsidiaries

Effective Date of 2022 Amendment

Pub. L. 117–328, div. U, title I, §101(b), Dec. 29, 2022, 136 Stat. 5408, provided that: "The amendment made by subsection (a) [amending this section] shall take effect on March 31, 2023."

Pub. L. 117–168, title I, §111(e), Aug. 10, 2022, 136 Stat. 1766, provided that: "This section [amending this section] and the amendments made by this section shall take effect on October 1, 2022."

Amendment by section 403(c) of Pub. L. 117–168 effective Aug. 10, 2022, with additional provisions for different applicability dates applying to various categories of veterans and claimants for compensation, see section 403(e) of Pub. L. 117–168, set out as a note under section 1116 of this title.

Effective Date of 2019 Amendment

Amendment by Pub. L. 116–23 effective Jan. 1, 2020, see section 2(g) of Pub. L. 116–23, set out as an Effective Date note under section 1116A of this title.

Effective Date of 2018 Amendment

Amendment by Pub. L. 115–232 effective Feb. 1, 2019, with provision for the coordination of amendments and special rule for certain redesignations, see section 800 of Pub. L. 115–232, set out as a note preceding section 3001 of Title 10, Armed Forces.

Effective Date of 2013 Amendment

Amendment by Pub. L. 113–37 effective Oct. 1, 2013, see section 4(a) of Pub. L. 113–37, set out as a note under section 322 of this title.

Effective Date of 2012 Amendment

Pub. L. 112–154, title I, §102(d), Aug. 6, 2012, 126 Stat. 1169, provided that:

"(1) In general.—The provisions of this section [enacting section 1787 of this title and amending this section] and the amendments made by this section shall take effect on the date of the enactment of this Act [Aug. 6, 2012].

"(2) Applicability.—Subparagraph (F) of section 1710(e)(1) of such title [probably means title 38, United States Code], as added by subsection (a), and section 1787 of title 38, United States Code, as added by subsection (b)(1), shall apply with respect to hospital care and medical services provided on or after the date of the enactment of this Act."

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

Pub. L. 105–33, title VIII, §8023(g), Aug. 5, 1997, 111 Stat. 668, 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

Pub. L. 103–210, §1(c)(1), Dec. 20, 1993, 107 Stat. 2497, 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]."

Pub. L. 101–508, title VIII, §8013(d), (e), Nov. 5, 1990, 104 Stat. 1388–347, 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

Pub. L. 99–576, title II, §237(c), Oct. 28, 1986, 100 Stat. 3267, 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."

Pub. L. 99–272, title XIX, §19011(f), Apr. 7, 1986, 100 Stat. 380, 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

Pub. L. 97–37, §5(d), Aug. 14, 1981, 95 Stat. 937, 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

Pub. L. 104–262, title I, §102(b), Oct. 9, 1996, 110 Stat. 3182, 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

Pub. L. 100–322, title I, §102(c), May 20, 1988, 102 Stat. 493, 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."

Assessments of Implementation and Operation

Pub. L. 117–168, title I, §104, Aug. 10, 2022, 136 Stat. 1763, provided that:

"(a) Initial Resource Assessment and Report.—Not later than 180 days after the date of the enactment of this Act [Aug. 10, 2022], the Secretary of Veterans Affairs shall—

"(1) complete an assessment to determine—

"(A) the personnel and material resources necessary to implement section 103 [amending this section] (including the amendments made by such section); and

"(B) the total number of covered veterans, as such term is defined in section 1119(c) of title 38, United States Code (as added by section 302), who receive hospital care or medical services furnished by the Secretary under chapter 17 of such title, disaggregated by priority group specified in section 1705(a) of such title; and

"(2) submit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives a report containing the findings of the assessment completed under paragraph (1), including a specific determination as to whether the Department has the personnel and material resources necessary to implement section 103.

"(b) Information Systems.—Not later than October 1, 2024, the Secretary shall establish information systems to assess the implementation of section 103, including the amendments made by such section, and use the results of assessments under such systems to inform the reports under subsection (c).

"(c) Annual Reports.—

"(1) Reports.—Not later than October 1, 2025, and on an annual basis thereafter until October 1, 2033, 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 following:

"(A) The effect of the implementation of, and the provision and management of care under, section 103 (including the amendments made by such section) on the demand by veterans described in subparagraphs (G), (H), and (I) of section 1710(e)(1) of title 38, United States Code (as added by such section 103) for health care services furnished by the Secretary.

"(B) Any differing patterns of demand for health care services by such veterans, disaggregated by factors such as the relative distance of the veteran from medical facilities of the Department and whether the veteran had previously received hospital care or medical services furnished by the Secretary under chapter 17 of such title.

"(C) The extent to which the Secretary has met such demand.

"(D) Any changes, during the year covered by the report, in the delivery patterns of health care furnished by the Secretary under chapter 17 of such title, and the fiscal impact of such changes.

"(2) Matters.—Each report under paragraph (1) shall include, with respect to the year covered by the report, detailed information on the following:

"(A) The total number of veterans enrolled in the patient enrollment system who, during such year, received hospital care or medical services furnished by the Secretary under chapter 17 of title 38, United States Code.

"(B) Of the veterans specified in subparagraph (A), the number of such veterans who, during the preceding three fiscal years, had not received such care or services.

"(C) With respect to the veterans specified in subparagraph (B), the cost of providing health care to such veterans during the year covered by the report, shown in total and disaggregated by—

"(i) the level of care; and

"(ii) whether the care was provided through the Veterans Community Care Program.

"(D) With respect to the number of veterans described in subparagraphs (G), (H), and (I) of section 1710(e)(1) of title 38, United States Code (as added by section 103), the following (shown in total and disaggregated by medical facility of the Department, as applicable):

"(i) The number of such veterans who, during the year covered by the report, enrolled in the patient enrollment system.

"(ii) The number of such veterans who applied for, but were denied, such enrollment.

"(iii) The number of such veterans who were denied hospital care or a medical service furnished by the Secretary that was considered to be medically necessary but not of an emergency nature.

"(E) The numbers and characteristics of, and the type and extent of health care furnished by the Secretary to, veterans enrolled in the patient enrollment system (shown in total and disaggregated by medical facility of the Department).

"(F) The numbers and characteristics of, and the type and extent of health care furnished by the Secretary to, veterans not enrolled in the patient enrollment system (disaggregated by each class of eligibility for care under section 1710 of title 38, United States Code, and further shown as a total per class and disaggregated by medical facility of the Department).

"(G) The specific fiscal impact (shown in total and disaggregated by geographic health care delivery areas) of changes in the delivery patterns of health care furnished by the Secretary under chapter 17 of such title as a result of the implementation of section 103 (including the amendments made by such section).

"(d) Definitions.—In this section:

"(1) Patient enrollment system.—The term 'patient enrollment system' means the patient enrollment system of the Department of Veterans Affairs established and operated under section 1705(a) of title 38, United States Code.

"(2) Veterans community care program.—The term 'Veterans Community Care Program' means the program established under section 1703 of title 38, United States Code."

Contact of Certain Veterans To Encourage Receipt of Comprehensive Medical Examinations

Pub. L. 116–214, title II, §204, Dec. 5, 2020, 134 Stat. 1037, provided that:

"(a) Notice.—Not later than 90 days after the date of the enactment of this Act [Dec. 5, 2020], the Under Secretary of Health of the Department of Veterans Affairs shall seek to contact each covered veteran by mail, telephone, or email to encourage each covered veteran to receive medical examinations including the following:

"(1) A comprehensive physical examination.

"(2) A comprehensive mental health examination.

"(3) A comprehensive eye examination if the covered veteran has not received such an examination in the year immediately preceding the date of such examination.

"(4) A comprehensive audiological examination if the covered veteran has not received such an examination in the year immediately preceding the date of such examination.

"(b) Examinations.—

"(1) Va health care facilities.—If a covered veteran elects to receive more than one examination described in subsection (a) at a health care facility of the Department of Veterans Affairs, the Under Secretary of Health shall seek to furnish all such scheduled examinations on the same day.

"(2) Community care.—Pursuant to subsection (d) or (e) of section 1703 of title 38, United States Code, a covered veteran may receive an examination described in subsection (a) from a health care provider described in subsection (c) of that section.

"(c) Transportation.—

"(1) Beneficiary travel program.—Pursuant to section 111 of title 38, United States Code, the Secretary of Veterans Affairs may pay for a rural covered veteran to travel to a health care facility to receive an examination described in subsection (a).

"(2) Shuttle service.—The Under Secretary of Health shall seek to enter into agreements with non-profit organizations to provide shuttle service to rural covered veterans for examinations described in subsection (a).

"(d) Report Required.—Not later than 18 months after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to Congress a report regarding how many covered veterans scheduled examinations described in subsection (a) after receiving a letter, telephone call, or email under that subsection.

"(e) Definitions.—In this section:

"(1) The term 'covered 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; and

"(B) has not received health care furnished or paid for by the Secretary of Veterans Affairs during the two years immediately preceding the date in subsection (a)(1).

"(2) The term 'rural covered veteran' means a covered veteran—

"(A) who lives in an area served by the Office of Rural Health of the Department of Veterans Affairs; and

"(B) whom [sic] the Under Secretary of Health determines requires assistance to travel to a health care facility to receive an examination described in subsection (a).

"(3) The term 'veteran' has the meaning given that term in section 101 of title 38, United States Code."

Report on Locations Where Women Veterans Are Using Health Care From Department of Veterans Affairs

Pub. L. 116–214, title III, §302, Dec. 5, 2020, 134 Stat. 1039, provided that:

"(a) Report.—Not later than 90 days after the date of the enactment of this Act [Dec. 5, 2020], and annually thereafter, the Secretary of Veterans Affairs shall submit to the Committees on Veterans' Affairs of the House of Representatives and the Senate a report on the use by women veterans of health care from the Department of Veterans Affairs.

"(b) Elements.—Each report required by subsection (a) shall include the following information:

"(1) The number of women veterans who reside in each State.

"(2) The number of women veterans in each State who are enrolled in the patient enrollment system of the Department under section 1705(a) of title 38, United States Code.

"(3) Of the women veterans who are so enrolled, the number who have received health care under the laws administered by the Secretary at least one time during the one-year period preceding the submission of the report.

"(4) The number of women veterans who have been seen at each medical facility of the Department during such year, disaggregated by facility.

"(5) The number of appointments that women veterans have had at a medical facility of the Department during such year, disaggregated by—

"(A) facility; and

"(B) appointments for—

"(i) primary care;

"(ii) specialty care; and

"(iii) mental health care.

"(6) For each appointment type specified in paragraph (5)(B), the number of appointments completed in-person and the number of appointments completed through the use of telehealth.

"(7) If known, an identification of the medical facility of the Department in each Veterans Integrated Service Network with the largest rate of increase in patient population of women veterans as measured by the increase in unique women veteran patient use.

"(8) If known, an identification of the medical facility of the Department in each Veterans Integrated Service Network with the largest rate of decrease in patient population of women veterans as measured by the decrease in unique women veterans patient use."

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, as amended by Pub. L. 113–37, §2(i), Sept. 30, 2013, 127 Stat. 525; Pub. L. 113–175, title I, §103, Sept. 26, 2014, 128 Stat. 1903; Pub. L. 114–58, title I, §105, Sept. 30, 2015, 129 Stat. 532; Pub. L. 114–228, title I, §105, Sept. 29, 2016, 130 Stat. 937; Pub. L. 115–62, title I, §105, Sept. 29, 2017, 131 Stat. 1161; Pub. L. 115–251, title I, §106, Sept. 29, 2018, 132 Stat. 3168; Pub. L. 116–159, div. E, title I, §5104, Oct. 1, 2020, 134 Stat. 748; Pub. L. 116–315, title V, §5107(a)(2), Jan. 5, 2021, 134 Stat. 5031, 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) Termination.—The authority to carry out a pilot program under this section shall terminate on the date of the enactment of the Deborah Sampson Act of 2020 [Jan. 5, 2021].

"(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, 2015, 2016, 2017, 2018, 2019, 2020, 2021, and 2022."

[Pub. L. 116–315, §5107(a)(2), which directed amendment of section 205(e) of Pub. L. 111–163, set out above, by substituting "the date of the enactment of the Deborah Sampson Act of 2020" for "September 30, 2020", was executed by making the substitution for "September 30, 2022" to reflect the probable intent of Congress and the amendment by Pub. L. 116–159, which had substituted "September 30, 2022" for "September 30, 2020". For establishment of child care assistance program by Pub. L. 116–315, see section 1709C of this title.]

Grants for Veterans Service Organizations for Transportation of Highly Rural Veterans

Pub. L. 111–163, title III, §307, May 5, 2010, 124 Stat. 1154, as amended by Pub. L. 113–175, title I, §104, Sept. 26, 2014, 128 Stat. 1903; Pub. L. 114–58, title I, §106, Sept. 30, 2015, 129 Stat. 532; Pub. L. 114–228, title I, §106, Sept. 29, 2016, 130 Stat. 937; Pub. L. 115–62, title I, §106, Sept. 29, 2017, 131 Stat. 1161; Pub. L. 115–251, title I, §107, Sept. 29, 2018, 132 Stat. 3168; Pub. L. 116–159, div. E, title I, §5105, Oct. 1, 2020, 134 Stat. 748, 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 2022 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, as amended by Pub. L. 115–141, div. J, title II, §245(a), Mar. 23, 2018, 132 Stat. 822, 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.—(1) 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.

"(2) The program shall be carried out at not fewer than two medical centers or clinics in each Veterans Integrated Service Network by not later than December 31, 2019, and at not fewer than 50 percent of all medical centers in each Veterans Integrated Service Network by not later than December 31, 2021.

"(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, required the Secretary of Veterans Affairs, not later than Oct. 1, 1999, to submit to Congress a report on the Secretary's plan for establishing and operating the system for collection and analysis of information required by subsec. (e)(5) of this section.

Demonstration Projects for Treatment of Persian Gulf Illness

Pub. L. 105–114, title II, §209(b), Nov. 21, 1997, 111 Stat. 2290, 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

Pub. L. 104–262, title III, §322, Oct. 9, 1996, 110 Stat. 3196, 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

Pub. L. 104–262, title III, §341, Oct. 9, 1996, 110 Stat. 3205, 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."

Pub. L. 104–110, title I, §103, Feb. 13, 1996, 110 Stat. 769, 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."

Pub. L. 103–452, title I, §105, Nov. 2, 1994, 108 Stat. 4787, 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

Pub. L. 103–210, §1(c)(2), Dec. 20, 1993, 107 Stat. 2497, 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

Pub. L. 99–272, title XIX, §19011(e), Apr. 7, 1986, 100 Stat. 379, 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

Pub. L. 99–166, title I, §109, Dec. 3, 1985, 99 Stat. 948, 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.

¹ See References in Text note below.

§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 September 30, 2025.

(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; Pub. L. 113–59, §8, Dec. 20, 2013, 127 Stat. 662; Pub. L. 113–175, title I, §101, Sept. 26, 2014, 128 Stat. 1902; Pub. L. 114–58, title I, §102, Sept. 30, 2015, 129 Stat. 532; Pub. L. 114–228, title I, §102, Sept. 29, 2016, 130 Stat. 937; Pub. L. 115–62, title I, §102, Sept. 29, 2017, 131 Stat. 1161; Pub. L. 115–251, title I, §102, Sept. 29, 2018, 132 Stat. 3168; Pub. L. 116–159, div. E, title I, §5102, Oct. 1, 2020, 134 Stat. 748; Pub. L. 117–180, div. E, title I, §102, Sept. 30, 2022, 136 Stat. 2136; Pub. L. 118–83, div. B, title III, §302, Sept. 26, 2024, 138 Stat. 1539.)

Editorial Notes

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

2024—Subsec. (d). Pub. L. 118–83 substituted "September 30, 2025" for "September 30, 2024".

2022—Subsec. (d). Pub. L. 117–180 substituted "September 30, 2024" for "September 30, 2022".

2020—Subsec. (d). Pub. L. 116–159 substituted "September 30, 2022" for "September 30, 2020".

2018—Subsec. (d). Pub. L. 115–251 substituted "September 30, 2020" for "September 30, 2019".

2017—Subsec. (d). Pub. L. 115–62 substituted "September 30, 2019" for "December 31, 2017".

2016—Subsec. (d). Pub. L. 114–228 substituted "December 31, 2017" for "December 31, 2016".

2015—Subsec. (d). Pub. L. 114–58 substituted "December 31, 2016" for "December 31, 2015".

2014—Subsec. (d). Pub. L. 113–175 substituted "December 31, 2015" for "December 31, 2014".

2013—Subsec. (d). Pub. L. 113–59 substituted "December 31, 2014" for "December 31, 2013".

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".

Statutory Notes and Related Subsidiaries

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;

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

(D) to a veteran who was awarded the medal of honor under section 7271, 8291, or 9271 of title 10 or section 491 ¹ of title 14.

(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; Pub. L. 114–315, title VI, §603(c), Dec. 16, 2016, 130 Stat. 1570; Pub. L. 115–232, div. A, title VIII, §809(n)(1)(C), Aug. 13, 2018, 132 Stat. 1843.)

Editorial Notes

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.

Section 491 of title 14, referred to in subsec. (c)(2)(D), was redesignated section 2732 of title 14 by Pub. L. 115–282, title I, §116(b), Dec. 4, 2018, 132 Stat. 4226, and references to section 491 of title 14 deemed to refer to such redesignated section, see section 123(b)(1) of Pub. L. 115–282, set out as a References to Redesignated Sections of Title 14 note preceding section 101 of Title 14, Coast Guard.

Amendments

2018—Subsec. (c)(2)(D). Pub. L. 115–232 substituted "section 7271, 8291, or 9271 of title 10" for "section 3741, 6241, or 8741 of title 10".

2016—Subsec. (c)(2)(D). Pub. L. 114–315 added subpar. (D).

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".

Statutory Notes and Related Subsidiaries

Effective Date of 2018 Amendment

Amendment by Pub. L. 115–232 effective Feb. 1, 2019, with provision for the coordination of amendments and special rule for certain redesignations, see section 800 of Pub. L. 115–232, set out as a note preceding section 3001 of Title 10, Armed Forces.

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)."

Modifications to Veteran Directed Care Program of Department of Veterans Affairs

Pub. L. 116–136, div. B, title X, §20006, Mar. 27, 2020, 134 Stat. 587, as amended by Pub. L. 116–315, title III, §3001, Jan. 5, 2021, 134 Stat. 4990, provided that:

"(a) Telephone or Telehealth Renewals.—For the Veteran Directed Care program of the Department of Veterans Affairs (in this section referred to as the 'Program'), during the period specified in subsection (f), the Secretary of Veterans Affairs shall—

"(1) waive the requirement that a covered provider process new enrollments and six-month renewals for the Program via an in-person or home visit; and

"(2) allow new enrollments and sixth-month renewals for the Program to be conducted via telephone or telehealth modality.

"(b) No Suspension or Disenrollment.—During the period specified in subsection (f), the Secretary shall not suspend or dis-enroll a veteran or caregiver of a veteran from the Program unless—

"(1) requested to do so by the veteran or a representative of the veteran; or

"(2) a mutual decision is made between the veteran and a health care provider of the veteran to suspend or dis-enroll the veteran or caregiver from the Program.

"(c) Waiver of Paperwork Requirement.—During the period specified in subsection (f), the Secretary may waive the requirement for signed, mailed paperwork to confirm the enrollment or renewal of a veteran in the Program and may allow verbal consent of the veteran via telephone or telehealth modality to suffice for purposes of such enrollment or renewal.

"(d) Waiver of Other Requirements.—During the period specified in subsection (f), the Secretary shall waive—

"(1) any penalty for late paperwork relating to the Program; and

"(2) any requirement to stop payments for veterans or caregivers of veterans under the Program if they are out of State for more than 14 days.

"(e) Transfer of Certain Veterans to the Program.—During the period specified in subsection (f), the Secretary shall allow a veteran residing in an area covered by the Program to be transferred to the Program for the duration of such period if—

"(1) the veteran had been receiving extended care services paid for by the Department, such as adult day services or homemaker or home health aide services, immediately preceding such period; and

"(2) those services are no longer available due to a public health emergency.

"(f) Period Specified.—The period specified in this subsection is the period beginning on the date on which a public health emergency was first declared and ending on the date that is 60 days after the date on which a public health emergency is no longer in effect.

"(g) Covered Provider Defined.—In this section, the term 'covered provider' means a provider participating in the Program, including—

"(1) an Aging and Disability Resource Center, an area agency on aging, or a State agency (as those terms are defined in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002)); or

"(2) a center for independent living (as defined in section 702 of the Rehabilitation Act of 1973 (29 U.S.C. 796a))."

[For definition of "public health emergency" as used in section 20006 of Pub. L. 116–136, set out above, see section 20003 of Pub. L. 116–136, set out as a note under section 303 of this title.]

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 with the goal of maximizing the individual's independence; 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 (and sustaining improvement in) the physical, cognitive, behavioral, 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 services and rehabilitative components of the traumatic brain injury continuum of care, and where appropriate, to long-term care services.

(3) A description of specific rehabilitative services and other services to achieve the objectives described in paragraph (1), which shall set forth the type, frequency, duration, and location of such 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 ophthalmologist.

(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.

(h) Rehabilitative Services Defined.—For purposes of this section, and sections 1710D and 1710E of this title, the term "rehabilitative services" includes—

(1) rehabilitative services, as defined in section 1701 of this title;

(2) treatment and services (which may be of ongoing duration) to sustain, and prevent loss of, functional gains that have been achieved; and

(3) any other rehabilitative services or supports that may contribute to maximizing an individual's independence.

(Added Pub. L. 110–181, div. A, title XVII, §1702(a), Jan. 28, 2008, 122 Stat. 486; amended Pub. L. 112–154, title I, §107(a), (d), Aug. 6, 2012, 126 Stat. 1173.)

Editorial Notes

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.

Amendments

2012—Subsec. (a)(1). Pub. L. 112–154, §107(a)(1), inserted "with the goal of maximizing the individual's independence" before semicolon.

Subsec. (b)(1). Pub. L. 112–154, §107(a)(2)(A), inserted "(and sustaining improvement in)" after "improving" and "behavioral," after "cognitive,".

Subsec. (b)(2). Pub. L. 112–154, §107(a)(2)(B), inserted "rehabilitative services and" before "rehabilitative components".

Subsec. (b)(3). Pub. L. 112–154, §107(a)(2)(C), substituted "rehabilitative services" for "rehabilitative treatments" and struck out "treatments and" after "location of such".

Subsec. (c)(2)(S). Pub. L. 112–154, §107(d), substituted "ophthalmologist" for "opthamologist".

Subsec. (h). Pub. L. 112–154, §107(a)(3), added subsec. (h).

Statutory Notes and Related Subsidiaries

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."

[Functions which the Director of the National Institute on Disability and Rehabilitation Research exercised before July 22, 2014 (including all related functions of any officer or employee of the National Institute on Disability and Rehabilitation Research), transferred to the National Institute on Disability, Independent Living, and Rehabilitation Research, see subsection (n) of section 3515e of Title 42, The Public Health and Welfare.]

Pilot Program on Community-Based Brain Injury Residential Rehabilitative Care Services for Veterans With Traumatic Brain Injury

Pub. L. 110–181, div. A, title XVII, §1705, Jan. 28, 2008, 122 Stat. 491, as amended by Pub. L. 113–146, title V, §501, Aug. 7, 2014, 128 Stat. 1792; Pub. L. 113–257, §2(a), (b), Dec. 18, 2014, 128 Stat. 2924, 2925; Pub. L. 115–62, title I, §107(a), (b), Sept. 29, 2017, 131 Stat. 1161, 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 pilot program to assess the effectiveness of providing community-based brain injury rehabilitative care 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 Community-Based Brain Injury Residential Rehabilitative Care Services.—

"(1) Agreements.—In carrying out the pilot program, the Secretary may enter into agreements for the provision of community-based brain injury rehabilitative care 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 community-based brain injury rehabilitative care 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 community-based brain injury rehabilitative care 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) Reports.—

"(1) Quarterly reports.—

"(A) In general.—For each calendar quarter occurring during the period beginning January 1, 2015, and ending September 30, 2017, the Secretary shall submit to the Committees on Veterans' Affairs of the Senate and the House of Representatives a report on the pilot program.

"(B) Elements.—Each report submitted under subparagraph (A) shall include each of the following for the quarter preceding the quarter during which the report is submitted the following:

"(i) The number of individuals that participated in the pilot program.

"(ii) The number of individuals that successfully completed the pilot program.

"(iii) The degree to which pilot program participants and family members of pilot program participants were satisfied with the pilot program.

"(iv) The interim findings and conclusions of the Secretary with respect to the success of the pilot program and recommendations for improvement.

"(2) Final report.—

"(A) In general.—Not later than December 6, 2017, the Secretary shall submit to the Committees on Veterans' Affairs of the Senate and the House of Representatives a final report on the pilot program.

"(B) Elements.—The final report required by subparagraph (A) shall include the following:

"(i) A description of the pilot program.

"(ii) The Secretary's assessment of the utility of the activities carried out under the pilot program in enhancing the rehabilitation, quality of life, and community reintegration of veterans with traumatic brain injury.

"(iii) An evaluation of the pilot program in light of independent living programs carried out by the Secretary under title 38, United States Code, including—

     "(I) whether the pilot program duplicates services provided under such independent living programs;

     "(II) the ways in which the pilot program provides different services that the services provided under such independent living program;

     "(III) how the pilot program could be better defined or shaped; and

     "(IV) whether the pilot program should be incorporated into such independent living programs.

"(iv) Such recommendations as the Secretary considers appropriate regarding improving the pilot program.

"(f) Definitions.—In this section:

"(1) The term 'community-based brain injury rehabilitative care services' means services of a facility in providing room, board, rehabilitation, 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."

"(g) Termination.—The pilot program shall terminate on January 6, 2018."

