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38 U.S.C. § 1720L — Home- and community-based services: programs

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38 U.S.C. § 1720L — Home- and community-based services: programs

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Source location: Title 38, Chapter 17, § 1720L; chapter-017-hospital-nursing-home-domiciliary-and-medical-care.md

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**(a) In General.—** In furnishing noninstitutional alternatives to nursing home care pursuant to the authority of [section 1720C of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section1720c&num=0&edition=prelim) (or any other authority under this chapter or other provision of law administered by the Secretary of Veterans Affairs), the Secretary shall carry out each of the programs specified in this section in accordance with such relevant authorities except as otherwise provided in this section. **(b) Veteran-Directed Care Program.—** (1) The Secretary of Veterans Affairs, in collaboration with the Secretary of Health and Human Services, shall carry out a program to be known as the “Veteran-Directed Care program”. Under such program, the Secretary of Veterans Affairs may enter into agreements with the providers described in paragraph (2) to provide to eligible veterans funds, to the extent practicable, to obtain such in-home care services and related items that support clinical need and improve quality of life, as may be determined appropriate by the Secretary of Veterans Affairs and selected by the veteran, including through the veteran hiring individuals to provide such services and items or directly purchasing such services and items. (2) The providers described in this paragraph are the following: (A) An Aging and Disability Resource Center, an area agency on aging, or a State agency. (B) A center for independent living. (C) An Indian tribe or tribal organization receiving assistance under title VI of the Older Americans Act of 1965 ([42 U.S.C. 3057](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section3057&num=0&edition=prelim) et seq.). (D) Any other entity that the Secretary, in consultation with the Secretary of Health and Human Services, determines appropriate. (3) In carrying out the Veteran-Directed Care program, the Secretary of Veterans Affairs shall— (A) administer such program through each medical center of the Department of Veterans Affairs; (B) seek to ensure the availability of such program in American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the Commonwealth of Puerto Rico, the Virgin Islands of the United States, and any other territory or possession of the United States, to the extent practicable; and (C) seek to ensure the availability of such program for eligible veterans who are Native American veterans receiving care and services furnished by the Indian Health Service, a tribal health program, an Urban Indian organization, or (in the case of a Native Hawaiian veteran) a Native Hawaiian health care system, to the extent practicable. (4) If a veteran participating in the Veteran-Directed Care program is hospitalized, the veteran may continue to use funds under the program during a period of hospitalization in the same manner that the veteran would be authorized to use such funds under the program if the veteran were not hospitalized. **(c) Homemaker and Home Health Aide Program.—** (1) The Secretary shall carry out a program to be known as the “Homemaker and Home Health Aide program” under which the Secretary may enter into agreements with home health agencies to provide to eligible veterans such home health aide services as may be determined appropriate by the Secretary. (2) In carrying out the Homemaker and Home Health Aide program, the Secretary shall— (A) administer such program in the locations specified in subparagraph (A) of subsection (b)(3); (B) seek to ensure the availability of such program in the locations specified in subparagraph (B) of subsection (b)(3); and (C) seek to ensure the availability of such program for the veteran populations specified in subparagraph (C) of subsection (b)(3). **(d) Home-Based Primary Care Program.—** The Secretary shall carry out a program to be known as the “Home-Based Primary Care program” under which the Secretary may furnish to eligible veterans in-home health care, the provision of which is overseen by a provider of the Department. **(e) Purchased Skilled Home Care Program.—** The Secretary shall carry out a program to be known as the “Purchased Skilled Home Care program” under which the Secretary may furnish to eligible veterans such in-home care services as may be determined appropriate and selected by the Secretary for the veteran. **(f) Caregiver Support.—** (1) With respect to a resident eligible caregiver of a veteran participating in a program under this section, the Secretary shall— (A) if the veteran meets the requirements of a covered veteran under [section 1720G(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section1720G/b&num=0&edition=prelim), provide to such caregiver the option of enrolling in the program of general caregiver support services under such section; (B) provide to such caregiver covered respite care of not less than 30 days annually; and (C) conduct on an annual basis (and, to the extent practicable, in connection with in-person services provided under the program in which the veteran is participating), a wellness contact of such caregiver. (2) Covered respite care provided to a resident eligible caregiver of a veteran under paragraph (1) may exceed 30 days annually if such extension is requested by the resident eligible caregiver or veteran and determined medically appropriate by the Secretary. **(g) Rule of Construction.—** Nothing in this section shall be construed to limit the authority of the Secretary to carry out programs providing home- and community-based services under any other provision of law. **(h) Definitions.—** In this section: (1) The terms “Aging and Disability Resource Center”, “area agency on aging”, and “State agency” have the meanings given those terms in section 102 of the Older Americans Act of 1965 ([42 U.S.C. 3002](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section3002&num=0&edition=prelim)). (2) The terms “caregiver” and “family caregiver”, with respect to a veteran, have the meanings given those terms, respectively, under subsection (e) 11 So in original. Probably should be “subsection (d)”. of [section 1720G of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section1720g&num=0&edition=prelim) with respect to an eligible veteran under subsection (a) of such section or a covered veteran under subsection (b) of such section, as the case may be. (3) The term “center for independent living” has the meaning given that term in section 702 of the Rehabilitation Act of 1973 ([29 U.S.C. 796a](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section796a&num=0&edition=prelim)). (4) The term “covered respite care” has the meaning given such term in [section 1720G(d) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section1720G/d&num=0&edition=prelim). (5) The term “eligible veteran” means any veteran— (A) for whom the Secretary determines participation in a specific program under this section is medically necessary to promote, preserve, or restore the health of the veteran; and (B) who absent such participation would be at increased risk for hospitalization, placement in a nursing home, or emergency room care. (6) The term “home health aide” means an individual employed by a home health agency to provide in-home care services. (7) The term “in-home care service” means any service, including a personal care service, provided to enable the recipient of such service to live at home. (8) The terms “Indian tribe” and “tribal organization” have the meanings given those terms in section 4 of the Indian Self-Determination and Education Assistance Act ([25 U.S.C. 5304](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section5304&num=0&edition=prelim)). (9) The terms “Native American” and “Native American veteran” have the meanings given those terms in [section 3765 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section3765&num=0&edition=prelim). (10) The terms “Native Hawaiian” and “Native Hawaiian health care system” have the meanings given those terms in section 12 of the Native Hawaiian Health Care Improvement Act ([42 U.S.C. 11711](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section11711&num=0&edition=prelim)). (11) The terms “tribal health programs” and “Urban Indian organizations” have the meanings given those terms in section 4 of the Indian Health Care Improvement Act ([25 U.S.C. 1603](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section1603&num=0&edition=prelim)). (12) The term “resident eligible caregiver” means an individual who— (A) is a caregiver, or a family caregiver, of a veteran and resides with that veteran; and (B) has not entered into a contract, agreement, or other arrangement for such individual to act as a caregiver for that veteran unless such individual is a family member of the veteran or is furnishing caregiver services through a medical foster home.

