38 U.S.C. § 1720A — Treatment and rehabilitative services

Page 411 TITLE 38—VETERANS’ BENEFITS § 1720A 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 para- graph (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 sec- tion [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 REIM- BURSEMENT 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 sec- tion) 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 sec- tion that reflects the overall methodology of reim- bursement for such care that was in effect for such State home on the day before the date of the enact- ment 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 work- load 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), in- cluding 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 ap- plying to participate under such section, disaggregated by those approved and those denied ap- proval 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 assess- ments 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 author- ity under such section is functioning as intended and care is provided to veterans under such section as in- tended. ‘‘(3) MEDICAL FOSTER HOME DEFINED.—In this sub- section, the term ‘medical foster home’ has the mean- ing 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 com- parative 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 Vet- erans’ 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 compara- tive 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. § 1720A. Treatment and rehabilitative services for persons with drug or alcohol dependency (a) The Secretary, in consultation with the Secretary of Labor and the Director of the Of- fice of Personnel Management, may take appro- priate steps to (1) urge all Federal agencies and appropriate private and public firms, organiza- tions, agencies, and persons to provide appro- priate employment and training opportunities for veterans who have been provided treatment and rehabilitative services under this title for alcohol or drug dependence or abuse disabilities and have been determined by competent medical authority to be sufficiently rehabilitated to be employable, and (2) provide all possible assist- ance to the Secretary of Labor in placing such veterans in such opportunities. (b) Upon receipt of an application for treat- ment and rehabilitative services under this title for an alcohol or drug dependence or abuse dis- ability from any individual who has been dis- charged or released from active military, naval, air, or space service but who is not eligible for such treatment and services, the Secretary shall— (1) provide referral services to assist such in- dividual, to the maximum extent practicable, in obtaining treatment and rehabilitative services from sources outside the Department; and (2) if pertinent, advise such individual of such individual’s rights to apply to the appro- priate military, naval, air, or space service and the Department for review of such individ- ual’s discharge or release from such service. (c)(1) Any person serving in the active mili- tary, naval, air, or space service who is deter- mined by the Secretary concerned to have an al- cohol or drug dependence or abuse disability may be transferred to any facility in order for the Secretary to furnish care or treatment and Page 412 TITLE 38—VETERANS’ BENEFITS § 1720A rehabilitative services for such disability. Care and services provided to a member so trans- ferred shall be provided as if such member were a veteran. Any transfer of any such member for such care and services shall be made pursuant to such terms as may be agreed upon by the Sec- retary concerned and the Secretary, subject to the provisions of sections 1535 and 1536 of title 31. (2) No person serving in the active military, naval, air, or space service may be transferred pursuant to an agreement made under paragraph (1) of this subsection unless such person requests such transfer in writing for a specified period of time. No such person transferred pursuant to such a request may be furnished such care and services by the Secretary beyond the period of time specified in such request unless such per- son requests in writing an extension for a fur- ther specified period of time and such request is approved by the Secretary. (d)(1) The Secretary shall ensure that each medical center of the Department develops and carries out a plan to provide treatment for sub- stance use disorders, either through referral or direct provision of services, to veterans who re- quire such treatment. (2) Each plan under paragraph (1) shall make available clinically proven substance abuse treatment methods, including opioid substi- tution therapy, to veterans with respect to whom a qualified medical professional has deter- mined such treatment methods to be appro- priate. (Added Pub. L. 96–22, title I, § 104(a), June 13, 1979, 93 Stat. 50, § 620A; amended Pub. L. 96–128, title V, § 501(c), Nov. 28, 1979, 93 Stat. 987; Pub. L. 97–251, § 6, Sept. 8, 1982, 96 Stat. 716; Pub. L. 97–258, § 3(k)(1), Sept. 13, 1982, 96 Stat. 1065; Pub. L. 99–108, § 3, Sept. 