SUBCHAPTER V—PAYMENTS TO STATE HOMES
§1741. Criteria for payment
(a)(1) Except as provided in section 1745 of this title, the Secretary shall pay each State at the per diem rate of—
(A) $8.70 for domiciliary care; and
(B) $20.35 for nursing home care and hospital care,
for each veteran receiving such care in a State home, if such veteran is eligible for such care under the laws administered by the Secretary.
(2) The Secretary may pay each State per diem at a rate determined by the Secretary for each veteran receiving extended care services described in any of paragraphs (4) through (6) of section 1710B(a) of this title under a program administered by a State home, if such veteran is eligible for such care under laws administered by the Secretary.
(b) In no case shall the payments made with respect to any veteran under this section exceed one-half of the cost of the veterans' care in such State home.
(c) Whenever the Secretary makes a determination pursuant to section 1720(a)(2)(A) of this title that the cost of care furnished by the Department in a general hospital under the direct jurisdiction of the Secretary has increased, the Secretary may, effective no earlier than the date of such determination, increase the rates paid under subsection (a) of this section by a percentage not greater than the percentage by which the Secretary has determined that such cost of care has increased.
(d) Subject to section 1743 of this title, the payment of per diem for care furnished in a State home facility shall commence on the date of the completion of the inspection for recognition of the facility under section 1742(a) of this title if the Secretary determines, as a result of that inspection, that the State home meets the standards described in such section.
(e) Payments to States pursuant to this section shall not be considered a liability of a third party, or otherwise be used to offset or reduce any other payment made to assist veterans.
(f) Any State home that requests payment or reimbursement for services provided to a veteran under this section shall provide to the Secretary such information as the Secretary considers necessary to identify each individual veteran eligible for payment under such section.
(g) In this subchapter, the term "State" means each of the several States and each Indian tribe (as defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304)).
(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1146, §641; Pub. L. 86–625, July 12, 1960, 74 Stat. 424; Pub. L. 87–819, §1, Oct. 15, 1962, 76 Stat. 935; Pub. L. 88–450, §3(a), Aug. 19, 1964, 78 Stat. 500; Pub. L. 90–432, §1, July 26, 1968, 82 Stat. 448; Pub. L. 91–178, §1, Dec. 30, 1969, 83 Stat. 836; Pub. L. 93–82, title IV, §403(a), Aug. 2, 1973, 87 Stat. 196; Pub. L. 94–417, §1(a), Sept. 21, 1976, 90 Stat. 1277; Pub. L. 94–581, title II, §202(o), Oct. 21, 1976, 90 Stat. 2856; Pub. L. 96–151, title I, §101(b)(1), Dec. 20, 1979, 93 Stat. 1092; Pub. L. 98–160, title I, §105(a), Nov. 21, 1983, 97 Stat. 998; Pub. L. 100–322, title I, §134(a), May 20, 1988, 102 Stat. 507; renumbered §1741 and amended Pub. L. 102–83, §§4(a)(3), (4), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–585, title IV, §406, Nov. 4, 1992, 106 Stat. 4954; Pub. L. 104–66, title I, §1141(a), Dec. 21, 1995, 109 Stat. 726; Pub. L. 104–262, title III, §342(a), Oct. 9, 1996, 110 Stat. 3206; Pub. L. 106–117, title I, §101(g), Nov. 30, 1999, 113 Stat. 1550; Pub. L. 108–422, title II, §202, Nov. 30, 2004, 118 Stat. 2382; Pub. L. 109–461, title II, §211(a)(3)(A), (b)(2), Dec. 22, 2006, 120 Stat. 3419, 3420; Pub. L. 116–315, title III, §§3004(b), 3007(b), Jan. 5, 2021, 134 Stat. 4992, 4996.)
Editorial Notes
Prior Provisions
Prior sections 1740 and 1741 were renumbered sections 3540 and 3541 of this title, respectively.
Amendments
2021—Subsec. (a)(1). Pub. L. 116–315, §3007(b), substituted "under the laws administered by the Secretary" for "in a Department facility" in concluding provisions.
Subsec. (g). Pub. L. 116–315, §3004(b), added subsec. (g).