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 3002 — Definitions

For the purposes of this chapter— (1) The term “abuse” means the knowing infliction of physical or psychological harm or the knowing deprivation of goods or services that are necessary to meet essential needs or to avoid physical or psychological harm. (2) The term “Administration” means the Administration on Aging. (3) The term “adult protective services” means such services provided to adults as the Secretary may specify and includes services such as— (A) receiving reports of adult abuse, neglect, or exploitation; (B) investigating the reports described in subparagraph (A); (C) case planning, monitoring, evaluation, and other casework and services; and (D) providing, arranging for, or facilitating the provision of medical, social service, economic, legal, housing, law enforcement, or other protective, emergency, or support services. (4) The term “Aging and Disability Resource Center” means an entity, network, or consortium established by a State as part of the State system of long-term care, to provide a coordinated and integrated system for older individuals and individuals with disabilities (as defined in [section 12102 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section12102&num=0&edition=prelim)), and the caregivers of older individuals and individuals with disabilities, that provides, in collaboration with (as appropriate) area agencies on aging, centers for independent living (as described in part C of chapter 1 of title VII of the Rehabilitation Act of 1973 ([29 U.S.C. 796f](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section796f&num=0&edition=prelim) et seq.)), and other aging or disability entities— (A) comprehensive information on the full range of available public and privat

