38 U.S.C. § 111 (2024) — Title 38: VETERANS' BENEFITS / Chapter 1 / Section 111: Payments or allowances for beneficiary travel
Payments or allowances for beneficiary travel
Status: in_force

(a) Under regulations prescribed by the President pursuant to the provisions of this section, the Secretary may pay the actual necessary expense of travel (including lodging and subsistence), or in lieu thereof an allowance based upon mileage (at a rate of 41.5 cents per mile), of any person to or from a Department facility or other place in connection with vocational rehabilitation, counseling required by the Secretary pursuant to chapter 34 or 35 of this title, or for the purpose of examination, treatment, or care. Actual necessary expense of travel includes the reasonable costs of airfare if travel by air is the only practical way to reach a Department facility. In addition to the mileage allowance authorized by this section, there may be allowed reimbursement for the actual cost of ferry fares, and bridge, road, and tunnel tolls.

(b)(1) Except as provided in subsection (c) of this section and notwithstanding subsection (g)(2) of this section or any other provision of law, if, with respect to any fiscal year, the Secretary exercises the authority under this section to make any payments, the Secretary shall make the payments provided for in this section to or for the following persons for travel during such fiscal year for examination, treatment, or care for which the person is eligible:

(A) A veteran or other person whose travel is in connection with treatment or care for a service-connected disability.

(B) A veteran with a service-connected disability rated at 30 percent or more.

(C) A veteran receiving pension under section 1521 of this title.

(D) A veteran (i) who is not traveling by air and whose annual income (as determined under section 1503 of this title) does not exceed the maximum annual rate of pension which would be payable to such veteran if such veteran were eligible for pension under section 1521 of this title, or (ii) who is determined, under regulations prescribed by the Secretary, to be unable to defray the expenses of the travel for which payment under this section is claimed.

(E) Subject to paragraph (3) of this subsection, a veteran or other person whose travel to or from a Department facility is medically required to be performed by a special mode of travel and who is determined under such regulations to be unable to defray the expenses of the travel for which payment under this section is claimed.

(F) A veteran whose travel to a Department facility is incident to a scheduled compensation and pension examination.

(G) A veteran with vision impairment, a veteran with a spinal cord injury or disorder, or a veteran with double or multiple amputations whose travel is in connection with care provided through a special disabilities rehabilitation program of the Department (including programs provided by spinal cord injury centers, blind rehabilitation centers, and prosthetics rehabilitation centers) if such care is provided—

(i) on an in-patient basis; or

(ii) during a period in which the Secretary provides the veteran with temporary lodging at a facility of the Department to make such care more accessible to the veteran.

(2) The Secretary may make payments provided for in this section to or for any person not covered by paragraph (1) of this subsection for travel by such person for examination, treatment, or care. Such payments shall be made in accordance with regulations which the Secretary shall prescribe.

(3)(A) Except as provided in subparagraph (B) of this paragraph, the Secretary shall not make payments under this section for travel performed by a special mode of travel unless (i) the travel by such mode is medically required and is authorized by the Secretary before the travel begins, or (ii) the travel by such mode is in connection with a medical emergency of such a nature that the delay incident to obtaining authorization from the Secretary to use that mode of travel would have been hazardous to the person's life or health.

(B) In the case of travel by a person to or from a Department facility by special mode of travel, the Secretary may provide payment under this section to the provider of the transportation by special mode before determining the eligibility of such person for such payment if the Secretary determines that providing such payment is in the best interest of furnishing care and services. Such a payment shall be made subject to subsequently recovering from such person the amount of the payment if such person is determined to have been ineligible for payment for such travel.

(C) In the case of transportation of a person to or from a Department facility by ambulance, the Secretary may pay the provider of the transportation the lesser of the actual charge for the transportation or the amount determined by the fee schedule established under section 1834(l) of the Social Security Act (42 U.S.C. 1395m(l)) unless the Secretary has entered into a contract for that transportation with the provider.

(4) In determining for purposes of subsection (a) whether travel by air is the only practical way for a veteran to reach a Department facility, the Secretary shall consider the medical condition of the veteran and any other impediments to the use of ground transportation by the veteran.

(c)(1) Except as otherwise provided in this subsection, the Secretary, in making a payment under this section to or for a person described in subparagraph (A), (B), (C), or (D) of subsection (b)(1) of this section for travel for examination, treatment, or care, shall deduct from the amount otherwise payable an amount equal to $3 for each one-way trip.

(2) In the case of a person who is determined by the Secretary to be a person who is required to make six or more one-way trips for needed examination, treatment, or care during the remainder of the calendar month in which the determination is made or during any subsequent calendar month during the one-year period following the last day of the month in which the determination is made, the amount deducted by the Secretary pursuant to paragraph (1) of this subsection from payments for trips made to or from such facility during any such month shall not exceed $18.

(3) No deduction shall be made pursuant to paragraph (1) of this subsection in the case of a person whose travel to or from a Department facility is performed by a special mode of travel for which payment under this section is authorized under subsection (b)(3) of this section.

(4) The Secretary may waive the deduction requirement of paragraph (1) of this subsection in the case of the travel of any veteran for whom the imposition of the deduction would cause severe financial hardship. The Secretary shall prescribe in regulations the conditions under which a finding of severe financial hardship is warranted for purposes of this paragraph.

(d) Payment of the following expenses or allowances in connection with vocational rehabilitation, counseling, or upon termination of examination, treatment, or care, may be made before the completion of travel:

(1) The mileage allowance authorized by subsection (a) of this section.

(2) Actual local travel expenses.

(3) The expense of hiring an automobile or ambulance, or the fee authorized for the services of a nonemployee attendant.

(e)(1) Except as provided in paragraph (2), when any person entitled to mileage under this section requires an attendant (other than an employee of the Department) in order to perform such travel, the attendant may be allowed expenses of travel upon the same basis as such person.

(2)(A) Without regard to whether an eligible veteran entitled to mileage under this section for travel to a Department facility for the purpose of medical examination, treatment, or care requires an attendant in order to perform such travel, an attendant of such veteran described in subparagraph (B) may be allowed expenses of travel (including lodging and subsistence) upon the same basis as such veteran during—

(i) the period of time in which such veteran is traveling to and from a Department facility for the purpose of medical examination, treatment, or care; and

(ii) the duration of the medical examination, treatment, or care episode for such veteran.

(B) An attendant of a veteran described in this subparagraph is a provider of personal care services for such veteran who is approved under paragraph (6) of section 1720G(a) of this title or designated under paragraph (7) of such section 1720G(a).

(C) The Secretary may prescribe regulations to carry out this paragraph. Such regulations may include provisions—

(i) to limit the number of attendants that may receive expenses of travel under this paragraph for a single medical examination, treatment, or care episode of an eligible veteran; and

(ii) to require such attendants to use certain travel services.

(D) In this subsection, the term "eligible veteran" has the meaning given that term in section 1720G(a)(2) of this title.

(f) The Secretary may provide for the purchase of printed reduced-fare requests for use by veterans and their authorized attendants when traveling at their own expense to or from any Department facility.

(g)(1) Beginning one year after the date of the enactment of the Caregivers and Veterans Omnibus Health Services Act of 2010, the Secretary may adjust the mileage rate described in subsection (a) to be equal to the mileage reimbursement rate for the use of privately owned vehicles by Government employees on official business (when a Government vehicle is available), as prescribed by the Administrator of General Services under section 5707(b) of title 5.

(2) If an adjustment in the mileage rate under paragraph (1) results in a lower mileage rate than the mileage rate otherwise specified in subsection (a), the Secretary shall, not later than 60 days before the date of the implementation of the mileage rate as so adjusted, submit to Congress a written report setting forth the adjustment in the mileage rate under this subsection, together with a justification for the decision to make the adjustment in the mileage rate under this subsection.

(h)(1) Notwithstanding any other provision of law, the Secretary may make payments to or for any person traveling in, to, or from the Freely Associated States for receipt of care or services authorized to be legally provided by the Secretary in the Freely Associated States under section 1724(f)(1) of this title.

(2) A person who has received payment for travel in a country pursuant to this subsection shall remain eligible for payment for such travel in that country regardless of whether the country continues to qualify as a Freely Associated State for purposes of this subsection.

(3) The Secretary shall prescribe regulations to carry out this subsection.

(4) In this subsection, the term "Freely Associated States" means—

(A) the Federated States of Micronesia, during such time as it is a party to the Compact of Free Association set forth in section 201 of the Compact of Free Association Act of 1985 (Public Law 99–239; 48 U.S.C. 1901 note);

(B) the Republic of the Marshall Islands, during such time as it is a party to the Compact of Free Association set forth in section 201 of the Compact of Free Association Act of 1985 (Public Law 99–239; 48 U.S.C. 1901 note); and

(C) the Republic of Palau, during such time as it is a party to the Compact of Free Association between the United States and the Government of Palau set forth in section 201 of Joint 1 Resolution entitled "Joint Resolution to approve the 'Compact of Free Association' between the United States and the Government of Palau, and for other purposes" (Public Law 99–658; 48 U.S.C. 1931 note).

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1113; Pub. L. 86–590, July 5, 1960, 74 Stat. 329; Pub. L. 89–358, §4(g), Mar. 3, 1966, 80 Stat. 24; Pub. L. 89–455, June 18, 1966, 80 Stat. 208; Pub. L. 94–581, title I, §101, Oct. 21, 1976, 90 Stat. 2842; Pub. L. 96–151, title II, §201(a), Dec. 20, 1979, 93 Stat. 1093; Pub. L. 97–295, §4(5), Oct. 12, 1982, 96 Stat. 1305; Pub. L. 100–322, title I, §108(a), (b)(1), (c)–(e)(1), May 20, 1988, 102 Stat. 496–498; Pub. L. 102–83, §§4(a)(3), (4), (6), (b)(1), (2)(E), 5(c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 103–446, title XII, §1201(e)(1), Nov. 2, 1994, 108 Stat. 4685; Pub. L. 110–387, title IV, §401(a)(1), (b), Oct. 10, 2008, 122 Stat. 4122; Pub. L. 111–163, title I, §104, title III, §305(a)–(d), May 5, 2010, 124 Stat. 1140, 1151, 1152; Pub. L. 112–56, title II, §263, Nov. 21, 2011, 125 Stat. 732; Pub. L. 112–154, title VII, §704, Aug. 6, 2012, 126 Stat. 1206; Pub. L. 112–260, title II, §202(b)(1)–(3), Jan. 10, 2013, 126 Stat. 2424; Pub. L. 114–58, title VI, §601(1), Sept. 30, 2015, 129 Stat. 538; Pub. L. 114–223, div. A, title II, §250(a), Sept. 29, 2016, 130 Stat. 892; Pub. L. 118–42, div. G, title II, §209(a)(3), Mar. 9, 2024, 138 Stat. 439.)

Editorial Notes

References in Text

The date of the enactment of the Caregivers and Veterans Omnibus Health Services Act of 2010, referred to in subsec. (g)(1), is the date of enactment of Pub. L. 111–163, which was approved May 5, 2010.

Amendments

2024—Subsec. (h). Pub. L. 118–42 added subsec. (h).

2016—Subsec. (b)(1)(G). Pub. L. 114–223 added subpar. (G).

2015—Subsec. (b)(1). Pub. L. 114–58, §601(1)(A), substituted "subsection (g)(2)" for "subsection (g)(2)(A)".

Subsec. (b)(3)(C). Pub. L. 114–58, §601(1)(B), substituted "(42 U.S.C. 1395m(l))" for "(42 U.S.C. 1395(l))".

2013—Subsec. (h). Pub. L. 112–260 transferred subsec. (h), relating to transportation of veterans to Department facilities by third parties, to section 111A(b) of this title.

2012—Subsec. (b)(3)(C). Pub. L. 112–154 substituted "to or from a Department facility" for "under subparagraph (B)".

2011—Subsec. (b)(3)(C). Pub. L. 112–56 added subpar. (C).

2010—Subsec. (a). Pub. L. 111–163, §305(a)(1), (b), substituted "(at a rate of 41.5 cents per mile)," for "traveled," and inserted before last sentence "Actual necessary expense of travel includes the reasonable costs of airfare if travel by air is the only practical way to reach a Department facility."

Subsec. (b)(1)(D)(i). Pub. L. 111–163, §305(c), inserted "who is not traveling by air and" before "whose annual".

Subsec. (b)(4). Pub. L. 111–163, §305(d), added par. (4).

Subsec. (e). Pub. L. 111–163, §104, designated existing provisions as par. (1), substituted "Except as provided in paragraph (2), when" for "When", and added par. (2).

Subsec. (g). Pub. L. 111–163, §305(a)(2), amended subsec. (g) generally. Prior to amendment, subsec. (g) related to use of mileage reimbursement rate for use of privately owned vehicles by Government employees on official business to determine amount of allowances or reimbursement to be paid under this section and limitations.

2008—Subsec. (c)(2). Pub. L. 110–387, §401(a)(1)(B), struck out ", except as provided in paragraph (5) of this subsection," after "shall not".

Subsec. (c)(5). Pub. L. 110–387, §401(a)(1)(A), struck out par. (5) which read as follows: "Whenever the Secretary increases or decreases the rates of allowances or reimbursement to be paid under this section, the Secretary shall, effective on the date on which such increase or decrease takes effect, adjust proportionately the dollar amounts specified in paragraphs (1) and (2) of this subsection as such amounts may have been increased or decreased pursuant to this paragraph before such date."

Subsec. (g)(1). Pub. L. 110–387, §401(b)(1), amended par. (1) generally. Prior to amendment, par. (1) read as follows: "In carrying out the purposes of this section, the Secretary, in consultation with the Administrator of General Services, the Secretary of Transportation, the Comptroller General of the United States, and representatives of organizations of veterans, shall conduct periodic investigations of the actual cost of travel (including lodging and subsistence) to beneficiaries while traveling to or from a Department facility or other place pursuant to the provisions of this section, and the estimated cost of alternative modes of travel, including public transportation and the operation of privately owned vehicles. The Secretary shall conduct such investigations immediately following any alteration in the rates described in paragraph (3)(C) of this subsection, and, in any event, immediately following the enactment of this subsection and not less often than annually thereafter, and based thereon, shall determine rates of allowances or reimbursement to be paid under this section."

Subsec. (g)(3). Pub. L. 110–387, §401(b)(2), (3), added par. (3) and struck out former par. (3) which related to the Secretary's review and analysis of factors in conducting investigations and determining rates of mileage allowance or reimbursement.

Subsec. (g)(4). Pub. L. 110–387, §401(b)(2), struck out par. (4) which read as follows: "Before determining rates or adjusting amounts under this section and not later than sixty days after any alteration in the rates described in paragraph (3)(C) of this subsection, the Secretary shall submit to the Committees on Veterans' Affairs of the House of Representatives and the Senate a report containing the rates and amounts the Secretary proposes to establish or continue with a full justification therefor in terms of each of the limitations and factors set forth in this section."

1994—Subsec. (b)(3)(B). Pub. L. 103–446 substituted "a Department facility" for "the Department facility".

1991—Subsec. (a). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in two places.

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration".

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

Subsec. (b)(1)(C), (D). Pub. L. 102–83, §5(c)(1), substituted "1521" for "521" in subpar. (C) and "1503" for "503" and "1521" for "521" in subpar. (D).

Subsec. (b)(1)(E), (F). Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration".

Subsec. (b)(3)(B). Pub. L. 102–83, §4(a)(6), substituted "Department facility" for "Veteran's Administration facility".

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

Subsec. (c)(3). Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration".

Subsec. (c)(4), (5). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing.

Subsec. (e). Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration".

Subsec. (f). 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. (g)(1). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for first and third references to "Administrator".

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration".

Subsec. (g)(2)(A). Pub. L. 102–83, §5(c)(1), substituted "1521" for "521" in two places and "1503" for "503".

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

Subsec. (g)(3), (4). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing.

Subsec. (h). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for first reference to "Administrator".

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

1988—Pub. L. 100–322, §108(e)(1), substituted "Payments or allowances for beneficiary travel" for "Travel expenses" in section catchline.

Subsecs. (b), (c). Pub. L. 100–322, §108(a)(2), added subsecs. (b) and (c). Former subsecs. (b) and (c) redesignated (d) and (e), respectively.

Subsec. (d). Pub. L. 100–322, §108(a)(1), (d), redesignated subsec. (b) as (d), and in par. (1) substituted "The mileage" for "the mileage" and "of this section." for "hereof;", in par. (2) substituted "Actual" for "actual" and a period for a semicolon, and in par. (3) substituted "The expense" for "the expense". Former subsec. (d) redesignated (f).

Subsecs. (e), (f). Pub. L. 100–322, §108(a)(1), redesignated subsecs. (c) and (d) as (e) and (f), respectively. Former subsec. (e) redesignated (g).

Subsec. (g). Pub. L. 100–322, §108(a)(1), (c), redesignated subsec. (e) as (g), and in par. (4) substituted "Before determining rates or adjusting amounts" for "Before determining rates" and "containing the rates and amounts" for "containing the rates".

Subsec. (h). Pub. L. 100–322, §108(b)(1), added subsec. (h).

1982—Subsec. (e)(4). Pub. L. 97–295 substituted "and" for ", and not later than sixty days after the effective date of this subsection, and thereafter" after "under this section".

1979—Subsec. (e)(2)(A). Pub. L. 96–151 substituted provisions respecting determinations pursuant to regulations prescribed by the Administrator, subject to applicable exceptions, for provisions respecting determinations based on annual declarations and certifications by persons claiming reimbursements, subject to applicable exceptions.

1976—Subsec. (a). Pub. L. 94–581, §101(1), inserted "pursuant to the provisions of this section" after "President".

Subsec. (e). Pub. L. 94–581, §101(2), added subsec. (e).

1966—Subsec. (a). Pub. L. 89–358 substituted reference to chapter 34 for 33.

Subsec. (b). Pub. L. 89–455 authorized the prepayment of actual local travel expenses and the expense of hiring an automobile or ambulance, or the fee authorized for the services of a nonemployee attendant.

1960—Subsec. (a). Pub. L. 86–590 allowed reimbursement for actual cost of ferry fares, and bridge, road, and tunnel tolls.

Statutory Notes and Related Subsidiaries

Effective Date of 2016 Amendment

Pub. L. 114–223, div. A, title II, §250(c), Sept. 29, 2016, 130 Stat. 893, provided that: "The amendment made by subsection (a) [amending this section] shall take effect on the first day of the first fiscal year that begins after the date of the enactment of this Act [Sept. 29, 2016]."

