An Act to amend title 38, United States Code, to provide certain veterans with urgently needed nursing home care and nursing care facilities while reducing the cost to the United States of caring for such veterans, and for other purposes
PL 88-450 (H.R.8009), enacted 08/19/1964

500 
PUBLIC LAW 88-450-AUG. 19, 1964 
[78 
STAT. 
Public Law 88-450 
August 19, 1964 
[H. R. 8009] 
Veterans. 
Nursing home 
care. 
72 Stat. 1251. 
AN ACT 
Transfers to 
other institutions. 
72 Stat. 1141. 
38 u s e 61U-619. 
Conditions. 
Payments. 
72 Stat. 1146; 
74 Stat. 424. 
To amend title 38, United States Code, to provide veterans with urgently needed 
nursing home care and nursing care facilities while reducing the cost to the 
United States of caring for such veterans, and for other purposes. 
Be it enacted hy the Senate and House of Representatwes 
of the 
United States of America in Congress assembled^ That subsection (a) 
of section 5001 of title 38, LTnited States Code, is amended (1) by 
inserting "(1)" immediately after "(a)", (2) by redesignating clauses 
(1) and (2) thereof as clauses (A) and (B), respectively, and (3) 
by adding at the end thereof the following new paragraph: 
"(2) The Administrator, subject to the approval of the President, 
is authorized to establish and operate not less than four thousand beds 
for the furnishing of nursing home care to eligible veterans in facilities 
over which the Administrator has direct and exclusive jurisdiction."' 
SEC. 2. (a) Subchapter II of chapter 17 of title 38, TTnited States 
Code, is amended by adding at the end thereof the following new 
section: 
"§ 620. Transfers for nursing home care 
"(a) Subject to subsection (b) of this section, the Administrator 
may transfer any veteran, who has been furnished care by the Admin-
istrator in a hospital under the direct and exclusive jurisdiction of the 
Administrator, to any public or private institution not under the juris-
diction of the Administrator which furnishes nursing home care, for 
care at the expense of the United States, if the Administrator deter-
mines that— 
"(1) such veteran has received maximum benefits from such 
care in such hospital, but will require a protracted period of nurs-
ing home care which can be furnished in such institution, and 
"(2) the cost of such nursing home care in such institution will 
not exceed one-third of the cost of care furnished by the Veterans' 
Administration in a general hospital under the direct and exclu-
sive jurisdiction of the Administrator, as such cost may be deter-
mined from time to time by the Administrator. 
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 aggre-
gate in connection with any one transfer, except where in the judg-
ment of the Administrator a longer period is warranted in the case of 
any veteran. 
"(b) No veteran may be transferred to any institution for nursing 
home care under tliis section, unless such institution is determined by 
the Administrator to meet such standards as he may prescribe." 
(b) The analysis of chapter 17 of title 38, United States Code, is 
amended by inserting immediately below 
"619. Repair or replacement of certain prosthetic and other appliances." 
the following: 
"620. Transfers for nursing home care." 
SEC. 3. (a) Section 641 of title 38, United States Code, is amended 
to read as follows: 
"§ 641. Criteria for payment 
"The Administrator shall pay each State at the per diem rate of 
$2.50 for each veteran of any war receiving h'ospitalization or domi-
ciliary care in a State home in such State if the veteran is eligible for 
hospitalization or domiciliary care in a Veterans' Administration fa-
cility, and at the per diem rate of $3.50 for each veteran of any war 
78 STAT. ] 
PUBLIC LAW 88-450-AUG. 19, 1964 
501 
receiving nursing home care in a State home in such State, if such 
veteran meets the requirements of paragraph (1), (2), or (3) of 
section 610(a) of this title, except that the requirement in clause (B) 76^stat^*38\^^^' 
of such paragraph (1) shall, for this purpose, refer to the inability 
38 use eio. 
to defray the expenses of necessary nursing home care; however, such 
payment shall not be more, in any case, than one-half of the cost of 
the veteran's maintenance in such State home/' 
(b) No payment shall be made to any State home solely by reason 
Restriction. 
of the amendment made by this section on account of nursing home 
care furnished any veteran except where such care is furnished the 
veteran by the State home for the first time after the effective date 
of this section. 
(c) The amendment made by this section shall take effect on Jan-
uary 1, 1965; except that subsection (b) of section 641 of title 38, 
United States Code, as in effect immediately before such date, shall jJ^i^l^^gA^'^^'' 
remain in effect with respect to any amounts retained or collected by 
any State home before such date. 
SEC. 4. (a) Chapter 81 of title 38, United States Code, is amended 
H l'^^ ^^^^^ 
by adding at the end thereof the following new subchapter: 
5014. 