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38 U.S.C. § 3765 — Definitions

For the purposes of this subchapter— (1) The term “trust land” means any land that— (A) is held in trust by the United States for Native Americans; (B) is subject to restrictions on alienation imposed by the United States on Indian lands (including native Hawaiian homelands); (C) is located in the State of Alaska within a region established under section 7(a) of the Alaska Native Claims Settlement Act ([43 U.S.C. 1606(a)](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title43-section1606/a&num=0&edition=prelim)); (D) is on any island in the Pacific Ocean if such land is, by cultural tradition, communally-owned land, as determined by the Secretary; (E) is defined by the Secretary of the Interior and recognized by the United States as land over which an Indian Tribe has governmental dominion; or (F) is on any land that the Secretary determines is provided to Native American veterans because of their status as Native Americans. (2) The term “Native American veteran” means any veteran who is a Native American. (3) The term “Native American” means— (A) an Indian, as defined in section 4(d) of the Indian Self-Determination and Education Assistance Act ([25 U.S.C. 450b(d)](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section450b/d&num=0&edition=prelim)); 11 See References in Text note below. (B) a native Hawaiian, as that term is defined in section 201(a)(7) of the Hawaiian Homes Commission Act, 1920 (Public Law 67–34; 42 Stat. 108); (C) an Alaska Native, within the meaning provided for the term “Native” in section 3(b) of the Alaska Native Claims Settlement Act ([43 U.S.C. 1602(b)](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title43-section1602/b&num=0&edition=prelim)); and (D) a Pacific I

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Federal law — U.S. Code and appendices · legal_authorities

29 U.S.C. § 796a — Interagency Disability Coordinating Council

**(a) Establishment** There is hereby established an Interagency Disability Coordinating Council (hereafter in this section referred to as the “Council”) composed of the Secretary of Education, the Secretary of Health and Human Services, the Secretary of Labor, the Secretary of Housing and Urban Development, the Secretary of Transportation, the Assistant Secretary of the Interior for Indian Affairs, the Attorney General, the Director of the Office of Personnel Management, the Chairperson of the Equal Employment Opportunity Commission, the Chairperson of the Architectural and Transportation Barriers Compliance Board, the Chairperson of the National Council on Disability, and such other officials as may be designated by the President. **(b) Duties** The Council shall— (1) have the responsibility for developing and implementing agreements, policies, and practices designed to maximize effort, promote efficiency, and eliminate conflict, competition, duplication, and inconsistencies among the operations, functions, and jurisdictions of the various departments, agencies, and branches of the Federal Government responsible for the implementation and enforcement of the provisions of this subchapter, and the regulations prescribed thereunder; (2) be responsible for developing and implementing agreements, policies, and practices designed to coordinate operations, functions, and jurisdictions of the various departments and agencies of the Federal Government responsible for promoting the full integration into society, independence, and productivity of individuals with disabilities; and (3) carry out such studies and other activities, subject to the availability of resources, with advice from the National Council on Disability, in order to identify methods for overcoming barriers

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25 U.S.C. § 5304 — Authorization of appropriations

**(a) In general** There are authorized to be appropriated such sums as may be necessary to carry out this subchapter. **(b) Availability of appropriations** Notwithstanding any other provision of this chapter, the provision of funds under this chapter shall be subject to the availability of appropriations and the Secretary is not required to reduce funding for programs, projects, or activities serving a tribe in order to make funds available to another tribe or tribal organization under this chapter.