Effective Date of 2008 Amendment

Pub. L. 110–387, title IV, §401(d), Oct. 10, 2008, 122 Stat. 4123, provided that: "The amendments made by this section [amending this section] shall apply with respect to travel expenses incurred after the expiration of the 90-day period that begins on the date of the enactment of this Act [Oct. 10, 2008]."

Effective Date of 1988 Amendment

Pub. L. 100–322, title I, §108(g), May 20, 1988, 102 Stat. 499, provided that: "The amendments made by subsection (a) [amending this section] shall take effect with respect to travel performed after June 30, 1988."

Effective Date of 1979 Amendment

Pub. L. 96–151, title II, §206, Dec. 20, 1979, 93 Stat. 1095, provided that: "Except as otherwise provided in section 205(b), the amendments made by this title [amending this section and sections 601, 614, and 628 [now 1701, 1714, and 1728] of this title] shall take effect on January 1, 1980."

Effective Date of 1976 Amendment

Pub. L. 94–581, title II, §211, Oct. 21, 1976, 90 Stat. 2866, provided that: "Except as otherwise provided in this Act, the amendments made by this Act [see Tables for classification] to title 38, United States Code, shall take effect on October 1, 1976, or on the date of enactment [Oct. 21, 1976], whichever is later."

Transition Provision for 1988 Amendment

Pub. L. 100–322, title I, §108(f), May 20, 1988, 102 Stat. 498, provided that: "In determining for the purposes of subsection (b)(1) of section 111 of title 38, United States Code, as amended by subsection (a), whether during fiscal year 1988 the Administrator has exercised the authority under that section to make payments there shall be disregarded any exercise of authority under that section before the date of the enactment of this Act [May 20, 1988]."

Construction of 2010 Amendment

Pub. L. 111–163, title III, §305(e), May 5, 2010, 124 Stat. 1152, provided that: "The amendments made by subsections (b) and (d) of this section [amending this section] may not be construed as expanding or otherwise modifying eligibility for payments or allowances for beneficiary travel under section 111 of title 38, United States Code, as in effect on the day before the date of the enactment of this Act [May 5, 2010]."

Department of Veterans Affairs Transportation Pilot Program for Low Income Veterans

Pub. L. 117–328, div. U, title II, §243, Dec. 29, 2022, 136 Stat. 5459, provided that:

"(a) Pilot Program Required.—Not later than one year after the date of the enactment of this Act [Dec. 29, 2022], the Secretary of Veterans Affairs shall commence carrying out a pilot program to assess the feasibility and advisability of providing payments authorized under subsection (a) of section 111 of title 38, United States Code, 48 hours in advance of travel to eligible appointments to veterans and other eligible individuals who are also eligible for a deduction waiver as provided by paragraphs (3) and (4) of subsection (c) of such section.

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

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

"(d) Report.—

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

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

"(A) The number of individuals who benefitted from the pilot program broken, disaggregated by geographic location, race or ethnicity, age, disability rating, and sex.

"(B) Average distance traveled by participants to appointments and average funds provided per appointment, disaggregated by geographic region.

"(C) A description of any impediments to carrying out the pilot program.

"(D) An account of payments provided for travel that did not occur or was authorized incorrectly.

"(E) An account of any attempts to retrieve such payment.

"(F) Recommendations of the Secretary for legislative or administrative action to reduce improper payments.

"(G) An assessment of the feasibility and advisability of providing payments as described in subsection (a)."

Pilot Program for Travel Cost Reimbursement for Accessing Readjustment Counseling Services

Pub. L. 117–328, div. U, title II, §244, Dec. 29, 2022, 136 Stat. 5460, provided that:

"(a) Pilot Program Required.—Not later than 270 days after the date of the enactment of this Act [Dec. 29, 2022], the Secretary shall establish and commence a pilot program, within the Readjustment Counseling Services of the Veterans Health Administration, to assess the feasibility and advisability of providing payment to cover or offset financial difficulties of an individual in accessing or using transportation to and from the nearest Vet Center service site providing the necessary readjustment counseling services for the individual's plan of service.

"(b) Participation.—

"(1) In general.—In carrying out the pilot program required by subsection (a), the Secretary shall limit participation—

"(A) by individuals pursuant to paragraph (2); and

"(B) by Vet Centers pursuant to paragraph (3).

"(2) Participation by individuals.—

"(A) In general.—The Secretary shall limit participation in the pilot program to individuals who are eligible for services at a participating Vet Center and experiencing financial hardship.

"(B) Financial hardship.—The Secretary shall determine the meaning of 'financial hardship' for purposes of subparagraph (A).

"(3) Participation of vet centers.—Vet Centers participating in the program shall be chosen by the Secretary from among those serving individuals in areas designated by the Secretary as rural or highly rural or Tribal lands.

"(c) Travel Allowances and Reimbursements.—Under the pilot program required by subsection (a), the Secretary shall provide a participating individual a travel allowance or reimbursement at the earliest time practicable, but not later than 10 business days after the date of the appointment.

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

"(e) Locations.—

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

"(2) Existing initiative.—

"(A) Locations participating in existing initiative.—Of the locations selected under paragraph (1), four shall be the locations participating in the initiative commenced under section 104(a) of the Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012 (Public Law 112–154) [126 Stat. 1169], as most recently amended by section 105 of the Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023 (Public Law 117–180) [136 Stat. 2137], as of the date of the enactment of this Act.

"(B) Termination of existing initiative.—[Amended section 104(a) of Pub. L. 112–154, which is not classified to the Code.]

"(f) Annual Reports.—

"(1) In general.—Not later than one year after the date of the commencement of the pilot program required by subsection (a) and each year thereafter for the duration of the pilot program, 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 findings of the Secretary with respect to the pilot program.

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

"(A) The number of individuals who benefitted from the pilot program, disaggregated by age, race or ethnicity, and sex, to the extent possible.

"(B) The average distance traveled by each individual per each Vet Center.

"(C) The definition of financial hardship determined by the Secretary under subsection (b)(2)(B).

"(D) A description of how the funds are distributed.

"(E) The average amount of funds distributed per instance, disaggregated by Vet Center.

"(F) A description of any impediments to the Secretary in paying expenses or allowances under the pilot program.

"(G) An assessment of the potential for fraudulent receipt of payment under the pilot program and the recommendations of the Secretary for legislative or administrative action to reduce such fraud.

"(H) Such recommendations for legislative or administrative action as the Secretary considers appropriate with respect to the payment of expenses or allowances.

"(g) Vet Center Defined.—In this section, the term 'Vet Center' means a center for readjustment counseling and related mental health services for veterans under section 1712A of title 38, United States Code."

Clarification of Relation to Public Transportation in Veterans Health Administration Handbook

Pub. L. 111–163, title III, §305(f), May 5, 2010, 124 Stat. 1152, provided that: "Not later than 30 days after the date of the enactment of this Act [May 5, 2010], the Secretary of Veterans Affairs shall revise the Veterans Health Administration Handbook to clarify that an allowance for travel based on mileage paid under section 111(a) of title 38, United States Code, may exceed the cost of such travel by public transportation regardless of medical necessity."

Reinstatement of Amount of Deduction Specified by Statute

Pub. L. 110–387, title IV, §401(a)(2), Oct. 10, 2008, 122 Stat. 4122, provided that: "Notwithstanding any adjustment made by the Secretary of Veterans Affairs under paragraph (5) of section 111(c) of title 38, United States Code, as such paragraph was in effect before the date of the enactment of this Act [Oct. 10, 2008], the amount deducted under paragraph (1) of such section 111(c) on or after such date shall be the amount specified in such paragraph."

Interim Guidelines for Beneficiary Travel Between January 1, 1984, and the Promulgation of Regulations by Administrator of Veterans' Affairs

Pub. L. 98–160, title I, §108, Nov. 21, 1983, 97 Stat. 999, provided that promulgation of guidelines pending issuance of regulations covering the travel of beneficiaries during an interim period beginning Jan. 1, 1984, and directed that a report be made to Congress not later than Apr. 1, 1984, regarding travel payments.

Availability of Funds for Travel of Eligible Veterans, Dependents, or Survivors

Pub. L. 96–330, title IV, §406, Aug. 26, 1980, 94 Stat. 1052, provided that: "No provision of law enacted after the date of the enactment of this Act [Aug. 26, 1980] which imposes any restriction or limitation on the availability of funds for the travel and transportation of officers and employees of the executive branch of the Government and their dependents, or on the transportation of things of such officers and employees and their dependents, shall be applicable to the travel of eligible veterans, dependents, or survivors, for which reimbursement is authorized under title 38, United States Code, pursuant to the terms and conditions of section 111 of such title, unless such provision is expressly made applicable to the travel of such veterans, dependents, or survivors."

Executive Documents

Executive Order No. 10810

Ex. Ord. No. 10810, Apr. 22, 1959, 24 F.R. 3179, as amended by Ex. Ord. No. 10881, July 6, 1960, 25 F.R. 6414, which prescribed regulations governing allowances, was superseded by Ex. Ord. No. 11142, Feb. 12, 1964, 29 F.R. 2479.

Executive Order No. 11142

Ex. Ord. No. 11142, Feb. 12, 1964, 29 F.R. 2479, which prescribed regulations governing allowances, was superseded by Ex. Ord. No. 11302, Sept. 6, 1966, 31 F.R. 11741, set out below.

Ex. Ord. No. 11302. Regulations Governing Allowances

Ex. Ord. No. 11302, Sept. 6, 1966, 31 F.R. 11741, as amended by Ex. Ord. No. 11429, Sept. 9, 1968, 33 F.R. 12817; Ex. Ord. No. 11609, July 22, 1971, 36 F.R. 13747, provided:

By virtue of the authority vested in me by Section 111 of Title 38 of the United States Code, as amended by the Act of June 18, 1966 (Public Law 89–455), it is hereby ordered as follows:

Section 1. The Administrator of Veterans' Affairs may authorize or approve the payment of the actual necessary expenses of travel, including lodging and subsistence, of any claimant or beneficiary of the Veterans' Administration traveling to or from a Veterans' Administration facility, or other place, in connection with vocational rehabilitation or counseling, or for the purpose of examination, treatment, or care. The Administrator may authorize or approve such payment to the claimant or beneficiary, or, in his discretion, to the person who or the organization which has actually paid the expenses of such travel, including lodging and subsistence.

Sec. 2. The Administrator of Veterans' Affairs may authorize or approve in lieu of actual necessary expenses of travel, including lodging and subsistence, payment of an allowance, in such amount per mile as the Administrator shall from time to time fix pursuant to 38 U.S.C. 111 as affected by this order, to any claimant or beneficiary of the Veterans' Administration traveling to or from a Veterans' Administration facility, or other place, in connection with vocational rehabilitation or counseling, or for the purpose of examination, treatment, or care. In addition to such mileage allowance, the Administrator may allow reimbursement for the actual cost of ferry fares, and bridge, road, and tunnel tolls. In his discretion, the Administrator may authorize or approve such payment and such reimbursement to the person who or the organization which has actually paid the expenses of such travel, including lodging and subsistence.

Sec. 3. Whenever a claimant or beneficiary requires an attendant other than an employee of the Veterans' Administration for the performance of travel specified in Section 1 and 2 hereof, the travel expenses of such attendant may be allowed in the same manner and to the same extent that travel expenses are allowed to such claimant or beneficiary.

Sec. 4. Payment of the following expenses or allowances in connection with vocational rehabilitation, counseling, or upon termination of examination, treatment, or care, may be made before the completion of travel:

a. The mileage allowance and fare and tolls authorized by Section 2 hereof.

b. Actual local travel expenses.

c. The expense of hiring an automobile or ambulance, or the fee authorized for services of a non-employee attendant.

Sec. 5. The Administrator of Veterans' Affairs may prescribe such rules and regulations not inconsistent herewith as may be necessary to effectuate the provisions of this order.

Sec. 6. Executive Order No. 11142 of February 12, 1964, is hereby superseded.

1 So in original. Probably should be preceded by "the".
38 U.S.C. § 3018C (2024) — Title 38: VETERANS' BENEFITS / Chapter 30 / Subchapter II / Section 3018C: Opportunity for certain VEAP participants to enroll
Opportunity for certain VEAP participants to enroll
Status: in_force

(a) Notwithstanding any other provision of law, an individual who—

(1) is a participant on October 9, 1996, in the educational benefits program provided by chapter 32 of this title;

(2) is serving on active duty (excluding the periods referred to in section 3202(1)(C) of this title) on such date;

(3) before applying for benefits under this section, has completed the requirements of a secondary school diploma (or equivalency certificate) or has successfully completed (or otherwise received academic credit for) the equivalent of 12 semester hours in a program of education leading to a standard college degree;

(4) if discharged or released from active duty after the date on which the individual makes the election described in paragraph (5), is discharged or released therefrom with an honorable discharge; and

(5) during the one-year period beginning on October 9, 1996, makes an irrevocable election to receive benefits under this section in lieu of benefits under chapter 32 of this title, pursuant to procedures which the Secretary of each military department shall provide in accordance with regulations prescribed by the Secretary of Defense for the purpose of carrying out this section or which the Secretary of Homeland Security shall provide for such purpose with respect to the Coast Guard when it is not operating as a service in the Navy;

may elect to become entitled to basic educational assistance under this chapter.

(b) With respect to an individual who makes an election under subsection (a) to become entitled to basic education assistance under this chapter—

(1) the basic pay of the individual shall be reduced (in a manner determined by the Secretary of Defense) until the total amount by which such basic pay is reduced is $1,200; or

(2) to the extent that basic pay is not so reduced before the individual's discharge or release from active duty as specified in subsection (a)(4), the Secretary shall collect from the individual an amount equal to the difference between $1,200 and the total amount of reductions under paragraph (1), which shall be paid into the Treasury of the United States as miscellaneous receipts.

(c)(1) Except as provided in paragraph (3), an individual who is enrolled in the educational benefits program provided by chapter 32 of this title and who makes the election described in subsection (a)(5) shall be disenrolled from such chapter 32 program as of the date of such election.

(2) For each individual who is disenrolled from such program, the Secretary shall refund—

(A) to the individual, as provided in section 3223(b) of this title and subject to subsection (b)(2) of this section, the unused contributions made by the individual to the Post-Vietnam Era Veterans Education Account established pursuant to section 3222(a) of this title; and

(B) to the Secretary of Defense the unused contributions (other than contributions made under section 3222(c) of this title) made by such Secretary to the Account on behalf of such individual.

(3) Any contribution made by the Secretary of Defense to the Post-Vietnam Era Veterans Education Account pursuant to subsection (c) of section 3222 of this title on behalf of any individual referred to in paragraph (1) shall remain in such account to make payments of benefits to such individual under section 3015(f) of this title.

(d) The procedures provided in regulations referred to in subsection (a) shall provide for notice of the requirements of subparagraphs (B), (C), and (D) of section 3011(a)(3) and of subparagraph (A) of section 3012(a)(3) of this title. Receipt of such notice shall be acknowledged in writing.

(e)(1) A qualified individual (described in paragraph (2)) may make an irrevocable election under this subsection, during the one-year period beginning on the date of the enactment of this subsection, to become entitled to basic educational assistance under this chapter. Such an election shall be made in the same manner as elections made under subsection (a)(5).

(2) A qualified individual referred to in paragraph (1) is an individual who meets each of the following requirements:

(A) The individual was a participant in the educational benefits program under chapter 32 of this title on or before October 9, 1996.

(B) The individual has continuously served on active duty since October 9, 1996 (excluding the periods referred to in section 3202(1)(C) of this title), through at least April 1, 2000.

(C) The individual meets the requirements of subsection (a)(3).

(D) The individual, when discharged or released from active duty, is discharged or released therefrom with an honorable discharge.

(3)(A) Subject to the succeeding provisions of this paragraph, with respect to a qualified individual who makes an election under paragraph (1) to become entitled to basic education assistance under this chapter—

(i) the basic pay of the qualified individual shall be reduced (in a manner determined by the Secretary concerned) until the total amount by which such basic pay is reduced is $2,700; and

(ii) to the extent that basic pay is not so reduced before the qualified individual's discharge or release from active duty as specified in subsection (a)(4), at the election of the qualified individual—

(I) the Secretary concerned shall collect from the qualified individual; or

(II) the Secretary concerned shall reduce the retired or retainer pay of the qualified individual by,

an amount equal to the difference between $2,700 and the total amount of reductions under clause (i), which shall be paid into the Treasury of the United States as miscellaneous receipts.

(B)(i) The Secretary concerned shall provide for an 18-month period, beginning on the date the qualified individual makes an election under paragraph (1), for the qualified individual to pay that Secretary the amount due under subparagraph (A).

(ii) Nothing in clause (i) shall be construed as modifying the period of eligibility for and entitlement to basic education assistance under this chapter applicable under section 3031 of this title.

(C) The provisions of subsection (c) shall apply to qualified individuals making elections under this subsection in the same manner as they applied to individuals making elections under subsection (a)(5).

(4) With respect to qualified individuals referred to in paragraph (3)(A)(ii), no amount of educational assistance allowance under this chapter shall be paid to the qualified individual until the earlier of the date on which—

(A) the Secretary concerned collects the applicable amount under subclause (I) of such paragraph; or

(B) the retired or retainer pay of the qualified individual is first reduced under subclause (II) of such paragraph.

(5) The Secretary, in conjunction with the Secretary of Defense, shall provide for notice to participants in the educational benefits program under chapter 32 of this title of the opportunity under this subsection to elect to become entitled to basic educational assistance under this chapter.

(Added Pub. L. 104–275, title I, §106(a), Oct. 9, 1996, 110 Stat. 3327; amended Pub. L. 105–114, title IV, §401(c), Nov. 21, 1997, 111 Stat. 2293; Pub. L. 105–368, title II, §203(a), Nov. 11, 1998, 112 Stat. 3326; Pub. L. 106–398, §1 [[div. A], title XVI, §1601], Oct. 30, 2000, 114 Stat. 1654, 1654A–357; Pub. L. 106–419, title I, §104(a)–(c)(1), Nov. 1, 2000, 114 Stat. 1827, 1828; Pub. L. 107–14, §7(e)(1), June 5, 2001, 115 Stat. 33; Pub. L. 107–296, title XVII, §1704(d), Nov. 25, 2002, 116 Stat. 2315; Pub. L. 107–330, title III, §308(g)(9), Dec. 6, 2002, 116 Stat. 2829.)