2006—Subsec. (a)(1). Pub. L. 109–461, §211(a)(3)(A), substituted "Except as provided in section 1745 of this title, the" for "The".
Subsec. (f). Pub. L. 109–461, §211(b)(2), added subsec. (f).
2004—Subsec. (e). Pub. L. 108–422 added subsec. (e).
1999—Subsec. (a)(2). Pub. L. 106–117 substituted "extended care services described in any of paragraphs (4) through (6) of section 1710B(a) of this title under a program administered by a State home" for "adult day health care in a State home".
1996—Subsec. (a). Pub. L. 104–262 designated existing provisions as par. (1), redesignated former pars. (1) and (2) as subpars. (A) and (B), respectively, and added par. (2).
1995—Subsecs. (c) to (e). Pub. L. 104–66 redesignated subsecs. (d) and (e) as (c) and (d), respectively, and struck out former subsec. (c) which read as follows: "The Secretary shall submit every three years to the Committees on Veterans' Affairs of the Senate and House of Representatives a report on the adequacy of the rates provided in subsection (a) of this section in light of projections over each of the following five years of the demand on the Department for the provision of nursing home care to veterans eligible for such care under this section and sections 1710 and 1720 of this title. The first such report shall be submitted not later than June 30, 1986."
1992—Subsec. (e). Pub. L. 102–585 added subsec. (e).
1991—Pub. L. 102–83, §5(a), renumbered section 641 of this title as this section.
Subsec. (a). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in introductory provisions.
Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration" in concluding provisions.
Subsec. (c). Pub. L. 102–83, §5(c)(1), substituted "1710 and 1720" for "610 and 620".
Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator".
Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration".
Subsec. (d). Pub. L. 102–83, §5(c)(1), substituted "1720(a)(2)(A)" for "620(a)(2)(A)".
Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing.
Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration".
1988—Subsec. (a). Pub. L. 100–322, §134(a)(1), added cls. (1) and (2) and struck out former cls. (1) to (3) which read as follows:
"(1) $7.30 for domiciliary care,
"(2) $17.05 for nursing home care, and
"(3) $15.25 for hospital care,".
Subsec. (d). Pub. L. 100–322, §134(a)(2), added subsec. (d).
1983—Subsec. (a). Pub. L. 98–160, §105(a)(1), substituted "$7.30" for "$6.35" in par. (1), "$17.05" for "$12.10" in par. (2), and "$15.25" for "$13.25" in par. (3).
Subsec. (c). Pub. L. 98–160, §105(a)(2), added subsec. (c).
1979—Subsec. (a). Pub. L. 96–151 substituted "$6.35" for "$5.50", "$12.10" for "$10.50", and "$13.25" for "$11.50".
1976—Pub. L. 94–581 struck out "of any war or of service after January 31, 1955" after "for each veteran" in provisions following par. (3).
Pub. L. 94–417 designated existing provisions as subsec. (a), increased from $4.50 to $5.50 the per diem rate for domiciliary care, from $6 to $10.50 the per diem rate for nursing home care, and from $10 to $11.50 the per diem rate for hospital care, struck out "of any war or of service after January 31, 1955" after "for each veteran", ", in the case of such a veteran receiving domiciliary or hospital care," after "if", and provisions relating to the case of a veteran receiving nursing home care, and added subsec. (b).
1973—Pub. L. 93–82 increased from $3.50 to $4.50 the per diem rate for domiciliary care, from $5 to $6 the per diem rate for nursing home care, and from $7.50 to $10 the per diem rate for hospital care, and substituted "veteran of any war or of service after January 31, 1955" for "veteran of any war".
1969—Pub. L. 91–178 increased from $3.50 to $7.50 the per diem payment for hospital care.
1968—Pub. L. 90–432 increased from $2.50 to $3.50 the per diem rate for hospital or domiciliary care and from $3.50 to $5.00 the per diem rate for nursing home care as the amounts the Administrator shall pay each State providing such services for veterans.