30, 1985, 99 Stat. 481; Pub. L. 99–166, title I, § 101(a), (b)(1), Dec. 3, 1985, 99 Stat. 942, 943; Pub. L. 100–687, div. B, title XV, § 1509, Nov. 18, 1988, 102 Stat. 4137; Pub. L. 100–689, title V, § 502(a)(1), (b), Nov. 18, 1988, 102 Stat. 4179; Pub. L. 102–54, § 14(b)(13), June 13, 1991, 105 Stat. 284; renumbered § 1720A and amended Pub. L. 102–83, §§ 4(a)(3), (4), (b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–86, title III, § 303, Aug. 14, 1991, 105 Stat. 416; Pub. L. 103–452, title I, § 103(b), Nov. 2, 1994, 108 Stat. 4786; Pub. L. 104–110, title I, § 101(b), Feb. 13, 1996, 110 Stat. 768; Pub. L. 105–114, title II, § 202(b), Nov. 21, 1997, 111 Stat. 2287; Pub. L. 106–117, title I, § 114, Nov. 30, 1999, 113 Stat. 1558; Pub. L. 106–419, title IV, § 404(a)(4), Nov. 1, 2000, 114 Stat. 1864; Pub. L. 107–95, § 8(c), Dec. 21, 2001, 115 Stat. 920; Pub. L. 116–283, div. A, title IX, § 926(a)(25), Jan. 1, 2021, 134 Stat. 3830.) Editorial Notes AMENDMENTS 2021—Subsecs. (b), (c). Pub. L. 116–283 substituted ‘‘air, or space service’’ for ‘‘or air service’’ in two places. 2001—Subsec. (d). Pub. L. 107–95 added subsec. (d). 2000—Subsec. (c)(1). Pub. L. 106–419 substituted ‘‘for such disability. Care and services provided to a member so transferred’’ for ‘‘for such disability unless such transfer is during the last thirty days of such member’s enlistment period or tour of duty, in which case such care and services provided to such member’’. 1999—Subsec. (c)(1). Pub. L. 106–117, § 114(a), sub- stituted ‘‘may be transferred’’ for ‘‘may not be trans- ferred’’ in first sentence. Pub. L. 106–117, § 114(a)(2), which directed the amend- ment of first sentence of par. (1) by striking out ‘‘un- less such transfer is during the last thirty days of such member’s enlistment or tour of duty’’, could not be ex- ecuted because that phrase did not appear. Subsec. (c)(2). Pub. L. 106–117, § 114(b), struck out ‘‘during the last thirty days of such person’s enlistment period or tour of duty’’ before period at end of first sen- tence. 1997—Pub. L. 105–114, § 202(b)(2), substituted ‘‘Treat- ment and rehabilitative services for persons with drug and alcohol dependency’’ for ‘‘Treatment and rehabili- tation for alcohol or drug dependence or abuse disabil- ities’’ in section catchline. Subsecs. (a) to (d). Pub. L. 105–114, § 202(b)(1), redesig- nated subsecs. (b) to (d) as (a) to (c), respectively, and struck out former subsec. (a) which read as follows: ‘‘(a)(1) The Secretary, in furnishing hospital, nursing home, and domiciliary care and medical and rehabilita- tive services under this chapter, may contract for care and treatment and rehabilitative services in halfway houses, therapeutic communities, psychiatric residen- tial treatment centers, and other community-based treatment facilities for eligible veterans suffering from alcohol or drug dependence or abuse disabilities. ‘‘(2) Before furnishing such care and services to any veteran through a contract facility as authorized by paragraph (1) of this subsection, the Secretary shall ap- prove (in accordance with criteria which the Secretary shall prescribe by regulation) the quality and effective- ness of the program operated by such facility for the purpose for which such veteran is to be furnished such care and services.’’ Subsecs. (e) to (g). Pub. L. 105–114, § 202(b)(1)(B), struck out subsecs. (e) to (g) which read as follows: ‘‘(e) The Secretary may not furnish care and treat- ment and rehabilitative services under subsection (a) of this section after December 31, 1997. ‘‘(f)(1) During the period beginning on December 1, 1988, and ending on October 1, 1997, the Secretary shall conduct an ongoing clinical evaluation in order to de- termine the long-term results of drug and alcohol abuse treatment furnished to veterans in contract residential treatment facilities under this section. ‘‘(2) The evaluation shall include an assessment of the following: ‘‘(A) The long-term results of treatment referred to in paragraph (1) of this subsection on drug and alco- hol use by veterans who may have received such treatment. ‘‘(B) The need for hospitalization of such veterans for drug and alcohol abuse after completion of the residential treatment. ‘‘(C) The employment status and income of such veterans. ‘‘(D) The extent of any criminal activity of such veterans. ‘‘(E) Whether certain models and methods of resi- dential treatment for drug and alcohol abuse are more successful for veterans with specific abuses, specific levels of resources available to them, and specific needs than are other models and methods. ‘‘(3) To the extent feasible, the Secretary shall select for consideration in the evaluation veterans whose treatment for drug and alcohol abuse in contract resi- dential treatment facilities under such section rep- resents a variety of models and methods of residential drug and alcohol abuse treatment. ‘‘(4) The Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Represent- atives the following reports on the evaluation under this subsection: ‘‘(A) Not later than February 1, 1993, an interim re- port containing information obtained during the first four years of the evaluation and any conclusions that the Secretary has drawn on the basis of that informa- tion. Page 413 TITLE 38—VETERANS’ BENEFITS § 1720A ‘‘(B) Not later than March 31, 1998, a final report containing information obtained during the evalua- tion and the determinations and conclusions of the Secretary based on that information. ‘‘(g) The authority of the Secretary to enter into con- tracts under this section shall be effective for any fis- cal year only to such extent or in such amounts as are provided in appropriation Acts.’’ 1996—Subsec. (e). Pub. L. 104–110 substituted ‘‘Decem- ber 31, 1997’’ for ‘‘December 31, 1995’’. 