[Pub. L. 115–62, title I, §107(c), Sept. 29, 2017, 131 Stat. 1161, provided that: "Not later than December 6, 2017, the Secretary of Veterans Affairs shall notify veterans participating in the pilot program under such section [section 1705 of Pub. L. 110–181, set out above] regarding a plan for transition of care for such veterans."]

[Pub. L. 113–257, §2(c), Dec. 18, 2014, 128 Stat. 2925, provided that: "The amendments made by this section [amending section 1705 of Pub. L. 110–181, set out above] shall take effect on the date of the enactment of this Act [Dec. 18, 2014]."]

§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 and rehabilitative services (as defined in section 1710C of this title) for post-acute traumatic brain injury rehabilitation that includes residential, community, and home-based components utilizing interdisciplinary 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 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; amended Pub. L. 112–154, title I, §107(b), Aug. 6, 2012, 126 Stat. 1173; Pub. L. 114–58, title VI, §601(5), Sept. 30, 2015, 129 Stat. 538.)

Editorial Notes

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.

Amendments

2015—Subsec. (c)(1). Pub. L. 114–58 struck out "(as defined in section 1712A(a)(2)(B) of this title)" after "hostilities".

2012—Subsec. (a). Pub. L. 112–154 inserted "and rehabilitative services (as defined in section 1710C of this title)" after "long-term care" and struck out "treatment" before "teams".

§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, including rehabilitative services (as defined in section 1710C of this title), 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; Pub. L. 112–154, title I, §107(c), Aug. 6, 2012, 126 Stat. 1173.)

Editorial Notes

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

2012—Subsec. (a). Pub. L. 112–154, §107(c), inserted ", including rehabilitative services (as defined in section 1710C of this title)," after "medical services".

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.)

Editorial Notes

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".

Statutory Notes and Related Subsidiaries

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, air, or space 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, air, or space 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, air, or space 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, air, or space 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 or entered an agreement 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 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; Pub. L. 115–182, title I, §144(a)(1)(A), June 6, 2018, 132 Stat. 1429; Pub. L. 116–283, div. A, title IX, §926(a)(22), Jan. 1, 2021, 134 Stat. 3830.)

Editorial Notes

Prior Provisions

Prior section 1712 was renumbered section 3512 of this title.

Amendments

2021—Subsec. (a). Pub. L. 116–283 substituted "air, or space service" for "or air service" wherever appearing.

2018—Subsec. (a)(3). Pub. L. 115–182, §144(a)(1)(A)(i), substituted "or entered an agreement" for "under clause (1), (2), or (5) of section 1703(a) of this title".

Subsec. (a)(4)(A). Pub. L. 115–182, §144(a)(1)(A)(ii), struck out "under the provisions of this subsection and section 1703 of this title" after "amount for expenditures for contract dental care".

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).

Statutory Notes and Related Subsidiaries

Effective Date of 2018 Amendment

Pub. L. 115–182, title I, §144(b), June 6, 2018, 132 Stat. 1430, provided that: "The amendments made by subsection (a) [amending this section and sections 1712A and 2303 of this title and section 1395cc of Title 42, The Public Health and Welfare, and amending provisions set out as a note under section 1117 of this title] shall take effect on the date described in section 101(b) [June 6, 2019, see note set out under section 1703 of this title]."

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 Amendment

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.

Pub. L. 97–35, title XX, §2002(b), Aug. 13, 1981, 95 Stat. 782, 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, required the Secretary of Veterans Affairs to carry out a pilot program to assess the feasibility and advisability of providing a dental insurance plan to certain veterans and survivors and dependents of veterans, prior to repeal by Pub. L. 114–218, §2(b)(1), July 29, 2016, 130 Stat. 843. See section 1712C of this title.

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

Pub. L. 100–322, title I, §101(g)(2), May 20, 1988, 102 Stat. 492, 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

Pub. L. 100–322, title I, §113, May 20, 1988, 102 Stat. 499, 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

Pub. L. 100–322, title I, §115(a)–(f), May 20, 1988, 102 Stat. 501, 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

Pub. L. 100–322, title I, §114, May 20, 1988, 102 Stat. 500, 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.

Pub. L. 99–576, title II, §235, Oct. 28, 1986, 100 Stat. 3266, 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

Pub. L. 97–72, title I, §103(c), Nov. 3, 1981, 95 Stat. 1049, 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

Pub. L. 96–22, title V, §505, June 13, 1979, 93 Stat. 67, 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

Pub. L. 94–581, title I, §103(b), Oct. 21, 1976, 90 Stat. 2845, 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

Pub. L. 94–581, title I, §117(b), Oct. 21, 1976, 90 Stat. 2855, 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 individual referred to in subparagraph (C), the Secretary shall furnish counseling, including by furnishing counseling through a Vet Center, to the individual—

(i) in the case of an individual referred to in clauses (i) through (vii) of subparagraph (C), to assist the individual in readjusting to civilian life; and

(ii) in the case of an individual referred to in clause (viii) of such subparagraph who is a family member of a veteran or member described in such clause—

(I) in the case of a member who is deployed in a theater of combat operations or an area at a time during which hostilities are occurring in that area, during such deployment to assist such individual in coping with such deployment;

(II) in the case of a veteran or member who is readjusting to civilian life, to the degree that counseling furnished to such individual is found to aid in the readjustment of such veteran or member to civilian life; and

(III) in the case of a veteran or member who died by suicide, to the degree that counseling furnished to such individual is found to aid in coping with the effects of such suicide.

(B)(i) Counseling furnished to an individual under subparagraph (A) may include a comprehensive individual assessment of the individual's psychological, social, and other characteristics to ascertain whether—

(I) in the case of an individual referred to in clauses (i) through (vii) of subparagraph (C), such individual has difficulties associated with readjusting to civilian life; and

(II) in the case of an individual referred to in clause (viii) of such subparagraph, such individual has difficulties associated with—

(aa) coping with the deployment of a member described in subclause (I) of such clause;

(bb) readjustment to civilian life of a veteran or member described in subclause (II) of such clause; or

(cc) coping with the effects of a suicide described in subclause (III) of such clause.

(ii)(I) Except as provided in subclauses (IV) and (V), counseling furnished to an individual under subparagraph (A) may include reintegration and readjustment services described in subclause (II) furnished in group retreat settings.

(II) Reintegration and readjustment services described in this subclause are the following:

(aa) Information on reintegration of the individual into family, employment, and community.

(bb) Financial counseling.

(cc) Occupational counseling.

(dd) Information and counseling on stress reduction.

(ee) Information and counseling on conflict resolution.

(ff) Such other information and counseling as the Secretary considers appropriate to assist the individual in reintegration into family, employment, and community.

(III) In furnishing reintegration and readjustment services under subclause (I), the Secretary shall offer women the opportunity to receive such services in group retreat settings in which the only participants are women.

(IV) An individual described in subparagraph (C)(v) may receive reintegration and readjustment services under subclause (I) of this clause only if the individual receives such services with a family member described in subclause (I) or (II) of such subparagraph.

(V) In each of fiscal years 2021 through 2025, the maximum number of individuals to whom integration and readjustment services may be furnished in group retreat settings under this subclause (I) shall not exceed 1,200 individuals.

(C) Subparagraph (A) applies to the following individuals:

(i) Any individual who is a veteran or member of the Armed Forces, including a member of a reserve component of the Armed Forces, who served on active duty in a theater of combat operations or an area at a time during which hostilities occurred in that area.

(ii) Any individual who is a veteran or member of the Armed Forces, including a member of a reserve component of the Armed Forces, who provided direct emergency medical or mental health care, or mortuary services to the causalities of combat operations or hostilities, but who at the time was located outside the theater of combat operations or area of hostilities.

(iii) Any individual who is a veteran or member of the Armed Forces, including a member of a reserve component of the Armed Forces, who engaged in combat with an enemy of the United States or against an opposing military force in a theater of combat operations or an area at a time during which hostilities occurred in that area by remotely controlling an unmanned aerial vehicle, notwithstanding whether the physical location of such veteran or member during such combat was within such theater of combat operations or area.

(iv) Any individual who is a veteran or member of the Armed Forces, including a member of a reserve component of the Armed Forces, who served—

(I) on active service in response to a national emergency or major disaster declared by the President; or

(II) in the National Guard of a State under orders of the chief executive of that State in response to a disaster or civil disorder in such State.

(v) Any individual who participated in a drug interdiction operation as a member of the Coast Guard, regardless of the location of that operation.

(vi) Any individual who received counseling under this section before the date of the enactment of the National Defense Authorization Act for Fiscal Year 2013.

(vii) Any veteran or member of the Armed Forces pursuing a course of education using covered educational assistance benefits.

(viii) Any individual who is a family member of any—

(I) member of the Armed Forces, including a member of a reserve component of the Armed Forces, who is serving on active duty in a theater of combat operations or in an area at a time during which hostilities are occurring in that area;

(II) veteran or member of the Armed Forces described in this subparagraph; or

(III) veteran or member of the Armed Forces who died by suicide.

(D)(i) The Secretary, in consultation with the Secretary of Defense, may furnish to any member of the reserve components of the Armed Forces who has a behavioral health condition or psychological trauma, counseling under subparagraph (A)(i), which may include a comprehensive individual assessment under subparagraph (B)(i).

(ii) A member of the reserve components of the Armed Forces described in clause (i) shall not be required to obtain a referral before being furnished counseling or an assessment under this subparagraph.

(2)(A) Upon request of an individual described in paragraph (1)(C), the Secretary shall provide the individual a comprehensive individual assessment as described in paragraph (1)(B)(i) as soon as practicable after receiving the request, but not later than 30 days after receiving the request.

(B) Upon the request of an individual described in paragraph (1)(C), the Secretary shall furnish the individual reintegration and readjustment services in group retreat settings under paragraph (1)(B)(ii) if the Secretary determines the experience will be therapeutically appropriate.

(b)(1) If, on the basis of the assessment furnished to an individual under subsection (a) of this section, a licensed or certified mental health care provider employed by the Department (or, in areas where no such licensed or certified mental health care provider is available, a licensed or certified mental health care provider carrying out such function under a contract or fee arrangement with the Secretary) determines that the provision of mental health services to such individual is necessary to facilitate the successful readjustment of the individual to civilian life, such individual 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 individual, 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, air, or space 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, air, or space 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 or agreements with private facilities that is available to the Secretary 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) In carrying out this section and in furtherance of the Secretary's responsibility to carry out outreach activities under chapter 63 of this title, the Secretary may provide for and facilitate the participation of personnel employed by the Secretary to provide services under this section in recreational programs that are—

(1) designed to encourage the readjustment of veterans described in subsection (a)(1)(C); and

(2) operated by any organization named in or approved under section 5902 of this title.

(h) For the purposes of this section:

(1) The term "Vet Center" means a facility which is operated by the Department for the provision of services under this section and which is situated apart from Department general health care facilities.

(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.

(3) The term "family member", with respect to a veteran or member of the Armed Forces, means an individual who—

(A) is a member of the family of the veteran or member, 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 or member but is not a member of the family of the veteran or member.

(4) The term "active service" has the meaning given that term in section 101 of title 10.

(5) The term "civil disorder" has the meaning given that term in section 232 of title 18.

(6) The term "covered educational assistance benefits" means educational assistance benefits provided pursuant to—

(A) chapter 30, 31, 32, or 33 of this title;

(B) chapter 1606 or 1607 of title 10;

(C) section 116 of the Harry W. Colmery Veterans Educational Assistance Act of 2017 (Public Law 115–48; 38 U.S.C. 3001 note); or

(D) section 8006 of the American Rescue Plan Act of 2021 (Public Law 117–2; 38 U.S.C. 3001 note prec.).

(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; Pub. L. 112–239, div. A, title VII, §727, Jan. 2, 2013, 126 Stat. 1809; Pub. L. 115–182, title I, §144(a)(1)(B), June 6, 2018, 132 Stat. 1430; Pub. L. 116–176, §2, Oct. 20, 2020, 134 Stat. 849; Pub. L. 116–283, div. A, title VII, §762(a), (b), title IX, §926(a)(23), Jan. 1, 2021, 134 Stat. 3724, 3725, 3830; Pub. L. 116–315, title V, §5104, Jan. 5, 2021, 134 Stat. 5027; Pub. L. 117–328, div. V, title IV, §§402(a), 403(a), Dec. 29, 2022, 136 Stat. 5511.)

Editorial Notes

References in Text

The date of the enactment of the National Defense Authorization Act for Fiscal Year 2013, referred to in subsec. (a)(1)(C)(vi), is the date of enactment of Pub. L. 112–239, which was approved Jan. 2, 2013.

Amendments

Subsec. (a)(1)(A). Pub. L. 117–328, §402(a), substituted "clauses (i) through (vii)" for "clauses (i) through (vi)" in cl. (i) and "in clause (viii)" for "in clause (vii)" in cl. (ii).

Subsec. (a)(1)(A)(ii)(III). Pub. L. 117–328, §403(a)(1), added subcl. (III).

Subsec. (a)(1)(B)(i). Pub. L. 117–328, §402(a), substituted "clauses (i) through (vii)" for "clauses (i) through (vi)" in subcl. (I) and "in clause (viii)" for "in clause (vii)" in subcl. (II).

Subsec. (a)(1)(B)(i)(II)(cc). Pub. L. 117–328, §403(a)(2), added item (cc).

Subsec. (a)(1)(C)(vii). Pub. L. 117–328, §402(a)(3)(B), added cl. (vii). Former cl. (vii) redesignated (viii).

Subsec. (a)(1)(C)(viii). Pub. L. 117–328, §402(a)(3)(A), redesignated cl. (vii) as (viii).

Subsec. (a)(1)(C)(viii)(III). Pub. L. 117–328, §403(a)(3), which directed addition of subcl. (III) to cl. (vii), was executed by adding subcl. (III) to cl. (viii), to reflect the probable intent of Congress and the intervening amendment by Pub. L. 117–328, §402(a)(3)(A). See above.

Subsec. (h)(6). Pub. L. 117–328, §402(a)(4), added par. (6).

2021—Subsec. (a)(1)(B). Pub. L. 116–315, §5104(a), designated existing provisions as cl. (i), redesignated former cls. (i) and (ii) as subcls. (I) and (II), respectively, redesignated former subcls. (I) and (II) of cl. (ii) as items (aa) and (bb), respectively, of subcl. (II), and added cl. (ii).

Subsec. (a)(1)(D). Pub. L. 116–283, §762(a), added subpar. (D).

Subsec. (a)(2). Pub. L. 116–315, §5104(b), designated existing provisions as subpar. (A), substituted "paragraph (1)(B)(i)" for "paragraph (1)(B)", and added subpar. (B).

Subsec. (b)(1). Pub. L. 116–283, §762(b)(1), inserted "to an individual" after "If, on the basis of the assessment furnished" and substituted "individual" for "veteran" wherever appearing.

Subsec. (b)(2). Pub. L. 116–283, §762(b)(2), substituted "individual" for "veteran".

Subsec. (c). Pub. L. 116–283, §926(a)(23), substituted "air, or space service" for "or air service" in introductory provisions and par. (2).

2020—Subsec. (a)(1)(A), (B). Pub. L. 116–176, §2(1), (2), substituted "clauses (i) through (vi)" for "clauses (i) through (iv)" and "in clause (vii)" for "in clause (v)".

Subsec. (a)(1)(C)(iv) to (vii). Pub. L. 116–176, §2(3), added cls. (iv) and (v) and redesignated former cls. (iv) and (v) as (vi) and (vii), respectively.

Subsec. (h)(4), (5). Pub. L. 116–176, §2(4), added pars. (4) and (5).

2018—Subsec. (e)(1). Pub. L. 115–182 inserted "or agreements" after "contracts" and struck out "(under sections 1703(a)(2) and 1710(a)(1)(B) of this title)" after "available to the Secretary".

2013—Subsec. (a)(1)(A). Pub. L. 112–239, §727(1)(A)(i), substituted "Upon the request of any individual referred to in subparagraph (C), the Secretary shall furnish counseling, including by furnishing counseling through a Vet Center, to the individual—" for "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." and added cls. (i) and (ii).

Subsec. (a)(1)(B), (C). Pub. L. 112–239, §727(1)(A)(ii), added subpars. (B) and (C) and struck out former subpar. (B) which described veterans to whom subpar. (A) applied.

Subsec. (a)(2), (3). Pub. L. 112–239, §727(1)(B)–(D), redesignated par. (3) as (2), substituted "an individual described in paragraph (1)(C)" for "a veteran described in paragraph (1)(B)(iii)" and "the individual a comprehensive individual assessment as described in paragraph (1)(B)" for "the veteran a preliminary general mental health assessment", and struck out former par. (2) which provided for counseling to certain veterans who had been in combat situations.

Subsec. (b)(1). Pub. L. 112–239, §727(2), substituted "licensed or certified mental health care provider" for "physician or psychologist" wherever appearing.

Subsec. (g). Pub. L. 112–239, §727(4), added subsec. (g). Former subsec. (g) redesignated (h).

Subsec. (g)(1). Pub. L. 112–239, §727(3)(A), amended par. (1) generally. Prior to amendment, par. (1) read as follows: "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."

Subsec. (g)(3). Pub. L. 112–239, §727(3)(B), added par. (3).

Subsec. (h). Pub. L. 112–239, §727(4), redesignated subsec. (g) as (h).

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),".

Statutory Notes and Related Subsidiaries

Effective Date of 2022 Amendment

Pub. L. 117–328, div. V, title IV, §403(b), Dec. 29, 2022, 136 Stat. 5512, provided that: "The amendments made by subsection (a) [amending this section] shall apply with respect to family members of a member or veteran who died by suicide before, on, or after the date of the enactment of this Act [Dec. 29, 2022]."

Effective Date of 2021 Amendment

Pub. L. 116–283, div. A, title VII, §762(c), Jan. 1, 2021, 134 Stat. 3725, provided that: "The amendments made by this section [amending this section] shall take effect on the date that is one year after the date of the enactment of this Act [Jan. 1, 2021]."

Effective Date of 2018 Amendment

Amendment by Pub. L. 115–182 effective on the date described in section 101(b) of Pub. L. 115–182, see section 144(b) of Pub. L. 115–182, set out as a note under section 1712 of this 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

Pub. L. 97–72, title I, §104(a)(2), Nov. 3, 1981, 95 Stat. 1049, 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.

Mental Health and Suicide Prevention Outreach to Minority Veterans and American Indian and Alaska Native Veterans

Pub. L. 117–328, div. V, title I, §101(a)–(c), Dec. 29, 2022, 136 Stat. 5498, 5499, provided that:

"(a) Staffing Requirement.—Beginning not later than 90 days after the date of the enactment of this Act [Dec. 29, 2022], the Secretary of Veterans Affairs shall ensure that each medical center of the Department of Veterans Affairs has no fewer than one full-time employee whose responsibility is serving as a minority veteran coordinator.

"(b) Training.—Not later than 180 days after the date of the enactment of this Act, the Secretary, in consultation with the Indian Health Service and the Director of the Office of Mental Health and Suicide Prevention of the Department of Veterans Affairs, shall ensure that all minority veteran coordinators receive training in delivery of mental health and suicide prevention services culturally appropriate for American Indian and Alaska Native veterans, especially with respect to the identified populations and tribes within the coordinators' catchment areas.

"(c) Coordination With Suicide Prevention Coordinators.—Not later than 180 days after the date of the enactment of this Act, the Secretary, in consultation with the Director of the Office of Mental Health and Suicide Prevention, shall ensure that the suicide prevention coordinator and minority veteran coordinator of each medical center of the Department have developed and disseminated to the director of the medical center a written plan for conducting mental health and suicide prevention outreach to all tribes and urban Indian health organizations within the catchment area of the medical center. Each such plan shall include for each tribe covered by the plan—

"(1) contact information for tribal leadership and the tribal health facility or Indian Health Service facility serving that tribe;

"(2) a schedule for and list of outreach plans (including addressing any barriers to accessing Department mental health care);

"(3) documentation of any conversation with tribal leaders that may guide culturally appropriate delivery of mental health care to American Indian or Alaska Native veterans;

"(4) documentation of any progress in incorporating traditional healing practices into mental health and suicide prevention protocols and options available for veterans who are members of such tribe; and

"(5) documentation of any coordination among the Department, the Indian Health Service, urban Indian health organizations, and the Substance Abuse and Mental Health Services Administration for the purpose of improving suicide prevention efforts tailored to veterans who are members of such tribe and the provision of culturally competent mental health care to such veterans."

Expansion of Vet Center Workforce

Pub. L. 117–328, div. V, title I, §102, Dec. 29, 2022, 136 Stat. 5500, provided that:

"(a) In General.—Not later than one year after the date of the enactment of this Act [Dec. 29, 2022] and subject to the availability of appropriations, the Secretary of Veterans Affairs shall hire an additional 50 full-time equivalent employees for Vet Centers to bolster the workforce of Vet Centers and to provide expanded mental health care to veterans, members of the Armed Forces, and their families through outreach, community access points, outstations, and Vet Centers.

"(b) Vet Center Defined.—In this section, the term 'Vet Center' has the meaning given that term in section 1712A(h) of title 38, United States Code."

Designation of Buddy Check Week by Secretary of Veterans Affairs

Pub. L. 117–328, div. V, title III, §301, Dec. 29, 2022, 136 Stat. 5505, provided that:

"(a) In General.—The Secretary of Veterans Affairs shall designate one week each year to organize outreach events and educate veterans on how to conduct peer wellness checks, which shall be known as 'Buddy Check Week'.

"(b) Educational Opportunities.—

"(1) In general.—During Buddy Check Week, the Secretary, in consultation with organizations that represent veterans, nonprofits that serve veterans, mental health experts, members of the Armed Forces, and such other entities and individuals as the Secretary considers appropriate, shall collaborate with organizations that represent veterans to provide educational opportunities for veterans to learn how to conduct peer wellness checks.

"(2) Training matters.—As part of the educational opportunities provided under paragraph (1), the Secretary shall provide the following:

"(A) A script for veterans to use to conduct peer wellness checks that includes information on appropriate referrals to resources veterans might need.

"(B) Online and in-person training, as appropriate, on how to conduct a peer wellness check.

"(C) Opportunities for members of organizations that represent veterans to learn how to train individuals to conduct peer wellness checks.

"(D) Training for veterans participating in Buddy Check Week on how to transfer a phone call directly to the Veterans Crisis Line.

"(E) Resiliency training for veterans participating in Buddy Check Week on handling a veteran in crisis.

"(3) Online materials.—All training materials provided under the educational opportunities under paragraph (1) shall be made publicly available on a website of the Department of Veterans Affairs.

"(c) Outreach.—The Secretary, in collaboration with organizations that represent veterans, may conduct outreach regarding educational opportunities under subsection (b) at—

"(1) public events where many veterans are expected to congregate;

"(2) meetings of organizations that represent veterans;

"(3) facilities of the Department; and

"(4) such other locations as the Secretary, in collaboration with organizations that represent veterans, considers appropriate.

"(d) Veterans Crisis Line Plan.—

"(1) In general.—The Secretary shall ensure that a plan exists for handling the potential increase in the number of calls into the Veterans Crisis Line that may occur during Buddy Check Week.

"(2) Submittal of plan.—The head of the Veterans Crisis Line shall submit to the Secretary a plan for how to handle excess calls during Buddy Check Week, which may include the following:

"(A) Additional hours for staff.

"(B) The use of a backup call center.

"(C) Any other plan to ensure that calls from veterans in crisis are being answered in a timely manner by an individual trained at the same level as a Veterans Crisis Line responder.

"(e) Definitions.—In this section:

"(1) The term 'organization that represents veterans' means an organization recognized by the Secretary for the representation of veterans under section 5902 of title 38, United States Code.

"(2) The term 'veteran' has the meaning given that term in section 101 of such title.

"(3) The term 'Veterans Crisis Line' means the toll-free hotline for veterans provided by the Secretary under section 1720F(h) of such title."

Expansion of Rural Access Network for Growth Enhancement

Pub. L. 117–21, §§2, 4, June 30, 2021, 135 Stat. 292, 293, as amended by Pub. L. 118–83, div. B, title III, §303, Sept. 26, 2024, 138 Stat. 1539, provided that:

"SEC. 2. EXPANSION OF RURAL ACCESS NETWORK FOR GROWTH ENHANCEMENT PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS.

"(a) Expansion.—The Secretary of Veterans Affairs shall establish and maintain three new centers of the RANGE Program.

"(b) Locations.—The centers established under subsection (a) shall be located in areas determined by the Secretary based on—

"(1) the need for additional mental health care for rural veterans in such areas; and

"(2) interest expressed by personnel at facilities of the Department in such areas.

"(c) Timeline.—The Secretary shall establish the centers under subsection (a) during fiscal year 2022.

"(d) Funding.—There is authorized to be appropriated $1,200,000 for each of fiscal years 2022 through 2025 to carry out this section.

"SEC. 4. DEFINITIONS.

"In this Act [enacting this note, provisions set out as a note under section 101 of this title, and provisions not classified to the Code]:

"(1) The term 'covered mental health care' means mental health care that is more intensive than traditional outpatient therapy.

"(2) The term 'PRR center' means a psychosocial rehabilitation and recovery center of the Department of Veterans Affairs.

"(3) The term 'RANGE Program' means the Rural Access Network for Growth Enhancement Program of the Department of Veterans Affairs.

"(4) The term 'rural veteran' means a veteran who lives in a rural or highly rural area (including such an area in a Tribal or insular area), as determined through the use of the Rural-Urban Commuting Areas coding system of the Department of Agriculture."

Pilot Program on Assistance for Child Care for Certain Veterans Receiving Readjustment Counseling and Related Mental Health Services

Pub. L. 116–315, title V, §5107(b), Jan. 5, 2021, 134 Stat. 5031, provided that:

"(1) In general.—The Secretary of Veterans Affairs shall carry out a pilot program to assess the feasibility and advisability of providing, subject to paragraph (2), assistance to qualified veterans described in paragraph (3) to obtain child care so that such veterans can receive readjustment counseling and related mental health services.