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42 U.S.C. § 11711 — Definitions

For purposes of this chapter: (1) **Disease prevention** — The term “disease prevention” includes— (A) immunizations, (B) control of high blood pressure, (C) control of sexually transmittable diseases, (D) prevention and control of diabetes, (E) control of toxic agents, (F) occupational safety and health, (G) accident prevention, (H) fluoridation of water, (I) control of infectious agents, and (J) provision of mental health care. (2) **Health promotion** — The term “health promotion” includes— (A) pregnancy and infant care, including prevention of fetal alcohol syndrome, (B) cessation of tobacco smoking, (C) reduction in the misuse of alcohol and drugs, (D) improvement of nutrition, (E) improvement in physical fitness, (F) family planning, (G) control of stress, and (H) educational programs with the mission of improving the health, capability, and well-being of Native Hawaiians. (3) **Native Hawaiian** — The term “Native Hawaiian” means any individual who is— (A) a citizen of the United States, and (B) a descendant of the aboriginal people, who prior to 1778, occupied and exercised sovereignty in the area that now constitutes the State of Hawaii, as evidenced by— (i) genealogical records, (ii) Kupuna (elders) or Kama’aina (long-term community residents) verification, or (iii) birth records of the State of Hawaii. (4) **Native Hawaiian health center** — The term “Native Hawaiian health center” means an entity— (A) which is organized under the laws of the State of Hawaii, (B) which provides or arranges for health care services through practitioners licensed by the State of Hawaii, where licensure requirements are applicable, (C) which is a public or nonprofit private entity, and (D)

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25 U.S.C. § 1603 — Service of traditional foods in public facilities

**(a) Purposes** The purposes of this section are— (1) to provide access to traditional foods in food service programs; (2) to encourage increased consumption of traditional foods to decrease health disparities among Indians, particularly Alaska Natives; and (3) to provide alternative food options for food service programs. **(b) Definitions** In this section: (1) **Alaska Native** — The term “Alaska Native” means a person who is a member of any Native village, Village Corporation, or Regional Corporation (as those terms are defined in [section 1602 of title 43](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title43-section1602&num=0&edition=prelim)). (2) **Commissioner** — The term “Commissioner” means the Commissioner of Food and Drugs. (3) **Food service program** — The term “food service program” includes— (A) food service at residential child care facilities that have a license from an appropriate State agency; (B) any child nutrition program (as that term is defined in [section 1769f(b) of title 42](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1769f/b&num=0&edition=prelim)); (C) food service at hospitals, clinics, and long-term care facilities; and (D) senior meal programs. (4) **Indian; Indian tribe** — The terms “Indian” and “Indian tribe” have the meanings given those terms in section 4 of the Indian Self-Determination and Education Assistance Act ([25 U.S.C. 450b](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section450b&num=0&edition=prelim)).11 See References in Text note below. (5) **Traditional food** (A) *In general* — The term “traditional food” means food that has traditionally been prepared and consumed by an Indian tribe. (B) *Inclusions* — The term “traditi

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42 U.S.C. § 3057 — Authorization of appropriations

There are authorized to be appropriated to carry out this subchapter— (1) for parts A and B, $37,102,560 for fiscal year 2020, $39,298,714 for fiscal year 2021, $41,626,636 for fiscal year 2022, $44,094,235 for fiscal year 2023, and $46,709,889 for fiscal year 2024; and (2) for part C, $10,759,920 for fiscal year 2020, $11,405,515 for fiscal year 2021, $12,089,846 for fiscal year 2022, $12,815,237 for fiscal year 2023, and $13,584,151 for fiscal year 2024.