Editorial Notes

References in Text

The date of the enactment of this subsection, referred to in subsec. (e)(1), is the date of enactment of Pub. L. 106–419, which was approved Nov. 1, 2000.

Amendments

2002—Subsec. (a)(5). Pub. L. 107–296 substituted "of Homeland Security" for "of Transportation".

Subsec. (e)(2)(B). Pub. L. 107–330 struck out comma after "April".

2001—Subsec. (b). Pub. L. 107–14 struck out "or (e)" after "subsection (a)" in introductory provisions.

2000—Pub. L. 106–419, §104(c)(1), provided that as of the enactment of Pub. L. 106–419, the amendments made by Pub. L. 106–398, §1 [[div. A], title XVI, §1601], were deemed for all purposes not to have taken effect and that Pub. L. 106–398, §1 [[div. A], title XVI, §1601], ceased to be in effect. See Amendment notes below.

Subsec. (b). Pub. L. 106–419, §104(b), substituted "subsection (a) or (e)" for "subsection (a)" in introductory provisions.

Pub. L. 106–398, §1 [[div. A], title XVI, §1601(b)], which substituted "subsection (a) or (e)" for "subsection (a)" in introductory provisions, was terminated by Pub. L. 106–419, §104(c)(1). See Amendment note above.

Subsec. (e). Pub. L. 106–419, §104(a), added subsec. (e).

Pub. L. 106–398, §1 [[div. A], title XVI, §1601(a)], which added a subsec. (e) substantially identical to the subsec. (e) added by Pub. L. 106–419, §104(a), was terminated by Pub. L. 106–419, §104(c)(1). See Amendment notes above.

1998—Subsec. (a)(3). Pub. L. 105–368 substituted "successfully completed (or otherwise received academic credit for)" for "successfully completed".

1997—Subsec. (a)(1). Pub. L. 105–114, §401(c)(1), substituted "October 9, 1996," for "the date of the enactment of the Veterans' Benefits Improvements Act of 1996".

Subsec. (a)(4). Pub. L. 105–114, §401(c)(2), substituted "after the date on which the individual makes the election described" for "during the one-year period specified".

Subsec. (a)(5). Pub. L. 105–114, §401(c)(3), substituted "October 9, 1996" for "the date of the enactment of the Veterans' Benefits Improvements Act of 1996".

Statutory Notes and Related Subsidiaries

Effective Date of 2002 Amendment

Amendment by Pub. L. 107–296 effective on the date of transfer of the Coast Guard to the Department of Homeland Security, see section 1704(g) of Pub. L. 107–296, set out as a note under section 101 of Title 10, Armed Forces.

Effective Date of 1998 Amendment

Amendment by Pub. L. 105–368 effective Oct. 1, 1998, see section 203(b) of Pub. L. 105–368, set out as a note under section 3011 of this title.

Treatment of Certain Contributions

Pub. L. 107–14, §7(e)(2), June 5, 2001, 115 Stat. 33, provided that: "Any amount collected under section 3018C(b) of title 38, United States Code (whether by reduction in basic pay under paragraph (1) of that section, collection under paragraph (2) of that section, or both), with respect to an individual who enrolled in basic educational assistance under section 3018C(e) of that title, during the period beginning on November 1, 2000, and ending on the date of the enactment of this Act [June 5, 2001], shall be treated as an amount collected with respect to the individual under section 3018C(e)(3)(A) of that title (whether as a reduction in basic pay under clause (i) of that section, a collection under clause (ii) of that section, or both) for basic educational assistance under section 3018C of that title."
38 U.S.C. § 103 (2024) — Title 38: VETERANS' BENEFITS / Chapter 1 / Section 103: Special provisions relating to marriages
Special provisions relating to marriages
Status: in_force

(a) Whenever, in the consideration of any claim filed by a person as the widow or widower of a veteran for gratuitous death benefits under laws administered by the Secretary, it is established by evidence satisfactory to the Secretary that such person, without knowledge of any legal impediment, entered into a marriage with such veteran which, but for a legal impediment, would have been valid, and thereafter cohabited with the veteran for one year or more immediately before the veteran's death, or for any period of time if a child was born of the purported marriage or was born to them before such marriage, the purported marriage shall be deemed to be a valid marriage, but only if no claim has been filed by a legal widow or widower of such veteran who is found to be entitled to such benefits. No duplicate payments shall be made by virtue of this subsection.

(b) Where a surviving spouse has been legally married to a veteran more than once, the date of original marriage will be used in determining whether the statutory requirement as to date of marriage has been met.

(c) In determining whether or not a person is or was the spouse of a veteran, their marriage shall be proven as valid for the purposes of all laws administered by the Secretary according to the law of the place where the parties resided at the time of the marriage or the law of the place where the parties resided when the right to benefits accrued.

(d)(1) The remarriage of the surviving spouse of a veteran shall not bar the furnishing of benefits to such person as the surviving spouse of the veteran if the remarriage is void, or has been annulled by a court with basic authority to render annulment decrees unless the Secretary determines that the annulment was secured through fraud by either party or collusion.

(2)(A) The remarriage of the surviving spouse of a veteran shall not bar the furnishing of benefits specified in paragraph (5) to such person as the surviving spouse of the veteran if the remarriage has been terminated by death or divorce unless the Secretary determines that the divorce was secured through fraud or collusion.

(B) The remarriage after age 57 of the surviving spouse of a veteran shall not bar the furnishing of benefits specified in paragraph (5) to such person as the surviving spouse of the veteran. Notwithstanding the previous sentence, the remarriage after age 55 of the surviving spouse of a veteran shall not bar the furnishing of benefits under chapter 13 or section 1781 of this title to such person as the surviving spouse of the veteran.

(3) If the surviving spouse of a veteran ceases living with another person and holding himself or herself out openly to the public as that person's spouse, the bar to granting that person benefits as the surviving spouse of the veteran shall not apply in the case of the benefits specified in paragraph (5).

(4) The first month of eligibility for benefits for a surviving spouse by reason of paragraph (2)(A) or (3) shall be the month after—

(A) the month of the termination of such remarriage, in the case of a surviving spouse described in paragraph (2)(A); or

(B) the month of the cessation described in paragraph (3), in the case of a surviving spouse described in that paragraph.

(5) Paragraphs (2)(A) and (3) apply with respect to benefits under the following provisions of this title:

(A) Section 1311, relating to dependency and indemnity compensation.

(B) Section 1781, relating to medical care for survivors and dependents of certain veterans.

(C) Chapter 35, relating to educational assistance.

(D) Chapter 37, relating to housing loans.

(E) Section 1562(a)(2), relating to Medal of Honor special pension.

(e) The marriage of a child of a veteran shall not bar recognition of such child as the child of the veteran for benefit purposes if the marriage is void, or has been annulled by a court with basic authority to render annulment decrees unless the Secretary determines that the annulment was secured through fraud by either party or collusion.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1109; Pub. L. 87–674, §2, Sept. 19, 1962, 76 Stat. 558; Pub. L. 90–77, title I, §101(b), Aug. 31, 1967, 81 Stat. 178; Pub. L. 91–376, §4, Aug. 12, 1970, 84 Stat. 789; Pub. L. 93–527, §9(a), Dec. 21, 1974, 88 Stat. 1705; Pub. L. 99–576, title VII, §701(2), Oct. 28, 1986, 100 Stat. 3290; Pub. L. 101–508, title VIII, §8004(a), Nov. 5, 1990, 104 Stat. 1388–343; Pub. L. 102–83, §4(a)(1), (2)(A)(i), (b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 403–405; Pub. L. 106–117, title V, §502(a), Nov. 30, 1999, 113 Stat. 1574; Pub. L. 107–135, title II, §208(e)(1), Jan. 23, 2002, 115 Stat. 2463; Pub. L. 107–330, title I, §101(a), Dec. 6, 2002, 116 Stat. 2821; Pub. L. 108–183, title I, §101(a), title VII, §708(a)(1), Dec. 16, 2003, 117 Stat. 2652, 2673; Pub. L. 116–315, title II, §§2003(b)(2)(B), 2009, Jan. 5, 2021, 134 Stat. 4970, 4978.)

Editorial Notes

Amendments

2021—Subsec. (d)(2)(B). Pub. L. 116–315, §2009, inserted "chapter 13 or" after "benefits under".

Subsec. (d)(5)(E). Pub. L. 116–315, §2003(b)(2)(B), added subpar. (E).

2003—Subsec. (d)(2)(B). Pub. L. 108–183, §101(a), substituted "The remarriage after age 57 of the surviving spouse of a veteran shall not bar the furnishing of benefits specified in paragraph (5) to such person as the surviving spouse of the veteran. Notwithstanding the previous sentence, the remarriage after age 55" for "The remarriage after age 55".

Subsec. (d)(4). Pub. L. 108–183, §708(a)(1)(A)(i), substituted "paragraph (2)(A) or (3)" for "this subsection" in introductory provisions.

Subsec. (d)(4)(A). Pub. L. 108–183, §708(a)(1)(A)(ii), substituted "paragraph (2)(A)" for "paragraph (2)".

Subsec. (d)(5). Pub. L. 108–183, §708(a)(1)(B), substituted "Paragraphs (2)(A)" for "Paragraphs (2)" in introductory provisions.

2002—Subsec. (d)(2). Pub. L. 107–330 designated existing provisions as subpar. (A) and added subpar. (B).

Subsec. (d)(5)(B). Pub. L. 107–135 substituted "1781" for "1713".

1999—Subsec. (d). Pub. L. 106–117 designated existing provisions as par. (1) and added pars. (2) to (5).

1991—Subsec. (a). Pub. L. 102–83, §4(a)(1), (b)(1), (2)(E), substituted "administered by the Secretary" for "administered by the Veterans' Administration" and "Secretary" for "Administrator".

Subsec. (c). Pub. L. 102–83, §4(a)(1), substituted "administered by the Secretary" for "administered by the Veterans' Administration".

Subsecs. (d), (e). Pub. L. 102–83, §4(a)(2)(A)(i), substituted "Secretary" for "Veterans' Administration".

1990—Subsec. (d). Pub. L. 101–508, §8004(a)(1), designated par. (1) as entire subsec. (d) and struck out pars. (2) and (3) which read as follows:

"(2) The remarriage of the surviving spouse of a veteran shall not bar the furnishing of benefits to such person as the surviving spouse of the veteran if the remarriage has been terminated by death or has been dissolved by a court with basic authority to render divorce decrees unless the Veterans' Administration determines that the divorce was secured through fraud by the surviving spouse or collusion.

"(3) If a surviving spouse ceases living with another person and holding himself or herself out openly to the public as that person's spouse, the bar to granting that person benefits as the surviving spouse of the veteran shall not apply."

Subsec. (e). Pub. L. 101–508, §8004(a)(2), designated par. (1) as entire subsec. (e) and struck out par. (2) which read as follows: "The marriage of a child of a veteran shall not bar the recognition of such child as the child of the veteran for benefit purposes if the marriage has been terminated by death or has been dissolved by a court, with basic authority to render divorce decrees unless the Veterans' Administration determines that the divorce was secured through fraud by either party or collusion."

1986—Subsec. (a). Pub. L. 99–576, §701(2)(A), substituted "person as the widow or widower" for "woman as the widow", "such person" for "she", "the veteran" for "him", "the veteran's" for "his", and "legal widow or widower" for "legal widow".

Subsec. (b). Pub. L. 99–576, §701(2)(B), substituted "surviving spouse" for "widow".

Subsec. (c). Pub. L. 99–576, §701(2)(C), substituted "person is or was the spouse" for "woman is or was the wife".

Subsec. (d)(1). Pub. L. 99–576, §701(2)(D), substituted "surviving spouse of a veteran shall not bar the furnishing of benefits to such person as the surviving spouse" for "widow of a veteran shall not bar the furnishing of benefits to her as the widow".

Subsec. (d)(2). Pub. L. 99–576, §701(2)(E), substituted "surviving spouse" for "widow" wherever appearing, and "such person" for "her".

Subsec. (d)(3). Pub. L. 99–576, §701(2)(F), substituted "surviving spouse" for "widow" wherever appearing, "person" for "man", "himself or herself" for "herself", "that person's spouse" for "his wife", and "that person" for "her".

1974—Subsec. (e). Pub. L. 93–527 designated existing provisions as par. (1) and added par. (2).

1970—Subsec. (d). Pub. L. 91–376 designated existing provisions as par. (1) and added pars. (2) and (3).

1967—Subsec. (a). Pub. L. 90–77 reduced cohabitation period from five years to one year for purposes of deeming a purported marriage valid and provided for cohabitation for any period of time if a child was born of the purported marriage or was born before the marriage.

1962—Subsecs. (d), (e). Pub. L. 87–674 added subsecs. (d) and (e).

Statutory Notes and Related Subsidiaries

Effective Date of 2021 Amendment

Pub. L. 116–315, title II, §2003(b)(3), Jan. 5, 2021, 134 Stat. 4970, provided that: "The amendments made by this subsection [amending this section and section 1562 of this title] shall apply with respect to payment of pension under section 1562 of title 38, United States Code, for months beginning after the date of the enactment of this Act [Jan. 5, 2021]."

Effective Date of 2003 Amendment

Pub. L. 108–183, title I, §101(c), Dec. 16, 2003, 117 Stat. 2653, provided that: "The amendments made by subsections (a) and (b) [amending this section and section 1311 of this title] shall take effect on January 1, 2004."

Effective Date of 2002 Amendment

Pub. L. 107–330, title I, §101(c), Dec. 6, 2002, 116 Stat. 2821, provided that: "The amendments made by this section [amending this section] shall take effect on the date that is 60 days after the date of the enactment of this Act [Dec. 6, 2002]."

Effective Date of 1999 Amendment

Pub. L. 106–117, title V, §502(c), Nov. 30, 1999, 113 Stat. 1574, provided that: "The amendments made by subsections (a) and (b) [amending this section and section 1311 of this title] shall take effect on the first day of the first month beginning after the month in which this Act is enacted [November 1999]."

Effective Date of 1990 Amendment

Pub. L. 101–508, title VIII, §8004(b), Nov. 5, 1990, 104 Stat. 1388–343, provided that: "The amendments made by subsection (a) [amending this section] shall apply with respect to claims filed after October 31, 1990, and shall not operate to reduce or terminate benefits to any individual whose benefits were predicated on section 103(d)(2), 103(d)(3), or 103(e)(2) before the effective date of those amendments."

Effective Date of 1974 Amendment

Amendment by Pub. L. 93–527 effective Jan. 1, 1975, see section 10 of Pub. L. 93–527, set out as a note under section 1521 of this title.

Effective Date of 1970 Amendment

Amendment by Pub. L. 91–376 effective Jan. 1, 1971, see section 9 of Pub. L. 91–376, set out as a note under section 1114 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.

Retroactive Benefits Prohibited

Pub. L. 108–183, title I, §101(d), Dec. 16, 2003, 117 Stat. 2653, provided that: "No benefit may be paid to any person by reason of the amendments made by subsections (a) and (b) [amending this section and section 1311 of this title] for any period before the effective date specified in subsection (c) [set out as an Effective Date of 2003 Amendment note above]."

Application for Benefits

Pub. L. 108–183, title I, §101(e), Dec. 16, 2003, 117 Stat. 2653, provided that: "In the case of an individual who but for having remarried would be eligible for benefits under title 38, United States Code, by reason of the amendment made by subsection (a) [amending this section] and whose remarriage was before the date of the enactment of this Act [Dec. 16, 2003] and after the individual had attained age 57, the individual shall be eligible for such benefits by reason of such amendment only if the individual submits an application for such benefits to the Secretary of Veterans Affairs not later than the end of the one-year period beginning on the date of the enactment of this Act."

Pub. L. 107–330, title I, §101(b), Dec. 6, 2002, 116 Stat. 2821, as amended by Pub. L. 108–183, title I, §101(f), Dec. 16, 2003, 117 Stat. 2653, provided that: "In the case of an individual who but for having remarried would be eligible for medical care under section 1781 of title 38, United States Code, and whose remarriage was before the date of the enactment of this Act [Dec. 6, 2002] and after the individual had attained age 55, the individual shall be eligible for such medical care by reason of the amendments made by subsection (a) [amending this section] only if an application for such medical care is received by the Secretary of Veterans Affairs before the end of the one-year period beginning on the date of the enactment of the Veterans Benefits Act of 2003 [Dec. 16, 2003]."

Limitation on Payments

Pub. L. 106–117, title V, §502(d), Nov. 30, 1999, 113 Stat. 1574, provided that: "No payment may be made to a person by reason of paragraphs (2) and (3) of section 103(d) of title 38, United States Code, as added by subsection (a), for any period before the effective date specified in subsection (c) [set out as an Effective Date of 1999 Amendment note above]."

Applicability of Amendments

Pub. L. 102–568, title I, §103, Oct. 29, 1992, 106 Stat. 4322, provided that:

"(a) Exception.—The amendments made by section 8004 of the Omnibus Budget Reconciliation Act of 1990 (105 Stat. 424) [Pub. L. 101–508, 104 Stat. 1388–343, amending this section] shall not apply to any case in which a legal proceeding to terminate an existing marital relationship was commenced before November 1, 1990, by an individual described in subsection (b) if that proceeding directly resulted in the termination of such marriage.

"(b) Covered Individuals.—An individual referred to in subsection (a) is an individual who, but for the marital relationship referred to in subsection (a), would be considered to be the surviving spouse of a veteran."

Pub. L. 102–86, title V, §502, Aug. 14, 1991, 105 Stat. 424, provided that: "The amendments made by section 8004 of the Omnibus Budget Reconciliation Act of 1990 (Public Law 101–508) [amending this section] shall not apply with respect to any individual who on October 31, 1990, was a surviving spouse or child within the meaning of title 38, United States Code, unless after that date that individual (1) marries, or (2) in the case of a surviving spouse, begins to live with another person while holding himself or herself out openly to the public as that person's spouse."

Reinstatement of Benefits Subsequent to Termination of Relationship or Conduct Restricting Payment of Benefits; Effective Date of Award

Pub. L. 91–376, §5, Aug. 12, 1970, 84 Stat. 789, effective January 1, 1971, provided that:

"(a) If a widow terminates a relationship or conduct which resulted in imposition of a prior restriction on payment of benefits, in the nature of inference or presumption of remarriage, or relating to open and notorious adulterous cohabitation or similar conduct, she shall not be denied any benefits by the Veterans' Administration, other than insurance, solely because of such prior relationship or conduct.