"(2) Limitation on period of payments.—Assistance may be provided to a qualified veteran under the pilot program for receipt of child care only during the period that the qualified veteran receives readjustment counseling and related health care services at a Vet Center.

"(3) Qualified veterans.—For purposes of this subsection, a qualified veteran is a veteran who—

"(A) is the primary caretaker of a child or children; and

"(B)(i) receives from the Department regular readjustment counseling and related mental health services; or

"(ii) is in need of regular readjustment counseling and related mental health services from the Department, and but for lack of child care services, would receive such counseling and services from the Department.

"(4) Locations.—The Secretary shall carry out the pilot program in not fewer than three Readjustment Counseling Service Regions selected by the Secretary for purposes of the pilot program.

"(5) Forms of child care assistance.—

"(A) In general.—Child care assistance under the pilot program may include the following:

"(i) Stipends for the payment of child care offered by a licensed child care center (either directly or through a voucher program) that 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)].

"(ii) Payments to private child care agencies.

"(iii) Collaboration with facilities or programs of other Federal agencies.

"(iv) Such other forms of assistance as the Secretary considers appropriate.

"(B) Local area.—In providing child care assistance under the pilot program, the child care needs of the local area shall be considered and the head of each Vet Center may select the type of care that is most appropriate or feasible for such Vet Center.

"(C) Use of stipend.—In the case that child care assistance under the pilot program is provided as a stipend under subparagraph (A)(i), such stipend shall cover the full cost of such child care.

"(6) Duration.—The pilot program shall be carried out during the two-year period beginning on the date of the commencement of the pilot program.

"(7) Report.—

"(A) In general.—Not later than 180 days after the completion of the pilot program, the Secretary shall submit to Congress a report on the pilot program.

"(B) Elements.—The report required by subparagraph (A) shall include the findings and conclusions of the Secretary regarding the pilot program, and shall include such recommendations for the continuation or expansion of the pilot program as the Secretary considers appropriate.

"(8) Vet center defined.—In this subsection, the term 'Vet Center' has the meaning given that term in section 1712A(h) of title 38, United States Code."

Pilot Program To Provide Veterans Access to Complementary and Integrative Health Programs Through Animal Therapy, Agritherapy, Sports and Recreation Therapy, Art Therapy, and Posttraumatic Growth Programs

Pub. L. 116–171, title II, §203, Oct. 17, 2020, 134 Stat. 796, as amended by Pub. L. 118–83, div. B, title III, §304, Sept. 26, 2024, 138 Stat. 1539, provided that:

"(a) In General.—Not later than 180 days after the date on which the Creating Options for Veterans' Expedited Recovery Commission (commonly referred to as the 'COVER Commission') established under section 931 of the Jason Simcakoski Memorial and Promise Act (title IX of Public Law 114–198; 38 U.S.C. 1701 note) submits its final report under subsection (e)(2) of such section, the Secretary of Veterans Affairs shall commence the conduct of a pilot program to provide complementary and integrative health programs described in subsection (b) to eligible veterans from the Department of Veterans Affairs or through the use of non-Department entities for the treatment of post-traumatic stress disorder, depression, anxiety, or other conditions as determined by the Secretary.

"(b) Programs Described.—Complementary and integrative health programs described in this subsection may, taking into consideration the report described in subsection (a), consist of the following:

"(1) Equine therapy.

"(2) Other animal therapy.

"(3) Agritherapy.

"(4) Sports and recreation therapy.

"(5) Art therapy.

"(6) Posttraumatic growth programs.

"(c) Eligible Veterans.—A veteran is eligible to participate in the pilot program under this section if the veteran—

"(1) is enrolled in the system of patient enrollment of the Department under section 1705(a) of title 38, United States Code; and

"(2) has received health care under the laws administered by the Secretary during the two-year period preceding the initial participation of the veteran in the pilot program.

"(d) Duration.—

"(1) In general.—The Secretary shall carry out the pilot program under this section until September 30, 2025.

"(2) Extension.—The Secretary may extend the duration of the pilot program under this section if the Secretary, based on the results of the interim report submitted under subsection (f)(1), determines that it is appropriate to do so.

"(e) Locations.—

"(1) In general.—The Secretary shall select not fewer than five facilities of the Department at which to carry out the pilot program under this section.

"(2) Selection criteria.—In selecting facilities under paragraph (1), the Secretary shall ensure that—

"(A) the locations are in geographically diverse areas; and

"(B) not fewer than three facilities serve veterans in rural or highly rural areas (as determined through the use of the Rural-Urban Commuting Areas coding system of the Department of Agriculture).

"(f) Reports.—

"(1) Interim report.—

"(A) In general.—Not later than one year after the commencement of the pilot program under this section, 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 progress of the pilot program.

"(B) Elements.—The report required by subparagraph (A) shall include the following:

"(i) The number of participants in the pilot program.

"(ii) The type or types of therapy offered at each facility at which the pilot program is being carried out.

"(iii) An assessment of whether participation by a veteran in the pilot program resulted in any changes in clinically relevant endpoints for the veteran with respect to the conditions specified in subsection (a).

"(iv) An assessment of the quality of life of veterans participating in the pilot program, including the results of a satisfaction survey of the participants in the pilot program, disaggregated by program under subsection (b).

"(v) The determination of the Secretary with respect to extending the pilot program under subsection (d)(2).

"(vi) Any recommendations of the Secretary with respect to expanding the pilot program.

"(2) Final report.—Not later than 90 days after the termination of the pilot program under this section, 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 final report on the pilot program."

[Pub. L. 118–83, div. B, title III, §304, which directed amendment of section 203(d)(1) of the "Scott Hannon Veterans Mental Health Care Improvement Act of 2019" by substituting "until September 30, 2025" for "for a three-year period beginning on the commencement of the pilot program", was executed by making the substitution in section 203(d)(1) of the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019, set out above, to reflect the probable intent of Congress.]

Establishment by Department of Veterans Affairs and Department of Defense of a Clinical Provider Treatment Toolkit and Accompanying Training Materials for Comorbidities

Pub. L. 116–171, title III, §302, Oct. 17, 2020, 134 Stat. 801, provided that:

"(a) In General.—Not later than two years after the date of the enactment of this Act [Oct. 17, 2020], the Secretary of Veterans Affairs, in consultation with the Secretary of Defense, shall develop a clinical provider treatment toolkit and accompanying training materials for the evidence-based management of comorbid mental health conditions, comorbid mental health and substance use disorders, and a comorbid mental health condition and chronic pain.

"(b) Matters Included.—In developing the clinical provider treatment toolkit and accompanying training materials under subsection (a), the Secretary of Veterans Affairs and the Secretary of Defense shall ensure that the toolkit and training materials include guidance with respect to the following:

"(1) The treatment of patients with post-traumatic stress disorder who are also experiencing an additional mental health condition, a substance use disorder, or chronic pain.

"(2) The treatment of patients experiencing a mental health condition, including anxiety, depression, or bipolar disorder, who are also experiencing a substance use disorder or chronic pain.

"(3) The treatment of patients with traumatic brain injury who are also experiencing—

"(A) a mental health condition, including post-traumatic stress disorder, anxiety, depression, or bipolar disorder;

"(B) a substance use disorder; or

"(C) chronic pain."

Establishment by Department of Veterans Affairs and Department of Defense of Clinical Practice Guidelines for the Treatment of Serious Mental Illness

Pub. L. 116–171, title III, §304, Oct. 17, 2020, 134 Stat. 802, provided that:

"(a) In General.—Not later than two years after the date of the enactment of this Act [Oct. 17, 2020], the Secretary of Veterans Affairs, in consultation with the Secretary of Defense and the Secretary of Health and Human Services, shall complete the development of a clinical practice guideline or guidelines for the treatment of serious mental illness, to include the following conditions:

"(1) Schizophrenia.

"(2) Schizoaffective disorder.

"(3) Persistent mood disorder, including bipolar disorder I and II.

"(4) Any other mental, behavioral, or emotional disorder resulting in serious functional impairment that substantially interferes with major life activities as the Secretary of Veterans Affairs, in consultation with the Secretary of Defense and the Secretary of Health and Human Services, considers appropriate.

"(b) Matters Included in Guidelines.—The clinical practice guideline or guidelines developed under subsection (a) shall include the following:

"(1) Guidance contained in the 2016 Clinical Practice Guidelines for the Management of Major Depressive Disorders of the Department of Veterans Affairs and the Department of Defense.

"(2) Guidance with respect to the treatment of patients with a condition described in subsection (a).

"(3) A list of evidence-based therapies for the treatment of conditions described in subsection (a).

"(4) An appropriate guideline for the administration of pharmacological therapy, psychological or behavioral therapy, or other therapy for the management of conditions described in subsection (a).

"(c) Assessment of Existing Guidelines.—Not later than two years after the date of the enactment of this Act [Oct. 17, 2020], the Secretary of Veterans Affairs, in consultation with the Secretary of Defense and the Secretary of Health and Human Services, shall complete an assessment of the 2016 Clinical Practice Guidelines for the Management of Major Depressive Disorders to determine whether an update to such guidelines is necessary.

"(d) Work Group.—

"(1) Establishment.—The Secretary of Veterans Affairs, the Secretary of Defense, and the Secretary of Health and Human Services shall create a work group to develop the clinical practice guideline or guidelines under subsection (a) to be known as the 'Serious Mental Illness Work Group' (in this subsection referred to as the 'Work Group').

"(2) Membership.—The Work Group created under paragraph (1) shall be comprised of individuals that represent Federal Government entities and non-Federal Government entities with expertise in the areas covered by the Work Group, including the following entities:

"(A) Academic institutions that specialize in research for the treatment of conditions described in subsection (a).

"(B) The Health Services Research and Development Service of the Department of Veterans Affairs.

"(C) The Office of the Assistant Secretary for Mental Health and Substance Use of the Department of Health and Human Services.

"(D) The National Institute of Mental Health.

"(E) The Indian Health Service.

"(F) Relevant organizations with expertise in researching, diagnosing, or treating conditions described in subsection (a).

"(3) Relation to other work groups.—The Work Group shall be created and conducted in the same manner as other work groups for the development of clinical practice guidelines for the Department of Veterans Affairs and the Department of Defense.

"(e) Rule of Construction.—Nothing in this section shall be construed to prevent the Secretary of Veterans Affairs and the Secretary of Defense from considering all relevant evidence, as appropriate, in creating the clinical practice guideline or guidelines required under subsection (a) or from ensuring that the final clinical practice guideline or guidelines developed under such subsection and subsequently updated, as appropriate, remain applicable to the patient populations of the Department of Veterans Affairs and the Department of Defense."

Precision Medicine Initiative of Department of Veterans Affairs To Identify and Validate Brain and Mental Health Biomarkers

Pub. L. 116–171, title III, §305, Oct. 17, 2020, 134 Stat. 804, provided that:

"(a) In General.—Beginning not later than 18 months after the date of the enactment of this Act [Oct. 17, 2020], the Secretary of Veterans Affairs shall develop and implement an initiative of the Department of Veterans Affairs to identify and validate brain and mental health biomarkers among veterans, with specific consideration for depression, anxiety, post-traumatic stress disorder, bipolar disorder, traumatic brain injury, and such other mental health conditions as the Secretary considers appropriate. Such initiative may be referred to as the 'Precision Medicine for Veterans Initiative'.

"(b) Model of Initiative.—The initiative under subsection (a) shall be modeled on the All of Us Precision Medicine Initiative administered by the National Institutes of Health with respect to large-scale collection of standardized data and open data sharing.

"(c) Methods.—The initiative under subsection (a) shall include brain structure and function measurements, such as functional magnetic resonance imaging and electroencephalogram, and shall coordinate with additional biological methods of analysis utilized in the Million Veterans Program of the Department of Veterans Affairs.

"(d) Use of Data.—

"(1) Privacy and security.—In carrying out the initiative under subsection (a), the Secretary shall develop robust data privacy and security measures, consistent with section 552a of title 5, United States Code (commonly known as the 'Privacy Act of 1974'), and regulations promulgated pursuant to the Health Insurance Portability and Accountability Act of 1996 [Pub. L. 104–191] (parts 160, 162, and 164 of title 45, Code of Federal Regulations, or successor regulations) to ensure that information of veterans participating in the initiative is kept private and secure.

"(2) Consultation with the national institutes of science and technology.—The Secretary may consult with the National Institute of Science and Technology in developing the data privacy and security measures described in paragraph (1).

"(3) Access standards.—The Secretary shall provide access to information under the initiative consistent with the standards described in section 552a(d)(1) of title 5, United States Code, and section 164.524 of title 45, Code of Federal Regulations, or successor regulations.

"(4) Open platform.—

"(A) Availability of data.—The Secretary shall make de-identified data collected under the initiative available for research purposes to Federal agencies.

"(B) Contract.—The Secretary shall contract with nongovernment entities that comply with requisite data security measures to make available for research purposes de-identified data collected under the initiative.

"(C) Assistance.—The Secretary shall provide assistance to a Federal agency conducting research using data collected under the initiative at the request of that agency.

"(D) Prohibition on transfer of data.—Federal agencies may not disclose, transmit, share, sell, license, or otherwise transfer data collected under the initiative to any nongovernment entity other than as allowed under subparagraph (B).

"(5) Standardization.—

"(A) In general.—The Secretary shall ensure that data collected under the initiative is standardized.

"(B) Consultation.—The Secretary shall consult with the National Institutes of Health and the Food and Drug Administration to determine the most effective, efficient, and cost-effective way of standardizing data collected under the initiative.

"(C) Manner of standardization.—In consultation with the National Institute for Science and Technology, data collected under the initiative shall be standardized in the manner in which it is collected, entered into the database, extracted, and recorded.

"(6) Measures of brain function or structure.—Any measures of brain function or structure collected under the initiative shall be collected with a device that is approved by the Food and Drug Administration.

"(7) De-identified data defined.—In this subsection, the term 'de-identified data' means, with respect to data held by the Department of Veterans Affairs, that the Department—

"(A) alters, anonymizes, or aggregates the data so that there is a reasonable basis for expecting that the data could not be linked as a practical matter to a specific individual;

"(B) publicly commits to refrain from attempting to re-identify the data with a specific individual, and adopts controls to prevent such identification; and

"(C) causes the data to be covered by a contractual or other legally enforceable prohibition on each entity to which the Department discloses the data from attempting to use the data to identify a specific individual and requires the same of all onward disclosures.

"(e) Inclusion of Initiative in Program.—The Secretary shall coordinate efforts of the initiative under subsection (a) with the Million Veterans Program of the Department."

Short-Term Agreements or Contracts With Telecommunications Providers To Expand Telemental Health Services for Isolated Veterans During a Public Health Emergency

Pub. L. 116–136, div. B, title X, §20004, Mar. 27, 2020, 134 Stat. 585, provided that:

"(a) In General.—Notwithstanding any other provision of law, the Secretary of Veterans Affairs may enter into short-term agreements or contracts with telecommunications companies to provide temporary, complimentary or subsidized, fixed and mobile broadband services for the purposes of providing expanded mental health services to isolated veterans through telehealth or VA Video Connect during a public health emergency.

"(b) Eligibility.—

"(1) In general.—The Secretary may expand eligibility for services described in subsection (a) from the Department of Veterans Affairs to include veterans already receiving care from the Department who may not be eligible for mental health services or other health care services delivered through telehealth or VA Video Connect.

"(2) Priority.—For purposes of expanding eligibility under paragraph (1), the Secretary shall prioritize—

"(A) veterans who are in unserved and underserved areas;

"(B) veterans who reside in rural and highly rural areas, as defined in the Rural-Urban Commuting Areas coding system of the Department of Agriculture;

"(C) low-income veterans; and

"(D) any other veterans that the Secretary considers to be at a higher risk for suicide and mental health concerns during isolation periods due to a public health emergency.

"(c) Definitions.—In this section:

"(1) Telehealth.—

"(A) In general.—The term 'telehealth' means the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health, and health administration.

"(B) Technologies.—For purposes of subparagraph (A), telecommunications technologies include videoconferencing, the internet, streaming media, and terrestrial and wireless communications.

"(2) VA video connect.—The term 'VA Video Connect' means the program of the Department of Veterans Affairs to connect veterans with their health care team from anywhere, using encryption to ensure a secure and private session."

[For definition of "public health emergency" as used in section 20004 of Pub. L. 116–136, set out above, see section 20003 of Pub. L. 116–136, set out as a note under section 303 of this title.]

Publication of Internet Website To Provide Information Regarding Mental Health Care Services

Pub. L. 114–2, §3, Feb. 12, 2015, 129 Stat. 31, provided that:

"(a) In General.—Using funds made available to the Secretary of Veterans Affairs to publish the Internet websites of the Department of Veterans Affairs, the Secretary shall survey the existing Internet websites and information resources of the Department to publish an Internet website that serves as a centralized source to provide veterans with information regarding all of the mental health care services provided by the Secretary.

"(b) Elements.—The Internet website published under subsection (a) shall provide to veterans information regarding all of the mental health care services available in the Veteran Integrated Service Network that the veteran is seeking such services, including, with respect to each medical center, Vet Center (as defined in section 1712A of title 38, United States Code), and community-based outpatient center in the Veterans Integrated Service Network—

"(1) the name and contact information of each social work office;

"(2) the name and contact information of each mental health clinic;

"(3) a list of appropriate staff; and

"(4) any other information the Secretary determines appropriate.

"(c) Updated Information.—The Secretary shall ensure that the information described in subsection (b) that is published on the Internet website under subsection (a) is updated not less than once every 90 days.

"(d) Outreach.—In carrying out this section, the Secretary shall ensure that the outreach conducted under section 1720F(i) of title 38, United States Code, includes information regarding the Internet website published under subsection (a)."

Pilot Program on Community Outreach

Pub. L. 114–2, §5, Feb. 12, 2015, 129 Stat. 34, as amended by Pub. L. 114–92, div. A, title V, §563, Nov. 25, 2015, 129 Stat. 829; Pub. L. 114–328, div. A, title X, §1081(c)(1), Dec. 23, 2016, 130 Stat. 2419, provided that:

"(a) In General.—The Secretary of Veterans Affairs shall establish a pilot program to assist veterans transitioning from serving on active duty and to improve the access of veterans to mental health services.

"(b) Locations.—The Secretary shall carry out the pilot program under subsection (a) at not less than five Veterans Integrated Service Networks that have a large population of veterans who—

"(1) served in the reserve components of the Armed Forces; or

"(2) are transitioning into communities with an established population of veterans after having recently separated from the Armed Forces.

"(c) Functions.—The pilot program at each Veterans Integrated Service Network described in subsection (b) shall include the following:

"(1) A community oriented veteran peer support network, carried out in partnership with an appropriate entity with experience in peer support programs, that—

"(A) establishes peer support training guidelines;

"(B) develops a network of veteran peer support counselors to meet the demands of the communities in the Veterans Integrated Service Network;

"(C) conducts training of veteran peer support counselors;

"(D) with respect to one medical center selected by the Secretary in each such Veterans Integrated Service Network, has—

"(i) a designated peer support specialist who acts as a liaison to the community oriented veteran peer network; and

"(ii) a certified mental health professional designated as the community oriented veteran peer network mentor; and

"(E) is readily available to veterans, including pursuant to the Veterans Integrated Service Network cooperating and working with State and local governments and appropriate entities.

"(2) A community outreach team for each medical center selected by the Secretary pursuant to paragraph (1)(D) that—

"(A) assists veterans transitioning into communities;

"(B) establishes a veteran transition advisory group to facilitate outreach activities;

"(C) includes the participation of appropriate community organizations, State and local governments, colleges and universities, chambers of commerce and other local business organizations, and organizations that provide legal aid or advice;

"(D) coordinates with the Veterans Integrated Service Network regarding the Veterans Integrated Service Network carrying out an annual mental health summit to assess the status of veteran mental health care in the community and to develop new or innovative means to provide mental health services to veterans; and

"(E) conducts outreach to individuals transitioning from serving on active duty in the Armed Forces who are participating in the Transition Assistance Program of the Department of Defense or other similar transition programs to inform such individuals of the community oriented veteran peer support network under paragraph (1) and other support programs and opportunities that are available to such individuals.

"(d) Reports.—

"(1) Initial report.—Not later than 18 months after the date on which the pilot program under subsection (a) commences, 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 pilot program. With respect to each Veterans Integrated Service Network described in subsection (b), the report shall include—

"(A) a full description of the peer support model implemented under the pilot program, participation data, and data pertaining to past and current mental health related hospitalizations and fatalities;

"(B) recommendations on implementing peer support networks throughout the Department;

"(C) whether the mental health resources made available under the pilot program for members of the reserve components of the Armed Forces is effective;

"(D) a full description of the activities and effectiveness of community outreach coordinating teams under the pilot program, including partnerships that have been established with appropriate entities; and

"(E) the number of veterans who—

"(i) received outreach from the Department of Veterans Affairs while serving on active duty as a member of the Armed Forces; and

"(ii) participated in a peer support program under the pilot program for veterans transitioning from serving on active duty.

"(2) Final report.—Not later than 90 days before the date on which the pilot program terminates under subsection (e), the Secretary shall submit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives an update to the report submitted under paragraph (1).

"(e) Construction.—This section may not be construed to authorize the Secretary to hire additional employees of the Department to carry out the pilot program under subsection (a).

"(f) Termination.—The authority of the Secretary to carry out the pilot program under subsection (a) shall terminate on the date that is 3 years after the date on which the pilot program commences."

[Pub. L. 114–328, div. A, title X, §1081(c), Dec. 23, 2016, 130 Stat. 2419, provided that the amendment made by section 1081(c)(1) to section 563 of Pub. L. 114–92, which amended section 5 of Pub. L. 114–2, set out above, is effective as of Nov. 25, 2015, and as if included in Pub. L. 114–92 as enacted.]

Participation of Members of the Armed Forces in Peer Support Counseling Programs of the Department of Veterans Affairs

Pub. L. 112–239, div. A, title VII, §724, Jan. 2, 2013, 126 Stat. 1805, provided that:

"(a) Participation.—

"(1) In general.—The Secretary of Defense and the Secretary of Veterans Affairs shall jointly enter into a memorandum of understanding providing for members of the Armed Forces described in subsection (b) to volunteer or be considered for employment as peer counselors under the following:

"(A) The peer support counseling program carried out by the Secretary of Veterans Affairs under subsection (j) of section 1720F of title 38, United States Code, as part of the comprehensive program for suicide prevention among veterans under subsection (a) of such section.

"(B) The peer support counseling program carried out by the Secretary of Veterans Affairs under section 304(a)(1) of the Caregivers and Veterans Omnibus Health Services Act of 2010 (Public Law 111–163; 124 Stat. 1150; 38 U.S.C. 1712A note).

"(2) Training.—Any member participating in a peer support counseling program under paragraph (1) shall receive the training for peer counselors under section 1720F(j)(2) of title 38, United States Code, or section 304(c) of the Caregivers and Veterans Omnibus Health Services Act of 2010, as applicable, before performing peer support counseling duties under such program.

"(b) Covered Members.—Members of the Armed Forces described in this subsection are the following:

"(1) Members of the reserve components of the Armed Forces who are demobilizing after deployment in a theater of combat operations, including, in particular, members who participated in combat against the enemy while so deployed.

"(2) Members of the regular components of the Armed Forces separating from active duty who have been deployed in a theater of combat operations in which such members participated in combat against the enemy."

Transparency in Mental Health Care Services Provided by the Department of Veterans Affairs

Pub. L. 112–239, div. A, title VII, §726, Jan. 2, 2013, 126 Stat. 1806, provided that:

"(a) Measurement of Mental Health Care Services.—

"(1) In general.—Not later than December 31, 2013, the Secretary of Veterans Affairs shall develop and implement a comprehensive set of measures to assess mental health care services furnished by the Department of Veterans Affairs.

"(2) Elements.—The measures developed and implemented under paragraph (1) shall provide an accurate and comprehensive assessment of the following:

"(A) The timeliness of the furnishing of mental health care by the Department.

"(B) The satisfaction of patients who receive mental health care services furnished by the Department.

"(C) The capacity of the Department to furnish mental health care.

"(D) The availability and furnishing of evidence-based therapies by the Department.

"(b) Guidelines for Staffing Mental Health Care Services.—Not later than December 31, 2013, the Secretary shall develop and implement guidelines for the staffing of general and specialty mental health care services, including at community-based outpatient clinics. Such guidelines shall include productivity standards for providers of mental health care.

"(c) Study Committee.—

"(1) In general.—The Secretary shall seek to enter into a contract with the National Academy of Sciences to create a study committee—

"(A) to consult with the Secretary on the Secretary's development and implementation of the measures and guidelines required by subsections (a) and (b); and

"(B) to conduct an assessment and provide an analysis and recommendations on the state of Department mental health services.

"(2) Functions.—In entering into the contract described in paragraph (1), the Secretary shall, with respect to paragraph (1)(B), include in such contract a provision for the study committee—

"(A) to conduct a comprehensive assessment of barriers to access to mental health care by veterans who served in the Armed Forces in Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn;

"(B) to assess the quality of the mental health care being provided to such veterans (including the extent to which veterans are afforded choices with respect to modes of treatment) through site visits to facilities of the Veterans Health Administration (including at least one site visit in each Veterans Integrated Service Network), evaluating studies of patient outcomes, and other appropriate means;

"(C) to assess whether, and the extent to which, veterans who served in the Armed Forces in Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn are being offered a full range of necessary mental health services at Department health care facilities, including early intervention services for hazardous drinking, relationship problems, and other behaviors that create a risk for the development of a chronic mental health condition;

"(D) to conduct surveys or have access to Department-administered surveys of—

"(i) providers of Department mental health services;

"(ii) veterans who served in the Armed Forces in Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn who are receiving mental health care furnished by the Department; and

"(iii) eligible veterans who served in the Armed Forces in Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn who are not using Department health care services to assess those barriers described in subparagraph (A); and

"(E) to provide to the Secretary, on the basis of its assessments as delineated in subparagraphs (A) through (C), specific, detailed recommendations—

"(i) for overcoming barriers, and improving access, to timely, effective mental health care at Department health care facilities (or, where Department facilities cannot provide such care, through contract arrangements under existing law); and

"(ii) to improve the effectiveness and efficiency of mental health services furnished by the Secretary.

