### §4084. Health care program

#### (a) Establishment

The Secretary of State shall establish a health care program to promote and maintain the physical and mental health of members of the Service, and (when incident to service abroad) other designated eligible Government employees, and members of the families of such members and employees.

#### (b) Services provided

Any such health care program may include (1) medical examinations for applicants for employment, (2) medical examinations and inoculations or vaccinations, and other preventive and remedial care and services as necessary, for members of the Service and employees of the Department who are citizens of the United States and for members of their families, (3) health education and disease prevention programs for all employees, and (4) examinations necessary in order to establish disability or incapacity of participants in the Foreign Service Retirement and Disability System or Foreign Service Pension System or to provide survivor benefits under subchapter VIII.

#### (c) Facilities; employment of personnel

The Secretary of State may establish health care facilities and provide for the services of physicians, nurses, or other health care personnel at Foreign Service posts abroad at which, in the opinion of the Secretary of State, a sufficient number of Government employees are assigned to warrant such facilities or services.

#### (d) Costs of treatment

If an individual eligible for health care under this section incurs an illness, injury, or medical condition which requires treatment while assigned to a post abroad or located overseas pursuant to Government authorization, the Secretary may pay the cost of such treatment.

#### (e) Death or separation of member

Health care may be provided under this section to a member of the Service or other designated eligible Government employee after the separation of such member or employee from Government service. Health care may be provided under this section to a member of the family of a member of the Service or of a designated eligible Government employee after the separation from Government service or the death of such member of the Service or employee or after dissolution of the marriage.

#### (f) Review; medical care contracts

The Secretary of State shall review on a continuing basis the health care program provided for in this section. Whenever the Secretary of State determines that all or any part of such program can be provided for as well and as cheaply in other ways, the Secretary may, for such individuals, locations, and conditions as the Secretary of State deems appropriate, contract for health care pursuant to such arrangements as the Secretary deems appropriate.

#### (g) Retention of medical reimbursements

Reimbursements paid to the Department of State for funding the costs of medical care abroad for employees and eligible family members shall be credited to the currently available applicable appropriation account. Such reimbursements shall be available for obligation and expenditure during the fiscal year in which they are received or for such longer period of time as may be provided in law.

(Pub. L. 96–465, title I, §904, Oct. 17, 1980, 94 Stat. 2127; Pub. L. 99–93, title I, §122, Aug. 16, 1985, 99 Stat. 413; Pub. L. 100–238, title II, §243, Jan. 8, 1988, 101 Stat. 1776; Pub. L. 107–228, div. A, title III, §316, Sept. 30, 2002, 116 Stat. 1379; Pub. L. 109–140, §2, Dec. 22, 2005, 119 Stat. 2650.)

#### **Editorial Notes**

#### Amendments

2005—Subsec. (g). Pub. L. 109–140 added subsec. (g).

2002—Subsec. (b). Pub. L. 107–228 substituted "families, (3) health education and disease prevention programs for all employees, and (4)" for "families, and (3)".

1988—Subsec. (b). Pub. L. 100–238 inserted "or Foreign Service Pension System" after "System".

1985—Subsec. (a). Pub. L. 99–93, §122(1), substituted "shall" for "may".

Subsec. (b). Pub. L. 99–93, §122(2), inserted ", and other preventive and remedial care and services as necessary,".

Subsec. (d). Pub. L. 99–93, §122(3), amended subsec. (d) generally. Prior to amendment, subsec. (d) read as follows: "If an individual eligible for health care under this section incurs an illness, injury, or medical condition while abroad which requires hospitalization or similar treatment, the Secretary may pay all or part of the cost of such treatment. Limitations on such payments established by regulation may be waived whenever the Secretary determines that the illness, injury, or medical condition clearly was caused or materially aggravated by the fact that the individual concerned is or has been located abroad."

#### **Statutory Notes and Related Subsidiaries**

#### Effective Date of 1988 Amendment

Amendment by Pub. L. 100–238 effective 90 days after Jan. 8, 1988, see section 261(a) of Pub. L. 100–238, set out as a note under section 4054 of this title.

#### Improving Mental Health Services for Foreign and Civil Servants

Pub. L. 118–31, div. F, title LXII, §6222(a), Dec. 22, 2023, 137 Stat. 978, provided that:

"(a) Additional Personnel to Address Mental Health.—

"(1) In general.—The Secretary [of State] shall seek to increase the number of personnel within the Bureau of Medical Services to address mental health needs for both foreign and civil servants.

"(2) Employment targets.—Not later than 180 days after the date of the enactment of this division [Dec. 22, 2023], the Secretary shall seek to employ not fewer than 10 additional personnel in the Bureau of Medical Services, compared to the number of personnel employed as of the date of the enactment of this division."

#### Coronavirus Pandemic Response

Pub. L. 116–136, div. B, title XI, §21010, Mar. 27, 2020, 134 Stat. 592, provided that: "The Department of State and the United States Agency for International Development are authorized to enter into contracts with individuals for the provision of personal services (as described in section 104 of part 37 of title 48, Code of Federal Regulations and including pursuant to section 904 of the Foreign Service Act of 1980 (22 U.S.C. 4084)) to prevent, prepare for, and respond to coronavirus, within the United States and abroad, subject to prior consultation with, and the notification procedures of, the Committee on Appropriations and the Committee on Foreign Relations of the Senate and the Committee on Appropriations and the Committee on Foreign Affairs of the House of Representatives: Provided, That such individuals may not be deemed employees of the United States for the purpose of any law administered by the Office of Personnel Management: Provided further, That not later than 15 days after utilizing this authority, the Secretary of State shall provide a report to the Committee on Appropriations and the Committee on Foreign Relations of the Senate and the Committee on Appropriations and the Committee on Foreign Affairs of the House of Representatives on the overall staffing needs for the Office of Medical Services: Provided further, That the authority made available pursuant to this section shall expire on September 30, 2022."

[For definition of "coronavirus" as used in section 21010 of Pub. L. 116–136, set out above, see section 23005 of Pub. L. 116–136, set out as a note under section 162b of Title 2, The Congress.]