"Subchapter III—State Home Facilities for Furnishing Nursing 
Home Care 
"§5031. Definitions 
"For the purpose of this subchapter— 
"(a) The war veteran population of each State shall be deter-
mined on the basis of the latest figures certified by the Department 
of Commerce. 
"(b) The term 'State' does not include any possession of the 
United States. 
"(c) The term 'construction' means the construction of new 
buildings, the expansion, remodeling, modification, or alteration 
of existing buildings, and the providing of initial equipment for 
any such buildings. 
"(d) The term 'cost of construction' means the amount found 
by the Administrator to be necessary for a project of construction 
of nursing home care facilities, including architect fees, but not 
including the cost of acquisition of land. 
"§ 5032. Declaration of purpose 
"The purpose of this subchapter is to assist the several States to 
construct State home facilities for furnishing nursing home care to 
war veterans. 
"§ 5033. Authorization of appropriations 
"(a) There is hereby authorized to be appropriated $5,000,000 for 
the fiscal year ending June 30,1965, and a like sum for each of the four 
succeeding fiscal years. Sums appropriated pursuant to this section 
shall be used for making grants to States which have submitted, and 
have had approved by the Administrator, applications for carrying 
out the purposes of section 5032 of this title. 
"(b) Sums appropriated pursuant to subsection (a) of this section 
shall remain available until the end of the second fiscal year following 
the fiscal year for which they are appropriated. 
"(c) Not more than 10 per centum of the funds appropriated pur-
suant to subsection (a) of this section for any fiscal year shall be used 
to assist in the construction of nursing home care facilities in any one 
State. 
502 
PUBLIC LAW 88-450-AUG. 19, 1964 
[78 STAT. 
"§ 5034. General regulations 
"Within six months after the date of enactment of this subchapter, 
the Administrator shall prescribe the following by regulation: 
" (1) The number of beds required to provide adequate nursing 
home care to war veterans residing in each State, which number 
shall not exceed one-half bed per thousand war veteran population 
in the case of any State. 
"(2) General standards of construction, repairs, modernization, 
alteration, and equipment for facilities for furnishing nursing 
home care which are constructed with assistance received under 
this subchapter. 
"§ 5035. Applications with respect to projects; payments 
"(a) After regulations have been prescribed by the Administrator 
under section 5034 of this title, any State desiring to receive assistance 
for a project for construction of State home facilities for furnishing 
nursing home care must submit to the Administrator an application. 
Such application shall set forth— 
"(1) the amount of the grant requested with respect to such 
project which may not exceed 50 per centum of the estimated cost 
of construction of such project, 
" (2) a description of the site for such project, 
"(3) plans and specifications for such project in accordance 
with regulations prescribed by the Administrator pursuant to 
section 5034(2) of this title, 
" (4) reasonable assurance that upon completion of such project 
the facilities will be used principally to furnish nursing home 
care to war veterans and that not more than 10 per centum of the 
bed occupancy at any one time will consist of patients who are 
not receiving nursing home care as war veterans, 
"(5) reasonable assurance that title to such site is or will be 
vested solely in the applicant, a State home, or another agency 
or instrumentality of the State, 
"(6) reasonable assurance .that adequate financial support will 
be available for the construction of the project and for its mainte-
nance and operation when complete, 
" (7) reasonable assurance that the State will make such reports 
in such form and containing such information as the Adminis-
trator may from time to time reasonably require, and give the 
Administrator, upon demand, access to the records upon which 
such information is based, and 
"(8) reasonable assurance that the rates of pay for laborers 
and mechanics engaged in construction of the project will be not 
less than the prevailing local wage rates for similar work as deter-
mined in accordance with sections 276a through 276a-5 of title 40 
49 Stat. 1011. 
(known as the Davis-Bacon Act). 
Approval. 
"(I3) -j^j^g Administrator shall approve any such application if he 
finds that— 
"(1) there are sufficient funds available to make the grant 
requested with respect to such project, 
"(2) such grant does not exceed 50 per centum of the estimated 
cost of construction of such project, 
"(3) that such a grant would not result in more than 10 per 
centum of the funds appropriated for any fiscal year pursuant to 
section 5033(a) of this title being used to assist the construction 
of facilities in any one State, 
"(4) the application contains such reasonable assurance as to 
use, title, financial support, reports and access to records, and 
payment of prevailing rates of wages, as the Administrator may 
determine to be necessary, and 
78 STAT. ] 
PUBLIC LAW 88-450-AUG. 19, 1964 
503 
"(5) the plans and specifications for such project are in accord 
with regulations prescribed pursuant to section 5034(2) of this 
title and that the construction of such project, together with other 
projects under construction and other facilities, will not result in 
more than the number of beds prescribed by the Administrator 
pursuant to section 5034(1) of this title for the State in which 
such project is located being available for furnishing nursing 
home care to war veterans in such State. 