"(3) Participation by former officials and employees of veterans health administration.—The Secretary shall ensure that any contract entered into under paragraph (1) provides for inclusion on any subcommittee which participates in conducting the assessments and formulating the recommendations provided for in paragraph (2) at least one former official of the Veterans Health Administration and at least two former employees of the Veterans Health Administration who were providers of mental health care.

"(4) Periodic reports to secretary.—In entering into the contract described in paragraph (1), the Secretary shall, with respect to paragraph (1)(A), include in such contract a provision for the submittal to the Secretary of periodic reports and provision of other consultation to the Secretary by the study committee to assist the Secretary in carrying out subsections (a) and (b).

"(5) Reports to congress.—Not later than 30 days after receiving a report under paragraph (4), 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 plans of the Secretary to implement such recommendations submitted to the Secretary by the study committee as the Secretary considers appropriate. Such report shall include a description of each recommendation submitted to the Secretary that the Secretary does not plan to carry out and an explanation of why the Secretary does not plan to carry out such recommendation.

"(d) Publication.—

"(1) In general.—The Secretary shall make available to the public on an Internet website of the Department the following:

"(A) The measures and guidelines developed and implemented under this section.

"(B) An assessment of the performance of the Department using such measures and guidelines.

"(2) Quarterly updates.—The Secretary shall update the measures, guidelines, and assessment made available to the public under paragraph (1) not less frequently than quarterly.

"(e) Semiannual Reports.—

"(1) In general.—Not later than June 30, 2013, and not less frequently than twice each year thereafter, the Secretary shall submit to the committees of Congress specified in subsection (c)(5) a report on the Secretary's progress in developing and implementing the measures and guidelines required by this section.

"(2) Elements.—Each report submitted under paragraph (1) shall include the following:

"(A) A description of the development and implementation of the measures required by subsection (a) and the guidelines required by subsection (b).

"(B) A description of the progress made by the Secretary in developing and implementing such measures and guidelines.

"(C) An assessment of the mental health care services furnished by the Department, using the measures developed and implemented under subsection (a).

"(D) An assessment of the effectiveness of the guidelines developed and implemented under subsection (b).

"(E) Such recommendations for legislative or administrative action as the Secretary may have to improve the effectiveness and efficiency of the mental health care services furnished under laws administered by the Secretary.

"(f) Implementation Report.—

"(1) In general.—Not later than 30 days before the date on which the Secretary begins implementing the measures and guidelines required by this section, the Secretary shall submit to the committees of Congress specified in subsection (c)(5) a report on the Secretary's planned implementation of such measures and guidelines.

"(2) Elements.—The report required by paragraph (1) shall include the following:

"(A) A detailed description of the measures and guidelines that the Secretary plans to implement under this section.

"(B) A description of the rationale for each measure and guideline the Secretary plans to implement under this section.

"(C) A discussion of each measure and guideline that the Secretary considered under this section but chose not to implement.

"(D) The number of current vacancies in mental health care provider positions in the Department.

"(E) An assessment of how many additional positions are needed to meet current or expected demand for mental health services furnished by the Department."

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, as amended by Pub. L. 113–175, title I, §102, Sept. 26, 2014, 128 Stat. 1902; Pub. L. 114–58, title I, §109, Sept. 30, 2015, 129 Stat. 533; Pub. L. 114–228, title I, §107, Sept. 29, 2016, 130 Stat. 937; Pub. L. 115–62, title I, §108, Sept. 29, 2017, 131 Stat. 1162; Pub. L. 115–251, title I, §108, Sept. 29, 2018, 132 Stat. 3168; Pub. L. 116–159, div. E, title I, §5106, Oct. 1, 2020, 134 Stat. 748, 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) Termination.—The authority to carry out a pilot program under this section shall terminate on September 30, 2022.

"(e) Report.—Not later than March 31, 2018, 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, 2011, 2015, 2016, 2017, 2018, 2019, 2020, 2021, and 2022, $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, as amended by Pub. L. 112–239, div. A, title VII, §730(b)(1), Jan. 2, 2013, 126 Stat. 1814, 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) Provision of Peer Outreach and Peer Support Services at Department Medical Centers.—The Secretary shall carry out the services required by subparagraphs (A) and (B) of subsection (a)(1) at each Department medical center.

"(f) 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."

[Pub. L. 112–239, div. A, title VII, §730(b)(2), Jan. 2, 2013, 126 Stat. 1814, provided that: "The Secretary of Veterans Affairs shall commence carrying out the services required by subparagraphs (A) and (B) of subsection (a)(1) of such section [section 304 of Pub. L. 111–163, set out above] at each Department of Veterans Affairs medical center, as required by subsection (e) of such section (as added by paragraph (1)), not later than 270 days after the date of the enactment of this Act [Jan. 2, 2013]."]

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.) [now 25 U.S.C. 5301 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

Pub. L. 102–405, title I, §121, Oct. 9, 1992, 106 Stat. 1978, 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

Pub. L. 102–405, title I, §123, Oct. 9, 1992, 106 Stat. 1981, 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 [former] section 1712A(a)(2)(B) of such title) occurred in such area."

Updates of Reports on Post-Traumatic Stress Disorder

Pub. L. 102–405, title I, §122(b), Oct. 9, 1992, 106 Stat. 1981, 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

Pub. L. 100–687, div. B, title XV, §1501(b), Nov. 18, 1988, 102 Stat. 4132, 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; Pub. L. 112–260, title II, §204, Jan. 10, 2013, 126 Stat. 2424, 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 2016, 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

Pub. L. 98–160, title I, §102, Nov. 21, 1983, 97 Stat. 994, 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

Pub. L. 96–22, title I, §103(b), June 13, 1979, 93 Stat. 50, 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."

Executive Documents

Ex. Ord. No. 13822. Supporting Our Veterans During Their Transition From Uniformed Service to Civilian Life

Ex. Ord. No. 13822, Jan. 9, 2018, 83 F.R. 1513, provided:

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:

Section 1. Policy. It is the policy of the United States to support the health and well-being of uniformed service members and veterans. After serving our Nation, veterans deserve long, fulfilling civilian lives. Accordingly, our Government must improve mental healthcare and access to suicide prevention resources available to veterans, particularly during the critical 1-year period following the transition from uniformed service to civilian life. Most veterans' experience in uniform increases their resilience and broadens the skills they bring to the civilian workforce. Unfortunately, in some cases within the first year following transition, some veterans can have difficulties reintegrating into civilian life after their military experiences and some tragically take their own lives. Veterans, in their first year of separation from uniformed service, experience suicide rates approximately two times higher than the overall veteran suicide rate. To help prevent these tragedies, all veterans should have seamless access to high-quality mental healthcare and suicide prevention resources as they transition, with an emphasis on the 1-year period following separation.

Sec. 2. Implementation. (a) In furtherance of the policy described in section 1 of this order, I hereby direct the Secretary of Defense, the Secretary of Veterans Affairs, and the Secretary of Homeland Security to collaborate to address the complex challenges faced by our transitioning uniformed service members and veterans.

(b) Within 60 days of the date of this order, the Secretary of Defense, the Secretary of Veterans Affairs, and the Secretary of Homeland Security shall submit to the President, through the Assistant to the President for Domestic Policy, a Joint Action Plan that describes concrete actions to provide, to the extent consistent with law, seamless access to mental health treatment and suicide prevention resources for transitioning uniformed service members in the year following discharge, separation, or retirement.

(c) Within 180 days of the date of this order, the Secretary of Defense, the Secretary of Veterans Affairs, and the Secretary of Homeland Security shall submit to the President, through the Assistant to the President for Domestic Policy, a status report on the implementation of the Joint Action Plan and how the proposed reforms have been effective in improving mental health treatment for all transitioning uniformed service members and veterans. The report shall include:

(i) preliminary progress of reforms implemented by the Joint Action Plan;

(ii) any additional reforms that could help further address the problems that obstruct veterans' access to resources and continuous mental healthcare treatment, including any suggestions for legislative and regulatory reforms; and

(iii) a timeline describing next steps and the results anticipated from continued and additional reforms.

Sec. 3. General Provisions. (a) Nothing in this order shall be construed to impair or otherwise affect:

(i) the authority granted by law to an executive department or agency, or the head thereof; or

(ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

(b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

Donald J. Trump.      

§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.)

Editorial Notes

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".

§1712C. Dental insurance plan for veterans and survivors and dependents of veterans

(a) In General.—The Secretary shall establish and administer a dental insurance plan for 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 this title.

(2) Any survivor or dependent of a veteran who is eligible for medical care under section 1781 of this title.

(c) Administration.—The Secretary shall contract with a dental insurer to administer the dental insurance plan under this section.

(d) Benefits.—The dental insurance plan under this section 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.

(e) Enrollment.—(1) Enrollment in the dental insurance plan under this section shall be voluntary.

(2) Enrollment in the dental insurance plan shall be for such minimum period as the Secretary shall prescribe for purposes of this section.

(f) Premiums.—(1) Premiums for coverage under the dental insurance plan under this section shall be in such amount or amounts as the Secretary shall prescribe to cover all costs associated with carrying out this section.

(2) The Secretary shall adjust the premiums payable under this section 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) 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.

(g) Voluntary Disenrollment.—(1) With respect to enrollment in the dental insurance plan under this section, 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) 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) 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.

(h) 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 this title, and the participation of an individual in the dental insurance plan under this section shall not affect the entitlement of the individual to outpatient dental services and treatment, and related dental appliances, under such section 1712.

(i) Regulations.—The dental insurance plan under this section shall be administered under such regulations as the Secretary shall prescribe.

(Added Pub. L. 114–218, §2(a)(1), July 29, 2016, 130 Stat. 842; amended Pub. L. 117–42, §2, Sept. 30, 2021, 135 Stat. 342.)

Editorial Notes

Amendments

2021—Subsec. (j). Pub. L. 117–42 struck out subsec. (j). Text read as follows: "This section terminates on December 31, 2021."

[§1713. Renumbered §1781]

Editorial Notes

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)(1) 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.

(2) In furnishing prosthetic appliances under paragraph (1), the Secretary shall ensure women veterans are able to access clinically appropriate prosthetic appliances through each medical facility of the Department.

(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.

(e) The Secretary may provide a service dog to a veteran under subsection (c)(3) regardless of whether the veteran has a mobility impairment.

(f)(1) The Secretary shall provide to any veteran described in paragraph (2) a commercially available veterinary insurance policy for each dog provided to such veteran under subsection (b) or (c).

(2) A veteran described in this paragraph is a veteran who—

(A) is diagnosed with post-traumatic stress disorder or a visual, hearing, or substantial mobility impairment;

(B) has received a dog under subsection (b) or (c) in connection with such disorder or impairment; and

(C) meets such other requirements as the Secretary may prescribe.

(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; Pub. L. 116–315, title V, §5108(a), Jan. 5, 2021, 134 Stat. 5032; Pub. L. 117–37, §3(a), Aug. 25, 2021, 135 Stat. 331.)

Editorial Notes

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

2021—Subsec. (a). Pub. L. 116–315 designated existing provisions as par. (1) and added par. (2).

Subsecs. (e), (f). Pub. L. 117–37 added subsecs. (e) and (f).

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).

Statutory Notes and Related Subsidiaries

Effective Date of 2021 Amendment

Pub. L. 117–37, §3(b), Aug. 25, 2021, 135 Stat. 332, provided that: "Section 1714(f) of title 38, United States Code, as added by subsection (a), shall apply with respect to a veteran provided a dog by the Secretary of Veterans Affairs on or after the date of the enactment of this Act [Aug. 25, 2021]."

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.

Department of Veterans Affairs Pilot Program on Dog Training Therapy

Pub. L. 117–37, §2, Aug. 25, 2021, 135 Stat. 329, provided that:

"(a) In General.—Not later than 180 days after the date of the enactment of the Act [probably means "this Act", approved Aug. 25, 2021], the Secretary of Veterans Affairs shall commence the conduct of a pilot program to provide canine training to eligible veterans diagnosed with post-traumatic stress disorder (in this section referred to as 'PTSD') as an element of a complementary and integrative health program for such veterans.

"(b) Duration; Medical Centers.—

"(1) Duration.—The Secretary shall carry out the pilot program under subsection (a) for a 5-year period beginning on the date of the commencement of the pilot program.

"(2) Medical centers.—The Secretary shall ensure that such pilot program is carried out by not fewer than five medical centers of the Department of Veterans Affairs located in geographically diverse areas.

"(c) Agreements With Entities.—In carrying out the pilot program under subsection (a), the Secretary shall seek to enter into agreements with nongovernmental entities that the Secretary determines have the demonstrated ability to provide the canine training specified in subsection (a).

"(d) Required Conditions.—The Secretary shall include in any agreement under subsection (c) conditions requiring that the nongovernmental entity seeking to enter into the agreement—

"(1) submits to the Secretary certification that the entity is an accredited service dog training organization;

"(2) agrees to ensure that veterans participating in the pilot program under subsection (a) receive training from certified service dog training instructors for a period of time determined appropriate by the entity;

"(3) agrees to ensure that veterans participating in such pilot program are prohibited from having access to a dog under such pilot program at any time during such participation without the supervision of a certified service dog training instructor;

"(4) agrees to ensure that veterans participating in such pilot program receive training in skills unique to the needs of the veteran to address or alleviate PTSD symptoms of the veteran;

"(5) agrees not to use shock collars or prong collars as training tools and to use positive reinforcement training; and

"(6) agrees to provide any follow-up training support specified in subsection (e)(2), as applicable.

"(e) Adoption of Dog.—

"(1) In general.—A veteran who has participated in the pilot program under subsection (a) may adopt a dog that the veteran assisted in training during such pilot program if the veteran and the veteran's health provider (in consultation with the entity that provided the canine training with respect to the dog under such pilot program) determine that it is in the best interest of the veteran.

"(2) Follow-up training support.—If a veteran adopts a dog under paragraph (1), the entity that provided the canine training with respect to the dog under the pilot program shall provide follow-up training support for the life of the dog. Such support shall include the provision of a contact plan between the veteran and the entity that enables the veteran to seek and receive assistance from the entity to ensure the dog is being properly cared for.

"(f) Eligibility for Other Care and Treatment.—Participation in the pilot program under subsection (a) may not preclude a veteran from receiving any other medical care or treatment for PTSD furnished by the Department, including therapy, for which the veteran is otherwise eligible.

"(g) Collection of Data.—In carrying out this section, the Secretary shall—

"(1) develop metrics and other appropriate means to measure, with respect to veterans participating in the pilot program under subsection (a)—

"(A) the number of such veterans participating;

"(B) the satisfaction of such veterans with the pilot program;

"(C) whether participation in the pilot program resulted in any clinically relevant improvements for such veterans, as determined by the health care provider or clinical team that referred the veteran to participate in the pilot program; and

"(D) such other factors as the Secretary may determine appropriate; and

"(2) establish processes to document and track the progress of such veterans under the pilot program with respect to health benefits and improvements.

"(h) Report by Secretary.—Not later than 1 year before the date on which the pilot program under subsection (a) terminates, the Secretary shall submit to the Committees on Veterans' Affairs of the House of Representatives and the Senate a report containing the recommendations of the Secretary regarding—

"(1) whether to extend or make permanent the pilot program; and

"(2) the feasibility and advisability of expanding the pilot program to address mental health conditions other than PTSD.

"(i) GAO Briefing and Study.—

"(1) Briefing.—Not later than 1 year after the date of the commencement of the pilot program under subsection (a), the Comptroller General of the United States shall provide to the Committees on Veterans' Affairs of the House of Representatives and the Senate a briefing on the methodology established for the pilot program.

"(2) Report.—Not later than 270 days after the date on which the pilot program terminates, the Comptroller General shall submit to the committees specified in paragraph (1) a report on the pilot program. Such report shall include an evaluation of the approach and methodology used for the pilot program with respect to—

"(A) assisting veterans with PTSD; and

"(B) measuring relevant metrics, such as reduction in scores under the Clinician Administered PTSD Scale (CAPS), improvement in psychosocial function, and therapeutic compliance.

"(j) Definitions.—In this section:

"(1) The term 'accredited service dog training organization' means an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 [26 U.S.C. 501(c)(3)] that—

"(A) provides service dogs to veterans with PTSD; and

"(B) is accredited by an accrediting organization with demonstrated experience, national scope, and recognized leadership and expertise in the training of service dogs and education in the use of service dogs (as determined by the Secretary).

"(2) The term 'eligible veteran' means a veteran who—

"(A) is enrolled in the patient enrollment system in the Department of Veterans Affairs under section 1705 of title 38, United States Code; and

"(B) has been recommended for participation in the pilot program under subsection (a) by a qualified mental health care provider or clinical team based on medical judgment that the veteran may benefit from such participation with respect to the diagnosed PTSD of the veteran.

"(3) The term 'service dog training instructor' means an instructor who provides the direct training of veterans with PTSD in the art and science of service dog training and handling."

Provision by Department of Veterans Affairs of Prosthetic Appliances Through Non-Department Providers During Public Health Emergency

Pub. L. 116–136, div. B, title X, §20007, Mar. 27, 2020, 134 Stat. 587, provided that: "The Secretary of Veterans Affairs shall ensure that, to the extent practicable, veterans who are receiving or are eligible to receive a prosthetic appliance under section 1714 or 1719 of title 38, United States Code, are able to receive such an appliance that the Secretary determines is needed from a non-Department of Veterans Affairs provider under a contract with the Department during a public health emergency."

[For definition of "public health emergency" as used in section 20007 of Pub. L. 116–136, set out above, see section 20003 of Pub. L. 116–136, set out as a note under section 303 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.)

Editorial Notes

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".

Statutory Notes and Related Subsidiaries

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.)

Editorial Notes

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".

Statutory Notes and Related Subsidiaries

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, air, or space 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; Pub. L. 116–283, div. A, title IX, §926(a)(24), Jan. 1, 2021, 134 Stat. 3830.)

Editorial Notes

Amendments

2021—Subsec. (d)(1). Pub. L. 116–283 substituted "air, or space service" for "or air service".

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).

Statutory Notes and Related Subsidiaries

Effective Date of 1992 Amendment

Pub. L. 102–405, title I, §101(b), Oct. 9, 1992, 106 Stat. 1973, 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]."

Pub. L. 102–405, title I, §101(c), Oct. 9, 1992, 106 Stat. 1973, 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.)

Editorial Notes

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, 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).

Statutory Notes and Related Subsidiaries

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

Pub. L. 102–54, §7, June 13, 1991, 105 Stat. 269, 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

Pub. L. 94–581, title I, §105(b), Oct. 21, 1976, 90 Stat. 2846, 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.)

Editorial Notes

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".

Statutory Notes and Related Subsidiaries

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

Pub. L. 87–850, §2, Oct. 23, 1962, 76 Stat. 1126, 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));

(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.); and

(iii) a provider of services eligible to enter into a contract pursuant to section 1745(a) of this title that is not otherwise described in clause (i) or (ii).

(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.

(h)(1) During the five-year period beginning on the date of the enactment of the Joseph Maxwell Cleland and Robert Joseph Dole Memorial Veterans Benefits and Health Care Improvement Act of 2022, and subject to paragraph (3)—

(A) at the request of a veteran for whom the Secretary is required to provide nursing home care under section 1710A of this title, the Secretary may place the veteran in a medical foster home that meets Department standards, at the expense of the United States, pursuant to a contract, agreement, or other arrangement entered into between the Secretary and the medical foster home for such purpose; and

(B) the Secretary may pay for care of a veteran placed in a medical foster home before such date of enactment, if the home meets Department standards, pursuant to a contract, agreement, or other arrangement entered into between the Secretary and the medical foster home for such purpose.

(2) A veteran on whose behalf the Secretary pays for care in a medical foster home under paragraph (1) shall agree, as a condition of such payment, to accept home health services furnished by the Secretary under section 1717 of this title.

(3) In any year, not more than a daily average of 900 veterans receiving care in a medical foster home, whether placed before, on, or after the date of the enactment of the Joseph Maxwell Cleland and Robert Joseph Dole Memorial Veterans Benefits and Health Care Improvement Act of 2022, may have their care covered at the expense of the United States under paragraph (1).

(4) The prohibition under section 1730(b)(3) of this title shall not apply to a veteran whose care is covered at the expense of the United States under paragraph (1).

(5) In this subsection, the term "medical foster home" means a home designed to provide non-institutional, long-term, supportive care for veterans who are unable to live independently and prefer a family setting.

(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; Pub. L. 112–154, title I, §105(b), Aug. 6, 2012, 126 Stat. 1170; Pub. L. 117–328, div. U, title I, §165(a)(1), Dec. 29, 2022, 136 Stat. 5431.)

Editorial Notes

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.

The date of the enactment of the Joseph Maxwell Cleland and Robert Joseph Dole Memorial Veterans Benefits and Health Care Improvement Act of 2022, referred to in subsec. (h)(1), (3), is the date of enactment of Pub. L. 117–328, which was approved Dec. 29, 2022.

Prior Provisions

Prior section 1720 was renumbered section 3520 of this title.

Amendments

2022—Subsec. (h). Pub. L. 117–328 added subsec. (h).

2012—Subsec. (c)(1)(A)(iii). Pub. L. 112–154 added cl. (iii).

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).

Statutory Notes and Related Subsidiaries

Effective Date of 2022 Amendment

Pub. L. 117–328, div. U, title I, §165(a)(2), Dec. 29, 2022, 136 Stat. 5432, provided that: "Subsection (h) of section 1720 of title 38, United States Code, as added by paragraph (1), shall take effect 90 days after the date of the enactment of this Act [Dec. 29, 2022]."

Effective Date of 2012 Amendment

Pub. L. 112–154, title I, §105(c), Aug. 6, 2012, 126 Stat. 1170, provided that:

"(1) In general.—The amendments made by this section [amending this section and section 1745 of this title] shall apply to care provided on or after the date that is 180 days after the date of the enactment of this Act [Aug. 6, 2012].

"(2) Maintenance of prior methodology of reimbursement for certain state homes.—In the case of a State home that provided nursing home care on the day before the date of the enactment of this Act for which the State home was eligible for pay under section 1745(a)(1) of title 38, United States Code, at the request of any State home, the Secretary shall offer to enter into a contract (or agreement described in such section) with such State home under such section, as amended by subsection (a), for payment for nursing home care provided by such State home under such section that reflects the overall methodology of reimbursement for such care that was in effect for such State home on the day before the date of the enactment of this Act."

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.

Ongoing Monitoring of Medical Foster Home Program

Pub. L. 117–328, div. U, title I, §165(b), Dec. 29, 2022, 136 Stat. 5432, provided that:

"(1) In general.—The Secretary of Veterans Affairs shall create a system to monitor and assess the workload for the Department of Veterans Affairs in carrying out the authority under section 1720(h) of title 38, United States Code, as added by subsection (a)(1), including by tracking—

"(A) requests by veterans to be placed in a medical foster home under such section;

"(B) denials of such requests, including the reasons for such denials;

"(C) the total number of medical foster homes applying to participate under such section, disaggregated by those approved and those denied approval by the Department to participate;

"(D) veterans receiving care at a medical foster home at the expense of the United States; and

"(E) veterans receiving care at a medical foster home at their own expense.

"(2) Report.—Based on the monitoring and assessments conducted under paragraph (1), the Secretary shall identify and submit to Congress a report on such modifications to implementing section 1720(h) of title 38, United States Code, as added by subsection (a)(1), as the Secretary considers necessary to ensure the authority under such section is functioning as intended and care is provided to veterans under such section as intended.

"(3) Medical foster home defined.—In this subsection, the term 'medical foster home' has the meaning given that term in section 1720(h) of title 38, United States Code, as added by subsection (a)(1)."

Comparison Study Between Adult Day Health Care and Nursing Home Care

Pub. L. 100–322, title I, §111(b), (c), May 20, 1988, 102 Stat. 499, 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.

Pub. L. 98–160, title I, §103(b), (c), Nov. 21, 1983, 97 Stat. 996, 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, air, or space 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, air, or space 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, air, or space 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, air, or space 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; Pub. L. 116–283, div. A, title IX, §926(a)(25), Jan. 1, 2021, 134 Stat. 3830.)

Editorial Notes

Amendments

2021—Subsecs. (b), (c). Pub. L. 116–283 substituted "air, or space service" for "or air service" in two places.

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".

Statutory Notes and Related Subsidiaries

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 Award of Grants for Substance Use Disorder Recovery for Homeless Veterans

Pub. L. 117–328, div. U, title III, §311, Dec. 29, 2022, 136 Stat. 5475, provided that:

"(a) Pilot Program Required.—Not later than 270 days after the date of the enactment of this Act [Dec. 29, 2022], the Secretary of Veterans Affairs shall commence carrying out a pilot program under which the Secretary shall award grants to eligible entities for the provision or coordination of services for recovery from substance use disorder for veterans who are homeless, were previously homeless and are transitioning to permanent housing, or are at risk of becoming homeless.

"(b) Duration.—The Secretary shall carry out the pilot program during the five-year period beginning on the date of the commencement of the pilot program.

"(c) Locations.—The Secretary shall carry out the pilot program at not fewer than five locations selected by the Secretary for purposes of the pilot program.

"(d) Award of Grants.—

"(1) In general.—In carrying out the pilot program, the Secretary shall award a grant to an eligible entity for each veteran with substance use disorder participating in the pilot program for which the eligible entity is providing or coordinating the provision of recovery services for substance use disorder under the pilot program.

"(2) Intervals of payment and maximum amounts.—The Secretary may establish intervals of payment for the administration of grants under this section and a maximum amount to be awarded, in accordance with the services being provided and the duration of such services.

"(3) Preference.—In awarding grants under paragraph (1), the Secretary shall give preference to eligible entities providing or coordinating the provision of recovery services for substance use disorder for veterans with substance-use dependency who face barriers in accessing substance-use recovery services from the Department of Veterans Affairs.

