§ 1710B. Extended care services

§ 1710B. Extended care services

(a) The Secretary (subject to section 1710(a)(4) of this title and subsection (c) of this section) shall operate and maintain a program to provide extended care services to eligible veterans in accordance with this section. Such services shall include the following:

(1) Geriatric evaluation.

(2) Nursing home care (A) in facilities operated by the Secretary, and (B) in community-based facilities through contracts under section 1720 of this title.

(3) Domiciliary services under section 1710(b) of this title.

(4) Adult day health care under section 1720(f) of this title.

(5) Such other noninstitutional alternatives to nursing home care as the Secretary may furnish as medical services under section 1701(10) 11 See References in Text note below. of this title.

(6) Respite care under section 1720B of this title.

(b) The Secretary shall ensure that the staffing and level of extended care services provided by the Secretary nationally in facilities of the Department during any fiscal year is not less than the staffing and level of such services provided nationally in facilities of the Department during fiscal year 1998.

(c)

(1) Except as provided in paragraph (2), the Secretary may not furnish extended care services for a non-service-connected disability other than in the case of a veteran who has a compensable service-connected disability unless the veteran agrees to pay to the United States a copayment (determined in accordance with subsection (d)) for any period of such services in a year after the first 21 days of such services provided that veteran in that year.

(2) Paragraph (1) shall not apply—

(A) to a veteran whose annual income (determined under section 1503 of this title) is less than the amount in effect under section 1521(b) of this title;

(B) to a veteran being furnished hospice care under this section;

(C) with respect to an episode of extended care services that a veteran is being furnished by the Department on November 30, 1999; or

(D) to a veteran who was awarded the medal of honor under section 7271, 8291, or 9271 of title 10 or section 491 ^1 of title 14.

(d)

(1) A veteran who is furnished extended care services under this chapter and who is required under subsection (c) to pay an amount to the United States in order to be furnished such services shall be liable to the United States for that amount.

(2) In implementing subsection (c), the Secretary shall develop a methodology for establishing the amount of the copayment for which a veteran described in subsection (c) is liable. That methodology shall provide for—

(A) establishing a maximum monthly copayment (based on all income and assets of the veteran and the spouse of such veteran);

(B) protecting the spouse of a veteran from financial hardship by not counting all of the income and assets of the veteran and spouse (in the case of a spouse who resides in the community) as available for determining the copayment obligation; and

(C) allowing the veteran to retain a monthly personal allowance.

(e)

(1) There is established in the Treasury of the United States a revolving fund known as the Department of Veterans Affairs Extended Care Fund (hereinafter in this section referred to as the “fund”). Amounts in the fund shall be available, without fiscal year limitation and without further appropriation, exclusively for the purpose of providing extended care services under subsection (a).

(2) All amounts received by the Department under this section shall be deposited in or credited to the fund.

(Added Pub. L. 106–117, title I, § 101(c)(1), Nov. 30, 1999, 113 Stat. 1548; amended Pub. L. 107–14, § 8(a)(2), (16), June 5, 2001, 115 Stat. 34, 35; Pub. L. 107–103, title V, § 509(b), Dec. 27, 2001, 115 Stat. 997; Pub. L. 108–422, title II, § 204, Nov. 30, 2004, 118 Stat. 2382; Pub. L. 114–315, title VI, § 603(c), Dec. 16, 2016, 130 Stat. 1570; Pub. L. 115–232, div. A, title VIII, § 809(n)(1)(C), Aug. 13, 2018, 132 Stat. 1843.)

Editorial Notes

References in Text

Section 1701(10) of this title, referred to in subsec. (a)(5), was repealed by Pub. L. 110–387, title VIII, § 801(1), Oct. 10, 2008, 122 Stat. 4140.