"(b) The effective date of an award of benefits resulting from enactment of subsection (a) of this section shall not be earlier than the date of receipt of application therefor, filed after termination of the particular relationship or conduct and after December 31, 1970."
38 U.S.C. § 1720G (2024) — Title 38: VETERANS' BENEFITS / Chapter 17 / Subchapter II / Section 1720G: Assistance and support services for caregivers
Assistance and support services for caregivers
Status: in_force

(a) Program of Comprehensive Assistance for Family Caregivers.—(1)(A) The Secretary shall establish a program of comprehensive assistance for family caregivers of eligible veterans.

(B) The Secretary shall only provide support under the program required by subparagraph (A) to a family caregiver of an eligible veteran if the Secretary determines it is in the best interest of the eligible veteran to do so.

(2) For purposes of this subsection, an eligible veteran is any individual who—

(A) is a veteran or member of the Armed Forces undergoing medical discharge from the Armed Forces;

(B) for assistance provided under this subsection—

(i) before the date on which the Secretary submits to Congress a certification that the Department has fully implemented the information technology system required by section 162(a) of the Caring for Our Veterans Act of 2018, has a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, air, or space service on or after September 11, 2001;

(ii) during the 2-year period beginning on the date on which the Secretary submitted to Congress the certification described in clause (i), has a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, air, or space service—

(I) on or before May 7, 1975; or

(II) on or after September 11, 2001; or

(iii) after the date that is 2 years after the date on which the Secretary submits to Congress the certification described in clause (i), has a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, air, or space service; and

(C) is in need of personal care services because of—

(i) an inability to perform one or more activities of daily living;

(ii) a need for supervision or protection based on symptoms or residuals of neurological or other impairment or injury;

(iii) a need for regular or extensive instruction or supervision without which the ability of the veteran to function in daily life would be seriously impaired; or

(iv) such other matters as the Secretary considers appropriate.

(3)(A) As part of the program required by paragraph (1), the Secretary shall provide to family caregivers of eligible veterans the following assistance:

(i) To each family caregiver who is approved as a provider of personal care services for an eligible veteran under paragraph (6)—

(I) such instruction, preparation, and training as the Secretary considers appropriate for the family caregiver to provide personal care services to the eligible veteran;

(II) ongoing technical support consisting of information and assistance to address, in a timely manner, the routine, emergency, and specialized caregiving needs of the family caregiver in providing personal care services to the eligible veteran;

(III) counseling; and

(IV) lodging and subsistence under section 111(e) of this title.

(ii) To each family caregiver who is designated as the primary provider of personal care services for an eligible veteran under paragraph (7)—

(I) the assistance described in clause (i);

(II) such mental health services as the Secretary determines appropriate;

(III) covered respite care of not less than 30 days annually;

(IV) medical care under section 1781 of this title;

(V) a monthly personal caregiver stipend; and

(VI) through the use of contracts with, or the provision of grants to, public or private entities—

(aa) financial planning services relating to the needs of injured veterans and their caregivers; and

(bb) legal services, including legal advice and consultation, relating to the needs of injured veterans and their caregivers.

(B)(i) The amount of the monthly personal caregiver stipend provided under subparagraph (A)(ii)(V) shall be determined in accordance with a schedule established by the Secretary that specifies stipends based upon the amount and degree of personal care services provided.

(ii) The Secretary shall ensure, to the extent practicable, that the schedule required by clause (i) specifies that the amount of the monthly personal caregiver stipend provided to a primary provider of personal care services for the provision of personal care services to an eligible veteran is not less than the monthly amount a commercial home health care entity would pay an individual in the geographic area of the eligible veteran to provide equivalent personal care services to the eligible veteran.

(iii) In determining the amount and degree of personal care services provided under clause (i) with respect to an eligible veteran whose need for personal care services is based in whole or in part on a need for supervision or protection under paragraph (2)(C)(ii) or regular instruction or supervision under paragraph (2)(C)(iii), the Secretary shall take into account the following:

(I) The assessment by the family caregiver of the needs and limitations of the veteran.

(II) The extent to which the veteran can function safely and independently in the absence of such supervision, protection, or instruction.

(III) The amount of time required for the family caregiver to provide such supervision, protection, or instruction to the veteran.

(iv) If personal care services are not available from a commercial home health entity in the geographic area of an eligible veteran, the amount of the monthly personal caregiver stipend payable under the schedule required by clause (i) with respect to the eligible veteran shall be determined by taking into consideration the costs of commercial providers of personal care services in providing personal care services in geographic areas other than the geographic area of the eligible veteran with similar costs of living.

(C) In providing instruction, preparation, and training under subparagraph (A)(i)(I) and technical support under subparagraph (A)(i)(II) to each family caregiver who is approved as a provider of personal care services for an eligible veteran under paragraph (6), the Secretary shall periodically evaluate the needs of the eligible veteran and the skills of the family caregiver of such veteran to determine if additional instruction, preparation, training, or technical support under those subparagraphs is necessary.

(4) An eligible veteran and a family member of the eligible veteran seeking to participate in the program required by paragraph (1) shall jointly submit to the Secretary an application therefor in such form and in such manner as the Secretary considers appropriate.

(5) For each application submitted jointly by an eligible veteran and family member, the Secretary shall evaluate (in collaboration with the primary care team for the eligible veteran to the maximum extent practicable)—

(A) the eligible veteran—

(i) to identify the personal care services required by the eligible veteran; and

(ii) to determine whether such requirements could be significantly or substantially satisfied through the provision of personal care services from a family member; and

(B) the family member to determine the amount of instruction, preparation, and training, if any, the family member requires to provide the personal care services required by the eligible veteran—

(i) as a provider of personal care services for the eligible veteran; and

(ii) as the primary provider of personal care services for the eligible veteran.

(6)(A) The Secretary shall provide each family member of an eligible veteran who makes a joint application under paragraph (4) the instruction, preparation, and training determined to be required by such family member under paragraph (5)(B).

(B) Upon the successful completion by a family member of an eligible veteran of instruction, preparation, and training under subparagraph (A), the Secretary shall approve the family member as a provider of personal care services for the eligible veteran.

(C) The Secretary shall, subject to regulations the Secretary shall prescribe, provide for necessary travel, lodging, and per diem expenses incurred by a family member of an eligible veteran in undergoing instruction, preparation, and training under subparagraph (A).

(D) If the participation of a family member of an eligible veteran in instruction, preparation, and training under subparagraph (A) would interfere with the provision of personal care services to the eligible veteran, the Secretary shall, subject to regulations as the Secretary shall prescribe and in consultation with the veteran, provide respite care to the eligible veteran during the provision of such instruction, preparation, and training to the family member so that the family member can participate in such instruction, preparation, and training without interfering with the provision of such services to the eligible veteran.

(7)(A) For each eligible veteran with at least one family member who is described by subparagraph (B), the Secretary shall designate one family member of such eligible veteran as the primary provider of personal care services for such eligible veteran.

(B) A primary provider of personal care services designated for an eligible veteran under subparagraph (A) shall be selected from among family members of the eligible veteran who—

(i) are approved under paragraph (6) as a provider of personal care services for the eligible veteran;

(ii) elect to provide the personal care services to the eligible veteran that the Secretary determines the eligible veteran requires under paragraph (5)(A)(i);

(iii) have the consent of the eligible veteran to be the primary provider of personal care services for the eligible veteran; and

(iv) are considered by the Secretary as competent to be the primary provider of personal care services for the eligible veteran.

(C) An eligible veteran receiving personal care services from a family member designated as the primary provider of personal care services for the eligible veteran under subparagraph (A) may, in accordance with procedures the Secretary shall establish for such purposes, revoke consent with respect to such family member under subparagraph (B)(iii).

(D) If a family member designated as the primary provider of personal care services for an eligible veteran under subparagraph (A) subsequently fails to meet any requirement set forth in subparagraph (B), the Secretary—

(i) shall immediately revoke the family member's designation under subparagraph (A); and

(ii) may designate, in consultation with the eligible veteran, a new primary provider of personal care services for the eligible veteran under such subparagraph.

(E) The Secretary shall take such actions as may be necessary to ensure that the revocation of a designation under subparagraph (A) with respect to an eligible veteran does not interfere with the provision of personal care services required by the eligible veteran.

(8) If an eligible veteran lacks the capacity to make a decision under this subsection, the Secretary may, in accordance with regulations and policies of the Department regarding appointment of guardians or the use of powers of attorney, appoint a surrogate for the eligible veteran who may make decisions and take action under this subsection on behalf of the eligible veteran.

(9)(A) The Secretary shall monitor the well-being of each eligible veteran receiving personal care services under the program required by paragraph (1).

(B) The Secretary shall document each finding the Secretary considers pertinent to the appropriate delivery of personal care services to an eligible veteran under the program.

(C) The Secretary shall establish procedures to ensure appropriate follow-up regarding findings described in subparagraph (B). Such procedures may include the following:

(i) Visiting an eligible veteran in the eligible veteran's home to review directly the quality of personal care services provided to the eligible veteran.

(ii) Taking such corrective action with respect to the findings of any review of the quality of personal care services provided an eligible veteran as the Secretary considers appropriate, which may include—

(I) providing additional training to a family caregiver; and

(II) suspending or revoking the approval of a family caregiver under paragraph (6) or the designation of a family caregiver under paragraph (7).

(10) The Secretary shall carry out outreach to inform eligible veterans and family members of eligible veterans of the program required by paragraph (1) and the benefits of participating in the program.

(11)(A) In providing assistance under this subsection to family caregivers of eligible veterans, the Secretary may enter into contracts, provider agreements, and memoranda of understanding with Federal agencies, States, and private, nonprofit, and other entities to provide such assistance to such family caregivers.

(B) The Secretary may provide assistance under this paragraph only if such assistance is reasonably accessible to the family caregiver and is substantially equivalent or better in quality to similar services provided by the Department.

(C) The Secretary may provide fair compensation to Federal agencies, States, and other entities that provide assistance under this paragraph.

(12)(A) The Secretary shall notify the individuals described in subparagraph (C) regarding decisions affecting the furnishing of assistance under this subsection using standardized letters, as the Secretary determines such notifications and letters to be appropriate, which shall include all criteria used to determine eligibility for such assistance and, in the case of a completed evaluation, how such criteria were used to evaluate information provided in assessments to determine such eligibility.

(B) A notification provided under subparagraph (A) shall include the elements required for notices of decisions under section 5104(b) of this title to the extent that those elements apply to such notification, unless, not later than 60 days after the date of the enactment of the Transparency and Effective Accountability Measures for Veteran Caregivers Act, the Secretary determines that it would not be feasible to include such elements in such notifications and submits to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives a report setting forth the reasons for such determination.

(C) The individuals described in this subparagraph shall include—

(i) an individual who—

(I) submits an application for the program established under paragraph (1); or

(II) is being reassessed for eligibility to continue in such program.

(ii) an individual determined by the Secretary to be an eligible veteran pursuant to such an application; and

(iii) a family caregiver of an eligible veteran who is—

(I) approved as a provider of personal care services under paragraph (6)(B); or

(II) designated as a primary provider of personal care services under paragraph (7)(A).

(13)(A) If the Secretary determines that a veteran receiving services under the program established under paragraph (1) is no longer eligible for such program solely because of improvement in the condition of the veteran—

(i) the effective date of discharge of the veteran from the program shall be not earlier than the date that is 60 days after the date on which the Secretary provides notice of such lack of eligibility under paragraph (12)(A) to the relevant individuals described in paragraph (12)(C); and

(ii) the Secretary shall extend benefits under the program established under paragraph (1) for a family caregiver of the veteran described in paragraph (12)(C)(iii), including stipends under paragraph (3)(A)(ii)(V), if such an extension is determined appropriate by the Secretary, for a 90-day period following discharge of the veteran from the program.

(B) This paragraph shall not be construed to limit the authority of the Secretary—

(i) to prescribe regulations addressing other bases for—

(I) the discharge of a veteran from the program established under paragraph (1); or

(II) the revocation of the designation of a family caregiver of a veteran as a primary provider of personal care services under paragraph (7)(A); or

(ii) to provide advance notice and extended benefits under the program, as appropriate, if another basis for discharge of a veteran described in subclause (I) of clause (i) or revocation of a designation described in subclause (II) of such clause applies.

(14)(A) In the case of a veteran or caregiver who seeks services under this subsection and is denied such services, or a veteran or the family caregiver of a veteran who is discharged from the program under this subsection, the Secretary shall—

(i) if the veteran meets the requirements of a covered veteran under subsection (b), provide to such caregiver the option of enrolling in the program of general caregiver support services under such subsection;

(ii) assess the veteran or caregiver for participation in any other available program of the Department for home- and community-based services (including the programs specified in section 1720L of this title) for which the veteran or caregiver may be eligible and, with respect to the veteran, store (and make accessible to the veteran) the results of such assessment in the electronic medical record of the veteran; and

(iii) provide to the veteran or caregiver written information on any such program identified pursuant to the assessment under clause (ii), including information about facilities, eligibility requirements, and relevant contact information for each such program.

(B) The Secretary shall, to the extent practicable, provide to a veteran or family caregiver the option of obtaining clinically appropriate services under any other available program of the Department for home- and community-based services (including the programs specified in section 1720L of this title) for which the veteran or family caregiver may be eligible prior to discharging the veteran or family caregiver from the program under this subsection.

(C) For each veteran or family caregiver who is discharged from the program under this subsection, a caregiver support coordinator shall provide for a smooth and personalized transition from such program to an appropriate program of the Department for home- and community-based services (including the programs specified in section 1720L of this title), including by integrating caregiver support across programs.

(15)(A) Not less frequently than annually, the Secretary shall submit to the Committees on Veterans' Affairs of the Senate and the House of Representatives a comprehensive report on the program required by paragraph (1) that includes, with respect to the one-year period preceding the date of the submission of such report, the following:

(i) The number of applications received for such program.

(ii) The number, disaggregated by race, sex, and era and branch of service in the Armed Forces of the applicant, of—

(I) approvals of such applications; and

(II) denials of such applications.

(iii) The number of reassessments conducted for such program.

(iv) An identification of each decision made with respect to a reassessment conducted for such program, disaggregated by decisions resulting in—

(I) disenrollment, including removal, discharge, or voluntary withdrawal;

(II) tier reduction; and

(III) tier continuation.

(v) The number of appeals of decisions made with respect to such program, disaggregated by type of appeal.

(vi) With respect to each appeal described in clause (v), the decision rendered, if any.

(vii) A description of all tools used in assessments conducted for such program, including an explanation of how and by whom such tools are administered.

(viii) A description of procedures used under such program for reviewing and integrating clinical records from health care providers that includes an explanation of how such records are used in determinations of eligibility for such program.

(ix) A description of procedures available under such program for health care providers to communicate medical opinions to the teams conducting assessments to determine eligibility for such program, including health care providers in the private sector and health care providers specified in subsection (c) of section 1703 of this title.

(x) A description of information technology systems and processes used under such program to upload and integrate all clinical records from all non-Department providers, including providers in the private sector and providers under the Veterans Community Care Program established under such section.

(B) The Secretary shall ensure that all data included in a report under subparagraph (A)—

(i) relating to a decision made under the program required by paragraph (1), are disaggregated by the specific reason for the decision;

(ii) relating to a veteran, include comprehensive demographic information of the veteran, including the time period of the injuries, if any, of the veteran and the Veterans Integrated Service Network in which the veteran is located; and

(iii) with respect to eligibility determinations relating to a serious injury of a veteran, specify—

(I) how many such determinations relate to the ability of the veteran to perform activities of daily living; and

(II) how many such determinations relate to the need of a veteran for supervision and protection.

(C) The Secretary shall provide the data under paragraph (B) pursuant to Federal laws and in a manner that is wholly consistent with applicable Federal privacy and confidentiality laws, including the Privacy Act (5 U.S.C. 552a), the Health Insurance Portability and Accountability Act (Public Law 104–191; 42 U.S.C. 201 note) and regulations (title 45, Code of Federal Regulations, parts 160 and 164, or successor regulations), and sections 5701, 5705, and 7332 of this title to ensure that the provided data, or some portion of the data, will not undermine the anonymity of a veteran.

(b) Program of General Caregiver Support Services.—(1) The Secretary shall establish a program of support services for caregivers of covered veterans who are enrolled in the health care system established under section 1705(a) of this title (including caregivers who do not reside with such veterans).

(2) For purposes of this subsection, a covered veteran is any individual who needs personal care services because of—

(A) an inability to perform one or more activities of daily living;

(B) a need for supervision or protection based on symptoms or residuals of neurological or other impairment or injury; or

(C) such other matters as the Secretary shall specify.

(3)(A) The support services furnished to caregivers of covered veterans under the program required by paragraph (1) shall include the following:

(i) Services regarding the administering of personal care services, which, subject to subparagraph (B), shall include—

(I) educational sessions made available both in person and on an Internet website;

(II) use of telehealth and other available technologies; and

(III) teaching techniques, strategies, and skills for caring for a disabled veteran;

(ii) Counseling and other services under section 1782 of this title.

(iii) Covered respite care of not less than 30 days annually.

(iv) Information concerning the supportive services available to caregivers under this subsection and other public, private, and nonprofit agencies that offer support to caregivers.

(B) If the Secretary certifies to the Committees on Veterans' Affairs of the Senate and the House of Representatives that funding available for a fiscal year is insufficient to fund the provision of services specified in one or more subclauses of subparagraph (A)(i), the Secretary shall not be required under subparagraph (A) to provide the services so specified in the certification during the period beginning on the date that is 180 days after the date the certification is received by the Committees and ending on the last day of the fiscal year.

(4) In providing information under paragraph (3)(A)(iv), the Secretary shall collaborate with the Assistant Secretary for Aging of the Department of Health and Human Services in order to provide caregivers access to aging and disability resource centers under the Administration on Aging of the Department of Health and Human Services.

(5) In carrying out the program required by paragraph (1), the Secretary shall conduct outreach to inform covered veterans and caregivers of covered veterans about the program. The outreach shall include an emphasis on covered veterans and caregivers of covered veterans living in rural areas.

(c) Construction.—(1) A decision by the Secretary under this section affecting the furnishing of assistance or support shall be considered a medical determination.