1964—Pub. L. 88–450 amended section generally and, among other changes, authorized payment at the per diem rate of $3.50 for each veteran receiving nursing care in a State home, if such veteran meets the requirements of paragraph (1), (2), or (3) of section 610(a) of this title, except that the requirement in clause (B) of such paragraph (1) shall, for this purpose, refer to the inability to defray the expenses of necessary nursing home care, and eliminated provisions which permitted reduction of the amount payable to the State homes under certain conditions and prohibited payments to State homes where a bar or canteen is maintained therein where intoxicating liquors are sold.
1962—Subsec. (b). Pub. L. 87–819 provided that no reduction shall be made by the retention or collection by a State home of amounts from the estate of a deceased veteran if such amounts are placed in a post or other special fund for the benefit of the State home or its inhabitants in providing the benefits enumerated in clauses (A) to (C).
1960—Subsec. (a). Pub. L. 86–625 substituted "at the per diem rate of $2.50 per diem for each veteran" for "at the annual rate of $700.00 for each veteran".
Statutory Notes and Related Subsidiaries
Effective Date of 2006 Amendment
Amendment by section 211(a)(3)(A) of Pub. L. 109–461 effective 90 days after Dec. 22, 2006, see section 211(a)(5) of Pub. L. 109–461, set out as a note under section 1710 of this title.
Effective Date of 1988 Amendment
Pub. L. 100–322, title I, §134(b), May 20, 1988, 102 Stat. 507, provided that:
"(1) The amendment made by subsection (a)(1) [amending this section] shall take effect as of January 1, 1988.
"(2) The amendment made by subsection (a)(2) [amending this section] shall take effect on October 1, 1988."
Effective Date of 1983 Amendment
Pub. L. 98–160, title I, §105(b), Nov. 21, 1983, 97 Stat. 998, provided that: "The amendments made by subsection (a) [amending this section] shall take effect on April 1, 1984."
Effective Date of 1979 Amendment
Pub. L. 96–151, title I, §101(b)(2), Dec. 20, 1979, 93 Stat. 1092, provided that: "The amendments made by paragraph (1) [amending this section] shall take effect on January 1, 1980, but, with respect to fiscal year 1980, shall take effect only to such extent and in such amounts as may be specifically provided for such purpose in appropriation Acts."
Effective Date of 1976 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.
Pub. L. 94–417, §1(c), Sept. 21, 1976, 90 Stat. 1277, provided that:
"(1) The amendments made by subsection (a) of this section [amending this section] shall be effective on October 1, 1976.
"(2) At the time of the first payment to a State under section 641 [now 1741] of title 38, United States Code, as amended by subsection (a) of this section, the Administrator of Veterans' Affairs shall pay such State, in a lump sum, an amount equal to the difference between the total amount paid each such State under such section 641 [now 1741] for care provided by such State in a State home from January 1, 1976, to October 1, 1976, and the amount such State would have been paid for providing such care if the amendment made by subsection (a) of this section had been effective on January 1, 1976."
Effective Date of 1973 Amendment
Amendment by Pub. L. 93–82 effective Sept. 1, 1973, see section 501 of Pub. L. 93–82, set out as a note under section 1701 of this title.
Effective Date of 1964 Amendment
Pub. L. 88–450, §3(c), Aug. 19, 1964, 78 Stat. 501, provided that: "The amendment made by this section [amending this section] shall take effect on January 1, 1965; except that subsection (b) of section 641 [now 1741] of title 38, United States Code, as in effect immediately before such date, shall remain in effect with respect to any amounts retained or collected by any State home before such date."
Improvement of State Veterans Homes
Pub. L. 117–328, div. U, title I, §162, Dec. 29, 2022, 136 Stat. 5430, provided that:
"(a) Standardized Sharing Agreements.—The Secretary of Veterans Affairs shall develop a standardized process throughout the Department of Veterans Affairs for entering into sharing agreements between State homes and medical centers of the Department.
"(b) Provision of Medication to Catastrophically Disabled Veterans.—[Amended section 1745 of this title]
"(c) Oversight of Inspections.—
"(1) Monitoring.—The Secretary shall monitor any contractor used by the Department to conduct inspections of State homes, including by reviewing the inspections conducted by each such contractor for quality not less frequently than quarterly.
"(2) Reporting of deficiencies.—The Secretary shall require that any deficiencies of a State home noted during the inspection of the State home be reported to the Secretary.