"(4) Equitable distribution.—The Secretary shall ensure that, to the extent practicable, grant amounts awarded under paragraph (1) are equitably distributed across geographic regions, including rural and Tribal communities.

"(5) Report on services provided.—The Secretary shall require each eligible entity awarded a grant under paragraph (1) to submit to the Secretary a report that describes the services provided or coordinated with amounts under such grant.

"(e) Requirements for Receipt of Grants.—

"(1) Notification that services are from department.—Each entity receiving a grant under this section shall notify the recipients of services provided pursuant to grant amounts that such services are being paid for, in whole or in part, by the Department.

"(2) Coordination.—An entity receiving a grant under this section shall—

"(A) coordinate with the Secretary with respect to the provision of clinical services to eligible individuals or any other provisions of law regarding the delivery of health care by the Secretary;

"(B) inform each veteran who receives assistance under this section from the entity of the ability of the veteran to apply for enrollment in the patient enrollment system of the Department under section 1705(a) of title 38, United States Code; and

"(C) if such a veteran wishes to so enroll, inform the veteran of a point of contact at the Department who can assist the veteran in such enrollment.

"(f) Grant Application.—

"(1) In general.—An eligible entity seeking the award of a grant under this section shall submit to the Secretary an application therefor in such form, in such manner, and containing such commitments and information as the Secretary considers necessary to carry out this section.

"(2) Contents of application.—Each application submitted by an eligible entity under paragraph (1) shall contain the following:

"(A) A description of the recovery services for substance use disorder proposed to be provided by the eligible entity under the pilot program and the identified need for those services.

"(B) A description of the types of veterans with substance use disorder proposed to be provided such recovery services.

"(C) An estimate of the number of veterans with substance use disorder proposed to be provided such recovery services.

"(D) Evidence of the experience of the eligible entity in providing such recovery services to veterans with substance use disorder.

"(E) A description of the managerial capacity of the eligible entity—

"(i) to assess continually the needs of veterans with substance use disorder for such recovery services;

"(ii) to coordinate the provision of such recovery services with services provided by the Department; and

"(iii) to tailor such recovery services to the needs of veterans with substance use disorder.

"(3) Criteria for selection.—

"(A) In general.—The Secretary shall establish criteria for the selection of eligible entities to be awarded grants under this section.

"(B) Elements.—Criteria established under subparagraph (A) with respect to an eligible entity shall include the following:

"(i) Relevant accreditation as may be required by each State in which the eligible entity operates.

"(ii) Experience coordinating care or providing treatment for veterans or members of the Armed Forces.

"(g) Participation.—Participation by a veteran in the pilot program shall not affect any eligibility status or requirements for such veteran with respect to other benefits or services provided by the Department.

"(h) Technical Assistance.—

"(1) In general.—The Secretary shall provide training and technical assistance to eligible entities awarded grants under this section regarding the planning, development, and provision of recovery services for substance use disorder under this section.

"(2) Provision of training.—The Secretary may provide the training required under paragraph (1) directly or through grants or contracts with such public or nonprofit private entities as the Secretary considers appropriate for purposes of this section, including through grants awarded under section 2064 of title 38, United States Code.

"(i) Collection of Information.—To the extent practicable, the Secretary may collect information from an eligible entity awarded a grant under this section relating to a substance use disorder of a veteran participating in the pilot program for inclusion in the electronic health record of the Department for such veteran for the sole purpose of improving care provided to such veteran.

"(j) Study on Effectiveness of Pilot Program.—

"(1) In general.—The Secretary shall conduct a study on the effectiveness of the pilot program in meeting the needs of veterans with substance use disorder.

"(2) Comparison.—In conducting the study required by paragraph (1), the Secretary shall compare the results of the pilot program with other programs of the Department dedicated to the delivery to veterans of recovery services for substance use disorder.

"(3) Criteria.—In making the comparison required by paragraph (2), to the extent data is available, the Secretary shall examine the following:

"(A) The satisfaction of veterans targeted by the programs described in paragraph (2).

"(B) The health status of such veterans, including mental health.

"(C) The degree to which such programs encourage such veterans to engage in productive activity.

"(D) The number of veterans using such programs, disaggregated by—

"(i) veterans who have received health care provided by the Department during the two-year period preceding the conduct of the study;

"(ii) veterans who have not received health care provided by the Department during such period;

"(iii) veterans eligible for health care provided by the Department, disaggregated by—

     "(I) veterans eligible for services from the Department similar to services provided under the pilot program; and

     "(II) veterans not eligible for such services from the Department; and

"(iv) veterans ineligible for health care provided by the Department.

"(E) The number of veterans who are still homeless or at risk of becoming homeless one year after completion of receipt of recovery services under such programs.

"(F) The number of veterans who still have a substance use disorder that negatively impacts their daily living and ability to maintain independent housing 180 days after discharge from receipt of services provided under this section.

"(G) The status of the discharge from the Armed Forces of veterans covered under this paragraph.

"(4) Reports.—Not later than one year after the date on which the first grant is awarded under this section, 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 report on the results of the study required by paragraph (1).

"(k) Definitions.—In this section:

"(1) Eligible entity.—The term 'eligible entity' means any of the following:

"(A) An incorporated private institution or foundation—

"(i) no part of the net earnings of which inures to the benefit of any member, founder, contributor, or individual;

"(ii) that has a governing board that is responsible for the operation of the recovery services for substance use disorder provided under this section; and

"(iii) that is approved by the Secretary with respect to financial responsibility.

"(B) A for-profit limited partnership, the sole general partner of which is an organization meeting the requirements of subparagraph (A).

"(C) A corporation wholly owned and controlled by an organization meeting the requirements of subparagraph (A).

"(D) A tribally designated housing entity (as defined in section 4 of the Native American Housing Assistance and Self-Determination Act of 1996 (25 U.S.C. 4103)).

"(2) Substance use disorder.—The term 'substance use disorder', with respect to a veteran, means the veteran has been diagnosed with, or is seeking treatment for, substance use disorder, as determined by the Secretary."

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

Pub. L. 104–110, title II, §202(a), Feb. 13, 1996, 110 Stat. 770, 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

Pub. L. 102–54, §8, June 13, 1991, 105 Stat. 271, 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

Pub. L. 100–689, title V, §502(a)(2), Nov. 18, 1988, 102 Stat. 4179, 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.)

Editorial Notes

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".

Statutory Notes and Related Subsidiaries

Ratification of Actions of Secretary of Veterans Affairs During Transition Periods

Pub. L. 101–237, title VI, §604, Dec. 18, 1989, 103 Stat. 2097, 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

Pub. L. 99–576, title II, §201(b), Oct. 28, 1986, 100 Stat. 3254, 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.)

Editorial Notes

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".

Statutory Notes and Related Subsidiaries

Effective Date of 1994 Amendment

Pub. L. 103–452, title I, §103(c)(1), Nov. 2, 1994, 108 Stat. 4786, 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

Pub. L. 101–366, title II, §201(b), Aug. 15, 1990, 104 Stat. 438, 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, required the Secretary of Veterans Affairs, not later than Feb. 1, 1995, to submit to Congress a report setting forth the Secretary's evaluation, findings, and conclusions regarding the conduct, through Sept. 30, 1993, of the pilot program required by this section and the results of the furnishing of care under the pilot program for the participating veterans.

§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 include care for physical health conditions, as appropriate, to former members of the Armed Forces who the Secretary determines require such counseling and care and services to treat a condition, which in the judgment of a health care 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 former member of the Armed Forces was serving on duty, regardless of duty status or line of duty determination (as that term is used in section 12323 of title 10).

(2)(A) In operating the program required by paragraph (1), the Secretary may, in consultation with the Secretary of Defense, provide counseling and care and services to members of the Armed Forces (including members of the National Guard and Reserves) to treat a condition described in that paragraph that was suffered by the member while serving on duty, regardless of duty status or line of duty determination (as that term is used in section 12323 of title 10).

(B) A member described in subparagraph (A) shall not be required to obtain a referral before receiving counseling and care and services under this paragraph.

(3) In furnishing counseling to an individual 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 individual in facilities of the Department would be clinically inadvisable, or (B) Department facilities are not capable of furnishing such counseling to that individual 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 former member of the Armed Forces eligible for counseling and care and services under subsection (a), the Secretary shall ensure that the former member of the Armed Forces 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 former members of the Armed Forces 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 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 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 members of the Armed Forces and individuals who are being separated from active military, naval, air, or space 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 and other health care 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 and other health care 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 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 individuals who received counseling and care and services under subsection (a) from professionals and providers who received training under subsection (d), disaggregated by—

(A) former members of the Armed Forces;

(B) members of the Armed Forces (including members of the National Guard and Reserves) on active duty; and

(C) for each of subparagraphs (A) and (B)—

(i) men; and

(ii) women.

(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 individuals requiring treatment and care for sexual trauma and post-traumatic stress disorder.

(5) Such recommendations for improvements in the treatment of individuals with sexual trauma and post-traumatic stress disorder as the Secretary considers appropriate, including specific recommendations for individuals specified in subparagraphs (A), (B), and (C) of paragraph (2).

(6) Such other information as the Secretary considers appropriate.

(f) In this section, the term "sexual harassment" means unsolicited verbal or physical contact of a sexual nature which is threatening in character.

(g) In this section, the term "former member of the Armed Forces" includes the following:

(1) A veteran.

(2) An individual described in section 1720I(b) of this title.

(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; Pub. L. 113–146, title IV, §§401–402(c), Aug. 7, 2014, 128 Stat. 1789, 1790; Pub. L. 115–91, div. A, title VII, §707, Dec. 12, 2017, 131 Stat. 1436; Pub. L. 116–283, div. A, title IX, §926(a)(26), Jan. 1, 2021, 134 Stat. 3830; Pub. L. 116–315, title V, §§5301, 5303(c), Jan. 5, 2021, 134 Stat. 5037, 5041.)

Editorial Notes

Amendments

2021—Subsec. (a)(1). Pub. L. 116–315, §5301(a)(1)(A), (2), (3), (b)(1)(A), inserted ", to include care for physical health conditions, as appropriate," after "counseling and appropriate care and services" and substituted "former members of the Armed Forces" for "veterans", "treat a condition" for "overcome psychological trauma", "health care professional" for "mental health professional", "former member of the Armed Forces" for "veteran", and "duty, regardless of duty status or line of duty determination (as that term is used in section 12323 of title 10)" for "active duty, active duty for training, or inactive duty training".

Subsec. (a)(2)(A). Pub. L. 116–315, §5301(a)(1)(B), (b)(1)(B), substituted "treat a condition" for "overcome psychological trauma" and "duty, regardless of duty status or line of duty determination (as that term is used in section 12323 of title 10)" for "active duty, active duty for training, or inactive duty training".

Subsec. (b). Pub. L. 116–315, §5301(a)(2), (3), substituted "former member of the Armed Forces" for "veteran" in two places in par. (1) and "former members of the Armed Forces" for "veterans" par. (2)(C).

Subsec. (c)(3). Pub. L. 116–283 substituted "air, or space service" for "or air service".

Subsec. (d)(1), (2)(A). Pub. L. 116–315, §5301(b)(2), inserted "and other health care professionals" after "mental health professionals".

Subsec. (e)(2)(A). Pub. L. 116–315, §5301(a)(3), substituted "former members of the Armed Forces" for "veterans".

Subsec. (f). Pub. L. 116–315, §5303(c), struck out "repeated," before "unsolicited".

Subsec. (g). Pub. L. 116–315, §5301(a)(4), added subsec. (g).

2017—Subsec. (a)(2)(A). Pub. L. 115–91 struck out "on active duty" before "to overcome psychological trauma" and inserted before period at end "that was suffered by the member while serving on active duty, active duty for training, or inactive duty training".

2014—Subsec. (a)(1). Pub. L. 113–146, §401, substituted ", active duty for training, or inactive duty training" for "or active duty for training".

Subsec. (a)(2). Pub. L. 113–146, §402(a)(2), added par. (2). Former par. (2) redesignated (3).

Subsec. (a)(3). Pub. L. 113–146, §402(a)(1), (3), redesignated par. (2) as (3), substituted "an individual" for "a veteran", and substituted "that individual" for "that veteran" in two places.

Subsec. (c). Pub. L. 113–146, §402(b)(1), struck out "to veterans" after "treatment available" in introductory provisions and par. (2).

Subsec. (c)(3). Pub. L. 113–146, §402(b)(2), inserted "members of the Armed Forces and" before "individuals".

Subsec. (e). Pub. L. 113–146, §402(c)(1), struck out "to veterans" after "services provided" in introductory provisions.

Subsec. (e)(2). Pub. L. 113–146, §402(c)(2)(A), (B), substituted "individuals" for "women veterans" and "training under subsection (d), disaggregated by—" for "training under subsection (d)." and added subpars. (A) to (C).

Subsec. (e)(4). Pub. L. 113–146, §402(c)(3), substituted "individuals" for "veterans".

Subsec. (e)(5). Pub. L. 113–146, §402(c)(4), substituted "individuals" for "women veterans" and inserted ", including specific recommendations for individuals specified in subparagraphs (A), (B), and (C) of paragraph (2)" before period at end.

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).

Statutory Notes and Related Subsidiaries

Effective Date of 2014 Amendment

Pub. L. 113–146, title IV, §402(d), Aug. 7, 2014, 128 Stat. 1790, provided that: "The amendments made by this section [amending this section] shall take effect on the date that is 1 year after the date of the enactment of this Act [Aug. 7, 2014]."

Study and Task Force on Veterans Experiencing Intimate Partner Violence or Sexual Assault

Pub. L. 116–315, title V, §5305, Jan. 5, 2021, 134 Stat. 5043, provided that:

"(a) National Baseline Study.—

"(1) In general.—Not later than one year after the date of the enactment of this Act [Jan. 5, 2021], the Secretary of Veterans Affairs, in consultation with the Attorney General, shall conduct a national baseline study to examine the scope of the problem of intimate partner violence and sexual assault among veterans and spouses and intimate partners of veterans.

"(2) Matters included.—The study under paragraph (1) shall—

"(A) include a literature review of all relevant research on intimate partner violence and sexual assault among veterans and spouses and intimate partners of veterans;

"(B) examine the prevalence of the experience of intimate partner violence among—

"(i) women veterans;

"(ii) veterans who are minority group members (as defined in section 544 of title 38, United States Code, and including other minority populations as the Secretary determines appropriate);

"(iii) urban and rural veterans;

"(iv) veterans who are enrolled in a program under section 1720G of title 38, United States Code;

"(v) veterans who are in intimate relationships with other veterans; and

"(vi) veterans who are described in more than one clause of this subparagraph;

"(C) examine the prevalence of the perpetration of intimate partner violence by veterans; and

"(D) include recommendations to address the findings of the study.

"(3) Report.—Not later than 30 days after the date on which the Secretary completes the study under paragraph (1), 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 such study.

"(b) Task Force.—

"(1) In general.—Not later than 90 days after the date on which the Secretary completes the study under subsection (a), the Secretary, in consultation with the Attorney General and the Secretary of Health and Human Services, shall establish a national task force (in this section referred to as the 'Task Force') to develop a comprehensive national program, including by integrating facilities, services, and benefits of the Department of Veterans Affairs into existing networks of community-based intimate partner violence and sexual assault services, to address intimate partner violence and sexual assault among veterans.

"(2) Leadership.—The Secretary of Veterans Affairs shall lead the Task Force in collaboration with the Attorney General and the Secretary of Health and Human Services.

"(c) Consultation With Stakeholders.—In carrying out this section, the Task Force shall consult with—

"(1) representatives from veteran service organizations and military service organizations;

"(2) representatives from not fewer than three national organizations or State coalitions with demonstrated expertise in intimate partner violence prevention, response, or advocacy; and

"(3) representatives from not fewer than three national organizations or State coalitions, particularly those representing underserved and ethnic minority communities, with demonstrated expertise in sexual assault prevention, response, or advocacy.

"(d) Duties.—The duties of the Task Force shall include the following:

"(1) To review existing services and policies of the Department and develop a comprehensive national program to be carried out by the Secretary of Veterans Affairs, in collaboration with the heads of relevant Federal agencies, to address intimate partner violence and sexual assault prevention, response, and treatment.

"(2) To review the feasibility and advisability of establishing an expedited process to secure emergency, temporary benefits, including housing or other benefits, for veterans who are experiencing intimate partner violence or sexual assault.

"(3) To review and make recommendations regarding the feasibility and advisability of establishing dedicated, temporary housing assistance for veterans experiencing intimate partner violence or sexual assault.

"(4) To identify any requirements regarding intimate partner violence assistance or sexual assault response and services that are not being met by the Department and make recommendations on how the Department can meet such requirements.

"(5) To review and make recommendations regarding the feasibility and advisability of providing direct services or contracting for community-based services for veterans in response to a sexual assault, including through the use of sexual assault nurse examiners, particularly in underserved or remote areas, including services for Native American veterans.

"(6) To review the availability of counseling services provided by the Department and through peer network support, and to provide recommendations for the enhancement of such services, to address—

"(A) the perpetration of intimate partner violence and sexual assault; and

"(B) the recovery of veterans, particularly women veterans, from intimate partner violence and sexual assault.

"(7) To review and make recommendations to expand services available for veterans at risk of perpetrating intimate partner violence.

"(e) Report.—Not later than one year after the date of the enactment of this Act [Jan. 5, 2021], and not less frequently than annually thereafter by October 1 of each year, the Task Force shall submit to the Secretary of Veterans Affairs and Congress a report on the activities of the Task Force, including any recommendations for legislative or administrative action.

"(f) Nonapplicability of FACA.—The Task Force shall not be subject to the requirements of the Federal Advisory Committee Act ([former] 5 U.S.C. App.) [see 5 U.S.C. 1001 et seq.].

"(g) Definitions.—In this section:

"(1) Native american veteran.—The term 'Native American veteran' has the meaning given that term in section 3765 of title 38, United States Code.

"(2) State.—The term 'State' has the meaning given that term in section 101 of title 38, United States Code."

Information on Telephone Counseling Availability; Personnel Training; Client Confidentiality; Publicity; Report

Pub. L. 103–452, title I, §101(g)(2)–(5), Nov. 2, 1994, 108 Stat. 4785, 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

Pub. L. 102–585, title I, §102(b), Nov. 4, 1992, 106 Stat. 4946, 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

Pub. L. 102–585, title I, §104, Nov. 4, 1992, 106 Stat. 4946, 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

Pub. L. 102–585, title I, §105, Nov. 4, 1992, 106 Stat. 4946, 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, air, or space 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; amended Pub. L. 116–283, div. A, title IX, §926(a)(27), Jan. 1, 2021, 134 Stat. 3830.)

Editorial Notes

Amendments

2021—Subsec. (a). Pub. L. 116–283 substituted "air, or space service" for "or air service".

§1720F. Comprehensive program for suicide prevention among veterans and members of the reserve components of the Armed Forces

(a) Establishment.—The Secretary shall develop and carry out a comprehensive program designed to reduce the incidence of suicide among covered individuals 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 covered individuals. 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 covered individuals who may be at high risk for suicide; and

(3) best practices for suicide prevention.

(c) Health Assessments.—In carrying out the comprehensive program, the Secretary shall direct that medical staff offer mental health in their overall health assessment when covered individuals 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 individual concerned, to appropriate counseling and treatment programs for covered individuals 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 covered individuals and improve the coordination of mental health care to covered individuals.

(e) Best Practices Research.—In carrying out the comprehensive program, the Secretary shall provide for research on best practices for suicide prevention among covered individuals. 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 covered individuals who have experienced sexual trauma while in military service. The research design shall include consideration of veterans or members 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 covered individuals on a 24-hour basis.

(h) Hotline.—In carrying out the comprehensive program, the Secretary may provide for a toll-free hotline for covered individuals to be staffed by appropriately trained mental health personnel and available at all times.

(i) Outreach and Education.—In carrying out the comprehensive program, the Secretary shall provide for outreach to and education for covered individuals and the families of covered individuals, 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 covered individuals to seek treatment and assistance for mental illness;

(3) promote skills for coping with mental illness; and

(4) help families of covered individuals with—

(A) understanding issues arising from the readjustment of covered individuals to civilian life;

(B) identifying signs and symptoms of mental illness; and

(C) encouraging covered individuals to seek assistance for mental illness.

(j) Peer Support Counseling Program.—(1) In carrying out the comprehensive program, the Secretary shall establish and carry out a peer support counseling program, under which covered individuals shall be permitted to volunteer as peer counselors—

(A) to assist other covered individuals with issues related to mental health and readjustment; and

(B) to conduct outreach to covered individuals and the families of covered individuals.

(2) In carrying out the peer support counseling program under this subsection, the Secretary shall provide adequate training for peer counselors, including training carried out under the national program of training required by section 304(c) of the Caregivers and Veterans Omnibus Health Services Act of 2010 (38 U.S.C. 1712A note).

(3) In addition to other locations the Secretary considers appropriate, the Secretary shall carry out the peer support program under this subsection at each Department medical center.

(4)(A) As part of the counseling program under this subsection, the Secretary shall emphasize appointing peer support counselors for covered individuals who are women. To the degree practicable, the Secretary shall seek to recruit women peer support counselors with expertise in—

(i) female gender-specific issues and services;

(ii) the provision of information about services and benefits provided under laws administered by the Secretary; or

(iii) employment mentoring.

(B) To the degree practicable, the Secretary shall emphasize facilitating peer support counseling for covered individuals who are women and are eligible for counseling and services under section 1720D of this title, have post-traumatic stress disorder or suffer from another mental health condition, are homeless or at risk of becoming homeless, or are otherwise at increased risk of suicide, as determined by the Secretary.

(C) The Secretary shall conduct outreach to inform covered individuals who are women about the program and the assistance available under this paragraph.

(D) In carrying out this paragraph, the Secretary shall coordinate with such community organizations, State and local governments, institutions of higher education, chambers of commerce, local business organizations, organizations that provide legal assistance, and other organizations as the Secretary considers appropriate.

(E) In carrying out this paragraph, the Secretary shall provide adequate training for peer support counselors, including training carried out under the national program of training required by section 304(c) of the Caregivers and Veterans Omnibus Health Services Act of 2010 (38 U.S.C. 1712A note).

(k) Other Components.—In carrying out the comprehensive program, the Secretary may provide for other actions to reduce the incidence of suicide among covered individuals that the Secretary considers appropriate.

(l)(1) Covered Individual Defined.—In this section, the term "covered individual" means a veteran or a member of the reserve components of the Armed Forces.

(2) In determining coverage of members of the reserve components of the Armed Forces under the comprehensive program, the Secretary shall consult with the Secretary of Defense.

(Added Pub. L. 110–110, §3(a)(1), Nov. 5, 2007, 121 Stat. 1031; amended Pub. L. 112–239, div. A, title VII, §730(a)(1)–(3), Jan. 2, 2013, 126 Stat. 1814; Pub. L. 115–271, title VIII, §8051(a), Oct. 24, 2018, 132 Stat. 4093; Pub. L. 116–283, div. A, title VII, §764(a)(1)–(3)(A), Jan. 1, 2021, 134 Stat. 3725, 3726.)

Editorial Notes

References in Text

Section 304(c) of the Caregivers and Veterans Omnibus Health Services Act of 2010, referred to in subsec. (j)(2), (4)(E), is section 304(c) of Pub. L. 111–163, which is set out as a note under section 1712A of this title.

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.

Amendments

2021—Pub. L. 116–283, §764(a)(3)(A), inserted "and members of the reserve components of the Armed Forces" after "veterans" in section catchline.

Subsec. (a). Pub. L. 116–283, §764(a)(2)(A), substituted "covered individuals" for "veterans".

Subsec. (b). Pub. L. 116–283, §764(a)(2)(B), substituted "covered individuals" for "veterans" in introductory provisions and par. (2).

Subsec. (c). Pub. L. 116–283, §764(a)(2)(C), in heading, struck out "of Veterans" after "Assessments", and in text, substituted "covered individuals" for "veterans" in two places and "individual" for "veteran".

Subsec. (d). Pub. L. 116–283, §764(a)(2)(D), substituted "to covered individuals" for "to veterans" in two places.

Subsec. (e). Pub. L. 116–283, §764(a)(2)(E), substituted "covered individuals" for "veterans" in introductory provisions.

Subsec. (f). Pub. L. 116–283, §764(a)(2)(F), substituted "covered individuals" for "veterans" in first sentence and inserted "or members" after "veterans" in second sentence.

Subsec. (g). Pub. L. 116–283, §764(a)(2)(G), substituted "covered individuals" for "veterans".

Subsec. (h). Pub. L. 116–283, §764(a)(2)(H), substituted "covered individuals" for "veterans".

Subsec. (i). Pub. L. 116–283, §764(a)(2)(I)(i), (ii), struck out "for Veterans and Families" after "Education" in heading, and substituted "covered individuals and the families of covered individuals" for "veterans and the families of veterans" in introductory provisions.

Subsec. (i)(2). Pub. L. 116–283, §764(a)(2)(I)(iii), substituted "covered individuals" for "veterans".

Subsec. (i)(4). Pub. L. 116–283, §764(a)(2)(I)(iv), substituted "covered individuals" for "veterans" wherever appearing.

Subsec. (j)(1). Pub. L. 116–283, §764(a)(2)(J)(i), substituted "covered individuals" for "veterans" wherever appearing.

Subsec. (j)(4)(A). Pub. L. 116–283, §764(a)(2)(J)(ii)(I), substituted "covered individuals who are women" for "women veterans" in introductory provisions.

Subsec. (j)(4)(B). Pub. L. 116–283, §764(a)(2)(J)(ii)(II), substituted "covered individuals who are women and" for "women veterans who".

Subsec. (j)(4)(C). Pub. L. 116–283, §764(a)(2)(J)(ii)(III), substituted "covered individuals who are women" for "women veterans".

Subsec. (k). Pub. L. 116–283, §764(a)(2)(K), substituted "covered individuals" for "veterans".

Subsec. (l). Pub. L. 116–283, §764(a)(1), added subsec. (l).

2018—Subsec. (j)(4). Pub. L. 115–271 added par. (4).