(2) Nothing in this section shall be construed to create—

(A) an employment relationship between the Secretary and an individual in receipt of assistance or support under this section; or

(B) any entitlement to any assistance or support provided under this section.

(d) Definitions.—In this section:

(1) The term "caregiver", with respect to an eligible veteran under subsection (a), a veteran denied or discharged as specified in paragraph (14) of such subsection, or a covered veteran under subsection (b), means an individual who provides personal care services to the veteran.

(2) The term "covered respite care" means, with respect to a caregiver of a veteran, respite care under section 1720B of this title that—

(A) is medically and age appropriate for the veteran (including 24-hour per day care of the veteran commensurate with the care provided by the caregiver); and

(B) includes in-home care.

(3) The term "family caregiver", with respect to an eligible veteran under subsection (a) or a veteran denied or discharged as specified in paragraph (14) of such subsection, means a family member who is a caregiver of the veteran.

(4) The term "family member", with respect to an eligible veteran under subsection (a) or a veteran denied or discharged as specified in paragraph (14) of such subsection, means an individual who—

(A) is a member of the family of the veteran, including—

(i) a parent;

(ii) a spouse;

(iii) a child;

(iv) a step-family member; and

(v) an extended family member; or

(B) lives with the veteran but is not a member of the family of the veteran.

(5) The term "personal care services", with respect to an eligible veteran under subsection (a), a veteran denied or discharged as specified in paragraph (14) of such subsection, or a covered veteran under subsection (b), means services that provide the veteran the following:

(A) Assistance with one or more activities of daily living.

(B) Supervision or protection based on symptoms or residuals of neurological or other impairment or injury.

(C) Regular or extensive instruction or supervision without which the ability of the veteran to function in daily life would be seriously impaired.

(D) Any other non-institutional extended care (as such term is used in section 1701(6)(E) of this title).

(Added Pub. L. 111–163, title I, §101(a)(1), May 5, 2010, 124 Stat. 1132; amended Pub. L. 114–58, title I, §103, title VI, §601(6), Sept. 30, 2015, 129 Stat. 532, 538; Pub. L. 114–228, title I, §103, Sept. 29, 2016, 130 Stat. 937; Pub. L. 115–62, title I, §103, Sept. 29, 2017, 131 Stat. 1161; Pub. L. 115–182, title I, §161(a)(1)(A), (2)–(b), June 6, 2018, 132 Stat. 1438–1440; Pub. L. 115–251, title I, §103, Sept. 29, 2018, 132 Stat. 3168; Pub. L. 116–278, §2(b), Dec. 31, 2020, 134 Stat. 3374; Pub. L. 116–283, div. A, title IX, §926(a)(28), Jan. 1, 2021, 134 Stat. 3830; Pub. L. 118–210, title I, §§124(a)(1), (3), (b), 125, Jan. 2, 2025, 138 Stat. 2730, 2731.)

Applicability of Amendment

Subsec. (a)(14) of this section, as added by section 124(a)(1) of Pub. L. 118–210, applicable with respect to denials and discharges occurring on or after the date that is 180 days after Jan. 2, 2025. See 2025 Amendment note below.

Editorial Notes

References in Text

Section 162(a) of the Caring for Our Veterans Act of 2018, referred to in subsec. (a)(2)(B)(i), is section 162(a) of Pub. L. 115–182, June 6, 2018, 132 Stat. 1440, which is set out as a note under this section.

The date of the enactment of the Transparency and Effective Accountability Measures for Veteran Caregivers Act, referred to in subsec. (a)(12)(B), is the date of enactment of Pub. L. 116–278, which was approved Dec. 31, 2020.

The Health Insurance Portability and Accountability Act, referred to in subsec. (a)(15)(C), probably means the Health Insurance Portability and Accountability Act of 1996, Pub. L. 104–191, Aug. 21, 1996, 110 Stat. 1936. For complete classification of this Act to the Code, see Short Title note set out under section 201 of Title 42, The Public Health and Welfare, and Tables.

Amendments

2025—Subsec. (a)(3)(A)(ii)(III). Pub. L. 118–210, §124(b)(1)(A), amended subcl. (III) generally. Prior to amendment, subcl. (III) read as follows: "respite care of not less than 30 days annually, including 24-hour per day care of the veteran commensurate with the care provided by the family caregiver to permit extended respite;".

Subsec. (a)(3)(B) to (D). Pub. L. 118–210, §124(b)(1)(B), redesignated subpars. (C) and (D) as (B) and (C), respectively, and struck out former subpar. (B) which read as follows: "Respite care provided under subparagraph (A)(ii)(III) shall be medically and age-appropriate and include in-home care."

Subsec. (a)(12)(A). Pub. L. 118–210, §125(1)(A), inserted ", which shall include all criteria used to determine eligibility for such assistance and, in the case of a completed evaluation, how such criteria were used to evaluate information provided in assessments to determine such eligibility" before period at end.

Subsec. (a)(12)(C)(i). Pub. L. 118–210, §125(1)(B), substituted "who—" for "who", designated remainder of existing provisions as subcl. (I), and added subcl. (II).

Subsec. (a)(14). Pub. L. 118–210, §124(a)(1), added par. (14).

Subsec. (a)(15). Pub. L. 118–210, §125(2), added par. (15).

Subsec. (b)(3)(A)(iii). Pub. L. 118–210, §124(b)(2), amended cl. (iii) generally. Prior to amendment, cl. (iii) read as follows: "Respite care under section 1720B of this title that is medically and age appropriate for the veteran (including 24-hour per day in-home care)."

Subsec. (d)(1). Pub. L. 118–210, §124(a)(3)(A), substituted ", a veteran denied or discharged as specified in paragraph (14) of such subsection, or a covered veteran" for "or a covered veteran".

Subsec. (d)(2). Pub. L. 118–210, §124(b)(3), added par. (2). Former par. (2) redesignated (3).

Pub. L. 118–210, §124(a)(3)(B), substituted "under subsection (a) or a veteran denied or discharged as specified in paragraph (14) of such subsection, means" for "under subsection (a), means".

Subsec. (d)(3). Pub. L. 118–210, §124(b)(3), redesignated par. (2) as (3). Former par. (3) redesignated (4).

Pub. L. 118–210, §124(a)(3)(B), substituted "under subsection (a) or a veteran denied or discharged as specified in paragraph (14) of such subsection, means" for "under subsection (a), means" in introductory provisions.

Subsec. (d)(4). Pub. L. 118–210, §124(b)(3), redesignated par. (3) as (4). Former par. (4) redesignated (5).

Pub. L. 118–210, §124(a)(3)(A), substituted ", a veteran denied or discharged as specified in paragraph (14) of such subsection, or a covered veteran" for "or a covered veteran".

Subsec. (d)(5). Pub. L. 118–210, §124(b)(3), redesignated par. (4) as (5).

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

2020—Subsec. (a)(12), (13). Pub. L. 116–278 added pars. (12) and (13).

2018—Subsec. (a)(2)(B). Pub. L. 115–182, §161(a)(1)(A), amended subpar. (B) generally. Prior to amendment, text read as follows: "has a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, or air service on or after September 11, 2001; and".

Subsec. (a)(2)(C)(iii), (iv). Pub. L. 115–182, §161(a)(2), added cl. (iii) and redesignated former cl. (iii) as (iv).

Subsec. (a)(3)(A)(ii)(VI). Pub. L. 115–182, §161(a)(3), added subcl. (VI).

Subsec. (a)(3)(C)(iii), (iv). Pub. L. 115–182, §161(a)(4), added cl. (iii) and redesignated former cl. (iii) as (iv).

Subsec. (a)(3)(D). Pub. L. 115–182, §161(a)(5), added subpar. (D).

Subsec. (a)(5). Pub. L. 115–182, §161(a)(6), inserted "(in collaboration with the primary care team for the eligible veteran to the maximum extent practicable)" after "evaluate" in introductory provisions.

Subsec. (a)(11). Pub. L. 115–182, §161(a)(7), added par. (11).

Subsec. (d)(4)(A). Pub. L. 115–182, §161(b)(1), struck out "independent" before "activities of daily living".

Subsec. (d)(4)(B) to (D). Pub. L. 115–182, §161(b)(2), (3), added subpars. (B) and (C) and redesignated former subpar. (B) as (D).

Subsec. (e). Pub. L. 115–251 struck out subsec. (e) which authorized appropriations from fiscal years 2010 to 2019.

2017—Subsec. (e)(5). Pub. L. 115–62 added par. (5).

2016—Subsec. (e)(4). Pub. L. 114–228 added par. (4).

2015—Subsec. (a)(7)(B)(iii). Pub. L. 114–58, §601(6), substituted "have" for "has".

Subsec. (e)(3). Pub. L. 114–58, §103, added par. (3).

Statutory Notes and Related Subsidiaries

Effective Date of 2025 Amendment

Pub. L. 118–210, title I, §124(a)(2), Jan. 2, 2025, 138 Stat. 2731, provided that: "The amendments made by paragraph (1) [amending this section] shall apply with respect to denials and discharges occurring on or after the date that is 180 days after the date of the enactment of this Act [Jan. 2, 2025]."

Effective Date

Pub. L. 111–163, title I, §101(a)(3), May 5, 2010, 124 Stat. 1137, provided that:

"(A) In general.—The amendments made by this subsection [enacting this section] shall take effect on the date that is 270 days after the date of the enactment of this Act [May 5, 2010].

"(B) Implementation.—The Secretary of Veterans Affairs shall commence the programs required by subsections (a) and (b) of section 1720G of title 38, United States Code, as added by paragraph (1) of this subsection, on the date on which the amendments made by this subsection take effect."

Recognition of Organizations and Individuals to Assist Veterans, Family Members, and Caregivers Navigating Programs and Services of Veterans Health Administration

Pub. L. 118–210, title I, §129, Jan. 2, 2025, 138 Stat. 2738, provided that:

"(a) In General.—Not later than one year after the date of the enactment of this Act [Jan. 2, 2025], the Secretary of Veterans Affairs shall establish a process through which the Department of Veterans Affairs may recognize organizations and individuals to assist a veteran, a family member of a veteran, or a caregiver of a veteran (as defined in section 1720G(d) of title 38, United States Code) in navigating the programs and services of the Veterans Health Administration.

"(b) Solicitation of Feedback.—The Secretary shall solicit feedback and recommendations in the creation of the process under subsection (a) from such organizations as the Secretary may consider relevant.

"(c) Limitation.—The Secretary may not recognize an organization or individual pursuant to the process established under subsection (a) unless the organization or individual has certified to the Secretary that no fee or compensation of any nature will be charged to any individual for services rendered in providing assistance pursuant to such subsection."

[For definition of "caregiver" as used in section 129 of Pub. L. 118–210, set out above, see section 133 of Pub. L. 118–210, set out as a note under section 1720L of this title.]

Modification of Administration of Caregiver Programs of Department of Veterans Affairs

Pub. L. 116–278, §2(a), Dec. 31, 2020, 134 Stat. 3373, provided that:

"(a) Formal Recognition of Caregivers.—

"(1) Report.—

"(A) In general.—Not later than 60 days after the date of the enactment of this Act [Dec. 31, 2020], the Secretary shall submit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives a report regarding the feasibility and advisability of formally recognizing all caregivers of veterans by identifying any caregiver of a veteran in the electronic health record of the veteran.

"(B) Caregivers recognized.—The recognition of caregivers described in subparagraph (A) shall include recognition of—

"(i) any family caregiver who is approved as a provider of personal care services for an eligible veteran under the program of comprehensive assistance for family caregivers under subsection (a) of section 1720G of title 38, United States Code; and

"(ii) any caregiver of a covered veteran participating in the program of general caregiver support services under subsection (b) of such section.

"(C) Timeline.—If the Secretary determines that formally recognizing all caregivers of veterans as described in subparagraph (A) is feasible and advisable, the report required by such subparagraph shall include a timeline for implementing such recognition.

"(2) Implementation.—If the Secretary determines that formally recognizing all caregivers of veterans as described in paragraph (1)(A) is feasible and advisable, the Secretary shall implement such recognition in accordance with the timeline included in the report required by such paragraph."

Education Program for Family Members and Caregivers of Veterans With Mental Health Disorders

Pub. L. 116–214, title II, §202, Dec. 5, 2020, 134 Stat. 1033, provided that:

"(a) Establishment.—Not later than 270 days after the date of the enactment of this Act [Dec. 5, 2020], the Secretary of Veterans Affairs shall establish an education program (in this section referred to as the 'education program') for the education and training of caregivers and family members of eligible veterans with mental health disorders.

"(b) Education Program.—

"(1) In general.—Under the education program, the Secretary shall provide a course of education to caregivers and family members of eligible veterans on matters relating to coping with mental health disorders in veterans.

"(2) Duration.—The Secretary shall carry out the education program during the four-year period beginning on the date of the commencement of the education program.

"(3) Scope.—

"(A) Caregivers.—The Secretary, with respect to the component of the education program that relates to the education and training of caregivers, shall—

"(i) include such component in the training provided pursuant to the program of comprehensive assistance for family caregivers of the Department of Veterans Affairs established under section 1720G(a) of title 38, United States Code; and

"(ii) make such component available on the Internet website of the Department that relates to caregiver training.

"(B) Family members.—The Secretary shall carry out the component of the education program that relates to the education and training of non-caregiver family members at facilities of the Department as follows:

"(i) Not less than five medical centers of the Department.

"(ii) Not less than five clinics of the Department.

"(iii) Not less than five Vet Centers (as defined in section 1712A(h) of title 38, United States Code).

"(C) Solicitation of applications.—In selecting locations pursuant to subparagraph (B), the Secretary shall solicit applications from eligible facilities of the Department that are interested in carrying out the education program.

"(D) Considerations.—In selecting locations pursuant to subparagraph (B), the Secretary shall consider the feasibility and advisability of selecting locations in the following areas:

"(i) Rural areas.

"(ii) Areas that are not in close proximity to an active duty installation.

"(iii) Areas in different geographic locations.

"(4) Contracts.—

"(A) In general.—In carrying out the education program, the Secretary shall enter into contracts with qualified entities described in subparagraph (B) to offer the course of education described in paragraph (5) to family members and caregivers of eligible veterans and covered veterans.

"(B) Qualified entity described.—A qualified entity described in this subparagraph is a non-profit entity with experience in mental health education and outreach, including work with children, teens, and young adults, that—

"(i) uses high quality, relevant, and age-appropriate information in educational programming, materials, and coursework, including such programming, materials, and coursework for children, teens, and young adults; and

"(ii) works with agencies, departments, nonprofit mental health organizations, early childhood educators, and mental health providers to develop educational programming, materials, and coursework.

"(C) Priority.—In entering into contracts under this paragraph, the Secretary shall give priority to qualified entities that have demonstrated cultural competence in serving military and veteran populations, and, to the extent practicable, use internet technology for the delivery of course content in an effort to expand the availability of support services, especially in rural areas.

"(5) Course of education described.—The course of education described in this paragraph shall consist of curriculum that includes the following:

"(A) General education on different mental health disorders, including information to improve understanding of the experiences of individuals suffering from such disorders.

"(B) Techniques for handling crisis situations and administering mental health first aid to individuals suffering from a mental health disorder.

"(C) Techniques for coping with the stress of living with an individual suffering from a mental health disorder.

"(D) Information on additional services available for family members and caregivers through the Department or community organizations and providers related to mental health disorders.

"(E) Such other matters as the Secretary considers appropriate.

"(c) Surveys.—

"(1) In general.—The Secretary shall conduct a comprehensive survey of the satisfaction of individuals that have participated in the course of education described in subsection (b)(5). Such survey shall include a solicitation of feedback on the following:

"(A) The general satisfaction of those individuals with the education and assistance provided under the education program.

"(B) The perceived effectiveness of the education program in providing education and assistance that is useful for those individuals.

"(C) The applicability of the education program to the issues faced by those individuals.

"(D) Such other matters as the Secretary considers appropriate.

"(2) Compilation of information.—The information compiled as a result of the surveys conducted under paragraph (1) shall be—

"(A) disaggregated by facility type at which the education program was carried out; and

"(B) included in the annual reports under subsection (d)(1).

"(d) Reports.—

"(1) Annual reports.—

"(A) In general.—Not later than one year after the date of the commencement of the education program and not later than September 30 each year thereafter until 2024, the Secretary shall submit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives a report on—

"(i) the education program; and

"(ii) the feasibility and advisability of expanding the education program to include the establishment of a peer support program composed of individuals who complete the education program (in this section referred to as a 'peer support program').

"(B) Elements.—Each report submitted under subparagraph (A) shall include the following:

"(i) The number of individuals that participated in the course of education described in subsection (b)(5) during the year preceding the submission of the report.

"(ii) A detailed analysis of the surveys conducted under subsection (c) with respect to the individuals described in clause (i).

"(iii) Any plans for expansion of the education program.

"(iv) An analysis of the feasibility and advisability of establishing a peer support program.

"(v) The interim findings and conclusions of the Secretary with respect to the success of the education program and the feasibility and advisability of establishing a peer support program.

"(2) Final report.—

"(A) In general.—Not later than one year after the completion of the education program, the Secretary shall submit to the Committees on Veterans' Affairs of the House of Representatives and the Senate a final report on the feasibility and advisability of continuing the education program.

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

"(i) A detailed analysis of the surveys conducted under subsection (c).

"(ii) An analysis of the feasibility and advisability of continuing the education program without entering into contracts for the course of education described in subsection (b)(5).

"(iii) An analysis of the feasibility and advisability of expanding the education program.

"(iv) An analysis of the feasibility and advisability of establishing a peer support program.

"(e) Monitoring of Program.—The Secretary shall select mental health care providers of the Department to monitor the progress of the instruction provided under the education program.

"(f) Definitions.—In this section:

"(1) The term 'eligible veteran' means a veteran who is enrolled in the health care system established under section 1705(a) of title 38, United States Code.

"(2) The terms 'caregiver' and 'family member' have the meaning given those terms in section 1720G(d) of title 38, United States Code."

Publication in Federal Register

Pub. L. 115–182, title I, §161(a)(1)(B), June 6, 2018, 132 Stat. 1439, as amended by Pub. L. 115–251, title II, §211(b)(5), Sept. 29, 2018, 132 Stat. 3176, provided that: "Not later than 30 days after the date on which the Secretary of Veterans Affairs submits to Congress the certification described in subsection (a)(2)(B)(i) of section 1720G of title 38, United States Code, as amended by subparagraph (A) of this paragraph, the Secretary shall publish the date specified in such subsection in the Federal Register."