"(3) Transparency.—The Secretary shall publish the results of any inspection of a State home, and any associated corrective actions planned by the State home, on a publicly available internet website of the Department.
"(d) State Home Defined.—In this section, the term 'State home' has the meaning given that term in section 101(19) of title 38, United States Code."
Geriatric Psychiatry Pilot Program at State Veterans Homes
Pub. L. 117–328, div. U, title I, §163, Dec. 29, 2022, 136 Stat. 5430, provided that:
"(a) In General.—Not later than one year after the date of the enactment of this Act [Dec. 29, 2022], the Secretary of Veterans Affairs shall commence the conduct of a pilot program under which the Secretary shall provide geriatric psychiatry assistance to eligible veterans at State homes.
"(b) Duration.—The Secretary shall carry out the pilot program under this section for a two-year period.
"(c) Type of Assistance.—Assistance provided under the pilot program under this section may include—
"(1) direct provision of geriatric psychiatry services, including health care if feasible;
"(2) payments to non-Department of Veterans Affairs providers in the community to provide such services;
"(3) collaboration with other Federal agencies to provide such services; or
"(4) such other forms of assistance as the Secretary considers appropriate.
"(d) Consideration of Local Area Needs.—In providing assistance under the pilot program under this section, the Secretary shall consider the geriatric psychiatry needs of the local area, including by considering—
"(1) State homes with a high proportion of residents with unmet mental health needs;
"(2) State homes located in mental health care health professional shortage areas designated under section 332 of the Public Health Service Act (42 U.S.C. 254e); or
"(3) State homes located in rural or highly rural areas.
"(e) Definitions.—In this section, the terms 'State home' and 'veteran' have the meanings given those terms in section 101 of title 38, United States Code."
Modification of State Home Program; Technical Support and Assistance
Pub. L. 116–315, title III, §3004(d)–(f), Jan. 5, 2021, 134 Stat. 4992, 4993, provided that:
"(d) Additional Legislative or Administrative Action.—
"(1) Consultation with indian tribes.—Not later than 180 days after the date of the enactment of this Act [Jan. 5, 2021], the Secretary of Veterans Affairs shall consult with Indian tribes to determine if any legislative or administrative action is necessary to modify the State home program to function efficiently in support of State homes operated by Indian tribes pursuant to the amendments made by this section [amending this section and sections 101, 8131 and 8132 of this title].
"(2) Report to congress.—Not later than 90 days after completing consultations under paragraph (1), the Secretary shall submit to the appropriate committees of Congress a report recommending legislative action that the Secretary considers appropriate to modify the State home program described in such paragraph in light of those consultations.
"(3) Modifications.—Not later than 180 days after completing consultations under paragraph (1), the Secretary shall make any modifications to regulations implementing the State home program, for which legislative action is not necessary, as the Secretary considers appropriate in light of those consultations.
"(e) Technical Support and Assistance.—The Secretary of Veterans Affairs shall provide technical support and assistance to Indian tribes in carrying out the State home program at State homes operated by Indian tribes pursuant to the amendments made by this section.
"(f) Definitions.—In this section:
"(1) Appropriate committees of congress.—The term 'appropriate committees of Congress' means—
"(A) the Committee on Veterans' Affairs and the Committee on Indian Affairs of the Senate; and
"(B) the Committee on Veterans' Affairs and the Subcommittee for Indigenous Peoples of the United States of the Committee on Natural Resources of the House of Representatives.
"(2) Indian tribe.—The term 'Indian tribe' has the meaning given that term in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304).
"(3) State home.—The term 'State home' has the meaning given that term in section 101(19) of title 38, United States Code.
"(4) State home program.—The term 'State home program' means the program of the Department of Veterans Affairs for which payments are made under subchapter V of chapter 17 of title 38, United States Code, and assistance is provided under subchapter III of chapter 81 of such title."