Section 491 of title 14, referred to in subsec. (c)(2)(D), was redesignated section 2732 of title 14 by Pub. L. 115–282, title I, § 116(b), Dec. 4, 2018, 132 Stat. 4226, and references to section 491 of title 14 deemed to refer to such redesignated section, see section 123(b)(1) of Pub. L. 115–282, set out as a References to Redesignated Sections of Title 14 note preceding section 101 of Title 14, Coast Guard.

Amendments

2018—Subsec. (c)(2)(D). Pub. L. 115–232 substituted “section 7271, 8291, or 9271 of title 10” for “section 3741, 6241, or 8741 of title 10”.

2016—Subsec. (c)(2)(D). Pub. L. 114–315 added subpar. (D).

2004—Subsec. (c)(2)(B), (C). Pub. L. 108–422 added subpar. (B) and redesignated former subpar. (B) as (C).

2001—Subsec. (c)(2)(B). Pub. L. 107–103 inserted “on” before “November 30, 1999”.

Pub. L. 107–14, § 8(a)(2), substituted “November 30, 1999” for “on the date of the enactment of the Veterans Millennium Health Care and Benefits Act”.

Subsec. (e)(1). Pub. L. 107–14, § 8(a)(16), substituted “hereinafter” for “hereafter”.

Statutory Notes and Related Subsidiaries

Effective Date of 2018 Amendment

Amendment by Pub. L. 115–232 effective Feb. 1, 2019, with provision for the coordination of amendments and special rule for certain redesignations, see section 800 of Pub. L. 115–232, set out as a note preceding section 3001 of Title 10, Armed Forces.

Effective Date of 2004 Amendment

Pub. L. 108–422, title IV, § 411(f), (g), Nov. 30, 2004, 118 Stat. 2390, provided that: “(f) Contingent Effectiveness.—Subsection (d) [enacting provisions set out as a note under section 8118 of this title] and the amendments made by subsection (c) [repealing section 8116 of this title] shall take effect at the end of the 30-day period beginning on the date on which the Secretary of Veterans Affairs certifies to Congress that the Secretary is in compliance with subsection (b) of section 1710B of title 38, United States Code. “(g) Annual Update.—Following a certification under subsection (f), the Secretary shall submit to Congress an annual update on that certification.”

Effective Date

Pub. L. 106–117, title I, § 101(h), Nov. 30, 1999, 113 Stat. 1550, provided that: “(1) Except as provided in paragraph (2), the amendments made by this section [enacting this section and section 1710A of this title and amending sections 1701, 1710, 1720, 1720B and 1741 of this title] shall take effect on the date of the enactment of this Act [Nov. 30, 1999]. “(2) Subsection (c) of section 1710B of title 38, United States Code (as added by subsection (b)), shall take effect on the effective date of regulations prescribed by the Secretary of Veterans Affairs under subsections (c) and (d) of such section. The Secretary shall publish the effective date of such regulations in the Federal Register. “(3) The provisions of section 1710(f) of title 38, United States Code, shall not apply to any day of nursing home care on or after the effective date of regulations under paragraph (2).”