Implementation of Information Technology System of Department of Veterans Affairs To Assess and Improve the Family Caregiver Program

Pub. L. 115–182, title I, §162, June 6, 2018, 132 Stat. 1440, provided that:

"(a) Implementation of New System.—

"(1) In general.—Not later than October 1, 2018, the Secretary of Veterans Affairs shall implement an information technology system that fully supports the Program and allows for data assessment and comprehensive monitoring of the Program.

"(2) Elements of system.—The information technology system required to be implemented under paragraph (1) shall include the following:

"(A) The ability to easily retrieve data that will allow all aspects of the Program (at the medical center and aggregate levels) and the workload trends for the Program to be assessed and comprehensively monitored.

"(B) The ability to manage data with respect to a number of caregivers that is more than the number of caregivers that the Secretary expects to apply for the Program.

"(C) The ability to integrate the system with other relevant information technology systems of the Veterans Health Administration.

"(b) Assessment of Program.—Not later than 180 days after implementing the system described in subsection (a), the Secretary shall, through the Under Secretary for Health, use data from the system and other relevant data to conduct an assessment of how key aspects of the Program are structured and carried out.

"(c) Ongoing Monitoring of and Modifications to Program.—

"(1) Monitoring.—The Secretary shall use the system implemented under subsection (a) to monitor and assess the workload of the Program, including monitoring and assessment of data on—

"(A) the status of applications, appeals, and home visits in connection with the Program; and

"(B) the use by caregivers participating in the Program of other support services under the Program such as respite care.

"(2) Modifications.—Based on the monitoring and assessment conducted under paragraph (1), the Secretary shall identify and implement such modifications to the Program as the Secretary considers necessary to ensure the Program is functioning as intended and providing veterans and caregivers participating in the Program with services in a timely manner.

"(d) Reports.—

"(1) Initial report.—

"(A) In general.—Not later than 90 days after the date of the enactment of this Act [June 6, 2018], the Secretary shall submit to the Committee on Veterans' Affairs of the Senate, the Committee on Veterans' Affairs of the House of Representatives, and the Comptroller General of the United States a report that includes—

"(i) the status of the planning, development, and deployment of the system required to be implemented under subsection (a), including any changes in the timeline for the implementation of the system; and

"(ii) an assessment of the needs of family caregivers of veterans described in subparagraph (B), the resources needed for the inclusion of such family caregivers in the Program, and such changes to the Program as the Secretary considers necessary to ensure the successful expansion of the Program to include such family caregivers.

"(B) Veterans described.—Veterans described in this subparagraph are veterans who are eligible for the Program under clause (ii) or (iii) of section 1720G(a)(2)(B) of title 38, United States Code, as amended by section 161(a)(1) of this title, solely due to a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, or air service before September 11, 2001.

"(2) Notification by comptroller general.—The Comptroller General shall review the report submitted under paragraph (1) and notify the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives with respect to the progress of the Secretary in—

"(A) fully implementing the system required under subsection (a); and

"(B) implementing a process for using such system to monitor and assess the Program under subsection (c)(1) and modify the Program as considered necessary under subsection (c)(2).

"(3) Final report.—

"(A) In general.—Not later than October 1, 2019, the Secretary shall submit to the Committee on Veterans' Affairs of the Senate, the Committee on Veterans' Affairs of the House of Representatives, and the Comptroller General a report on the implementation of subsections (a) through (c).

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

"(i) A certification by the Secretary that the information technology system described in subsection (a) has been implemented.

"(ii) A description of how the Secretary has implemented such system.

"(iii) A description of the modifications to the Program, if any, that were identified and implemented under subsection (c)(2).

"(iv) A description of how the Secretary is using such system to monitor the workload of the Program.

"(e) Definitions.—In this section:

"(1) Active military, naval, or air service.—The term 'active military, naval, or air service' has the meaning given that term in section 101 of title 38, United States Code.

"(2) Program.—The term 'Program' means the program of comprehensive assistance for family caregivers under section 1720G(a) of title 38, United States Code, as amended by section 161 of this title."

Annual Evaluation Report

Pub. L. 111–163, title I, §101(c), May 5, 2010, 124 Stat. 1138, as amended by Pub. L. 115–182, title I, §163, June 6, 2018, 132 Stat. 1442, provided that:

"(1) In general.—Not later than 2 years after the date described in subsection (a)(3)(A) [see Effective Date note above] and annually thereafter, the Secretary shall submit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives a comprehensive report on the implementation of section 1720G of title 38, United States Code, as added by subsection (a)(1).

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

"(A) With respect to the program of comprehensive assistance for family caregivers required by subsection (a)(1) of such section 1720G and the program of general caregiver support services required by subsection (b)(1) of such section—

"(i) the number of caregivers that received assistance under such programs;

"(ii) the cost to the Department of providing assistance under such programs;

"(iii) a description of the outcomes achieved by, and any measurable benefits of, carrying out such programs;

"(iv) an assessment of the effectiveness and the efficiency of the implementation of such programs, including a description of any barriers to accessing and receiving care and services under such programs; and

"(v) such recommendations, including recommendations for legislative or administrative action, as the Secretary considers appropriate in light of carrying out such programs.

"(B) With respect to the program of comprehensive assistance for family caregivers required by such subsection (a)(1)—

"(i) a description of the outreach activities carried out by the Secretary under such program;

"(ii) an assessment of the manner in which resources are expended by the Secretary under such program, particularly with respect to the provision of monthly personal caregiver stipends under paragraph (3)(A)(ii)(v) of such subsection (a); and

"(iii) an evaluation of the sufficiency and consistency of the training provided to family caregivers under such program in preparing family caregivers to provide care to veterans under such program.

"(C) With respect to the provision of general caregiver support services required by such subsection (b)(1)—

"(i) a summary of the support services made available under the program;

"(ii) the number of caregivers who received support services under the program;

"(iii) the cost to the Department of providing each support service provided under the program; and

"(iv) such other information as the Secretary considers appropriate."
38 U.S.C. § 3493 (2024) — Title 38: VETERANS' BENEFITS / Chapter 34 / Subchapter V / Section 3493: Effect on educational entitlement
Effect on educational entitlement
Status: in_force

The educational assistance allowance or cost of individualized tutorial assistance authorized by this subchapter shall be paid without charge to any period of entitlement the veteran may have earned pursuant to section 3461(a) of this title.

(Added Pub. L. 91–219, title II, §204(a)(4), Mar. 26, 1970, 84 Stat. 80, §1693; renumbered §3493 and amended Pub. L. 102–83, §5(a), (c)(1), Aug. 6, 1991, 105 Stat. 406.)

Editorial Notes

Amendments

1991—Pub. L. 102–83 renumbered section 1693 of this title as this section and substituted "3461(a)" for "1661(a)".
38 U.S.C. § 8136 (2024) — Title 38: VETERANS' BENEFITS / Chapter 81 / Subchapter III / Section 8136: Recapture provisions
Recapture provisions
Status: in_force

(a) If, within the 20-year period beginning on the date of the approval by the Secretary of the final architectural and engineering inspection of any project with respect to which a grant has been made under this subchapter (except that the Secretary, pursuant to regulations which the Secretary shall prescribe, may at the time of such grant provide for a shorter period than 20, but not less than seven, years, based on the magnitude of the project and the grant amount involved, in the case of the acquisition, expansion, remodeling, or alteration of existing facilities), the facilities covered by the project cease to be operated by a State, a State home, or an agency or instrumentality of a State principally for furnishing domiciliary, nursing home, or hospital care to veterans, the United States shall be entitled to recover from the State which was the recipient of the grant under this subchapter, or from the then owner of such facilities, 65 percent of the then value of such project (but in no event an amount greater than the amount of assistance provided under this subchapter), as determined by agreement of the parties or by action brought in the district court of the United States for the district in which such facilities are situated.

(b) The establishment and operation by the Secretary of an outpatient clinic in facilities described in subsection (a) shall not constitute grounds entitling the United States to any recovery under that subsection.

(Added Pub. L. 88–450, §4(a), Aug. 19, 1964, 78 Stat. 503, §5036; amended Pub. L. 93–82, title IV, §403(f), Aug. 2, 1973, 87 Stat. 196; Pub. L. 94–581, title II, §206(b), Oct. 21, 1976, 90 Stat. 2859; Pub. L. 95–62, §3(13), July 5, 1977, 91 Stat. 263; Pub. L. 97–295, §4(92), Oct. 12, 1982, 96 Stat. 1313; Pub. L. 98–528, title I, §105(4), Oct. 19, 1984, 98 Stat. 2690; renumbered §8136, Pub. L. 102–40, title IV, §402(b)(1), May 7, 1991, 105 Stat. 238; Pub. L. 102–83, §4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 102–585, title IV, §405, Nov. 4, 1992, 106 Stat. 4954; Pub. L. 106–419, title II, §222, Nov. 1, 2000, 114 Stat. 1845.)

Editorial Notes

Amendments

2000—Pub. L. 106–419 designated existing provisions as subsec. (a) and added subsec. (b).

1992—Pub. L. 102–585 substituted "If, within the 20-year period beginning on the date of the approval by the Secretary of the final architectural and engineering inspection of any project" for "If, within 20 years after completion of any project" and "the facilities covered by the project cease" for "such facilities cease".

1991—Pub. L. 102–40 renumbered section 5036 of this title as this section.

Pub. L. 102–83 substituted "Secretary" for "Administrator" in two places.

1984—Pub. L. 98–528 struck out "for construction" after "completion of any project"; inserted "acquisition," after "in the case of the"; substituted "value of such project" for "value of such construction"; struck out "for such construction" after "assistance provided for", which amendment was executed by striking out "for such construction" after "assistance provided" as the probable intent of Congress, because "for" appeared only once after "assistance provided"; and substituted "20" for "twenty" in two places.

1982—Pub. L. 97–295 substituted "percent" for "per centum".

1977—Pub. L. 95–62 substituted "If, within twenty years after completion of any project for construction with respect to which a grant has been made under this subchapter (except that the Administrator, pursuant to regulations which the Administrator shall prescribe, may at the time of such grant provide for a shorter period than twenty, but not less than seven, years, based on the magnitude of the project and the grant amount involved, in the case of the expansion, remodeling, or alteration of existing facilities), such facilities cease to be operated by a State, a State home, or an agency or instrumentality of a State principally for furnishing domiciliary, nursing home, or hospital care to veterans, the United States shall be entitled to recover from the State which was the recipient of the grant under this subchapter, or from the then owner of such facilities, 65 per centum of the then value of such construction (but in no event an amount greater than the amount of assistance provided for such construction under this subchapter)" for "If, within twenty years after completion of any project for construction of facilities for furnishing nursing home care with respect to which a grant has been made under this subchapter, such facilities cease to be operated by a State, a State home, or an agency or instrumentality of a State principally for furnishing nursing home care to veterans, the United States shall be entitled to recover from the State which was the recipient of the grant under this subchapter, or from the then owner of such facilities, 65 per centum of the then value of such facilities".

1976—Pub. L. 94–581 substituted "veterans" for "war veterans".

1973—Pub. L. 93–82 substituted "65 per centum" for "50 per centum".

Statutory Notes and Related Subsidiaries

Effective Date of 1977 Amendment

Amendment by Pub. L. 95–62 effective Oct. 1, 1977, with provision for the continuing force and effect of the terms and conditions of grants made prior to Oct. 1, 1977, under former section 644 of this title and with additional provision for the modification of the terms and conditions of both grants made under former section 644 of this title prior to Oct. 1, 1977, and of grants made under this subchapter prior to Oct. 1, 1977, see section 5 of Pub. L. 95–62, set out as a note under section 8131 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.
38 U.S.C. § 7320 (2024) — Title 38: VETERANS' BENEFITS / Chapter 73 / Subchapter II / Section 7320: Centers for mental illness research, education, and clinical activities
Centers for mental illness research, education, and clinical activities
Status: in_force

(a) The purpose of this section is to provide for the improvement of the provision of health-care services and related counseling services to eligible veterans suffering from mental illness (especially mental illness related to service-related conditions) through—

(1) the conduct of research (including research on improving mental health service facilities of the Department and on improving the delivery of mental health services by the Department);

(2) the education and training of health care personnel of the Department; and

(3) the development of improved models and systems for the furnishing of mental health services by the Department.

(b)(1) The Secretary shall establish and operate centers for mental illness research, education, and clinical activities. Such centers shall be established and operated by collaborating Department facilities as provided in subsection (c)(1). Each such center shall function as a center for—

(A) research on mental health services;

(B) the use by the Department of specific models for furnishing services to treat serious mental illness;

(C) education and training of health-care professionals of the Department; and

(D) the development and implementation of innovative clinical activities and systems of care with respect to the delivery of such services by the Department.

(2) The Secretary shall, upon the recommendation of the Under Secretary for Health, designate the centers under this section. In making such designations, the Secretary shall ensure that the centers designated are located in various geographic regions of the United States. The Secretary may designate a center under this section only if—

(A) the proposal submitted for the designation of the center meets the requirements of subsection (c);

(B) the Secretary makes the finding described in subsection (d); and

(C) the peer review panel established under subsection (e) makes the determination specified in subsection (e)(3) with respect to that proposal.

(3) Not more than five centers may be designated under this section.

(4) The authority of the Secretary to establish and operate centers under this section is subject to the appropriation of funds for that purpose.

(c) A proposal submitted for the designation of a center under this section shall—

(1) provide for close collaboration in the establishment and operation of the center, and for the provision of care and the conduct of research and education at the center, by a Department facility or facilities in the same geographic area which have a mission centered on care of the mentally ill and a Department facility in that area which has a mission of providing tertiary medical care;

(2) provide that no less than 50 percent of the funds appropriated for the center for support of clinical care, research, and education will be provided to the collaborating facility or facilities that have a mission centered on care of the mentally ill; and

(3) provide for a governance arrangement between the collaborating Department facilities which ensures that the center will be established and operated in a manner aimed at improving the quality of mental health care at the collaborating facility or facilities which have a mission centered on care of the mentally ill.

(d) The finding referred to in subsection (b)(2)(B) with respect to a proposal for designation of a site as a location of a center under this section is a finding by the Secretary, upon the recommendation of the Under Secretary for Health, that the facilities submitting the proposal have developed (or may reasonably be anticipated to develop) each of the following:

(1) An arrangement with an accredited medical school that provides education and training in psychiatry and with which one or more of the participating Department facilities is affiliated under which medical residents receive education and training in psychiatry through regular rotation through the participating Department facilities so as to provide such residents with training in the diagnosis and treatment of mental illness.

(2) An arrangement with an accredited graduate program of psychology under which students receive education and training in clinical, counseling, or professional psychology through regular rotation through the participating Department facilities so as to provide such students with training in the diagnosis and treatment of mental illness.

(3) An arrangement under which nursing, social work, counseling, or allied health personnel receive training and education in mental health care through regular rotation through the participating Department facilities.

(4) The ability to attract scientists who have demonstrated achievement in research—

(A) into the evaluation of innovative approaches to the design of mental health services; or

(B) into the causes, prevention, and treatment of mental illness.

(5) The capability to evaluate effectively the activities of the center, including activities relating to the evaluation of specific efforts to improve the quality and effectiveness of mental health services provided by the Department at or through individual facilities.

(e)(1) In order to provide advice to assist the Secretary and the Under Secretary for Health to carry out their responsibilities under this section, the official within the central office of the Veterans Health Administration responsible for mental health and behavioral sciences matters shall establish a peer review panel to assess the scientific and clinical merit of proposals that are submitted to the Secretary for the designation of centers under this section.

(2) The panel shall consist of experts in the fields of mental health research, education and training, and clinical care. Members of the panel shall serve as consultants to the Department.

(3) The panel shall review each proposal submitted to the panel by the official referred to in paragraph (1) and shall submit to that official its views on the relative scientific and clinical merit of each such proposal. The panel shall specifically determine with respect to each such proposal whether that proposal is among those proposals which have met the highest competitive standards of scientific and clinical merit.

(4) The panel shall not be subject to chapter 10 of title 5.

(f) Clinical and scientific investigation activities at each center established under this section—

(1) may compete for the award of funding from amounts appropriated for the Department of Veterans Affairs medical and prosthetics research account; and

(2) shall receive priority in the award of funding from such account insofar as funds are awarded to projects and activities relating to mental illness.

(g) The Under Secretary for Health shall ensure that at least three centers designated under this section emphasize research into means of improving the quality of care for veterans suffering from mental illness through the development of community-based alternatives to institutional treatment for such illness.

(h) The Under Secretary for Health shall ensure that information produced by the research, education and training, and clinical activities of centers established under this section that may be useful for other activities of the Veterans Health Administration is disseminated throughout the Veterans Health Administration. Such dissemination shall be made through publications, through programs of continuing medical and related education provided through regional medical education centers under subchapter VI of chapter 74 of this title, and through other means. Such programs of continuing medical education shall receive priority in the award of funding.

(i) The official within the central office of the Veterans Health Administration responsible for mental health and behavioral sciences matters shall be responsible for supervising the operation of the centers established pursuant to this section and shall provide for ongoing evaluation of the centers and their compliance with the requirements of this section.

(j)(1) There are authorized to be appropriated to the Department of Veterans Affairs for the basic support of the research and education and training activities of centers established pursuant to this section amounts as follows:

(A) $3,125,000 for fiscal year 1998.

(B) $6,250,000 for each of fiscal years 1999 through 2001.

(2) In addition to funds appropriated for a fiscal year pursuant to the authorization of appropriations in paragraph (1), the Under Secretary for Health shall allocate to such centers from other funds appropriated for that fiscal year generally for the Department of Veterans Affairs medical services account and the Department of Veterans Affairs medical and prosthetics research account such amounts as the Under Secretary for Health determines appropriate to carry out the purposes of this section.

(Added Pub. L. 104–262, title III, §334(a)(1), Oct. 9, 1996, 110 Stat. 3200; amended Pub. L. 110–387, title IX, §901(a)(8), Oct. 10, 2008, 122 Stat. 4142; Pub. L. 117–286, §4(a)(220), Dec. 27, 2022, 136 Stat. 4330.)

Editorial Notes

Amendments

2022—Subsec. (e)(4). Pub. L. 117–286 substituted "chapter 10 of title 5." for "the Federal Advisory Committee Act (5 U.S.C. App.)."

2008—Subsec. (j)(2). Pub. L. 110–387 substituted "medical services account" for "medical care account".