Waiver of Requirements of Department of Veterans Affairs for Receipt of Per Diem Payments for Domiciliary Care at State Homes and Modification of Eligibility for Such Payments
Pub. L. 116–315, title III, §3007, Jan. 5, 2021, 134 Stat. 4996, provided that:
"(a) Waiver of Requirements.—Notwithstanding section 1741 of title 38, United States Code (as amended by subsection (b)), the Secretary of Veterans Affairs shall modify section 51.51(b) of title 38, Code of Federal Regulations (or successor regulations), to provide the Secretary the authority to waive the requirements under such section 51.51(b) for a veteran to be eligible for per diem payments for domiciliary care at a State home if—
"(1) the veteran has met not fewer than four of the requirements set forth in such section; or
"(2) such waiver would be in the best interest of the veteran.
"(b) Modification of Eligibility.—[Amended this section.]
"(c) State Home Defined.—In this section, the term 'State home' has the meaning given that term in section 101(19) of title 38, United States Code."
Treatment of State Homes During Public Health Emergency
Pub. L. 116–136, div. B, title X, §20005, Mar. 27, 2020, 134 Stat. 586, provided that:
"(a) Waiver of Occupancy Rate Requirements.—During a public health emergency, occupancy rate requirements for State homes for purposes of receiving per diem payments set forth in section 51.40(c) of title 38, Code of Federal Regulations, or successor regulations, shall not apply.
"(b) Waiver of Veteran Percentage Requirements.—During a public health emergency, the veteran percentage requirements for State homes set forth in section 51.210(d) of title 38, Code of [Federal] Regulations, or successor regulations, and in agreements for grants to construct State homes, shall not apply.
"(c) Provision of Medicine, Equipment, and Supplies.—
"(1) In general.—During a public health emergency, the Secretary of Veterans Affairs may provide to State homes medicines, personal protective equipment, medical supplies, and any other equipment, supplies, and assistance available to the Department of Veterans Affairs.
"(2) Provision of equipment.—Personal protective equipment may be provided under paragraph (1) through the All Hazards Emergency Cache of the Department of Veterans Affairs or any other source available to the Department.
"(d) Definitions.—In this section:
"(1) Personal protective equipment.—The term 'personal protective equipment' means any protective equipment required to prevent the wearer from contracting COVID–19, including gloves, N–95 respirator masks, gowns, goggles, face shields, or other equipment required for safety.
"(2) Public health emergency.—The term 'public health emergency' means an emergency with respect to COVID–19 declared by a Federal, State, or local authority.
"(3) State home.—The term 'State home' has the meaning given that term in section 101(19) of title 38, United States Code."
[For definition of "public health emergency" as used in section 20005 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.]
Payments to States for Nursing Home Care
Pub. L. 88–450, §3(b), Aug. 19, 1964, 78 Stat. 501, provided that: "No payment shall be made to any State home solely by reason of the amendment made by this section [amending this section] on account of nursing home care furnished any veteran except where such care is furnished the veteran by the State home for the first time after the effective date of this section [Jan. 1, 1965]."
§1742. Inspections of such homes; restrictions on beneficiaries
(a) The Secretary may inspect any State home at such times as the Secretary deems necessary. No payment or grant may be made to any home under this subchapter unless such home is determined by the Secretary to meet such standards as the Secretary shall prescribe, which standards with respect to nursing home care shall be no less stringent than those prescribed pursuant to section 1720(b) of this title.
(b) The Secretary may ascertain the number of persons on account of whom payments may be made under this subchapter on account of any State home, but shall have no authority over the management or control of any State home.
(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1146, §642; Pub. L. 94–581, title I, §107(a), title II, §210(a)(16), Oct. 21, 1976, 90 Stat. 2847, 2863; renumbered §1742 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406.)
Editorial Notes
Prior Provisions
Prior section 1742 was renumbered section 3542 of this title.
Amendments
1991—Pub. L. 102–83, §5(a), renumbered section 642 of this title as this section.
Subsec. (a). Pub. L. 102–83, §5(c)(1), substituted "1720(b)" for "620(b)".
Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing.
Subsec. (b). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator".
1976—Subsec. (a). Pub. L. 94–581 substituted "as the Administrator deems necessary" for "as he deems necessary" in existing provisions and inserted provision that no payment or grant may be made to any home under this subchapter unless such home is determined by the Administrator to meet such standards as the Administrator shall prescribe, which standards with respect to nursing home care shall be no less stringent than those prescribed pursuant to section 620(b) of this title.
Statutory Notes and Related Subsidiaries
Effective Date of 1976 Amendment
Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.