2013—Subsec. (j)(1). Pub. L. 112–239, §730(a)(1), substituted "shall establish" for "may establish" in introductory provisions.

Subsec. (j)(2). Pub. L. 112–239, §730(a)(2), inserted ", including training carried out under the national program of training required by section 304(c) of the Caregivers and Veterans Omnibus Health Services Act of 2010 (38 U.S.C. 1712A note)" after "peer counselors".

Subsec. (j)(3). Pub. L. 112–239, §730(a)(3), added par. (3).

Statutory Notes and Related Subsidiaries

Veterans Crisis Line

Pub. L. 117–328, div. V, title II, Dec. 29, 2022, 136 Stat. 5501, provided that:

"SEC. 201. VETERANS CRISIS LINE.

"In this title, the term 'Veterans Crisis Line' means the toll-free hotline for veterans established under section 1720F(h) of title 38, United States Code.

"subtitle a—veterans crisis line training and quality management

"SEC. 211. STAFF TRAINING.

"(a) Review of Training for Veterans Crisis Line Call Responders.—

"(1) In general.—The Secretary of Veterans Affairs shall enter into an agreement with an organization outside the Department of Veterans Affairs to review the training for Veterans Crisis Line call responders on assisting callers in crisis.

"(2) Completion of review.—The review conducted under paragraph (1) shall be completed not later than one year after the date of the enactment of this Act [Dec. 29, 2022].

"(3) Elements of review.—The review conducted under paragraph (1) shall consist of a review of the training provided by the Department on subjects including risk assessment, lethal means assessment, substance use and overdose risk assessment, safety planning, referrals to care, supervisory consultation, and emergency dispatch.

"(4) Update of training.—If any deficiencies in the training for Veterans Crisis Line call responders are found pursuant to the review under paragraph (1), the Secretary shall update such training and associated standards of practice to correct those deficiencies not later than one year after the completion of the review.

"(b) Retraining Guidelines for Veterans Crisis Line Call Responders.—

"(1) In general.—Not later than one year after the date of the enactment of this Act, the Secretary shall develop guidelines on retraining and quality management for when a Veterans Crisis Line call responder has an adverse event or when a quality review check by a supervisor of such a call responder denotes that the call responder needs improvement.

"(2) Elements of guidelines.—The guidelines developed under paragraph (1) shall specify the subjects and quantity of retraining recommended and how supervisors should implement increased use of silent monitoring or other performance review mechanisms.

"SEC. 212. QUALITY REVIEW AND MANAGEMENT.

"(a) Monitoring of Calls on Veterans Crisis Line.—

"(1) In general.—The Secretary of Veterans Affairs shall require that not fewer than two calls per month for each Veterans Crisis Line call responder be subject to supervisory silent monitoring, which is used to monitor the quality of conduct by such call responder during the call.

"(2) Benchmarks.—The Secretary shall establish benchmarks for requirements and performance of Veterans Crisis Line call responders on supervisory silent monitored calls.

"(3) Quarterly reports.—Not less frequently than quarterly, the Secretary shall submit to the Office of Mental Health and Suicide Prevention of the Department of Veterans Affairs a report on occurrence and outcomes of supervisory silent monitoring of calls on the Veterans Crisis Line.

"(b) Quality Management Processes for Veterans Crisis Line.—Not later than one year after the date of the enactment of this Act [Dec. 29, 2022], the leadership for the Veterans Crisis Line, in partnership with the Office of Mental Health and Suicide Prevention of the Department and the National Center for Patient Safety of the Department, shall establish quality management processes and expectations for staff of the Veterans Crisis Line, including with respect to reporting of adverse events and close calls.

"(c) Annual Common Cause Analysis for Callers to Veterans Crisis Line Who Die by Suicide.—

"(1) In general.—Not less frequently than annually, the Secretary shall perform a common cause analysis for all identified callers to the Veterans Crisis Line that died by suicide during the one-year period preceding the conduct of the analysis before the caller received contact with emergency services and in which the Veterans Crisis Line was the last point of contact.

"(2) Submittal of results.—The Secretary shall submit to the Office of Mental Health and Suicide Prevention of the Department the results of each analysis conducted under paragraph (1).

"(3) Application of themes or lessons.—The Secretary shall apply any themes or lessons learned under an analysis under paragraph (1) to updating training and standards of practice for staff of the Veterans Crisis Line.

"SEC. 213. GUIDANCE FOR HIGH-RISK CALLERS.

"(a) Development of Enhanced Guidance and Procedures for Response to Calls Related to Substance Use and Overdose Risk.—Not later than one year after the date of the enactment of this Act [Dec. 29, 2022], the Secretary of Veterans Affairs, in consultation with national experts within the Department of Veterans Affairs on substance use disorder and overdose, shall—

"(1) develop enhanced guidance and procedures to respond to calls to the Veterans Crisis Line related to substance use and overdose risk;

"(2) update training materials for staff of the Veterans Crisis Line in response to such enhanced guidance and procedures; and

"(3) update criteria for monitoring compliance with such enhanced guidance and procedures.

"(b) Review and Improvement of Standards for Emergency Dispatch.—

"(1) In general.—Not later than one year after the date of the enactment of this Act, the Secretary shall—

"(A) review the current emergency dispatch standard operating procedure of the Veterans Crisis Line to identify any additions to such procedure to strengthen communication regarding—

"(i) emergency dispatch for disconnected callers; and

"(ii) the role of social service assistants in requesting emergency dispatch and recording such dispatches; and

"(B) update such procedure to include the additions identified under subparagraph (A).

"(2) Training.—The Secretary shall ensure that all staff of the Veterans Crisis Line are trained on all updates made under paragraph (1)(B) to the emergency dispatch standard operating procedure of the Veterans Crisis Line.

"SEC. 214. OVERSIGHT OF TRAINING OF SOCIAL SERVICE ASSISTANTS AND CLARIFICATION OF JOB RESPONSIBILITIES.

"Not later than one year after the date of the enactment of this Act [Dec. 29, 2022], the Secretary of Veterans Affairs shall—

"(1) establish oversight mechanisms to ensure that social service assistants and supervisory social service assistants working with the Veterans Crisis Line are appropriately trained and implementing guidance of the Department regarding the Veterans Crisis Line; and

"(2) refine standard operating procedures to delineate roles and responsibilities for all levels of supervisory social service assistants working with the Veterans Crisis Line.

"subtitle b—pilot programs and research on veterans crisis line

"SEC. 221. PILOT PROGRAMS.

"(a) Extended Safety Planning Pilot Program for Veterans Crisis Line.—

"(1) In general.—Commencing not later than 180 days after the date of the enactment of this Act [Dec. 29, 2022], the Secretary of Veterans Affairs shall carry out a pilot program to determine whether a lengthier, templated safety plan used in clinical settings could be applied in call centers for the Veterans Crisis Line.

"(2) Briefing.—Not later than two years after the date of the enactment of this Act, the Secretary shall provide to Congress a briefing on the findings of the Secretary under the pilot program conducted under paragraph (1), which shall include any recommendations of the Secretary with respect to the continuation or discontinuation of the pilot program.

"(b) Crisis Line Facilitation Pilot Program.—

"(1) In general.—Commencing not later than one year after the date of the enactment of this Act, the Secretary shall carry out a pilot program on the use of crisis line facilitation to increase use of the Veterans Crisis Line among high-risk veterans.

"(2) Briefing.—Not later than two years after the date of the enactment of this Act, the Secretary shall provide to Congress a briefing on the findings of the Secretary under the pilot program under paragraph (1), including any recommendations of the Secretary with respect to the continuation or discontinuation of the pilot program.

"(3) Definitions.—In this section:

"(A) The term 'crisis line facilitation', with respect to a high-risk veteran, means the presentation by a therapist of psychoeducational information about the Veterans Crisis Line and a discussion of the perceived barriers and facilitators to future use of the Veterans Crisis Line for the veteran, which culminates in the veteran calling the Veterans Crisis Line with the therapist to provide firsthand experiences that may counter negative impressions of the Veterans Crisis Line.

"(B) The term 'high-risk veteran' means a veteran receiving inpatient mental health care following a suicidal crisis.

"SEC. 222. AUTHORIZATION OF APPROPRIATIONS FOR RESEARCH ON EFFECTIVENESS AND OPPORTUNITIES FOR IMPROVEMENT OF VETERANS CRISIS LINE.

"There is authorized to be appropriated to the Secretary of Veterans Affairs for fiscal years 2022 and 2023, a total of $5,000,000 for the Mental Illness Research, Education, and Clinical Centers of the Department of Veterans Affairs to conduct research on the effectiveness of the Veterans Crisis Line and areas for improvement for the Veterans Crisis Line.

"subtitle c—transition of crisis line number

"SEC. 231. FEEDBACK ON TRANSITION OF CRISIS LINE NUMBER.

"(a) In General.—The Secretary of Veterans Affairs shall solicit feedback from veterans service organizations on how to conduct outreach to members of the Armed Forces, veterans, their family members, and other members of the military and veterans community on the move to 988 as the new, national three-digit suicide and mental health crisis hotline, which is expected to be implemented by July 2022, to minimize confusion and ensure veterans are aware of their options for reaching the Veterans Crisis Line.

"(b) Nonapplication of FACA.—The Federal Advisory Committee Act ([former] 5 U.S.C. App.) [see 5 U.S.C. 1001 et seq.] shall not apply to any feedback solicited under subsection (a).

"(c) Veterans Service Organization Defined.—In this section, the term 'veterans service organization' means an organization recognized by the Secretary for the representation of veterans under section 5902 of title 38, United States Code."

Department of Veterans Affairs Governors Challenge Program

Pub. L. 117–328, div. V, title III, §303, Dec. 29, 2022, 136 Stat. 5508, provided that: "The Secretary of Veterans Affairs may enter into agreements with States, territories, and American Indian and Alaska Native tribes for the development and implementation of veteran suicide prevention proposals through the Governors Challenge Program."

Financial Assistance to Certain Entities To Provide or Coordinate the Provision of Suicide Prevention Services for Eligible Individuals and Their Families

Pub. L. 116–171, title II, §201, Oct. 17, 2020, 134 Stat. 783, provided that:

"(a) Purpose; Designation.—

"(1) Purpose.—The purpose of this section is to reduce veteran suicide through a community-based grant program to award grants to eligible entities to provide or coordinate suicide prevention services to eligible individuals and their families.

"(2) Designation.—The grant program under this section shall be known as the 'Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program'.

"(b) Financial Assistance and Coordination.—The Secretary shall provide financial assistance to eligible entities approved under this section through the award of grants to such entities to provide or coordinate the provision of services to eligible individuals and their families to reduce the risk of suicide. The Secretary shall carry out this section in coordination with the President's Roadmap to Empower Veterans and End a National Tragedy of Suicide Task Force and in consultation with the Office of Mental Health and Suicide Prevention of the Department, to the extent practicable.

"(c) Award of Grants.—

"(1) In general.—The Secretary shall award a grant to each eligible entity for which the Secretary has approved an application under subsection (f) to provide or coordinate the provision of suicide prevention services under this section.

"(2) Grant amounts, intervals of payment, and matching funds.—In accordance with the services being provided under a grant under this section and the duration of those services, the Secretary shall establish—

"(A) a maximum amount to be awarded under the grant of not more than $750,000 per grantee per fiscal year; and

"(B) intervals of payment for the administration of the grant.

"(d) Distribution of Grants and Preference.—

"(1) Distribution.—

"(A) Priority.—In compliance with subparagraphs (B) and (C), in determining how to distribute grants under this section, the Secretary may prioritize—

"(i) rural communities;

"(ii) Tribal lands;

"(iii) territories of the United States;

"(iv) medically underserved areas;

"(v) areas with a high number or percentage of minority veterans or women veterans; and

"(vi) areas with a high number or percentage of calls to the Veterans Crisis Line.

"(B) Areas with need.—The Secretary shall ensure that, to the extent practicable, grants under this section are distributed—

"(i) to provide services in areas of the United States that have experienced high rates of suicide by eligible individuals, including suicide attempts; and

"(ii) to eligible entities that can assist eligible individuals at risk of suicide who are not currently receiving health care furnished by the Department.

"(C) Geography.—In distributing grants under this paragraph, the Secretary may provide grants to eligible entities that furnish services to eligible individuals and their families in geographically dispersed areas.

"(2) Preference.—The Secretary shall give preference to eligible entities that have demonstrated the ability to provide or coordinate suicide prevention services.

"(e) Requirements for Receipt of Grants.—

"(1) Notification that services are from department.—Each entity receiving a grant under this section to provide or coordinate suicide prevention services to eligible individuals and their families shall notify the recipients of such services that such services are being paid for, in whole or in part, by the Department.

"(2) Development of plan with eligible individuals and their family.—Any plan developed with respect to the provision of suicide prevention services for an eligible individual or their family shall be developed in consultation with the eligible individual and their family.

"(3) Coordination.—An entity receiving a grant under this section shall—

"(A) coordinate with the Secretary with respect to the provision of clinical services to eligible individuals in accordance with subsection (n) or any other provisions of the law regarding the delivery of health care by the Secretary;

"(B) inform every veteran who receives assistance under this section from the entity of the ability of the veteran to apply for enrollment in the patient enrollment system of the Department under section 1705(a) of title 38, United States Code; and

"(C) if such a veteran wishes to so enroll, inform the veteran of a point of contact at the Department who can assist the veteran in such enrollment.

"(4) Measurement and monitoring.—An entity receiving a grant under this section shall submit to the Secretary a description of such tools and assessments the entity uses or will use to determine the effectiveness of the services furnished by the entity, which shall include the measures developed under subsection (h)(2) and may include—

"(A) the effect of the services furnished by the entity on the financial stability of the eligible individual;

"(B) the effect of the services furnished by the entity on the mental health status, wellbeing, and suicide risk of the eligible individual; and

"(C) the effect of the services furnished by the entity on the social support of the eligible individuals receiving those services.

"(5) Reports.—The Secretary—

"(A) shall require each entity receiving a grant under this section to submit to the Secretary an annual report that describes the projects carried out with such grant during the year covered by the report;

"(B) shall specify to each such entity the evaluation criteria and data and information to be submitted in such report; and

"(C) may require each such entity to submit to the Secretary such additional reports as the Secretary considers appropriate.

"(f) Application for Grants.—

"(1) In general.—An eligible entity seeking a grant under this section shall submit to the Secretary an application therefor in such form, in such manner, and containing such commitments and information as the Secretary considers necessary to carry out this section.

"(2) Matters to be included.—Each application submitted by an eligible entity under paragraph (1) shall contain the following:

"(A) A description of the suicide prevention services proposed to be provided by the eligible entity and the identified need for those services.

"(B) A detailed plan describing how the eligible entity proposes to coordinate or deliver suicide prevention services to eligible individuals, including—

"(i) an identification of the community partners, if any, with which the eligible entity proposes to work in delivering such services;

"(ii) a description of the arrangements currently in place between the eligible entity and such partners with regard to the provision or coordination of suicide prevention services;

"(iii) an identification of how long such arrangements have been in place;

"(iv) a description of the suicide prevention services provided by such partners that the eligible entity shall coordinate, if any; and

"(v) an identification of local suicide prevention coordinators of the Department and a description of how the eligible entity will communicate with local suicide prevention coordinators.

"(C) A description of the population of eligible individuals and their families proposed to be provided suicide prevention services.

"(D) Based on information and methods developed by the Secretary for purposes of this subsection, an estimate of the number of eligible individuals at risk of suicide and their families proposed to be provided suicide prevention services, including the percentage of those eligible individuals who are not currently receiving care furnished by the Department.

"(E) Evidence of measurable outcomes related to reductions in suicide risk and mood-related symptoms utilizing validated instruments by the eligible entity (and the proposed partners of the entity, if any) in providing suicide prevention services to individuals at risk of suicide, particularly to eligible individuals and their families.

"(F) A description of the managerial and technological capacity of the eligible entity—

"(i) to coordinate the provision of suicide prevention services with the provision of other services;

"(ii) to assess on an ongoing basis the needs of eligible individuals and their families for suicide prevention services;

"(iii) to coordinate the provision of suicide prevention services with the services of the Department for which eligible individuals are also eligible;

"(iv) to tailor suicide prevention services to the needs of eligible individuals and their families;

"(v) to seek continuously new sources of assistance to ensure the continuity of suicide prevention services for eligible individuals and their families as long as they are determined to be at risk of suicide; and

"(vi) to measure the effects of suicide prevention services provided by the eligible entity or partner organization, in accordance with subsection (h)(2), on the lives of eligible individuals and their families who receive such services provided by the organization using pre- and post-evaluations on validated measures of suicide risk and mood-related symptoms.

"(G) Clearly defined objectives for the provision of suicide prevention services.

"(H) A description and physical address of the primary location of the eligible entity.

"(I) A description of the geographic area the eligible entity plans to serve during the grant award period for which the application applies.

"(J) If the eligible entity is a State or local government or an Indian tribe, the amount of grant funds proposed to be made available to community partners, if any, through agreements.

"(K) A description of how the eligible entity will assess the effectiveness of the provision of grants under this section.

"(L) An agreement to use the measures and metrics provided by the Department for the purposes of measuring the effectiveness of the programming as described in subsection (h)(2).

"(M) Such additional application criteria as the Secretary considers appropriate.

"(g) Training and Technical Assistance.—

"(1) In general.—The Secretary shall provide training and technical assistance, in coordination with the Centers for Disease Control and Prevention, to eligible entities in receipt of grants under this section regarding—

"(A) suicide risk identification and management;

"(B) the data required to be collected and shared with the Department;

"(C) the means of data collection and sharing;

"(D) familiarization with and appropriate use of any tool to be used to measure the effectiveness of the use of the grants provided; and

"(E) the requirements for reporting under subsection (e)(5) on services provided via such grants.

"(2) Provision of training and technical assistance.—The Secretary may provide the training and technical assistance described in paragraph (1) directly or through grants or contracts with appropriate public or nonprofit entities.

"(h) Administration of Grant Program.—

"(1) Selection criteria.—The Secretary, in consultation with entities specified in paragraph (3), shall establish criteria for the selection of eligible entities that have submitted applications under subsection (f).

"(2) Development of measures and metrics.—The Secretary shall develop, in consultation with entities specified in paragraph (3), the following:

"(A) A framework for collecting and sharing information about entities in receipt of grants under this section for purposes of improving the services available for eligible individuals and their families, set forth by service type, locality, and eligibility criteria.

"(B) The measures and metrics to be used by each entity in receipt of grants under this section to determine the effectiveness of the programming being provided by such entity in improving mental health status, wellbeing, and reducing suicide risk and completed suicides of eligible individuals and their families, which shall include an existing measurement tool or protocol for the grant recipient to utilize when determining programmatic effectiveness.

"(3) Coordination.—In developing a plan for the design and implementation of the provision of grants under this section, including criteria for the award of grants, the Secretary shall consult with the following:

"(A) Veterans service organizations.

"(B) National organizations representing potential community partners of eligible entities in providing supportive services to address the needs of eligible individuals and their families, including national organizations that—

"(i) advocate for the needs of individuals with or at risk of behavioral health conditions;

"(ii) represent mayors;

"(iii) represent unions;

"(iv) represent first responders;

"(v) represent chiefs of police and sheriffs;

"(vi) represent governors;

"(vii) represent a territory of the United States; or

"(viii) represent a Tribal alliance.

"(C) National organizations representing members of the Armed Forces.

"(D) National organizations that represent counties.

"(E) Organizations with which the Department has a current memorandum of agreement or understanding related to mental health or suicide prevention.

"(F) State departments of veterans affairs.

"(G) National organizations representing members of the reserve components of the Armed Forces.

"(H) National organizations representing members of the Coast Guard.

"(I) Organizations, including institutions of higher education, with experience in creating measurement tools for purposes of advising the Secretary on the most appropriate existing measurement tool or protocol for the Department to utilize.

"(J) The National Alliance on Mental Illness.

"(K) A labor organization (as such term is defined in section 7103(a)(4) of title 5, United States Code).

"(L) The Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, the President's Roadmap to Empower Veterans and End a National Tragedy of Suicide Task Force, and such other organizations as the Secretary considers appropriate.

"(4) Report on grant criteria.—Not later than 30 days before notifying eligible entities of the availability of funding under this section, the Secretary shall submit to the appropriate committees of Congress a report containing—

"(A) criteria for the award of a grant under this section;

"(B) the already developed measures and metrics to be used by the Department to measure the effectiveness of the use of grants provided under this section as described in subsection (h)(2); and

"(C) a framework for the sharing of information about entities in receipt of grants under this section.

"(i) Information on Potential Eligible Individuals.—

"(1) In general.—The Secretary may make available to recipients of grants under this section certain information regarding potential eligible individuals who may receive services for which such grant is provided.

"(2) Information included.—The information made available under paragraph (1) with respect to potential eligible individuals may include the following:

"(A) Confirmation of the status of a potential eligible individual as a veteran.

"(B) Confirmation of whether the potential eligible individual is enrolled in the patient enrollment system of the Department under section 1705(a) of title 38, United States Code.

"(C) Confirmation of whether a potential eligible individual is currently receiving care furnished by the Department or has recently received such care.

"(3) Opt-out.—The Secretary shall allow an eligible individual to opt out of having their information shared under this subsection with recipients of grants under this section.

"(j) Duration.—The authority of the Secretary to provide grants under this section shall terminate on the date that is three years after the date on which the first grant is awarded under this section.

"(k) Reporting.—

"(1) Interim report.—

"(A) In general.—Not later than 18 months after the date on which the first grant is awarded under this section, the Secretary shall submit to the appropriate committees of Congress a report on the provision of grants to eligible entities under this section.

"(B) Elements.—The report submitted under subparagraph (A) shall include the following:

"(i) An assessment of the effectiveness of the grant program under this section, including—

     "(I) the effectiveness of grant recipients and their community partners, if any, in conducting outreach to eligible individuals;

     "(II) the effectiveness of increasing eligible individuals engagement in suicide prevention services; and

     "(III) such other validated instruments and additional measures as determined by the Secretary and as described in subsection (h)(2).

"(ii) A list of grant recipients and their partner organizations, if any, that delivered services funded by the grant and the amount of such grant received by each recipient and partner organization.

"(iii) The number of eligible individuals supported by each grant recipient, including through services provided to family members, disaggregated by—

     "(I) all demographic characteristics as determined necessary and appropriate by the Secretary in coordination with the Centers for Disease Control and Prevention;

     "(II) whether each such eligible individual is enrolled in the patient enrollment system of the Department under section 1705(a) of title 38, United States Code;

     "(III) branch of service in the Armed Forces;

     "(IV) era of service in the Armed Forces;

     "(V) type of service received by the eligible individual; and

     "(VI) whether each such eligible individual was referred to the Department for care.

"(iv) The number of eligible individuals supported by grants under this section, including through services provided to family members.

"(v) The number of eligible individuals described in clause (iv) who were not previously receiving care furnished by the Department, with specific numbers for the population of eligible individuals described in subsection (q)(4)(B).

"(vi) The number of eligible individuals whose mental health status, wellbeing, and suicide risk received a baseline measurement assessment under this section and the number of such eligible individuals whose mental health status, wellbeing, and suicide risk will be measured by the Department or a community partner over a period of time for any improvements.

"(vii) The types of data the Department was able to collect and share with partners, including a characterization of the benefits of that data.

"(viii) The number and percentage of eligible individuals referred to the point of contact at the Department under subsection (e)(3)(C).

"(ix) The number of eligible individuals newly enrolled in the patient enrollment system of the Department under section 1705(a) of title 38, United States Code[,] based on a referral to the Department from a grant recipient under subsection (e)(3)(C), disaggregated by grant recipient.

"(x) A detailed account of how the grant funds were used, including executive compensation, overhead costs, and other indirect costs.

"(xi) A description of any outreach activities conducted by the eligible entity in receipt of a grant with respect to services provided using the grant.

"(xii) The number of individuals who seek services from the grant recipient who are not eligible individuals.

"(C) Submittal of information by grant recipients.—The Secretary may require eligible entities receiving grants under this section to provide to Congress such information as the Secretary determines necessary regarding the elements described in subparagraph (B).

"(2) Final report.—Not later than three years after the date on which the first grant is awarded under this section, and annually thereafter for each year in which the program is in effect, the Secretary shall submit to the appropriate committees of Congress—

"(A) a follow-up on the interim report submitted under paragraph (1) containing the elements set forth in subparagraph (B) of such paragraph; and

"(B) a report on—

"(i) the effectiveness of the provision of grants under this section, including the effectiveness of community partners in conducting outreach to eligible individuals and their families and reducing the rate of suicide among eligible individuals;

"(ii) an assessment of the increased capacity of the Department to provide services to eligible individuals and their families, set forth by State, as a result of the provision of grants under this section;

"(iii) the feasibility and advisability of extending or expanding the provision of grants consistent with this section; and

"(iv) such other elements as considered appropriate by the Secretary.

"(l) Third-party Assessment.—

"(1) Study of grant program.—

"(A) In general.—Not later than 180 days after the commencement of the grant program under this section, the Secretary shall seek to enter into a contract with an appropriate entity described in paragraph (3) to conduct a study of the grant program.

"(B) Elements of study.—In conducting the study under subparagraph (A), the appropriate entity shall—

"(i) evaluate the effectiveness of the grant program under this section in—

     "(I) addressing the factors that contribute to suicides;

     "(II) increasing the use of suicide prevention services;

     "(III) reducing mood-related symptoms that increase suicide and suicide risk; and

     "(IV) where such information is available due to the time frame of the grant program, reducing suicidal ideation, suicide attempts, self-harm, and deaths by suicide; and

     "(V) reducing suicidal ideation, suicide attempts, self-harm, and deaths by suicide among eligible individuals through eligible entities located in communities; and

"(ii) compare the results of the grant program with other national programs in delivering resources to eligible individuals in the communities where they live that address the factors that contribute to suicide.

"(2) Assessment.—

"(A) In general.—The contract under paragraph (1) shall provide that not later than 24 months after the commencement of the grant program under this section, the appropriate entity shall submit to the Secretary an assessment based on the study conducted pursuant to such contract.