Statutory Notes and Related Subsidiaries

Annual Reports On and Designation of Centers

Pub. L. 104–262, title III, §334(b), (c), Oct. 9, 1996, 110 Stat. 3203, 3204, required the Secretary of Veterans Affairs, by Feb. 1 of each of the years 1999 to 2002, to submit to Congress a report on the status and activities during the previous fiscal year of the centers for mental illness research, education, and clinical activities established pursuant to this section, with each report to include descriptions of activities and advances at each center and actions taken under subsec. (h) of this section, and also required the Secretary to designate at least one center under this section by Jan. 1, 1998.
38 U.S.C. § 3108 (2024) — Title 38: VETERANS' BENEFITS / Chapter 31 / Section 3108: Allowances
Allowances
Status: in_force

(a)(1) Except in the case of a veteran who makes an election under subsection (f) of this section and subject to the provisions of paragraph (3) of this subsection, each veteran shall be paid a subsistence allowance in accordance with this section during a period determined by the Secretary to be a period of such veteran's participation under this chapter in a rehabilitation program.

(2)(A) In any case in which the Secretary determines, at the conclusion of such veteran's pursuit of a vocational rehabilitation program under this chapter, that such veteran has been rehabilitated to the point of employability, such veteran shall be paid a subsistence allowance, as prescribed in this section for full-time training for the type of program that the veteran was pursuing, for two months while satisfactorily following a program of employment services provided under section 3104(a)(5) of this title.

(B) In any case in which the Secretary determines that a veteran described in subparagraph (A) has been displaced as the result of a natural or other disaster while being paid a subsistence allowance under that subparagraph, as determined by the Secretary, the Secretary may extend the payment of a subsistence allowance under such subparagraph for up to an additional two months while the veteran is satisfactorily following a program of employment services described in such subparagraph.

(3) A subsistence allowance may not be paid under this chapter to a veteran for any period during which such veteran is being provided with an initial evaluation under section 3106(a) of this title or during which such veteran is being provided only with counseling or with placement or postplacement services under section 3105(b) of this title.

(b)(1) Except as otherwise provided in this section, the Secretary shall determine the subsistence allowance to be paid to a veteran under this chapter in accordance with the following table, which shall be the monthly amount shown in column II, III, IV, or V (whichever is applicable as determined by the veteran's dependency status) opposite the appropriate type of program being pursued as specified in column I:

 

Column IColumn 
II
Column 
III
Column 
IV
Column V

Type of 
program
No 
dependents
One 
dependent
Two 
dependents
More than 
two 

dependents

  
  
  
  
The amount in column IV, plus the following for each dependent in excess of two:

Institutional training:

Full-time 
$366 
$454 
$535 
     $39

Three-quarter time 
275 
341 
400 
      30

Half-time 
184 
228 
268 
      20

Farm cooperative, apprentice, or other on-job training:

Full-time 
320 
387 
446 
      29

Extended evaluation:

Full-time 
366 
454 
535 
      39

Independent living training:

Full-time 
366 
454 
535 
      39

Three-quarter time 
275 
341 
400 
      30

Half-time 
184 
228 
268 
      20

(2) With respect to the fiscal year beginning on October 1, 1994, the Secretary shall provide a percentage increase in the monthly rates payable under paragraph (1) of this subsection equal to the percentage by which the Consumer Price Index (all items, United States city average published by the Bureau of Labor Statistics) for the 12-month period ending June 30, 1994, exceeds such Consumer Price Index for the 12-month period ending June 30, 1993.

(3) With respect to any fiscal year beginning on or after October 1, 1995, the Secretary shall continue to pay, in lieu of the rates payable under paragraph (1) of this subsection, the monthly rates payable under this subsection for the previous fiscal year and shall provide, for any such fiscal year, a percentage increase in such rates equal to the percentage by which—

(A) the Consumer Price Index (all items, United States city average) for the 12-month period ending on June 30 preceding the beginning of the fiscal year for which the increase is made, exceeds

(B) such Consumer Price Index for the 12-month period preceding the 12-month period described in subparagraph (A).

(4) A veteran entitled to a subsistence allowance under this chapter and educational assistance under chapter 33 of this title may elect to receive payment from the Secretary in lieu of an amount otherwise determined by the Secretary under this subsection in an amount equal to the applicable monthly amount of basic allowance for housing payable under section 403 of title 37 for a member with dependents in pay grade E–5 residing in the military housing area that encompasses all or the majority portion of the ZIP code area in which is located the institution providing the rehabilitation program concerned.

(c)(1) In any case in which the vocational rehabilitation program for a veteran includes training on the job by an employer in any month, such employer shall be required to submit to the Secretary a statement in writing showing any wage, compensation, or other income paid (directly or indirectly) by the employer to such veteran for such month. Based upon such written statement, the Secretary is authorized to reduce the subsistence allowance of such veteran to an amount considered equitable and just in accordance with criteria which the Secretary shall establish in regulations which the Secretary shall prescribe.

(2) A veteran pursuing on-job training or work experience as part of a vocational rehabilitation program in a Federal, State, or local government agency or federally recognized Indian tribe under the provisions of section 3115(a)(1) of this title without pay or for nominal pay shall be paid the appropriate subsistence allowance rate provided in subsection (b) of this section for an institutional program.

(d)(1) The Secretary shall, in accordance with regulations which the Secretary shall prescribe, define full-time and each part-time status for veterans participating in rehabilitation programs under this chapter.

(2) A veteran participating in extended evaluation on less than a full-time basis may be paid a proportional subsistence allowance in accordance with regulations which the Secretary shall prescribe.

(e) In any case in which a veteran is pursuing a rehabilitation program on a residential basis in a specialized rehabilitation facility, the Secretary may (1) pay to such facility the cost of such veteran's room and board in lieu of payment to such veteran of the subsistence allowance (not including any portion payable for any dependents) payable under subsection (b) of this section, and (2) pay to such veteran that portion of the allowance for dependents payable, as determined by such veteran's dependency status, under subsection (b) of this section for a full-time institutional program.

(f)(1)(A) In any case in which the Secretary determines that a veteran is eligible for and entitled to rehabilitation under this chapter, to the extent that such veteran has remaining eligibility for and entitlement to educational assistance benefits under chapter 30 of this title, such veteran may elect, as part of a vocational rehabilitation program under this chapter, to pursue an approved program of education and receive allowances and other forms of assistance equivalent to those authorized for veterans enrolled under chapter 30 of this title, if the Secretary approves the educational, professional, or vocational objective chosen by such veteran for such program.

(B) In the event that such veteran makes such an election, the terms and conditions applicable to the pursuit of a comparable program of education and the payment of allowances and provision of assistance under chapter 30 of this title for such a comparable program shall be applied to the pursuit of the approved program of education under this chapter.

(2) A veteran who is receiving an allowance pursuant to paragraph (1) of this subsection may not receive any of the services or assistance described in section 3104(a)(3), (7), and (8) of this title (other than an allowance and other assistance under this subsection).

(g)(1) Notwithstanding any other provision of this title and subject to the provisions of paragraph (2) of this subsection, no subsistence allowance may be paid under this section in the case of any veteran who is pursuing a rehabilitation program under this chapter while incarcerated in a Federal, State, local, or other penal institution or correctional facility for conviction of a felony.

(2) Paragraph (1) of this subsection shall not apply in the case of any veteran who is pursuing a rehabilitation program under this chapter while residing in a halfway house or participating in a work-release program in connection with such veteran's conviction of a felony.

(h) Notwithstanding any other provision of this title, the amount of subsistence allowance, or other allowance under subsection (f) of this section, that may be paid to a veteran pursuing a rehabilitation program for any month for which such veteran receives compensation at the rate prescribed in section 1114(j) of this title as the result of hospital treatment (not including post-hospital convalescence) or observation at the expense of the Department of Veterans Affairs may not exceed, when added to any compensation to which such veteran is entitled for such month, an amount equal to the greater of—

(1) the sum of—

(A) the amount of monthly subsistence or other allowance that would otherwise be paid to such veteran under this section, and

(B) the amount of monthly compensation that would be paid to such veteran if such veteran were not receiving compensation at such rate as the result of such hospital treatment or observation; or

(2) the amount of monthly compensation payable under section 1114(j) of this title.

(i) Payment of a subsistence allowance may be made in advance in accordance with the provisions of section 3680(d) of this title.

(Added Pub. L. 96–466, title I, §101(a), Oct. 17, 1980, 94 Stat. 2178, §1508; amended Pub. L. 97–306, title II, §205(a), Oct. 14, 1982, 96 Stat. 1434; Pub. L. 98–525, title VII, §703(a), Oct. 19, 1984, 98 Stat. 2564; Pub. L. 98–543, title II, §201, Oct. 24, 1984, 98 Stat. 2740; Pub. L. 101–237, title IV, §§402(a), 423(b)(1), Dec. 18, 1989, 103 Stat. 2078, 2092; Pub. L. 102–16, §3(c), Mar. 22, 1991, 105 Stat. 49; renumbered §3108 and amended Pub. L. 102–83, §5(a), (c)(1), Aug. 6, 1991, 105 Stat. 406; Pub. L. 102–568, title IV, §405(a), (b), Oct. 29, 1992, 106 Stat. 4338, 4339; Pub. L. 103–446, title VI, §602(b), Nov. 2, 1994, 108 Stat. 4671; Pub. L. 104–275, title I, §101(g), Oct. 9, 1996, 110 Stat. 3325; Pub. L. 109–461, title X, §1002(b), Dec. 22, 2006, 120 Stat. 3465; Pub. L. 111–377, title II, §205(a), Jan. 4, 2011, 124 Stat. 4126; Pub. L. 112–154, title VII, §701(b), Aug. 6, 2012, 126 Stat. 1203; Pub. L. 114–58, title VI, §601(15), Sept. 30, 2015, 129 Stat. 539.)

Editorial Notes

Prior Provisions

Prior section 3108 was renumbered section 5308 of this title.

Provisions similar to those comprising this section were contained in former section 1504 of this title prior to the general revision of this chapter by Pub. L. 96–466.

Amendments

2015—Subsec. (b)(4). Pub. L. 114–58 inserted "the" before "rehabilitation program concerned".

2012—Subsec. (a)(2). Pub. L. 112–154 designated existing provisions as subpar. (A) and added subpar. (B).

2011—Subsec. (b)(4). Pub. L. 111–377 added par. (4).

2006—Subsec. (g)(1). Pub. L. 109–461 substituted "local, or other penal institution or correctional facility" for "or local penal institution".

1996—Subsec. (a)(2). Pub. L. 104–275, §101(g)(1), substituted "while satisfactorily following a program of employment services provided under section 3104(a)(5) of this title" for "following the conclusion of such pursuit".

Subsec. (f)(1)(A). Pub. L. 104–275, §101(g)(2)(A), inserted "eligible for and" after "veteran is" and substituted "chapter 30" for "chapter 30 or 34" and "enrolled under chapter 30" for "enrolled under either chapter 30 or chapter 34".

Subsec. (f)(1)(B). Pub. L. 104–275, §101(g)(2)(B), substituted "chapter 30" for "chapter 30 or 34".

1994—Subsec. (c)(2). Pub. L. 103–446 inserted "or federally recognized Indian tribe" after "local government agency".

1992—Subsec. (b). Pub. L. 102–568, §405(b), designated existing provisions as par. (1) and added pars. (2) and (3).

Pub. L. 102–568, §405(a), increased the monthly rehabilitation subsistence allowance for eligible veterans in column II from $333, $250, $167, $291, $333, $333, $250, and $167 to $366, $275, $184, $320, $366, $366, $275, and $184; in column III from $413, $310, $207, $352, $413, $413, $310, and $207 to $454, $341, $228, $387, $454, $454, $341, and $228; in column IV from $486, $364, $244, $405, $486, $486, $364, and $244 to $535, $400, $268, $446, $535, $535, $$400, and $268; and in column V from $35, $27, $18, $26, $35, $35, $27, and $18 to $39, $30, $20, $29, $39, $39, $30, and $20, respectively.

1991—Pub. L. 102–83, §5(a), renumbered section 1508 of this title as this section.

Subsec. (a)(3). Pub. L. 102–83, §5(c)(1), substituted "3106(a)" for "1506(a)" and "3105(b)" for "1505(b)".

Subsec. (c)(2). Pub. L. 102–83, §5(c)(1), substituted "3115(a)(1)" for "1515(a)(1)".

Pub. L. 102–16 inserted ", State, or local government" after "Federal".

Subsec. (f)(2). Pub. L. 102–83, §5(c)(1), substituted "3104(a)(3)" for "1504(a)(3)".

Subsec. (h). Pub. L. 102–83, §5(c)(1), substituted "1114(j)" for "314(j)" in two places.

Subsec. (i). Pub. L. 102–83, §5(c)(1), substituted "3680(d)" for "1780(d)".

1989—Subsec. (a)(1), (2). Pub. L. 101–237, §423(b)(1)(A), substituted "Secretary" for "Administrator".

Subsec. (b). Pub. L. 101–237, §423(b)(1)(A), substituted "Secretary" for "Administrator".

Pub. L. 101–237, §402(a), increased the monthly rehabilitation subsistence allowance for eligible veterans in column II from $310, $233, $155, $271, $310, $310, $233, and $155 to $333, $250, $167, $291, $333, $333, $250, and $167; in column III from $384, $288, $193, $327, $384, $384, $288, and $193 to $413, $310, $207, $352, $413, $413, $310, and $207; in column IV from $452, $339, $227, $377, $452, $452, $339, and $227 to $486, $364, $244, $405, $486, $486, $364, and $244; in column V from $33, $25, $17, $24, $33, $33, $25, and $17 to $35, $27, $18, $26, $35, $35, $27, and $18, respectively.

Subsecs. (c)(1) to (f)(1)(A). Pub. L. 101–237, §423(b)(1)(A), substituted "Secretary" for "Administrator" wherever appearing.

Subsec. (h). Pub. L. 101–237, §423(b)(1)(B), substituted "Department of Veterans Affairs" for "Veterans' Administration".

1984—Subsec. (b). Pub. L. 98–543 increased the monthly rehabilitation subsistence allowance for eligible veterans in column II from $282, $212, $141, $246, $282, $282, $212, and $141 to $310, $233, $155, $271, $310, $310, $233, and $155; in column III from $349, $262, $175, $297, $349, $349, $262, and $175 to $384, $288, $193, $323, $384, $384, $288, and $193; in column IV from $411, $308, $206, $343, $411, $411, $308, and $206 to $452, $339, $227, $377, $452, $452, $339, and $227; in column V from $30, $23, $15, $22, $30, $30, $23, and $15 to $33, $25, $17, $24, $33, $33, $25, and $17, respectively.

Subsec. (f)(1)(A), (B). Pub. L. 98–525 inserted references to chapter 30 of this title.

1982—Subsec. (g)(2). Pub. L. 97–306 inserted "not" after "shall" and struck out "if the Administrator determines that all the veteran's living expenses are being defrayed by a Federal, State, or local government" at end.

Statutory Notes and Related Subsidiaries

Effective Date of 2012 Amendment

Amendment by Pub. L. 112–154 effective on the date that is one year after Aug. 6, 2012, see section 701(g) of Pub. L. 112–154, set out as an Effective Date note under section 2109 of this title.

Effective Date of 2011 Amendment

Pub. L. 111–377, title II, §205(b), Jan. 4, 2011, 124 Stat. 4126, provided that: "The amendment made by this section [amending this section] shall take effect on August 1, 2011."

Effective Date of 1992 Amendment

Pub. L. 102–568, title IV, §405(c), Oct. 29, 1992, 106 Stat. 4339, provided that: "The amendments made by subsections (a) and (b) [amending this section] shall take effect on October 1, 1993."

Effective Date of 1989 Amendment

Pub. L. 101–237, title IV, §402(b), Dec. 18, 1989, 103 Stat. 2078, provided that: "The amendment made by this section [amending this section] shall take effect on January 1, 1990."

Effective Date of 1984 Amendment

Pub. L. 98–543, title II, §205, Oct. 24, 1984, 98 Stat. 2743, provided that: "The amendments made by this part [part A (§§201–205) of title II of Pub. L. 98–543, see Tables for classification] shall take effect as of October 1, 1984."

Effective Date; Veterans Pursuing Program of Vocational Rehabilitation Under This Chapter

Section effective Oct. 1, 1980, and during period beginning on Oct. 1, 1980, and ending on Mar. 31, 1981, the provisions of this section, as added by Pub. L. 96–466, title I, §101(a), Oct. 17, 1980, 94 Stat. 2178, shall apply to veterans pursuing a program of vocational rehabilitation training under this chapter in the same manner as former section 1504 of this title applied to veterans pursuing such a program under this chapter on Sept. 30, 1980, see section 802(a)(2), (4) of Pub. L. 96–466, set out as an Effective Date note under section 3100 of this title.

Extension of Payment of Vocational Rehabilitation Subsistence Allowances

Pub. L. 116–140, §8, Apr. 28, 2020, 134 Stat. 634, which temporarily allowed for additional subsistence allowances for certain veterans, was repealed by Pub. L. 117–333, §4(b), Jan. 5, 2023, 136 Stat. 6128.

Applicability of Subsection (g)(1) to Apportionments Made Before October 17, 1980

Pub. L. 96–466, title I, §101(c), Oct. 17, 1980, 94 Stat. 2186, provided that: "The provisions of section 1508(g)(1) [now 3108(g)(1)] of title 38, United States Code, as added by subsection (a) shall not apply to an apportionment made under section 3107(c) [now 5307(c)] of such title before the date of the enactment of this Act [Oct. 17, 1980]."
38 U.S.C. § 1720 (2024) — Title 38: VETERANS' BENEFITS / Chapter 17 / Subchapter II / Section 1720: Transfers for nursing home care; adult day health care
Transfers for nursing home care; adult day health care
Status: in_force

(a)(1) Subject to subsection (b) of this section, the Secretary may transfer to a non-Department nursing home, for care at the expense of the United States—

(A) a veteran—

(i) who has been furnished care by the Secretary in a facility under the direct jurisdiction of the Secretary; and

(ii) who the Secretary determines—

(I) requires a protracted period of nursing home care which can be furnished in the non-Department nursing home; and

(II) in the case of a veteran who has been furnished hospital care in a facility under the direct jurisdiction of the Secretary, has received maximum benefits from such care; and

(B) a member of the Armed Forces—

(i) who has been furnished care in a hospital of the Armed Forces;

(ii) who the Secretary concerned determines has received maximum benefits from such care but requires a protracted period of nursing home care; and

(iii) who upon discharge from the Armed Forces will become a veteran.