§1743. Applications
Payments on account of any veteran cared for in a State home shall be made under this subchapter only from the date the Secretary receives a request for determination of such veteran's eligibility; however, if such request is received by the Secretary within ten days after care of such veteran begins, payments shall be made on account of such veteran from the date care began.
(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1147, §643; Pub. L. 97–251, §7, Sept. 8, 1982, 96 Stat. 716; renumbered §1743 and amended Pub. L. 102–83, §§4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.)
Editorial Notes
Prior Provisions
Prior section 1743 was renumbered section 3543 of this title.
Amendments
1991—Pub. L. 102–83 renumbered section 643 of this title as this section and substituted "Secretary" for "Administrator" in two places.
1982—Pub. L. 97–251 struck out "of any war" after "Payments on account of any veteran".
§1744. Hiring and retention of nurses: payments to assist States
(a) Payment Program.—The Secretary shall make payments to States under this section for the purpose of assisting State homes in the hiring and retention of nurses and the reduction of nursing shortages at State homes.
(b) Eligible Recipients.—Payments to a State for a fiscal year under this section shall, subject to submission of an application, be made to any State that during that fiscal year—
(1) receives per diem payments under this subchapter for that fiscal year; and
(2) has in effect an employee incentive scholarship program or other employee incentive program at a State home designed to promote the hiring and retention of nursing staff and to reduce nursing shortages at that home.
(c) Use of Funds Received.—A State may use an amount received under this section only to provide funds for a program described in subsection (b)(2). Any program shall meet such criteria as the Secretary may prescribe. In prescribing such criteria, the Secretary shall take into consideration the need for flexibility and innovation.
(d) Limitations on Amount of Payment.—(1) A payment under this section may not be used to provide more than 50 percent of the costs for a fiscal year of the employee incentive scholarship or other employee incentive program for which the payment is made.
(2) The amount of the payment to a State under this section for any fiscal year is, for each State home in that State with a program described in subsection (b)(2), the amount equal to 2 percent of the amount of payments estimated to be made to that State, for that State home, under section 1741 of this title for that fiscal year.
(e) Applications.—A payment under this section for any fiscal year with respect to any State home may only be made based upon an application submitted by the State seeking the payment with respect to that State home. Any such application shall describe the nursing shortage at the State home and the employee incentive scholarship program or other employee incentive program described in subsection (c) for which the payment is sought.
(f) Source of Funds.—Payments under this section shall be made from funds available for other payments under this subchapter.
(g) Disbursement.—Payments under this section to a State home shall be made as part of the disbursement of payments under section 1741 of this title with respect to that State home.
(h) Use of Certain Receipts.—The Secretary shall require as a condition of any payment under this section that, in any case in which the State home receives a refund payment made by an employee in breach of the terms of an agreement for employee assistance that used funds provided under this section, the payment shall be returned to the State home's incentive program account and credited as a non-Federal funding source.
(i) Annual Report From Payment Recipients.—Any State home receiving a payment under this section for any fiscal year, shall, as a condition of the payment, be required to agree to provide to the Secretary a report setting forth in detail the use of funds received through the payment, including a descriptive analysis of how effective the incentive program has been on nurse staffing in the State home during that fiscal year. The report for any fiscal year shall be provided to the Secretary within 60 days of the close of the fiscal year and shall be subject to audit by the Secretary. Eligibility for a payment under this section for any later fiscal year is contingent upon the receipt by the Secretary of the annual report under this subsection for the previous fiscal year in accordance with this subsection.
(j) Regulations.—The Secretary shall prescribe regulations to carry out this section. The regulations shall include the establishment of criteria for the award of payments under this section.
(Added Pub. L. 108–422, title II, §201(a)(1), Nov. 30, 2004, 118 Stat. 2380.)
Statutory Notes and Related Subsidiaries
Implementation
Pub. L. 108–422, title II, §201(b), Nov. 30, 2004, 118 Stat. 2382, provided that: "The Secretary of Veterans Affairs shall implement section 1744 of title 38, United States Code, as added by subsection (a), as expeditiously as possible. The Secretary shall establish such interim procedures as necessary so as to ensure that payments are made to eligible States under that section commencing not later than June 1, 2005, notwithstanding that regulations under subsection (j) of that section may not have become final."
