[USC02] 38 USC PART II, CHAPTER 17, SUBCHAPTER II: HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL TREATMENT
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38 USC PART II, CHAPTER 17, SUBCHAPTER II: HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL TREATMENT
From Title 38—VETERANS' BENEFITSPART II—GENERAL BENEFITSCHAPTER 17—HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE

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


Editorial Notes

Amendments

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

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

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

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

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


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

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

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

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

(D) who is a former prisoner of war, 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 the Mexican border period or of World War I;

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

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


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

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

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

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

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

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

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


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

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

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

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

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

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


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

(D) Subject to paragraphs (2) and (3), a veteran who served on active duty in a theater of combat operations (as determined by the Secretary in consultation with the Secretary of Defense) during a period of war after the Persian Gulf War, or in combat against a hostile force during a period of hostilities 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.


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

(3) 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, or air service after January 27, 2003, the five-year period beginning on the date of such discharge or release.

(B) With respect to a veteran described in paragraph (1)(D) who is discharged or released from the active military, naval, or air 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.

(C) With respect to a veteran described in paragraph (1)(D) who is discharged or released from the active military, naval, or air 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.


(4) For purposes of this subsection—

(A) The term "Vietnam-era herbicide-exposed veteran" means a veteran (i) who served on active duty in the Republic of Vietnam (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.

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


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

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

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

(A) the lesser of—

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

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


(B) before September 30, 2022, 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.)


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.

The date of the enactment of the Clay Hunt Suicide Prevention for American Veterans Act, referred to in subsec. (e)(3)(B), is the date of enactment of Pub. L. 114–2, which was approved Feb. 12, 2015.

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

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".

1991Pub. 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.

1976Pub. 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).

1966Pub. 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 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."

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, 2022.

(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.)


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

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."

1991Pub. 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".

1976Pub. 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, or air service;

(ii) the veteran had served on active duty for a period of not less than 180 days or, in the case of a veteran who served on active duty during the Persian Gulf War, 90 days immediately before such discharge or release;

(iii) application for treatment is made within 180 days after such discharge or release, except that (I) in the case of a veteran who reentered active military, naval, or air service within 90 days after the date of such veteran's prior discharge or release from such service, application may be made within 180 days from the date of such veteran's subsequent discharge or release from such service, and (II) if a disqualifying discharge or release has been corrected by competent authority, application may be made within 180 days after the date of correction; and

(iv) the veteran's certificate of discharge or release from active duty does not bear a certification that the veteran was provided, within the 90-day period immediately before the date of such discharge or release, a complete dental examination (including dental X-rays) and all appropriate dental services and treatment indicated by the examination to be needed;


(C) which is a service-connected dental condition or disability due to combat wounds or other service trauma, or of a former prisoner of war;

(D) which is associated with and is aggravating a disability resulting from some other disease or injury which was incurred in or aggravated by active military, naval, or air service;

(E) which is a non-service-connected condition or disability of a veteran for which treatment was begun while such veteran was receiving hospital care under this chapter and such services and treatment are reasonably necessary to complete such treatment;

(F) from which a veteran who is a former prisoner of war is suffering;

(G) from which a veteran who has a service-connected disability rated as total is suffering; or

(H) the treatment of which is medically necessary (i) in preparation for hospital admission, or (ii) for a veteran otherwise receiving care or services under this chapter.


(2) The Secretary concerned shall at the time a member of the Armed Forces is discharged or released from a period of active military, naval, or air service of not less than 180 days or, in the case of a veteran who served on active duty during the Persian Gulf War, 90 days provide to such member a written explanation of the provisions of clause (B) of paragraph (1) of this subsection and enter in the service records of the member a statement signed by the member acknowledging receipt of such explanation (or, if the member refuses to sign such statement, a certification from an officer designated for such purpose by the Secretary concerned that the member was provided such explanation).

(3) The total amount which the Secretary may expend for furnishing, during any twelve-month period, outpatient dental services, treatment, or related dental appliances to a veteran under this section through private facilities for which the Secretary has contracted 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.)


Editorial Notes

Prior Provisions

Prior section 1712 was renumbered section 3512 of this title.

Amendments

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.

1996Pub. 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).

1991Pub. 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))."

1988Pub. 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 (vi) of subparagraph (C), to assist the individual in readjusting to civilian life; and

(ii) in the case of an individual referred to in clause (vii) 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; and

(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.


(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 (vi) 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 (vii) of such subparagraph, such individual has difficulties associated with—

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

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

(II) veteran or member of the Armed Forces described in 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 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 veteran is necessary to facilitate the successful readjustment of the veteran to civilian life, such veteran shall, within the limits of Department facilities, be furnished such services on an outpatient basis. For the purposes of furnishing such mental health services, the counseling furnished under subsection (a) of this section shall be considered to have been furnished by the Department as a part of hospital care. Any hospital care and other medical services considered necessary on the basis of the assessment furnished under subsection (a) of this section shall be furnished only in accordance with the eligibility criteria otherwise set forth in this chapter (including the eligibility criteria set forth in section 1784 of this title).

(2) Mental health services furnished under paragraph (1) of this subsection may, if determined to be essential to the effective treatment and readjustment of the veteran, include such consultation, counseling, training, services, and expenses as are described in sections 1782 and 1783 of this title.

(c) Upon receipt of a request for counseling under this section from any individual who has been discharged or released from active military, naval, or air service but who is not otherwise eligible for such counseling, the Secretary shall—

(1) provide referral services to assist such individual, to the maximum extent practicable, in obtaining mental health care and services from sources outside the Department; and

(2) if pertinent, advise such individual of such individual's rights to apply to the appropriate military, naval, or air service, and to the Department, for review of such individual's discharge or release from such service.


(d) The Under Secretary for Health may provide for such training of professional, paraprofessional, and lay personnel as is necessary to carry out this section effectively, and, in carrying out this section, may utilize the services of paraprofessionals, individuals who are volunteers working without compensation, and individuals who are veteran-students (as described in section 3485 of this title) in initial intake and screening activities.

(e)(1) In furnishing counseling and related mental health services under subsections (a) and (b) of this section, the Secretary shall have available the same authority to enter into contracts 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.

(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. 116–315, title V, §5104, Jan. 5, 2021, 134 Stat. 5027.)


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

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)(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).

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".

1991Pub. 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 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.

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, 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 for a three-year period beginning on the commencement of the pilot program.

"(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."

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