"(B) Submittal to congress.—Upon receipt of the assessment under subparagraph (A), the Secretary shall transmit to the appropriate committees of Congress a copy of the assessment.

"(3) Appropriate entity.—An appropriate entity described in this paragraph is a nongovernment entity with experience optimizing and assessing organizations that deliver services and assessing the effectiveness of suicide prevention programs.

"(m) Referral for Care.—

"(1) Mental health assessment.—If an eligible entity in receipt of a grant under this section determines that an eligible individual is at-risk of suicide or other mental or behavioral health condition pursuant to a baseline mental health screening conducted under subsection (q)(11)(A)(ii) with respect to the individual, the entity shall refer the eligible individual to the Department for additional care under subsection (n) or any other provision of law.

"(2) Emergency treatment.—If an eligible entity in receipt of a grant under this section determines that an eligible individual furnished clinical services for emergency treatment under subsection (q)(11)(A)(iv) requires ongoing services, the entity shall refer the eligible individual to the Department for additional care under subsection (n) or any other provision of law.

"(3) Refusal.—If an eligible individual refuses a referral by an entity under paragraph (1) or (2), any ongoing clinical services provided to the eligible individual by the entity shall be at the expense of the entity.

"(n) Provision of Care to Eligible Individuals.—When the Secretary determines it is clinically appropriate, the Secretary shall furnish to eligible individuals who are receiving or have received suicide prevention services through grants provided under this section an initial mental health assessment and mental health or behavioral health care services authorized under chapter 17 of title 38, United States Code, that are required to treat the mental or behavioral health care needs of the eligible individual, including risk of suicide.

"(o) Agreements With Community Partners.—

"(1) In general.—Subject to paragraph (2), an eligible entity may use grant funds to enter into an agreement with a community partner under which the eligible entity may provide funds to the community partner for the provision of suicide prevention services to eligible individuals and their families.

"(2) Limitation.—The ability of a recipient of a grant under this section to provide grant funds to a community partner shall be limited to grant recipients that are a State or local government or an Indian tribe.

"(p) Authorization of Appropriations.—There is authorized to be appropriated to the Secretary to carry out this section a total of $174,000,000 for fiscal years 2021 through 2025.

"(q) Definitions.—In this section:

"(1) Appropriate committees of congress.—The term 'appropriate committees of Congress' means—

"(A) the Committee on Veterans' Affairs and the Subcommittee on Military Construction, Veterans Affairs, and Related Agencies of the Committee on Appropriations of the Senate; and

"(B) the Committee on Veterans' Affairs and the Subcommittee on Military Construction, Veterans Affairs, and Related Agencies of the Committee on Appropriations of the House of Representatives.

"(2) Department.—The term 'Department' means the Department of Veterans Affairs.

"(3) Eligible entity.—The term 'eligible entity' means—

"(A) an incorporated private institution or foundation—

"(i) no part of the net earnings of which incurs to the benefit of any member, founder, contributor, or individual; and

"(ii) that has a governing board that would be responsible for the operation of the suicide prevention services provided under this section;

"(B) a corporation wholly owned and controlled by an organization meeting the requirements of clauses (i) and (ii) of subparagraph (A);

"(C) an Indian tribe;

"(D) a community-based organization that can effectively network with local civic organizations, regional health systems, and other settings where eligible individuals and their families are likely to have contact; or

"(E) A State or local government.

"(4) Eligible individual.—The term 'eligible individual' includes a person at risk of suicide who is—

"(A) a veteran as defined in section 101 of title 38, United States Code;

"(B) an individual described in section 1720I(b) of such title; or

"(C) an individual described in any of clauses (i) through (iv) of section 1712A(a)(1)(C) of such title.

"(5) Emergency treatment.—Medical services, professional services, ambulance services, ancillary care and medication (including a short course of medication related to and necessary for the treatment of the emergency condition that is provided directly to or prescribed for the patient for use after the emergency condition is stabilized and the patient is discharged) was rendered in a medical emergency of such nature that a prudent layperson would have reasonably expected that delay in seeking immediate medical attention would have been hazardous to life or health. This standard is met by an emergency medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) that a prudent layperson who possesses an average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result in placing the health of the individual in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.

"(6) Family.—The term 'family' means, with respect to an eligible individual, any of the following:

"(A) A parent.

"(B) A spouse.

"(C) A child.

"(D) A sibling.

"(E) A step-family member.

"(F) An extended family member.

"(G) Any other individual who lives with the eligible individual.

"(7) Indian tribe.—The term 'Indian tribe' has the meaning given that term in section 4 of the Native American Housing Assistance and Self-Determination Act of 1996 (25 U.S.C. 4103).

"(8) Risk of suicide.—

"(A) In general.—The term 'risk of suicide' means exposure to, or the existence of, any of the following (to a degree determined by the Secretary pursuant to regulations):

"(i) Health risk factors, including the following:

     "(I) Mental health challenges.

     "(II) Substance abuse.

     "(III) Serious or chronic health conditions or pain.

     "(IV) Traumatic brain injury.

"(ii) Environmental risk factors, including the following:

     "(I) Prolonged stress.

     "(II) Stressful life events.

     "(III) Unemployment.

     "(IV) Homelessness.

     "(V) Recent loss.

     "(VI) Legal or financial challenges.

"(iii) Historical risk factors, including the following:

     "(I) Previous suicide attempts.

     "(II) Family history of suicide.

     "(III) History of abuse, neglect, or trauma.

"(B) Degree of risk.—The Secretary may, by regulation, establish a process for determining degrees of risk of suicide for use by grant recipients to focus the delivery of services using grant funds.

"(9) Rural.—The term 'rural', with respect to a community, has the meaning given that term in the Rural-Urban Commuting Areas coding system of the Department of Agriculture.

"(10) Secretary.—The term 'Secretary' means the Secretary of Veterans Affairs.

"(11) Suicide prevention services.—

"(A) In general.—The term 'suicide prevention services' means services to address the needs of eligible individuals and their families and includes the following:

"(i) Outreach to identify those at risk of suicide with an emphasis on eligible individuals who are at highest risk or who are not receiving health care or other services furnished by the Department.

"(ii) A baseline mental health screening for risk.

"(iii) Education on suicide risk and prevention to families and communities.

"(iv) Provision of clinical services for emergency treatment.

"(v) Case management services.

"(vi) Peer support services.

"(vii) Assistance in obtaining any benefits from the Department that the eligible individual and their family may be eligible to receive, including—

     "(I) vocational and rehabilitation counseling;

     "(II) supportive services for homeless veterans;

     "(III) employment and training services;

     "(IV) educational assistance; and

     "(V) health care services.

"(viii) Assistance in obtaining and coordinating the provision of other benefits provided by the Federal Government, a State or local government, or an eligible entity.

"(ix) Assistance with emergent needs relating to—

     "(I) health care services;

     "(II) daily living services;

     "(III) personal financial planning and counseling;

     "(IV) transportation services;

     "(V) temporary income support services;

     "(VI) fiduciary and representative payee services;

     "(VII) legal services to assist the eligible individual with issues that may contribute to the risk of suicide; and

     "(VIII) child care (not to exceed $5,000 per family of an eligible individual per fiscal year).

"(x) Nontraditional and innovative approaches and treatment practices, as determined appropriate by the Secretary, in consultation with appropriate entities.

"(xi) Such other services necessary for improving the mental health status and wellbeing and reducing the suicide risk of eligible individuals and their families as the Secretary considers appropriate, which may include—

     "(I) adaptive sports, equine assisted therapy, or in-place or outdoor recreational therapy;

     "(II) substance use reduction programming;

     "(III) individual, group, or family counseling; and

     "(IV) relationship coaching.

"(B) Exclusion.—The term 'suicide prevention services' does not include direct cash assistance to eligible individuals or their families.

"(12) Veterans crisis line.—The term 'Veterans Crisis Line' means the toll-free hotline for veterans established under section 1720F(h) of title 38, United States Code.

"(13) Veterans service organization.—The term 'veterans service organization' means any organization recognized by the Secretary for the representation of veterans under section 5902 of title 38, United States Code."

Update of Clinical Practice Guidelines for Assessment and Management of Patients at Risk for Suicide

Pub. L. 116–171, title III, §303, Oct. 17, 2020, 134 Stat. 801, provided that:

"(a) In General.—In the first publication of the Department of Veterans Affairs and Department of Defense Clinical Practice Guideline for Assessment and Management of Patients at Risk for Suicide published after the date of the enactment of this Act [Oct. 17, 2020], the Secretary of Veterans Affairs and the Secretary of Defense, through the Assessment and Management of Patients at Risk for Suicide Work Group (in this section referred to as the 'Work Group'), shall ensure the publication includes the following:

"(1) Enhanced guidance with respect to gender-specific—

"(A) risk factors for suicide and suicidal ideation;

"(B) treatment efficacy for depression and suicide prevention;

"(C) pharmacotherapy efficacy; and

"(D) psychotherapy efficacy.

"(2) Guidance with respect to the efficacy of alternative therapies, other than psychotherapy and pharmacotherapy, including the following:

"(A) Yoga therapy.

"(B) Meditation therapy.

"(C) Equine therapy.

"(D) Other animal therapy.

"(E) Training and caring for service dogs.

"(F) Agritherapy.

"(G) Art therapy.

"(H) Outdoor sports therapy.

"(I) Music therapy.

"(J) Any other alternative therapy that the Work Group considers appropriate.

"(3) Guidance with respect to the findings of the Creating Options for Veterans' Expedited Recovery Commission (commonly referred to as the 'COVER Commission') established under section 931 of the Jason Simcakoski Memorial and Promise Act (title IX of Public Law 114–198; 38 U.S.C. 1701 note).

"(b) Rule of Construction.—Nothing in this section shall be construed to prevent the Secretary of Veterans Affairs and the Secretary of Defense from considering all relevant evidence, as appropriate, in updating the Department of Veterans Affairs and Department of Defense Clinical Practice Guideline for Assessment and Management of Patients at Risk for Suicide, as required under subsection (a), or from ensuring that the final clinical practice guidelines updated under such subsection remain applicable to the patient populations of the Department of Veterans Affairs and the Department of Defense."

Contracts Related to Suicide Prevention and Mental Health Outreach Media

Pub. L. 116–171, title IV, §401(e)–(g), Oct. 17, 2020, 134 Stat. 807, 808, provided that:

"(e) Treatment of Contracts for Suicide Prevention and Mental Health Outreach Media.—

"(1) Focus groups.—

"(A) In general.—The Secretary shall include in each contract to develop media relating to suicide prevention and mental health materials and campaigns a requirement that the contractor convene focus groups of veterans to assess the effectiveness of suicide prevention and mental health outreach.

"(B) Representation.—Each focus group required under subparagraph (A) shall, to the extent practicable, include veterans of diverse backgrounds, including—

"(i) veterans of all eras, as determined by the Secretary;

"(ii) women veterans;

"(iii) minority veterans;

"(iv) Native American veterans, as defined in section 3765 of title 38, United States Code;

"(v) veterans who identify as lesbian, gay, bisexual, transgender, or queer (commonly referred to as 'LGBTQ');

"(vi) veterans who live in rural or highly rural areas;

"(vii) individuals transitioning from active duty in the Armed Forces to civilian life; and

"(viii) other high-risk groups of veterans, as determined by the Secretary.

"(2) Subcontracting.—

"(A) In general.—The Secretary shall include in each contract described in paragraph (1)(A) a requirement that, if the contractor subcontracts for the development of media, the contractor shall subcontract with a subcontractor that has experience creating impactful media campaigns that target individuals age 18 to 34.

"(B) Budget limitation.—Not more than two percent of the budget of the Office of Mental Health and Suicide Prevention of the Department for contractors for suicide prevention and mental health media outreach shall go to subcontractors described in subparagraph (A).

"(f) Paperwork Reduction Act Exemption.—Chapter 35 of title 44, United States Code (commonly known as the 'Paperwork Reduction Act') shall not apply to any rulemaking or information collection required under this section [enacting this note and provisions not set out in the Code].

"(g) Rural and Highly Rural Defined.—In this section, with respect to an area, the terms 'rural' and 'highly rural' have the meanings given those terms in the Rural-Urban Commuting Areas coding system of the Department of Agriculture."

Oversight of Mental Health and Suicide Prevention Media Outreach Conducted by Department of Veterans Affairs

Pub. L. 116–171, title IV, §402, Oct. 17, 2020, 134 Stat. 808, provided that:

"(a) Establishment of Goals.—

"(1) In general.—The Secretary of Veterans Affairs shall establish goals for the mental health and suicide prevention media outreach campaigns of the Department of Veterans Affairs, which shall include the establishment of targets, metrics, and action plans to describe and assess those campaigns.

"(2) Use of metrics.—

"(A) In general.—The goals established under paragraph (1) shall be measured by metrics specific to different media types.

"(B) Factors to consider.—In using metrics under subparagraph (A), the Secretary shall determine the best methodological approach for each media type and shall consider the following:

"(i) Metrics relating to social media, which may include the following:

     "(I) Impressions.

     "(II) Reach.

     "(III) Engagement rate.

     "(IV) Such other metrics as the Secretary considers necessary.

"(ii) Metrics relating to television, which may include the following:

     "(I) Nielsen ratings.

     "(II) Such other metrics as the Secretary considers necessary.

"(iii) Metrics relating to email, which may include the following:

     "(I) Open rate.

     "(II) Response rate.

     "(III) Click rate.

     "(IV) Such other metrics as the Secretary considers necessary.

"(C) Update.—The Secretary shall periodically update the metrics under subparagraph (B) as more accurate metrics become available.

"(3) Targets.—The Secretary shall establish targets to track the metrics used under paragraph (2).

"(4) Consultation.—In establishing goals under paragraph (1), the Secretary shall consult with the following:

"(A) Relevant stakeholders, such as organizations that represent veterans, as determined by the Secretary.

"(B) Mental health and suicide prevention experts.

"(C) Such other persons as the Secretary considers appropriate.

"(5) Initial report.—Not later than 180 days after the date of the enactment of this Act [Oct. 17, 2020], 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 detailing the goals established under paragraph (1) for the mental health and suicide prevention media outreach campaigns of the Department, including the metrics and targets for such metrics by which those goals are to be measured under paragraphs (2) and (3).

"(6) Annual report.—Not later than one year after the submittal of the report under paragraph (5), 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 report detailing—

"(A) the progress of the Department in meeting the goals established under paragraph (1) and the targets established under paragraph (3); and

"(B) a description of action to be taken by the Department to modify mental health and suicide prevention media outreach campaigns if those goals and targets are not being met.

"(b) Report on Use of Funds by Office of Mental Health and Suicide Prevention.—Not later than 180 days after the date of the enactment of this Act [Oct. 17, 2020], and semiannually thereafter, the Secretary shall submit to the Committee on Appropriations and the Committee on Veterans' Affairs of the Senate and the Committee on Appropriations and the Committee on Veterans' Affairs of the House of Representatives a report containing the expenditures and obligations of the Office of Mental Health and Suicide Prevention of the Veterans Health Administration during the period covered by the report."

Staffing Requirement for Suicide Prevention Coordinators

Pub. L. 116–171, title V, §506(a), Oct. 17, 2020, 134 Stat. 820, provided that: "Beginning not later than one year after the date of the enactment of this Act [Oct. 17, 2020], the Secretary of Veterans Affairs shall ensure that each medical center of the Department of Veterans Affairs has not less than one suicide prevention coordinator."

Funding for Peer Support Counseling for Women Veterans

Pub. L. 115–271, title VIII, §8051(b), Oct. 24, 2018, 132 Stat. 4093, provided that: "The Secretary of Veterans Affairs shall carry out paragraph (4) of section 1720F(j) of title 38, United States Code, as added by subsection (a), using funds otherwise made available to the Secretary. No additional funds are authorized to be appropriated by reason of such paragraph."

Collaboration on Suicide Prevention Efforts Between Department of Veterans Affairs and Non-Profit Mental Health Organizations

Pub. L. 114–2, §6, Feb. 12, 2015, 129 Stat. 36, provided that:

"(a) Collaboration.—The Secretary of Veterans Affairs may collaborate with non-profit mental health organizations to prevent suicide among veterans as follows:

"(1) To improve the efficiency and effectiveness of suicide prevention efforts carried out by the Secretary and non-profit mental health organizations.

"(2) To assist non-profit mental health organizations with the suicide prevention efforts of such organizations through the use of the expertise of employees of the Department of Veterans Affairs.

"(3) To jointly carry out suicide prevention efforts.

"(b) Exchange of Resources.—In carrying out any collaboration under subsection (a), the Secretary and any non-profit mental health organization with which the Secretary is collaborating under such subsection shall exchange training sessions and best practices to help with the suicide prevention efforts of the Department and such organization.

"(c) Director of Suicide Prevention Coordination.—The Secretary shall select within the Department a Director of Suicide Prevention Coordination to undertake any collaboration with non-profit mental health organizations under this section or any other provision of law."

Deadline for Commencement of Program

Pub. L. 112–239, div. A, title VII, §730(a)(4), Jan. 2, 2013, 126 Stat. 1814, provided that: "The Secretary of Veterans Affairs shall ensure that the peer support counseling program required by section 1720F(j) of title 38, United States Code, as amended by this subsection, commences at each Department of Veterans Affairs medical center not later than 270 days after the date of the enactment of this Act [Jan. 2, 2013]."

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) for assistance provided under this subsection—

(i) before the date on which the Secretary submits to Congress a certification that the Department has fully implemented the information technology system required by section 162(a) of the Caring for Our Veterans Act of 2018, 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, air, or space service on or after September 11, 2001;

(ii) during the 2-year period beginning on the date on which the Secretary submitted to Congress the certification described in clause (i), 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, air, or space service—

(I) on or before May 7, 1975; or

(II) on or after September 11, 2001; or

(iii) after the date that is 2 years after the date on which the Secretary submits to Congress the certification described in clause (i), 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, air, or space service; 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;

(iii) a need for regular or extensive instruction or supervision without which the ability of the veteran to function in daily life would be seriously impaired; or

(iv) 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;

(V) a monthly personal caregiver stipend; and

(VI) through the use of contracts with, or the provision of grants to, public or private entities—

(aa) financial planning services relating to the needs of injured veterans and their caregivers; and

(bb) legal services, including legal advice and consultation, relating to the needs of injured veterans and their caregivers.

(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) In determining the amount and degree of personal care services provided under clause (i) with respect to an eligible veteran whose need for personal care services is based in whole or in part on a need for supervision or protection under paragraph (2)(C)(ii) or regular instruction or supervision under paragraph (2)(C)(iii), the Secretary shall take into account the following:

(I) The assessment by the family caregiver of the needs and limitations of the veteran.

(II) The extent to which the veteran can function safely and independently in the absence of such supervision, protection, or instruction.

(III) The amount of time required for the family caregiver to provide such supervision, protection, or instruction to the veteran.

(iv) 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.

(D) In providing instruction, preparation, and training under subparagraph (A)(i)(I) and technical support under subparagraph (A)(i)(II) to each family caregiver who is approved as a provider of personal care services for an eligible veteran under paragraph (6), the Secretary shall periodically evaluate the needs of the eligible veteran and the skills of the family caregiver of such veteran to determine if additional instruction, preparation, training, or technical support under those subparagraphs is necessary.

(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 (in collaboration with the primary care team for the eligible veteran to the maximum extent practicable)—

(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) have 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.

(11)(A) In providing assistance under this subsection to family caregivers of eligible veterans, the Secretary may enter into contracts, provider agreements, and memoranda of understanding with Federal agencies, States, and private, nonprofit, and other entities to provide such assistance to such family caregivers.

(B) The Secretary may provide assistance under this paragraph only if such assistance is reasonably accessible to the family caregiver and is substantially equivalent or better in quality to similar services provided by the Department.

(C) The Secretary may provide fair compensation to Federal agencies, States, and other entities that provide assistance under this paragraph.

(12)(A) The Secretary shall notify the individuals described in subparagraph (C) regarding decisions affecting the furnishing of assistance under this subsection using standardized letters, as the Secretary determines such notifications and letters to be appropriate.

(B) A notification provided under subparagraph (A) shall include the elements required for notices of decisions under section 5104(b) of this title to the extent that those elements apply to such notification, unless, not later than 60 days after the date of the enactment of the Transparency and Effective Accountability Measures for Veteran Caregivers Act, the Secretary determines that it would not be feasible to include such elements in such notifications and submits to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives a report setting forth the reasons for such determination.

(C) The individuals described in this subparagraph shall include—

(i) an individual who submits an application for the program established under paragraph (1);

(ii) an individual determined by the Secretary to be an eligible veteran pursuant to such an application; and

(iii) a family caregiver of an eligible veteran who is—

(I) approved as a provider of personal care services under paragraph (6)(B); or

(II) designated as a primary provider of personal care services under paragraph (7)(A).

(13)(A) If the Secretary determines that a veteran receiving services under the program established under paragraph (1) is no longer eligible for such program solely because of improvement in the condition of the veteran—

(i) the effective date of discharge of the veteran from the program shall be not earlier than the date that is 60 days after the date on which the Secretary provides notice of such lack of eligibility under paragraph (12)(A) to the relevant individuals described in paragraph (12)(C); and

(ii) the Secretary shall extend benefits under the program established under paragraph (1) for a family caregiver of the veteran described in paragraph (12)(C)(iii), including stipends under paragraph (3)(A)(ii)(V), if such an extension is determined appropriate by the Secretary, for a 90-day period following discharge of the veteran from the program.

(B) This paragraph shall not be construed to limit the authority of the Secretary—

(i) to prescribe regulations addressing other bases for—

(I) the discharge of a veteran from the program established under paragraph (1); or

(II) the revocation of the designation of a family caregiver of a veteran as a primary provider of personal care services under paragraph (7)(A); or

(ii) to provide advance notice and extended benefits under the program, as appropriate, if another basis for discharge of a veteran described in subclause (I) of clause (i) or revocation of a designation described in subclause (II) of such clause applies.

(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 activities of daily living.

(B) Supervision or protection based on symptoms or residuals of neurological or other impairment or injury.

(C) Regular or extensive instruction or supervision without which the ability of the veteran to function in daily life would be seriously impaired.

(D) Any other non-institutional extended care (as such term is used in section 1701(6)(E) of this title).

(Added Pub. L. 111–163, title I, §101(a)(1), May 5, 2010, 124 Stat. 1132; amended Pub. L. 114–58, title I, §103, title VI, §601(6), Sept. 30, 2015, 129 Stat. 532, 538; Pub. L. 114–228, title I, §103, Sept. 29, 2016, 130 Stat. 937; Pub. L. 115–62, title I, §103, Sept. 29, 2017, 131 Stat. 1161; Pub. L. 115–182, title I, §161(a)(1)(A), (2)–(b), June 6, 2018, 132 Stat. 1438–1440; Pub. L. 115–251, title I, §103, Sept. 29, 2018, 132 Stat. 3168; Pub. L. 116–278, §2(b), Dec. 31, 2020, 134 Stat. 3374; Pub. L. 116–283, div. A, title IX, §926(a)(28), Jan. 1, 2021, 134 Stat. 3830.)

Editorial Notes

References in Text

Section 162(a) of the Caring for Our Veterans Act of 2018, referred to in subsec. (a)(2)(B)(i), is section 162(a) of Pub. L. 115–182, June 6, 2018, 132 Stat. 1440, which is set out as a note under this section.

The date of the enactment of the Transparency and Effective Accountability Measures for Veteran Caregivers Act, referred to in subsec. (a)(12)(B), is the date of enactment of Pub. L. 116–278, which was approved Dec. 31, 2020.

Amendments

2021—Subsec. (a)(2)(B). Pub. L. 116–283 substituted "air, or space service" for "or air service" wherever appearing.

2020—Subsec. (a)(12), (13). Pub. L. 116–278 added pars. (12) and (13).

2018—Subsec. (a)(2)(B). Pub. L. 115–182, §161(a)(1)(A), amended subpar. (B) generally. Prior to amendment, text read as follows: "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".

Subsec. (a)(2)(C)(iii), (iv). Pub. L. 115–182, §161(a)(2), added cl. (iii) and redesignated former cl. (iii) as (iv).

Subsec. (a)(3)(A)(ii)(VI). Pub. L. 115–182, §161(a)(3), added subcl. (VI).

Subsec. (a)(3)(C)(iii), (iv). Pub. L. 115–182, §161(a)(4), added cl. (iii) and redesignated former cl. (iii) as (iv).

Subsec. (a)(3)(D). Pub. L. 115–182, §161(a)(5), added subpar. (D).

Subsec. (a)(5). Pub. L. 115–182, §161(a)(6), inserted "(in collaboration with the primary care team for the eligible veteran to the maximum extent practicable)" after "evaluate" in introductory provisions.

Subsec. (a)(11). Pub. L. 115–182, §161(a)(7), added par. (11).

Subsec. (d)(4)(A). Pub. L. 115–182, §161(b)(1), struck out "independent" before "activities of daily living".

Subsec. (d)(4)(B) to (D). Pub. L. 115–182, §161(b)(2), (3), added subpars. (B) and (C) and redesignated former subpar. (B) as (D).

Subsec. (e). Pub. L. 115–251 struck out subsec. (e) which authorized appropriations from fiscal years 2010 to 2019.

2017—Subsec. (e)(5). Pub. L. 115–62 added par. (5).

2016—Subsec. (e)(4). Pub. L. 114–228 added par. (4).

2015—Subsec. (a)(7)(B)(iii). Pub. L. 114–58, §601(6), substituted "have" for "has".

Subsec. (e)(3). Pub. L. 114–58, §103, added par. (3).

Statutory Notes and Related Subsidiaries

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."

Modification of Administration of Caregiver Programs of Department of Veterans Affairs

Pub. L. 116–278, §2(a), Dec. 31, 2020, 134 Stat. 3373, provided that:

"(a) Formal Recognition of Caregivers.—

"(1) Report.—

"(A) In general.—Not later than 60 days after the date of the enactment of this Act [Dec. 31, 2020], 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 regarding the feasibility and advisability of formally recognizing all caregivers of veterans by identifying any caregiver of a veteran in the electronic health record of the veteran.