§1745. Nursing home care, adult day health care, and medications for veterans with service-connected disabilities
(a)(1) The Secretary shall enter into a contract (or an agreement) with each State home for payment by the Secretary for nursing home care provided in the home, in any case in which such care is provided to any veteran as follows:
(A) Any veteran in need of such care for a service-connected disability.
(B) Any veteran who—
(i) has a service-connected disability rated at 70 percent or more; and
(ii) is in need of such care.
(2) Payment under each contract (or agreement) between the Secretary and a State home under paragraph (1) shall be based on a methodology, developed by the Secretary in consultation with the State home, to adequately reimburse the State home for the care provided by the State home under the contract (or agreement).
(3) Payment by the Secretary under paragraph (1) to a State home for nursing home care provided to a veteran described in that paragraph constitutes payment in full to the State home for such care furnished to that veteran.
(4)(A) An agreement under this section may be authorized by the Secretary or any Department official authorized by the Secretary, and any such action is not an award for purposes of such laws that would otherwise require the use of competitive procedures for the furnishing of hospital care, medical services, and extended care services.
(B)(i) Except as provided in the agreement itself, in clause (ii), and unless otherwise provided in this section or regulations prescribed pursuant to this section, a State home that enters into an agreement under this section is not subject to, in the carrying out of the agreement, any provision of law to which providers of services and suppliers under the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) are not subject.
(ii) A State home that enters into an agreement under this section is subject to—
(I) all provisions of law regarding integrity, ethics, or fraud, or that subject a person to civil or criminal penalties;
(II) all provisions of law that protect against employment discrimination or that otherwise ensure equal employment opportunities; and
(III) all provisions in this subchapter.
(iii) Notwithstanding subparagraph (B)(ii)(I), a State home that enters into an agreement under this section may not be treated as a Federal contractor or subcontractor for purposes of chapter 67 of title 41 (known as the "McNamara-O'Hara Service Contract Act of 1965").
(b) The Secretary shall furnish such drugs and medicines as may be ordered on prescription of a duly licensed physician as specific therapy in the treatment of illness or injury to any veteran as follows:
(1) Any veteran who—
(A) is not being provided nursing home care for which payment is payable under subsection (a); and
(B) is in need of such drugs and medicines for a service-connected disability.
(2) Any veteran who—
(A) has a service-connected disability rated at 50 percent or more;
(B) is not being provided nursing home care for which payment is payable under subsection (a); and
(C) is in need of such drugs and medicines.
(3) Any veteran who has been determined by the Secretary to be catastrophically disabled, as defined in section 17.36(e) of title 38, Code of Federal Regulations, or successor regulations, and on whose behalf the Secretary is paying a per diem for nursing home or domiciliary care in a State home under this chapter.
(c) Any State home that requests payment or reimbursement for services provided to a veteran under this section shall provide to the Secretary such information as the Secretary considers necessary to identify each individual veteran eligible for payment under such section.
(d)(1) The Secretary shall enter into an agreement with each State home for payment by the Secretary for medical supervision model adult day health care provided to a veteran described in subsection (a)(1) on whose behalf the State home is not in receipt of payment for nursing home care from the Secretary.
(2)(A) Payment under each agreement between the Secretary and a State home under paragraph (1) for each veteran who receives medical supervision model adult day health care under such agreement shall be made at a rate established through regulations prescribed by the Secretary to adequately reimburse the State home for the care provided by the State home, including necessary transportation expenses.
(B) The Secretary shall consult with the State homes in prescribing regulations under subparagraph (A).
(C) The rate established through regulations under subparagraph (A) shall not take effect until the date that is 30 days after the date on which those regulations are published in the Federal Register.
(3) Payment by the Secretary under paragraph (1) to a State home for medical supervision model adult day health care provided to a veteran described in that paragraph constitutes payment in full to the State home for such care furnished to that veteran.
(4) In this subsection, the term "medical supervision model adult day health care" means adult day health care that includes the coordination of physician services, dental services, nursing services, the administration of drugs, and such other requirements as determined appropriate by the Secretary.