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25 U.S.C. § 1603 — Definitions

Page 242 TITLE 25—INDIANS § 1602 § 1602. Declaration of national Indian health pol- icy Congress declares that it is the policy of this Nation, in fulfillment of its special trust respon- sibilities and legal obligations to Indians— (1) to ensure the highest possible health sta- tus for Indians and urban Indians and to pro- vide all resources necessary to effect that pol- icy; (2) to raise the health status of Indians and urban Indians to at least the levels set forth in the goals contained within the Healthy People 2010 initiative or successor objectives; (3) to ensure maximum Indian participation in the direction of health care services so as to render the persons administering such services and the services themselves more responsive to the needs and desires of Indian commu- nities; (4) to increase the proportion of all degrees in the health professions and allied and associ- ated health professions awarded to Indians so that the proportion of Indian health profes- sionals in each Service area is raised to at least the level of that of the general popu- lation; (5) to require that all actions under this chapter shall be carried out with active and meaningful consultation with Indian tribes and tribal organizations, and conference with urban Indian organizations, to implement this chapter and the national policy of Indian self- determination; (6) to ensure that the United States and In- dian tribes work in a government-to-govern- ment relationship to ensure quality health care for all tribal members; and (7) to provide funding for programs and fa- cilities operated by Indian tribes and tribal or- ganizations in amounts that are not less than the amounts provided to programs and facili- ties operated directly by the Service. (Pub. L. 94–437, §

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Federal law — U.S. Code and appendices · legal_authorities

25 U.S.C. § 5304 — Definitions

Page 719 TITLE 25—INDIANS § 5304 with the Secretary of the Interior, shall report to the President on progress toward establishing training modules regarding Tribal consultation and shall iden- tify additional resources or other support necessary to implement this training. SEC. 9. Definitions. The terms ‘‘Tribal officials,’’ ‘‘policies that have Tribal implications,’’ and ‘‘agency’’ as used in this memorandum are as defined in Execu- tive Order 13175. The terms ‘‘Tribes’’ and ‘‘Tribal Na- tions’’ as used in this memorandum have the same defi- nition as the term ‘‘Indian Tribe’’ as defined in Execu- tive Order 13175. SEC. 10. Scope. Nothing in this memorandum shall be construed to impair or otherwise affect the ability of heads of agencies to set more specific or more stringent standards, or to incorporate other best practices, for conducting Tribal consultation. SEC. 11. General Provisions. (a) Nothing in this memo- randum shall be construed to impair or otherwise af- fect: (i) the authority granted by law to an executive de- partment or agency, or the head thereof; or (ii) the functions of the Director of the Office of Man- agement and Budget relating to budgetary, administra- tive, or legislative proposals. (b) This memorandum shall be implemented con- sistent with applicable law and subject to the avail- ability of appropriations. (c) This memorandum is not intended to, and does not, create any right or benefit, substantive or proce- dural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person. (d) Independent agencies are strongly encouraged to comply with the provisions of this memorandum. (e) The Director of the Office of Manage

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Federal law — U.S. Code and appendices · legal_authorities

29 U.S.C. § 796a — Definitions

Page 319 TITLE 29—LABOR § 796a as having been added by Pub. L. 105–220, title IV, § 410, Aug. 7, 1998, 112 Stat. 1217, without reference to those intervening amendments because of the extensive revi- sion of title VII by Pub. L. 105–220. PART A—INDIVIDUALS WITH SIGNIFICANT DISABILITIES SUBPART 1—GENERAL PROVISIONS § 796. Purpose The purpose of this part is to promote a phi- losophy of independent living, including a phi- losophy of consumer control, peer support, self- help, self-determination, equal access, and indi- vidual and system advocacy, in order to maxi- mize the leadership, empowerment, independ- ence, and productivity of individuals with dis- abilities, and the integration and full inclusion of individuals with disabilities into the main- stream of American society, by— (1) providing financial assistance to States for providing, expanding, and improving the provision of independent living services; (2) providing financial assistance to develop and support statewide networks of centers for independent living; and (3) providing financial assistance to States for improving working relationships among State independent living rehabilitation serv- ice programs, centers for independent living, Statewide Independent Living Councils estab- lished under section 796d of this title, State vocational rehabilitation programs receiving assistance under subchapter I, State programs of supported employment services receiving assistance under subchapter VI, client assist- ance programs receiving assistance under sec- tion 732 of this title, programs funded under other subchapters of this chapter, programs funded under other Federal law, and programs funded through non-Federal sources, with the goal of improving the independence of individ- uals with di

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