"(B) Caregivers recognized.—The recognition of caregivers described in subparagraph (A) shall include recognition of—

"(i) any family caregiver who is approved as a provider of personal care services for an eligible veteran under the program of comprehensive assistance for family caregivers under subsection (a) of section 1720G of title 38, United States Code; and

"(ii) any caregiver of a covered veteran participating in the program of general caregiver support services under subsection (b) of such section.

"(C) Timeline.—If the Secretary determines that formally recognizing all caregivers of veterans as described in subparagraph (A) is feasible and advisable, the report required by such subparagraph shall include a timeline for implementing such recognition.

"(2) Implementation.—If the Secretary determines that formally recognizing all caregivers of veterans as described in paragraph (1)(A) is feasible and advisable, the Secretary shall implement such recognition in accordance with the timeline included in the report required by such paragraph."

Education Program for Family Members and Caregivers of Veterans With Mental Health Disorders

Pub. L. 116–214, title II, §202, Dec. 5, 2020, 134 Stat. 1033, provided that:

"(a) Establishment.—Not later than 270 days after the date of the enactment of this Act [Dec. 5, 2020], the Secretary of Veterans Affairs shall establish an education program (in this section referred to as the 'education program') for the education and training of caregivers and family members of eligible veterans with mental health disorders.

"(b) Education Program.—

"(1) In general.—Under the education program, the Secretary shall provide a course of education to caregivers and family members of eligible veterans on matters relating to coping with mental health disorders in veterans.

"(2) Duration.—The Secretary shall carry out the education program during the four-year period beginning on the date of the commencement of the education program.

"(3) Scope.—

"(A) Caregivers.—The Secretary, with respect to the component of the education program that relates to the education and training of caregivers, shall—

"(i) include such component in the training provided pursuant to the program of comprehensive assistance for family caregivers of the Department of Veterans Affairs established under section 1720G(a) of title 38, United States Code; and

"(ii) make such component available on the Internet website of the Department that relates to caregiver training.

"(B) Family members.—The Secretary shall carry out the component of the education program that relates to the education and training of non-caregiver family members at facilities of the Department as follows:

"(i) Not less than five medical centers of the Department.

"(ii) Not less than five clinics of the Department.

"(iii) Not less than five Vet Centers (as defined in section 1712A(h) of title 38, United States Code).

"(C) Solicitation of applications.—In selecting locations pursuant to subparagraph (B), the Secretary shall solicit applications from eligible facilities of the Department that are interested in carrying out the education program.

"(D) Considerations.—In selecting locations pursuant to subparagraph (B), the Secretary shall consider the feasibility and advisability of selecting locations in the following areas:

"(i) Rural areas.

"(ii) Areas that are not in close proximity to an active duty installation.

"(iii) Areas in different geographic locations.

"(4) Contracts.—

"(A) In general.—In carrying out the education program, the Secretary shall enter into contracts with qualified entities described in subparagraph (B) to offer the course of education described in paragraph (5) to family members and caregivers of eligible veterans and covered veterans.

"(B) Qualified entity described.—A qualified entity described in this subparagraph is a non-profit entity with experience in mental health education and outreach, including work with children, teens, and young adults, that—

"(i) uses high quality, relevant, and age-appropriate information in educational programming, materials, and coursework, including such programming, materials, and coursework for children, teens, and young adults; and

"(ii) works with agencies, departments, nonprofit mental health organizations, early childhood educators, and mental health providers to develop educational programming, materials, and coursework.

"(C) Priority.—In entering into contracts under this paragraph, the Secretary shall give priority to qualified entities that have demonstrated cultural competence in serving military and veteran populations, and, to the extent practicable, use internet technology for the delivery of course content in an effort to expand the availability of support services, especially in rural areas.

"(5) Course of education described.—The course of education described in this paragraph shall consist of curriculum that includes the following:

"(A) General education on different mental health disorders, including information to improve understanding of the experiences of individuals suffering from such disorders.

"(B) Techniques for handling crisis situations and administering mental health first aid to individuals suffering from a mental health disorder.

"(C) Techniques for coping with the stress of living with an individual suffering from a mental health disorder.

"(D) Information on additional services available for family members and caregivers through the Department or community organizations and providers related to mental health disorders.

"(E) Such other matters as the Secretary considers appropriate.

"(c) Surveys.—

"(1) In general.—The Secretary shall conduct a comprehensive survey of the satisfaction of individuals that have participated in the course of education described in subsection (b)(5). Such survey shall include a solicitation of feedback on the following:

"(A) The general satisfaction of those individuals with the education and assistance provided under the education program.

"(B) The perceived effectiveness of the education program in providing education and assistance that is useful for those individuals.

"(C) The applicability of the education program to the issues faced by those individuals.

"(D) Such other matters as the Secretary considers appropriate.

"(2) Compilation of information.—The information compiled as a result of the surveys conducted under paragraph (1) shall be—

"(A) disaggregated by facility type at which the education program was carried out; and

"(B) included in the annual reports under subsection (d)(1).

"(d) Reports.—

"(1) Annual reports.—

"(A) In general.—Not later than one year after the date of the commencement of the education program and not later than September 30 each year thereafter until 2024, 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—

"(i) the education program; and

"(ii) the feasibility and advisability of expanding the education program to include the establishment of a peer support program composed of individuals who complete the education program (in this section referred to as a 'peer support program').

"(B) Elements.—Each report submitted under subparagraph (A) shall include the following:

"(i) The number of individuals that participated in the course of education described in subsection (b)(5) during the year preceding the submission of the report.

"(ii) A detailed analysis of the surveys conducted under subsection (c) with respect to the individuals described in clause (i).

"(iii) Any plans for expansion of the education program.

"(iv) An analysis of the feasibility and advisability of establishing a peer support program.

"(v) The interim findings and conclusions of the Secretary with respect to the success of the education program and the feasibility and advisability of establishing a peer support program.

"(2) Final report.—

"(A) In general.—Not later than one year after the completion of the education program, the Secretary shall submit to the Committees on Veterans' Affairs of the House of Representatives and the Senate a final report on the feasibility and advisability of continuing the education program.

"(B) Elements.—The final report under subparagraph (A) shall include the following:

"(i) A detailed analysis of the surveys conducted under subsection (c).

"(ii) An analysis of the feasibility and advisability of continuing the education program without entering into contracts for the course of education described in subsection (b)(5).

"(iii) An analysis of the feasibility and advisability of expanding the education program.

"(iv) An analysis of the feasibility and advisability of establishing a peer support program.

"(e) Monitoring of Program.—The Secretary shall select mental health care providers of the Department to monitor the progress of the instruction provided under the education program.

"(f) Definitions.—In this section:

"(1) The term 'eligible veteran' means a veteran who is enrolled in the health care system established under section 1705(a) of title 38, United States Code.

"(2) The terms 'caregiver' and 'family member' have the meaning given those terms in section 1720G(d) of title 38, United States Code."

Publication in Federal Register

Pub. L. 115–182, title I, §161(a)(1)(B), June 6, 2018, 132 Stat. 1439, as amended by Pub. L. 115–251, title II, §211(b)(5), Sept. 29, 2018, 132 Stat. 3176, provided that: "Not later than 30 days after the date on which the Secretary of Veterans Affairs submits to Congress the certification described in subsection (a)(2)(B)(i) of section 1720G of title 38, United States Code, as amended by subparagraph (A) of this paragraph, the Secretary shall publish the date specified in such subsection in the Federal Register."

Implementation of Information Technology System of Department of Veterans Affairs To Assess and Improve the Family Caregiver Program

Pub. L. 115–182, title I, §162, June 6, 2018, 132 Stat. 1440, provided that:

"(a) Implementation of New System.—

"(1) In general.—Not later than October 1, 2018, the Secretary of Veterans Affairs shall implement an information technology system that fully supports the Program and allows for data assessment and comprehensive monitoring of the Program.

"(2) Elements of system.—The information technology system required to be implemented under paragraph (1) shall include the following:

"(A) The ability to easily retrieve data that will allow all aspects of the Program (at the medical center and aggregate levels) and the workload trends for the Program to be assessed and comprehensively monitored.

"(B) The ability to manage data with respect to a number of caregivers that is more than the number of caregivers that the Secretary expects to apply for the Program.

"(C) The ability to integrate the system with other relevant information technology systems of the Veterans Health Administration.

"(b) Assessment of Program.—Not later than 180 days after implementing the system described in subsection (a), the Secretary shall, through the Under Secretary for Health, use data from the system and other relevant data to conduct an assessment of how key aspects of the Program are structured and carried out.

"(c) Ongoing Monitoring of and Modifications to Program.—

"(1) Monitoring.—The Secretary shall use the system implemented under subsection (a) to monitor and assess the workload of the Program, including monitoring and assessment of data on—

"(A) the status of applications, appeals, and home visits in connection with the Program; and

"(B) the use by caregivers participating in the Program of other support services under the Program such as respite care.

"(2) Modifications.—Based on the monitoring and assessment conducted under paragraph (1), the Secretary shall identify and implement such modifications to the Program as the Secretary considers necessary to ensure the Program is functioning as intended and providing veterans and caregivers participating in the Program with services in a timely manner.

"(d) Reports.—

"(1) Initial report.—

"(A) In general.—Not later than 90 days after the date of the enactment of this Act [June 6, 2018], the Secretary shall submit to the Committee on Veterans' Affairs of the Senate, the Committee on Veterans' Affairs of the House of Representatives, and the Comptroller General of the United States a report that includes—

"(i) the status of the planning, development, and deployment of the system required to be implemented under subsection (a), including any changes in the timeline for the implementation of the system; and

"(ii) an assessment of the needs of family caregivers of veterans described in subparagraph (B), the resources needed for the inclusion of such family caregivers in the Program, and such changes to the Program as the Secretary considers necessary to ensure the successful expansion of the Program to include such family caregivers.

"(B) Veterans described.—Veterans described in this subparagraph are veterans who are eligible for the Program under clause (ii) or (iii) of section 1720G(a)(2)(B) of title 38, United States Code, as amended by section 161(a)(1) of this title, solely due to 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 before September 11, 2001.

"(2) Notification by comptroller general.—The Comptroller General shall review the report submitted under paragraph (1) and notify the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives with respect to the progress of the Secretary in—

"(A) fully implementing the system required under subsection (a); and

"(B) implementing a process for using such system to monitor and assess the Program under subsection (c)(1) and modify the Program as considered necessary under subsection (c)(2).

"(3) Final report.—

"(A) In general.—Not later than October 1, 2019, the Secretary shall submit to the Committee on Veterans' Affairs of the Senate, the Committee on Veterans' Affairs of the House of Representatives, and the Comptroller General a report on the implementation of subsections (a) through (c).

"(B) Elements.—The report required by subparagraph (A) shall include the following:

"(i) A certification by the Secretary that the information technology system described in subsection (a) has been implemented.

"(ii) A description of how the Secretary has implemented such system.

"(iii) A description of the modifications to the Program, if any, that were identified and implemented under subsection (c)(2).

"(iv) A description of how the Secretary is using such system to monitor the workload of the Program.

"(e) Definitions.—In this section:

"(1) Active military, naval, or air service.—The term 'active military, naval, or air service' has the meaning given that term in section 101 of title 38, United States Code.

"(2) Program.—The term 'Program' means the program of comprehensive assistance for family caregivers under section 1720G(a) of title 38, United States Code, as amended by section 161 of this title."

Annual Evaluation Report

Pub. L. 111–163, title I, §101(c), May 5, 2010, 124 Stat. 1138, as amended by Pub. L. 115–182, title I, §163, June 6, 2018, 132 Stat. 1442, 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, including a description of any barriers to accessing and receiving care and services under 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;

"(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); and

"(iii) an evaluation of the sufficiency and consistency of the training provided to family caregivers under such program in preparing family caregivers to provide care to veterans under such program.

"(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."

§1720H. Mental health treatment for veterans and members of the reserve components of the Armed Forces who served in classified missions

(a) Establishment of Standards.—(1) The Secretary shall establish standards and procedures to ensure that each eligible individual may access mental health care furnished by the Secretary in a manner that fully accommodates the obligation of the individual to not improperly disclose classified information.

(2) In establishing standards and procedures under paragraph (1), the Secretary shall consult with the Secretary of Defense to ensure that such standards and procedures are consistent with the policies on classified information of the Department of Defense.

(3) The Secretary shall disseminate guidance to employees of the Veterans Health Administration, including mental health professionals, on the standards and procedures established under paragraph (1) and how to best engage eligible individuals during the course of mental health treatment with respect to classified information.

(b) Identification.—In carrying out this section, the Secretary shall ensure that an individual may elect to identify as an eligible individual on an appropriate form.

(c) Definitions.—In this section:

(1) The term "classified information" means any information or material that has been determined by an official of the United States pursuant to law to require protection against unauthorized disclosure for reasons of national security.

(2) The term "eligible individual" means a veteran or a member of the reserve components of the Armed Forces who—

(A) is eligible to receive health care furnished by the Department under this title;

(B) is seeking mental health treatment; and

(C) in the course of serving in the Armed Forces, participated in a sensitive mission or served in a sensitive unit.

(3) The term "sensitive mission" means a mission of the Armed Forces that, at the time at which an eligible individual seeks treatment, is classified.

(4) The term "sensitive unit" has the meaning given that term in section 130b(c)(4) of title 10.

(Added Pub. L. 114–315, title VI, §605(b), Dec. 16, 2016, 130 Stat. 1571; amended Pub. L. 116–283, div. A, title VII, §764(b)(1), (2)(A), Jan. 1, 2021, 134 Stat. 3727.)

Editorial Notes

Amendments

2021—Pub. L. 116–283, §764(b)(2)(A), inserted "and members of the reserve components of the Armed Forces" after "veterans" in section catchline.

Subsec. (a)(1). Pub. L. 116–283, §764(b)(1)(A)(i), substituted "eligible individual" for "eligible veteran" and "the individual" for "the veteran".

Subsec. (a)(3). Pub. L. 116–283, §764(b)(1)(A)(ii), substituted "eligible individuals" for "eligible veterans".

Subsec. (b). Pub. L. 116–283, §764(b)(1)(B), substituted "an individual" for "a veteran" and "eligible individual" for "eligible veteran".

Subsec. (c)(2). Pub. L. 116–283, §764(b)(1)(C)(i), substituted "The term 'eligible individual' means a veteran or a member of the reserve components of the Armed Forces" for "The term 'eligible veteran' means a veteran" in introductory provisions.

Subsec. (c)(3). Pub. L. 116–283, §764(b)(1)(C)(ii), substituted "eligible individual" for "eligible veteran".

§1720I. Mental and behavioral health care for certain former members of the Armed Forces

(a) In General.—The Secretary shall furnish to former members of the Armed Forces described in subsection (b)—

(1) an initial mental health assessment; and

(2) the mental healthcare or behavioral healthcare services authorized under this chapter that are required to treat the mental or behavioral health care needs of the former service members, including risk of suicide or harming others.

(b) Eligible Individuals.—A former member of the Armed Forces described in this subsection is an individual who—

(1) is a former member of the Armed Forces, including the reserve components;

(2) while serving in the active military, naval, air, or space service, was discharged or released therefrom under a condition that is not honorable but not—

(A) a dishonorable discharge; or

(B) a discharge by court-martial;

(3) is not enrolled in the health care system established by section 1705 of this title; and

(4)(A)(i) served in the Armed Forces for a period of more than 100 cumulative days; and

(ii) was deployed in a theater of combat operations, in support of a contingency operation, or in an area at a time during which hostilities are occurring in that area during such service, including by controlling an unmanned aerial vehicle from a location other than such theater or area; or

(B) while serving in the Armed Forces, was the victim of a physical assault of a sexual nature, a battery of a sexual nature, or sexual harassment (as defined in section 1720D(f) of this title).

(c) Non-Department Care.—(1) In furnishing mental or behavioral health care services to an individual under this section, the Secretary may provide such mental or behavioral health care services at a non-Department facility if—

(A) in the judgment of a mental health professional employed by the Department, the receipt of mental or behavioral health care services by that individual in facilities of the Department would be clinically inadvisable; or

(B) facilities of the Department are not capable of furnishing such mental or behavioral health care services to that individual economically because of geographical inaccessibility.

(2) The Secretary shall carry out paragraph (1) pursuant to section 1703 of this title or any other provision of law authorizing the Secretary to enter into contracts or agreements to furnish hospital care and medical services to veterans at non-Department facilities.

(d) Setting and Referrals.—In furnishing mental and behavioral health care services to individuals under this section, the Secretary shall—

(1) seek to ensure that such services are furnished in settings that are therapeutically appropriate, taking into account the circumstances that resulted in the need for such services; and

(2) provide referral services to assist former members who are not eligible for services under this chapter to obtain services from sources outside the Department.

(e) Information.—The Secretary shall provide information on the mental and behavioral health care services available under this section. Efforts by the Secretary to provide such information—

(1) shall include notification of each eligible individual described in subsection (b) about the eligibility of the individual for covered mental and behavioral health care under this section not later than the later of—

(A) 180 days after the date of the enactment of the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2018; or

(B) 180 days after the date on which the individual was discharged or released from the active military, naval, air, or space service;

(2) shall include availability of a toll-free telephone number (commonly referred to as an 800 number);

(3) shall ensure that information about the mental health care services available 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 to State veteran agencies and through appropriate public information services; and

(4) shall include coordination with the Secretary of Defense seeking to ensure that members of the Armed Forces and individuals who are being separated from active military, naval, air, or space service are provided appropriate information about programs, requirements, and procedures for applying for mental health care services under this section.

(f) Annual Reports.—(1) Not later than February 15 each year, 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 mental and behavioral health care services provided under this section.

(2) Each report submitted under paragraph (1) shall include, with respect to the year preceding the submittal of the report, the following:

(A) The number of eligible individuals who were furnished mental or behavioral health care services under this section, disaggregated by the number of men who received such services and the number of women who received such services.

(B) The number of individuals who requested an initial mental health assessment under subsection (a)(1).

(C) The types of mental or behavioral health care needs treated under this section.

(D) The demographics of individuals being treated under this section, including—

(i) age;

(ii) era of service in the Armed Forces;

(iii) branch of service in the Armed Forces; and

(iv) geographic location.

(E) The average number of visits for an individual for mental or behavioral health care under this section.

(F) Such other information as the Secretary considers appropriate.

(Added Pub. L. 115–141, div. J, title II, §258(a), Mar. 23, 2018, 132 Stat. 826, §1712I; renumbered §1720I, Pub. L. 115–182, title V, §511, June 6, 2018, 132 Stat. 1481; amended Pub. L. 115–251, title II, §205, Sept. 29, 2018, 132 Stat. 3173; Pub. L. 116–171, title I, §104, Oct. 17, 2020, 134 Stat. 782; Pub. L. 116–283, div. A, title IX, §926(a)(29), Jan. 1, 2021, 134 Stat. 3830.)

Editorial Notes

References in Text

The date of the enactment of the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2018, referred to in subsec. (e)(1)(A), is the date of enactment of div. J of Pub. L. 115–141, which was approved Mar. 23, 2018.

Amendments

2021—Subsec. (b)(2). Pub. L. 116–283 substituted "air, or space service" for "or air service" in introductory provisions.

Subsec. (e)(1)(B), (4). Pub. L. 116–283 substituted "air, or space service" for "or air service".

2020—Subsec. (f)(1). Pub. L. 116–171, §104(1), substituted "Not later than February 15" for "Not less frequently than once".

Subsec. (f)(2)(C) to (F). Pub. L. 116–171, §104(2), added subpars. (C) to (E) and redesignated former subpar. (C) as (F).

2018—Pub. L. 115–182 renumbered section 1712I of this title as this section.

Subsec. (b)(3). Pub. L. 115–251 substituted "is not enrolled" for "is not otherwise eligible to enroll".

§1720J. Emergent suicide care

(a) Emergent Suicide Care.—Pursuant to this section, the Secretary shall—

(1) furnish emergent suicide care to an eligible individual at a medical facility of the Department;

(2) pay for emergent suicide care provided to an eligible individual at a non-Department facility; and

(3) reimburse an eligible individual for emergent suicide care provided to the eligible individual at a non-Department facility.

(b) Eligibility.—An individual is eligible for emergent suicide care under subsection (a) if the individual is in an acute suicidal crisis and is either of the following:

(1) A veteran (as defined in section 101).

(2) An individual described in section 1720I(b) of this title.

(c) Period of Care.—(1) Emergent suicide care provided under subsection (a) shall be furnished to an eligible individual—

(A) through inpatient or crisis residential care, for a period not to exceed 30 days; or

(B) if care under subparagraph (A) is unavailable, or if such care is not clinically appropriate, as outpatient care for a period not to exceed 90 days.

(2) If, upon the expiration of a period under paragraph (1), the Secretary determines that the eligible individual remains in an acute suicidal crisis, the Secretary may extend such period as the Secretary determines appropriate.

(d) Notification.—An eligible individual who receives emergent suicide care under subsection (a) at a non-Department facility (or a person acting on behalf of the individual) shall notify the Secretary of such care within seven days of admission to such facility.

(e) Outreach.—During any period when an eligible individual is receiving emergent suicide care under subsection (a), the Secretary shall—

(1) ensure that—

(A) in the case of an eligible individual whom the Veterans Crisis Line recommends to seek emergent suicide care at a medical facility of the Department, the Veterans Crisis Line notifies the Suicide Prevention Coordinator of such medical facility;

(B) in the case of an eligible individual who presents at a medical facility of the Department in an acute suicidal crisis without a recommendation by the Veterans Crisis Line, the Secretary notifies the Suicide Prevention Coordinator;

(C) in the case of an eligible individual whom the Veterans Crisis Line recommends to seek treatment at a non-Department facility, the Veterans Crisis Line notifies the Suicide Prevention Coordinator and the Office of Community Care at the medical facility of the Department located nearest to the eligible individual; and

(D) in the case of an eligible individual who presents at a non-Department facility in an acute suicidal crisis without a recommendation by the Veterans Crisis Line and for whom the Secretary receives a notification under subsection (d), the Secretary notifies the Suicide Prevention Coordinator and the Office of Community Care at the medical facility of the Department located nearest to the eligible individual;

(2) determine the eligibility of the eligible individual for other programs and benefits under the laws administered by the Secretary (or shall make such determination as soon as practicable following the period of such emergent suicide care); and

(3) make referrals for care following the period of such emergent suicide care, as the Secretary determines appropriate.

(f) Prohibition on Charge.—(1) If the Secretary provides emergent suicide care to an eligible individual under subsection (a), the Secretary—

(A) may not charge the eligible individual for any cost of such emergent suicide care; and

(B) shall pay for any costs of emergency transportation to a facility for such emergent suicide care (as such costs are determined pursuant to section 1725 of this title, to the extent practicable).

(2)(A) In addition to the requirements of paragraph (1), if the Secretary pays for emergent suicide care provided under subsection (a) to an eligible individual at a non-Department facility, the Secretary shall reimburse the facility for the reasonable value of such emergent suicide care.

(B)(i) In carrying out subparagraph (A), the Secretary may determine the amount to reimburse a non-Department facility in a similar manner to the manner in which the Secretary determines reimbursement amounts for that non-Department facility for medical care and services provided under another provision of this chapter.

(ii) The requirements of section 1725(c)(3) of this title shall apply with respect to payments made under subparagraph (A) of this paragraph.

(3) In the case of an eligible individual who receives emergent suicide care under this section and who is entitled to emergent suicide care (or payment for emergent suicide care) under a health-plan contract, the Secretary may recover the costs of such emergent suicide care provided under this section, other than for such care for a service-connected disability.

(4) In carrying out subsection (d), the Secretary may not charge an eligible individual for any cost of emergent suicide care provided under subsection (a) solely by reason of the Secretary not having been notified of such care pursuant to such subsection.

(g) Annual Report.—Not less than once each year, the Secretary shall submit to the Committees on Veterans' Affairs of the Senate and the House of Representatives a report on emergent suicide care provided under subsection (a). Each such report shall include, for the year covered by the report—

(1) the number of eligible individuals who received emergent suicide care under subsection (a);

(2) demographic information regarding eligible individuals described in paragraph (1);

(3) the types of care furnished or paid for this section; ¹ and

(4) the total cost of providing care under subsection (a).

(h) Definitions.—In this section:

(1) The term "acute suicidal crisis" means that an individual was determined to be at imminent risk of self-harm by a trained crisis responder or health care provider.

(2) The term "crisis residential care" means crisis stabilization care provided—

(A) in a residential setting; and

(B) in a facility other than a hospital.

(3) The term "crisis stabilization care" includes, with respect to an individual in acute suicidal crisis, care that ensures, to the extent practicable, immediate safety and reduces—

(A) the severity of distress;

(B) the need for urgent care; or

(C) the likelihood that the distress under subparagraph (A) or need under subparagraph (B) will increase during the transfer of that individual from a facility at which the individual has received care for that acute suicidal crisis.

(4) The term "emergent suicide care" means crisis stabilization care provided to an eligible individual—

(A) pursuant to a recommendation of the eligible individual from the Veterans Crisis Line; or

(B) who presents at a medical facility in an acute suicidal crisis.

(5) The term "health-plan contract" has the meaning given such term in section 1725 of this title.

(6) The term "Veterans Crisis Line" means the hotline under section 1720F(h) of this title.

(Added Pub. L. 116–214, title II, §201(a), Dec. 5, 2020, 134 Stat. 1030.)

Statutory Notes and Related Subsidiaries

Effective Date

Pub. L. 116–214, title II, §201(c), Dec. 5, 2020, 134 Stat. 1033, provided that: "The Secretary shall furnish or pay for emergent suicide care under section 1720J of title 38, United States Code, as added by subsection (a), beginning on the date that is 270 days after the date of the enactment of this Act [Dec. 5, 2020]."

¹ So in original. Probably should be "under this section;".