(Added and amended Pub. L. 109–461, title II, §211(a)(1), (2), (b)(1), Dec. 22, 2006, 120 Stat. 3418, 3419; Pub. L. 112–154, title I, §105(a), Aug. 6, 2012, 126 Stat. 1170; Pub. L. 115–159, §2(a), Mar. 27, 2018, 132 Stat. 1244; Pub. L. 115–182, title I, §103(a), June 6, 2018, 132 Stat. 1408; Pub. L. 115–251, title II, §211(a)(9), Sept. 29, 2018, 132 Stat. 3175; Pub. L. 117–328, div. U, title I, §162(b), Dec. 29, 2022, 136 Stat. 5430.)
Editorial Notes
References in Text
The Social Security Act, referred to in subsec. (a)(4)(B)(i), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XVIII of the Act is classified generally to subchapter XVIII (§1395 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.
Amendments
2022—Subsec. (b)(3). Pub. L. 117–328 added par. (3).
2018—Pub. L. 115–159, §2(a)(2), inserted ", adult day health care," after "home care" in section catchline.
Subsec. (a)(1). Pub. L. 115–182, §103(a)(1), substituted "(or an agreement)" for "(or agreement under section 1720(c)(1) of this title)" in introductory provisions.
Subsec. (a)(4). Pub. L. 115–182, §103(a)(2), added par. (4).
Subsec. (a)(4)(B)(ii)(III). Pub. L. 115–251 substituted "this subchapter" for "subchapter V of chapter 17 of this title".
Subsec. (d). Pub. L. 115–159, §2(a)(1), added subsec. (d).
2012—Subsec. (a)(1). Pub. L. 112–154, §105(a)(1), substituted in introductory provisions "The Secretary shall enter into a contract (or agreement under section 1720(c)(1) of this title) with each State home for payment by the Secretary for nursing home care provided in the home" for "The Secretary shall pay each State home for nursing home care at the rate determined under paragraph (2)".
Subsec. (a)(2). Pub. L. 112–154, §105(a)(2), added par. (2) and struck out former par. (2) which read as follows: "The rate determined under this paragraph with respect to a State home is the lesser of—
"(A) the applicable or prevailing rate payable in the geographic area in which the State home is located, as determined by the Secretary, for nursing home care furnished in a non-Department nursing home (as that term is defined in section 1720(e)(2) of this title); or
"(B) a rate not to exceed the daily cost of care, as determined by the Secretary, following a report to the Secretary by the director of the State home."
2006—Subsec. (b). Pub. L. 109–461, §211(a)(2), added subsec. (b).
Subsec. (c). Pub. L. 109–461, §211(b)(1), added subsec. (c).
Statutory Notes and Related Subsidiaries
Effective Date of 2018 Amendment
Pub. L. 115–182, title I, §103(b), June 6, 2018, 132 Stat. 1409, provided that: "The amendment made by subsection (a) [amending this section] shall apply to care provided on or after the effective date of regulations issued by the Secretary of Veterans Affairs to carry out this section." Final rule implementing section 103 of Pub. L. 115–182 effective Jan. 13, 2020, see 84 F.R. 67868.
Effective Date of 2012 Amendment
Amendment by Pub. L. 112–154 applicable to care provided on or after the date that is 180 days after Aug. 6, 2012, with certain exceptions, see section 105(c) of Pub. L. 112–154, set out as a note under 1720 of this title.
Effective Date
Section and amendment by section 211(a)(2) of Pub. L. 109–461 effective 90 days after Dec. 22, 2006, see section 211(a)(5) of Pub. L. 109–461, set out as an Effective Date of 2006 Amendment note under section 1710 of this title.
Initial Rate
Pub. L. 115–159, §2(b), Mar. 27, 2018, 132 Stat. 1245, provided that: "Before the Secretary of Veterans Affairs establishes a payment rate under subsection (d)(2)(A) of section 1745 of such title [meaning title 38, United States Code], as added by subsection (a), the Secretary shall pay to a State home that has entered into an agreement with the Secretary for medical supervision model adult day health care (as defined in subsection (d)(4) of such section) an amount equal to 65 percent of the rate the Secretary would pay under subsection (a)(2) of such section to the State home for nursing home care provided to the veteran."