(2) The Secretary may transfer a person to a nursing home under this subsection only if the Secretary determines that the cost to the United States of the care of such person in the nursing home will not exceed—

(A) the amount equal to 45 percent of the cost of care furnished by the Department in a general hospital under the direct jurisdiction of the Secretary (as such cost may be determined annually by the Secretary); or

(B) the amount equal to 50 percent of such cost, if such higher amount is determined to be necessary by the Secretary (upon the recommendation of the Under Secretary for Health) to provide adequate care.

(3) Nursing home care may not be furnished under this subsection at the expense of the United States for more than six months in the aggregate in connection with any one transfer except—

(A) in the case of a veteran—

(i) who is transferred to a non-Department nursing home from a hospital under the direct jurisdiction of the Secretary; and

(ii) whose hospitalization was primarily for a service-connected disability;

(B) in a case in which the nursing home care is required for a service-connected disability; or

(C) in a case in which, in the judgment of the Secretary, a longer period of nursing home care is warranted.

(4) A veteran who is furnished care by the Secretary in a hospital or domiciliary facility in Alaska or Hawaii may be furnished nursing home care at the expense of the United States under this subsection even if such hospital or domiciliary facility is not under the direct jurisdiction of the Secretary.

(b) No veteran may be transferred or admitted to any institution for nursing home care under this section, unless such institution is determined by the Secretary to meet such standards as the Secretary may prescribe. The standards prescribed and any report of inspection of institutions furnishing care to veterans under this section made by or for the Secretary shall, to the extent possible, be made available to all Federal, State, and local agencies charged with the responsibility of licensing or otherwise regulating or inspecting such institutions.

(c)(1)(A) In furnishing nursing home care, adult day health care, or other extended care services under this section, the Secretary may enter into agreements for furnishing such care or services with—

(i) in the case of the medicare program, a provider of services that has entered into a provider agreement under section 1866(a) of the Social Security Act (42 U.S.C. 1395cc(a));

(ii) in the case of the medicaid program, a provider participating under a State plan under title XIX of such Act (42 U.S.C. 1396 et seq.); and

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

(B) In entering into an agreement under subparagraph (A) with a provider of services described in clause (i) of that subparagraph or a provider described in clause (ii) of that subparagraph, the Secretary may use the procedures available for entering into provider agreements under section 1866(a) of the Social Security Act.

(2) In applying the provisions of section 6704(a) of title 41 with respect to any contract entered into under this section to provide nursing home care of veterans, the payment of wages not less than those specified in section 6(b) of the Fair Labor Standards Act of 1938 (29 U.S.C. 206(b)) shall be deemed to constitute compliance with such provisions.

(d)(1) Subject to subsection (b) of this section, the Secretary may authorize for any veteran requiring nursing home care for a service-connected disability direct admission for such care at the expense of the United States to any non-Department nursing home. The Secretary may also authorize a direct admission to such a nursing home for nursing home care for any veteran who has been discharged from a hospital under the direct jurisdiction of the Secretary and who is currently receiving medical services as part of home health services from the Department.

(2) Direct admission authorized by paragraph (1) of this subsection may be authorized upon determination of need therefor—

(A) by a physician employed by the Department; or

(B) in areas where no such physician is available, by a physician carrying out such function under contract or fee arrangement,

based on an examination by such physician.

(3) The amount which may be paid for such care and the length of care available under this subsection shall be the same as authorized under subsection (a) of this section.

(e)(1) The cost of intermediate care for purposes of payment by the United States pursuant to subsection (a)(2)(B) of this section shall be determined by the Secretary except that the rate of reimbursement shall be commensurately less than that provided for nursing home care.

(2) For the purposes of this section, the term "non-Department nursing home" means a public or private institution not under the direct jurisdiction of the Secretary which furnishes nursing home care.

(f)(1)(A) The Secretary may furnish adult day health care services to a veteran enrolled under section 1705(a) of this title who would otherwise require nursing home care.

(B) The Secretary may provide in-kind assistance (through the services of Department employees and the sharing of other Department resources) to a facility furnishing care to veterans under subparagraph (A) of this paragraph. Any such in-kind assistance shall be provided under a contract or agreement between the Secretary and the facility concerned. The Secretary may provide such assistance only for use solely in the furnishing of adult day health care and only if, under such contract or agreement, the Department receives reimbursement for the full cost of such assistance, including the cost of services and supplies and normal depreciation and amortization of equipment. Such reimbursement may be made by reduction in the charges to the United States or by payment to the United States. Any funds received through such reimbursement shall be credited to funds allotted to the Department facility that provided the assistance.

(2) The Secretary may conduct, at facilities over which the Secretary has direct jurisdiction, programs for the furnishing of adult day health care to veterans who are eligible for such care under paragraph (1) of this subsection, except that necessary travel and incidental expenses (or transportation in lieu thereof) may be furnished under such a program only under the terms and conditions set forth in section 111 of this title. The furnishing of care under any such program shall be subject to the limitations that are applicable to the duration of adult day health care furnished under paragraph (1) of this subsection.

(g) The Secretary may contract with appropriate entities to provide specialized residential care and rehabilitation services to a veteran of Operation Enduring Freedom or Operation Iraqi Freedom who the Secretary determines suffers from a traumatic brain injury, has an accumulation of deficits in activities of daily living and instrumental activities of daily living, and because of these deficits, would otherwise require admission to a nursing home even though such care would generally exceed the veteran's nursing needs.

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

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

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

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

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

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

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

(Added Pub. L. 88–450, §2(a), Aug. 19, 1964, 78 Stat. 500, §620; amended Pub. L. 90–429, July 26, 1968, 82 Stat. 446; Pub. L. 90–612, §§1, 3, Oct. 21, 1968, 82 Stat. 1202; Pub. L. 91–101, Oct. 30, 1969, 83 Stat. 167; Pub. L. 93–82, title I, §104, Aug. 2, 1973, 87 Stat. 182; Pub. L. 94–581, title I, §106, title II, §§202(h), 210(a)(7), Oct. 21, 1976, 90 Stat. 2847, 2856, 2863; Pub. L. 97–295, §4(19), Oct. 12, 1982, 96 Stat. 1306; Pub. L. 98–160, title I, §103(a)(1), (2), Nov. 21, 1983, 97 Stat. 995; Pub. L. 99–166, title I, §108(a)–(c), Dec. 3, 1985, 99 Stat. 946, 947; Pub. L. 99–272, title XIX, §19011(d)(5), Apr. 7, 1986, 100 Stat. 379; Pub. L. 100–322, title I, §§103(b), 111(a), May 20, 1988, 102 Stat. 493, 499; renumbered §1720 and amended Pub. L. 102–83, §§4(a)(2)(A)(ii), (3)–(5), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 403–406; Pub. L. 102–405, title III, §302(c)(1), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 104–262, title I, §101(d)(8), Oct. 9, 1996, 110 Stat. 3180; Pub. L. 105–114, title IV, §402(c), Nov. 21, 1997, 111 Stat. 2294; Pub. L. 106–117, title I, §101(d), Nov. 30, 1999, 113 Stat. 1549; Pub. L. 108–170, title I, §105, Dec. 6, 2003, 117 Stat. 2045; Pub. L. 111–163, title V, §507, May 5, 2010, 124 Stat. 1161; Pub. L. 111–350, §5(j)(1), Jan. 4, 2011, 124 Stat. 3850; Pub. L. 112–154, title I, §105(b), Aug. 6, 2012, 126 Stat. 1170; Pub. L. 117–328, div. U, title I, §165(a)(1), Dec. 29, 2022, 136 Stat. 5431.)

Editorial Notes

References in Text

The Social Security Act, referred to in subsec. (c)(1)(A)(ii), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XIX of the Act is classified generally to subchapter XIX (§1396 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.

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

Prior Provisions

Prior section 1720 was renumbered section 3520 of this title.

Amendments

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

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

2011—Subsec. (c)(2). Pub. L. 111–350 substituted "section 6704(a) of title 41" for "section 2(b)(1) of the Service Contract Act of 1965 (41 U.S.C. 351(b)(1))".

2010—Subsec. (g). Pub. L. 111–163 added subsec. (g).

2003—Subsec. (c). Pub. L. 108–170, §105(a), designated existing provisions as par. (2) and added par. (1).

Subsec. (f)(1)(B). Pub. L. 108–170, §105(b), inserted "or agreement" after "contract" in two places.

1999—Subsec. (f)(1)(A). Pub. L. 106–117 amended subpar. (A) generally. Prior to amendment, subpar. (A) read as follows: "The Secretary is authorized to furnish adult day health care as provided for in this subsection. For the purpose only of authorizing the furnishing of such care and specifying the terms and conditions under which it may be furnished to veterans needing such care—

"(i) references to 'nursing home care' in subsections (a) through (d) of this section shall be deemed to be references to 'adult day health care'; and

"(ii) a veteran who is eligible for medical services under paragraph (1), (2), or (3) of section 1710(a) of this title shall be deemed to be a veteran described in subsection (a)(1) of this section."

1997—Subsec. (a)(1)(A)(i). Pub. L. 105–114 substituted "care" for "hospital care, nursing home care, or domiciliary care".

1996—Subsec. (f)(1)(A)(ii). Pub. L. 104–262, §101(d)(8)(A), substituted "paragraph (1), (2), or (3) of section 1710(a)" for "section 1712(a)(1)(B)".

Subsec. (f)(3). Pub. L. 104–262, §101(d)(8)(B), struck out par. (3) which read as follows: "Adult day health care may not be furnished under this section after September 30, 1991."

1992—Subsec. (a)(2)(B). Pub. L. 102–405 substituted "Under Secretary for Health" for "Chief Medical Director".

1991—Pub. L. 102–83, §5(a), renumbered section 620 of this title as this section.

Subsec. (a). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" wherever appearing in par. (1) introductory provisions and subpar. (A) and pars. (2) to (4).

Pub. L. 102–83, §4(a)(5), substituted "non-Department" for "non-Veterans' Administration" wherever appearing in pars. (1) and (3)(A)(i).

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration" in par. (2)(A).

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

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

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

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration".

Subsec. (d)(2)(A). Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration".

Subsec. (e). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in pars. (1) and (2).

Pub. L. 102–83, §4(a)(5), substituted "non-Department" for "non-Veterans' Administration" in par. (2).

Subsec. (f)(1)(A). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in introductory provisions.

Subsec. (f)(1)(A)(ii). Pub. L. 102–83, §5(c)(1), substituted "1712(a)(1)(B)" for "612(a)(1)(B)".

Subsec. (f)(1)(B). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" before "may" in two places.

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

Pub. L. 102–83, §4(a)(2)(A)(ii), substituted "Secretary" for "Veterans' Administration" in second sentence.

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

1988—Subsec. (e)(1). Pub. L. 100–322, §103(b), struck out "For the purposes of this section, the term 'nursing home care' includes intermediate care, as determined by the Administrator in accordance with regulations which the Administrator shall prescribe." at beginning and struck out "(as defined in section 101(28) of this title)" after "provided for nursing home care".

Subsec. (f)(3). Pub. L. 100–322, §111(a), substituted "September 30, 1991" for "September 30, 1988".

1986—Subsec. (f)(1)(A)(ii). Pub. L. 99–272 substituted "612(a)(1)(B)" for "612(f)(2)".

1985—Subsec. (a). Pub. L. 99–166, §108(a), amended subsec. (a) generally. Prior to amendment, subsec. (a) read as follows: "Subject to subsection (b) and except as provided in subsection (e) of this section, the Administrator may transfer—

"(1) Any veteran who has been furnished care by the Administrator in a hospital under the direct jurisdiction of the Administrator, and

"(2) Any person (A) who has been furnished care in any hospital of any of the Armed Forces, (B) who the appropriate Secretary concerned has determined has received maximum hospital benefits but requires a protracted period of nursing home care, and (C) who upon discharge therefrom will become a veteran

to any public or private institution not under the jurisdiction of the Administrator which furnishes nursing home care, for care at the expense of the United States, only if the Administrator determines that—

"(i) such veteran has received maximum benefits from such care in such hospital, but will require a protracted period of nursing home care which can be furnished in such institution, and

"(ii) the cost of such nursing home care in such institution will not exceed 45 percent of the cost of care furnished by the Veterans' Administration in a general hospital under the direct and exclusive jurisdiction of the Administrator, as such cost may be determined annually by the Administrator, or not to exceed 50 percent of such cost where determined necessary by the Administrator, upon recommendation of the Chief Medical Director, to provide adequate care.

Nursing home care may not be furnished pursuant to this section at the expense of the United States for more than six months in the aggregate in connection with any one transfer, except (I) in the case of the veteran whose hospitalization was primarily for a service-connected disability, or (II) where in the judgment of the Administrator a longer period is warranted in the case of any other veteran. Any veteran who is furnished care by the Administrator in a hospital in Alaska or Hawaii may be furnished nursing home care under the provisions of this section even if such hospital is not under the direct jurisdiction of the Administrator."

Subsec. (d). Pub. L. 99–166, §108(b), designated existing first sentence as par. (1), substituted "to any non-Veterans' Administration nursing home" for "to any public or private institution not under the jurisdiction of the Administrator which furnishes nursing home care", inserted "The Administrator may also authorize a direct admission to such a nursing home for nursing home care for any veteran who has been discharged from a hospital under the direct jurisdiction of the Administrator and who is currently receiving medical services as part of home health services from the Veterans' Administration.", substituted par. (2) for "Such admission may be authorized upon determination of need therefor by a physician employed by the Veterans' Administration or, in areas where no such physician is available, carrying out such function under contract or fee arrangement based on an examination by such physician.", and designated existing last sentence as par. (3).

Subsec. (e). Pub. L. 99–166, §108(c), designated existing provisions as par. (1), substituted "subsection (a)(2)(B)" for "subsection (a)(ii)" in second sentence, and added par. (2).

1983—Pub. L. 98–160, §103(a)(2), inserted "; adult day health care" in section catchline.

Subsec. (f). Pub. L. 98–160, §103(a)(1), added subsec. (f).

1982—Subsec. (a)(ii) Pub. L. 97–295, §4(19)(A), substituted "percent" for "per centum" wherever appearing.

Subsec. (c). Pub. L. 97–295, §4(19)(B), inserted "(41 U.S.C. 351(b)(1))" after "the Service Contract Act of 1965" and substituted "(29 U.S.C. 206(b))" for ", as amended,".

1976—Subsec. (a). Pub. L. 94–581, §§106(1)–(3), 202(h), inserted "and except as provided in subsection (e)" after "subsection (b)" in provisions preceding par. (1), substituted "direct jurisdiction" for "direct and exclusive jurisdiction" in par. (1), substituted "45 per centum" for "40 per centum" and "annually" for "from time to time" in cl. (ii) and inserted ", or not to exceed 50 per centum of such cost where determined necessary by the Administrator, upon recommendation of the Chief Medical Director, to provide adequate care" at the end thereof, and substituted "direct jurisdiction" for "direct and exclusive jurisdiction" in provisions following cl. (ii).

Subsec. (b). Pub. L. 94–581, §210(a)(7), substituted "such standards as the Administrator may prescribe" for "such standards as he may prescribe".

Subsec. (e). Pub. L. 94–581, §106(4), added subsec. (e).

1973—Subsec. (a). Pub. L. 93–82, §104(a), (b), designated cls. (1) and (2) as (i) and (ii), respectively, and in provisions preceding cl. (i) as so designated, substituted authority of the Administrator to transfer veterans and other persons under pars. (1) and (2), for authority of the Administrator to transfer veterans who have been furnished care by the Administrator in a hospital under the direct and exclusive jurisdiction of the Administrator, to any public or private institution not under the jurisdiction of the Administrator which furnishes nursing home care for care at the expense of the United States, and in the provisions following cl. (ii) as so designated, substituted designations (I) and (II) for designations (A) and (B).

Subsec. (b). Pub. L. 93–82, §104(c), inserted provisions relating to the admissions of veterans to institutions for nursing home care and for the furnishing of standards and reports to Federal, State and local agencies charged with the responsibility of licensing or otherwise regulating or inspecting such institutions.

Subsec. (d). Pub. L. 93–82, §104(d), added subsec. (d).

1969—Subsec. (a). Pub. L. 91–101 inserted provision authorizing the furnishing of nursing home care for more than six months in the aggregate in connection with any one transfer in the case of a veteran whose hospitalization was primarily for a service-connected disability.

1968—Subsec. (a). Pub. L. 90–612, §1, authorized furnishing of nursing home care to veterans who are being furnished care by the Administrator in hospitals in Alaska or Hawaii even if the hospitals involved are not under the direct and exclusive jurisdiction of the Administrator.

Subsec. (a)(2). Pub. L. 90–429 substituted "40 per centum" for "one-third".

Subsec. (c). Pub. L. 90–612, §3, added subsec. (c).

Statutory Notes and Related Subsidiaries

Effective Date of 2022 Amendment

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

Effective Date of 2012 Amendment

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

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

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

Effective Date of 1986 Amendment

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

Effective Date of 1976 Amendment

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

Effective Date of 1973 Amendment

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

Ongoing Monitoring of Medical Foster Home Program

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

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

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

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

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

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

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

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

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

Comparison Study Between Adult Day Health Care and Nursing Home Care

Pub. L. 100–322, title I, §111(b), (c), May 20, 1988, 102 Stat. 499, directed Administrator to conduct a study of medical efficacy and cost-effectiveness of furnishing adult day health care under subsec. (f) of this section as an alternative to nursing home care and the comparative advantages and disadvantages of providing such care through facilities that are not under direct jurisdiction of Administrator and through facilities that are under direct jurisdiction of Administrator, with Administrator to submit to Committees on Veterans' Affairs of Senate and House of Representatives an interim report on the study not later than Feb. 1, 1988, a final report on such study not later than Feb. 1, 1991.

Pub. L. 98–160, title I, §103(b), (c), Nov. 21, 1983, 97 Stat. 996, which provided for a study and report, not later than Feb. 1, 1988, of the medical efficacy and cost-effectiveness of furnishing adult day health care as an alternative for nursing home care and of the comparative advantages and disadvantages of providing such care in Veterans' Administration or in other facilities, was repealed by Pub. L. 100–322, title I, §111(d), May 20, 1988, 102 Stat. 499.