"(c) No application submitted to the Administrator under this sec- 
"^^eai hearing. 
tion shall be disapproved until the Administrator has afforded the 
applicant an opportunity for a hearing. 
"(d) Upon approving an application under this section, the Admin-
istrator shall certify to the Secretary of the Treasury the amount of the 
grant requested with respect to such project in such application, but 
in no event an amount greater than 50 per centum of the estimated 
cost of construction of the project, and shall designate the appropria-
tion from which it shall be paid. 
Such certification shall provide for 
payment to the applicant or, if designated by the applicant, the State 
home for which such project is being constructed or any other agency 
or instrumentality of the applicant. 
Such amount shall be paid, in 
advance or by way of reimbursement, and in such installments con-
sistent with the progress of construction as the Administrator may 
determine and certify for payment to the Secretary of the Treasury. 
Funds paid under this section for the construction of an approved 
project shall be used solely for carrying out such project as so 
approved. 
"(e) Any amendment of any approved application shall be subject 
to approval in the same manner as an original application. 
"§ 5036. Recapture provisions 
"If, within twenty years after completion of any project for con-
struction 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 instru-
mentality of a State principally for furnishing nursing home care 
to war 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, 50 per centum of the then 
value of such facilities, 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. 
*
*
§ 5037. State control of operations 
"Except as otherwise specifically provided, nothing in this sub-
chapter shall be construed as conferring on any Federal officer or 
employee the right to exercise any supervision or control over the 
administration, personnel, maintenance, or operation of any State 
home for which facilities are constructed with assistance received 
under this subchapter." 
(b) The analysis of chapter 81 of title 38, United States Code, is 
amended by adding at the end thereof the following: 
"SUBCHAPTER III—STATE HOME FACILITIES FOR FURNISHING NURSING HOME CARE 
"5031. Definitions. 
"5032. Declaration of purpose. 
"5033. Autliorization of appropriations. 
"5034. General regulations. 
"5035. Applications with respect to projects; Payments. 
"5036. Recapture provisions. 
"5037. State control of operations." 
31-667 0-65—35 
504 
PUBLIC LAW 88-450-AUG. 19, 1964 
[78 STAT. 
72 Stat. 1107. 
"Nursing home 
Discontinuance 
of allowance. 
76 Stat. 441. 
72 Stat. 936; 
76 Stat. 441. 
Equipment. 
73 Stat. 435. 
Additional med-
ical treatment. 
72 Stat. 1142. 
38 u s e 501-562. 
(c) Paragraph (19) of section 101 of title 38, United States Code, 
is amended by adding at the end thereof the following: "Such term 
also includes such a home which furnishes nursing home care for 
veterans of any war." 
(d) Section 101 of title 38, United States Code, is amended by 
adding at the end thereof the following new paragraph: 
"(28) The term 'nursing home care' means the accommodation of 
convalescents or other persons who are not acutely ill and not in need 
of hospital care, but who require skilled nursing care and related 
medical services, if such nursing care and medical services are pre-
scribed by, or are performed under the general direction of, persons 
duly licensed to provide such care. The term includes intensive care 
where the nursing service is under the supervision of a registered 
professional nurse." 
SEC. 5. (a) Section 3203(f) of title 38, United States Code, is 
amended to read as follows: 
"(f) Where any veteran in receipt of an aid and attendance allow-
ance described in section 314(r) of this title is hospitalized at Govern-
ment expense, sr«ch allowance shall be discontinued from the first day 
of the second calendar month which begins after the date of his admis-
sion for such hospitalization for so long as such hospitalization con-
tinues. Any discontinuance required by administrative regulation, 
during hospitalization of a veteran by the Veterans' Administration, 
of increased pension based on need of regular aid and attendance or 
additional compensation based on need of regular aid and attendance 
as described in subsection (1) or (m) of section 314 of this title, shall 
not be effective earlier than the first day of the second calendar month 
which begins after the date of the veteran's admission for hospitaliza-
tion. 
In case a veteran affected by this subsection leaves a hospital 
against medical advice and is thereafter admitted to hospitalization, 
such allowance, increased pension, or additional compensation, as the 
case may be, shall be discontinued from the date of such readmission 
for so long as such hospitalization continues." 
(b) The amendment made by this section shall apply only with 
respect to compensation or pension based upon need of regular aid 
and attendance in the case of veterans admitted for hospitalization on 
or after the first day of the second calendar month which begins after 
the date of enactment of this Act. 