Modifications to Veteran Directed Care Program of Department of Veterans Affairs

Pub. L. 116–136, div. B, title X, § 20006, Mar. 27, 2020, 134 Stat. 587, as amended by Pub. L. 116–315, title III, § 3001, Jan. 5, 2021, 134 Stat. 4990, provided that: “(a) Telephone or Telehealth Renewals.—For the Veteran Directed Care program of the Department of Veterans Affairs (in this section referred to as the ‘Program’), during the period specified in subsection (f), the Secretary of Veterans Affairs shall—“(1) waive the requirement that a covered provider process new enrollments and six-month renewals for the Program via an in-person or home visit; and “(2) allow new enrollments and sixth-month renewals for the Program to be conducted via telephone or telehealth modality. “(b) No Suspension or Disenrollment.—During the period specified in subsection (f), the Secretary shall not suspend or dis-enroll a veteran or caregiver of a veteran from the Program unless—“(1) requested to do so by the veteran or a representative of the veteran; or “(2) a mutual decision is made between the veteran and a health care provider of the veteran to suspend or dis-enroll the veteran or caregiver from the Program. “(c) Waiver of Paperwork Requirement.—During the period specified in subsection (f), the Secretary may waive the requirement for signed, mailed paperwork to confirm the enrollment or renewal of a veteran in the Program and may allow verbal consent of the veteran via telephone or telehealth modality to suffice for purposes of such enrollment or renewal. “(d) Waiver of Other Requirements.—During the period specified in subsection (f), the Secretary shall waive—“(1) any penalty for late paperwork relating to the Program; and “(2) any requirement to stop payments for veterans or caregivers of veterans under the Program if they are out of State for more than 14 days. “(e) Transfer of Certain Veterans to the Program.—During the period specified in subsection (f), the Secretary shall allow a veteran residing in an area covered by the Program to be transferred to the Program for the duration of such period if—“(1) the veteran had been receiving extended care services paid for by the Department, such as adult day services or homemaker or home health aide services, immediately preceding such period; and “(2) those services are no longer available due to a public health emergency. “(f) Period Specified.—The period specified in this subsection is the period beginning on the date on which a public health emergency was first declared and ending on the date that is 60 days after the date on which a public health emergency is no longer in effect. “(g) Covered Provider Defined.—In this section, the term ‘covered provider’ means a provider participating in the Program, including—“(1) an Aging and Disability Resource Center, an area agency on aging, or a State agency (as those terms are defined in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002)); or “(2) a center for independent living (as defined in section 702 of the Rehabilitation Act of 1973 (29 U.S.C. 796a)).”

[For definition of “public health emergency” as used in section 20006 of Pub. L. 116–136, set out above, see section 20003 of Pub. L. 116–136, set out as a note under section 303 of this title.]

Pilot Program on Improvement of Caregiver Assistance Services

Pub. L. 109–461, title II, § 214, Dec. 22, 2006, 120 Stat. 3423, as amended by Pub. L. 110–387, § 809, Oct. 10, 2008, 122 Stat. 4142, provided that: “(a) In General.—Commencing not later than 120 days after the date of the enactment of this Act [Dec. 22, 2006], the Secretary of Veterans Affairs shall carry out a pilot program to assess the feasibility and advisability of various mechanisms to expand and improve caregiver assistance services. “(b) Duration of Pilot Program.—The pilot program required by subsection (a) shall be carried out during the three-year period beginning on the date of the commencement of the pilot program. “(c) Caregiver Assistance Services.—For purposes of this section, the term ‘caregiver assistance services’ means services of the Department of Veterans Affairs that assist caregivers of veterans. Such services including the following:“(1) Adult-day health care services. “(2) Coordination of services needed by veterans, including services for readjustment and rehabilitation. “(3) Transportation services. “(4) Caregiver support services, including education, training, and certification of family members in caregiver activities. “(5) Home care services. “(6) Respite care. “(7) Hospice services. “(8) Any modalities of non-institutional long-term care. “(d) Authorization of Appropriations.—There are authorized to be appropriated to the Department of Veterans Affairs $5,000,000 for each of fiscal years 2007 through 2009 to carry out the pilot program authorized by this section. “(e) Allocation of Funds to Facilities.—The Secretary shall allocate funds appropriated pursuant to the authorization of appropriations in subsection (d) to individual medical facilities of the Department in such amounts as the Secretary determines appropriate, based upon proposals submitted by such facilities for the use of such funds for improvements to the support of the provision of caregiver assistance services. Special consideration should be given to rural facilities, including those without a long-term care facility of the Department. “(f) Report.—Not later than one year after the date of the enactment of this Act [Dec. 22, 2006], the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the implementation of this section. The report shall include—“(1) a description and assessment of the activities carried out under the pilot program; “(2) information on the allocation of funds to facilities of the Department under subsection (e); and “(3) a description of the improvements made with funds so allocated to the support of the provision of caregiver assistance services.”

Pilot Programs Relating to Long-Term Care