SEC. 6. (a) Section 617 of title 38, United States Code, is amended 
by inserting " ( a ) " immediately before "The Administrator" and by 
adding at the end thereof the following new subsection: 
"(b) The Administrator may furnish any type of therapeutic or 
rehabilitative device, as well as other medical equipment and supplies 
(excluding medicines), if medically indicated, to any veteran who is 
eligible to receive an invalid lift under subsection (a) of this section, or 
v/ho would be so eligible, but for the fact that he has such a lift." 
(b) The analysis of chapter 17 of title 38, United States Code, is 
amended by striking out 
"617. Invalid lift for pensioners." 
and inserting in lieu thereof the following: 
''617. Invalid lifts and other devices for pensioners." 
(c) The heading of section 617 of title 38, United States Code, is 
amended to read as follows: 
*
*
§ 617. Invalid lifts and other devices for pensioners". 
SEC. 7. Section 612 of title 38, United States Code, is amended by 
adding at the end thereof the following: 
" (^) Where any veteran is in receipt of pension under chapter 15 
of this title based on the need of regular aid and attendance or of an 
78 STAT.] 
PUBLIC LAW 88-451-AUG. 19, 1964 
505 
aid and attendance allowance received under section 314 or 334 of this 
title, or who, but for the receipt of retired pay, would be in receipt 
of such pension or such an allowance, and— 
"(1) has received care for not less than one year under para-
graph (2) of subsection (f) of this section; and 
" (2) is suffering from (A) cardiovascular-renal disease, includ-
ing hypertension, (B) endocrinopathies, (C) diabetes mellitus, 
(D) cancer, (E) a neuropsychiatric disorder,or (F) tuberculosis; 
then the Administrator may furnish the veteran such further care as 
is reasonably necessary for such disease or disorder." 
Approved August 19, 1964. 
72 Stat. 1120, 
1123. 
Public Law 88-451 
AN ACT 
To amend the Alaska Omnibus Act to provide assistance to tiie State of Alaska 
for the reconstruction of areas damaged by the earthquake of March 1964 and 
subsequent seismic waves, and for other purposes. 
August 19, 1964 
[S. 2881] 
Be it enacted hy the Senate and House of Representatives 
of the-
United States of America in Congress assembled^ That this Act may be 
cited as the "1964 Amendments to the Alaska Omnibus Act". 
SEC. 2. The Congress hereby recognizes that the State of Alaska has 
experienced extensive property loss and damage as a result of the earth-
quake of March 27, 1964, and subsequent seismic waves, and declares 
the need for special measures designed to aid and accelerate the State's 
efforts in providing for the reconstruction of the areas in the State 
devastated by this natural disaster. 
SEC. 3. Section 21 of the Alaska Omnibus Act (73 Stat. 145) is 
amended by adding a new subsection (f) to read as follows: 
"(f) Notwithstanding the limitation contained in subsection (f) 
of section 120 of title 23, United States Code, the Secretary of Com-
merce is authorized to make expenditures from the emergency fund 
under section 125 of such title for the repair or reconstruction of high-
ways on the Federal-aid highway systems of Alaska which have been 
damaged or destroyed by the 1964 earthquake and subsequent seismic 
waves, in accordance with the Federal share payable under subsection 
(a) of section 120 of such title. The increase in expenditures resulting 
from the difference between the Federal share authorized by this sub-
section and that authorized by subsection (f) of section 120 of such 
title shall be reimbursed to the emergency fund by an appropriation 
from the general fund of the Treasury: Provided^ That such increase 
in expenditures shall not exceed $15,000,000 in the aggregate." 
SEC. 4. The Alaska Omnibus Act (73 Stat. 141) is amended by add-
ing the following new sections at the end of section 50 thereof: 
1964 Amend-
ments to the 
Alaska Omnibus 
Act. 
Earthquake 
damage. 
48 use 
5 note. 
73 Stat. 
73 Stat. 
prec. 
613. 
612. 
72 Stat. 898. 
U NEW FEDERAL LOAN ADJUSTMENTS 
"SEC. 51. (a) The Secretary of Agriculture is authorized to com-
promise or release such portion of a borrower's indebtedness under 
programs administered by the Farmers Home Administration in 
Alaska as he finds necessary because of loss resulting from the 1964 
earthquake and subsequent seismic waves, and he may refinance out-
standing indebtedness of applicants in Alaska for loans under section 
502 of the Housing Act of 1949 for the repair, reconstruction, or 
replacement of dwellings or farm buildings lost, destroyed, or dam-
aged by such causes and securing such outstanding indebtedness. 
Such loans may also provide for the purchase of building sites, when 
the original sites cannot be utilized. 
Indebtedness, 
release. 
63 Stat. 433. 
42 u s e 1472.