1994—Subsec. (e). Pub. L. 103–452 substituted ‘‘Decem- ber 31, 1995’’ for ‘‘December 31, 1994’’. 1991—Pub. L. 102–83, § 5(a), renumbered section 620A of this title as this section. Subsecs. (a), (b). Pub. L. 102–83, § 4(b)(1), (2)(E), sub- stituted ‘‘Secretary’’ for ‘‘Administrator’’ wherever ap- pearing. Subsec. (c). Pub. L. 102–83, § 4(b)(1), (2)(E), substituted ‘‘Secretary’’ for ‘‘Administrator’’ in introductory pro- visions. Pub. L. 102–83, § 4(a)(3), (4), substituted ‘‘Department’’ for ‘‘Veterans’ Administration’’ in pars. (1) and (2). Subsec. (d). Pub. L. 102–83, § 4(b)(1), (2)(E), substituted ‘‘Secretary’’ for ‘‘Administrator’’ wherever appearing. Subsec. (e). Pub. L. 102–86 amended subsec. (e) of this section as in effect before the redesignations made by Pub. L. 102–83, § 5, by substituting ‘‘December 31, 1994’’ for ‘‘September 30, 1991’’. Pub. L. 102–83, § 4(b)(1), (2)(E), substituted ‘‘Sec- retary’’ for ‘‘Administrator’’. Subsec. (f). Pub. L. 102–83, § 4(b)(1), (2)(E), substituted ‘‘Secretary’’ for ‘‘Administrator’’ wherever appearing. Pub. L. 102–54 struck out ‘‘during the period’’ before ‘‘beginning’’ in par. (1). Subsec. (g). Pub. L. 102–83, § 4(b)(1), (2)(E), substituted ‘‘Secretary’’ for ‘‘Administrator’’. 1988—Subsec. (e). Pub. L. 100–689, § 502(a)(1), sub- stituted ‘‘1991’’ for ‘‘1988’’. Subsec. (f). Pub. L. 100–689, § 502(b), amended subsec. (f) generally. Prior to amendment, subsec. (f) read as follows: ‘‘(1) The Administrator shall monitor the perform- ance of each contract facility furnishing care and serv- ices under the program carried out under subsection (a) of this section. ‘‘(2) The Administrator shall use the results of such monitoring to determine— ‘‘(A) with respect to the program, the medical ad- vantages and cost-effectiveness that result from fur- nishing such care and services; and ‘‘(B) with respect to such contract facilities gen- erally, the level of success under the program, consid- ering— ‘‘(i) the rate of successful rehabilitation for vet- erans furnished care and services under the pro- gram; ‘‘(ii) the rate of readmission to contract facilities under the program or to Veterans’ Administration health-care facilities by such veterans for care or services for disabilities referred to in subsection (a) of this section; ‘‘(iii) whether the care and services furnished under the program obviated the need of such vet- erans for hospitalization for such disabilities; ‘‘(iv) the average duration of the care and services furnished such veterans under the program; ‘‘(v) the ability of the program to aid in the tran- sition of such veterans back into their commu- nities; and ‘‘(vi) any other factor that the Administrator considers appropriate. ‘‘(3) The Administrator shall maintain records of— ‘‘(A) the total cost for the care and services fur- nished by each contract facility under the program; ‘‘(B) the average cost per veteran for the care and services furnished under the program; and ‘‘(C) the appropriateness of such costs, by compari- son to— ‘‘(i) the average charges for the same types of care and services furnished generally by other com- parable halfway houses, therapeutic communities, psychiatric residential treatment centers, and other community-based treatment facilities; and ‘‘(ii) the historical costs for such care and serv- ices for the period of time that the program carried out under subsection (a) of this section was a pilot program, taking into account economic inflation. ‘‘(4) Not later than February 1, 1988, the Adminis- trator shall submit to the Committees on Veterans’ Af- fairs of the Senate and House of Representatives a re- port on the experience under the program carried out under this section during fiscal years 1984 through 1987. The report shall include— ‘‘(A) a description of the care and services fur- nished; ‘‘(B) the matters referred to in paragraphs (1), (2), and (3) of this subsection; and ‘‘(C) the Administrator’s findings, assessment, and recommendations regarding the program under this section.’’ Subsec. (f)(1). Pub. L. 100–687 substituted ‘‘during the period beginning on December 1, 1988, and ending on Oc- tober 1, 1997’’ for ‘‘before October 1, 1997’’ in par. (1) as amended by Pub. L. 100–689 above. 1985—Pub. L. 99–166, § 101(b)(1), struck out ‘‘; pilot program’’ after ‘‘disabilities’’ in section catchline. Subsec. (a)(1). Pub. L. 99–166, § 101(a)(1), struck out ‘‘may conduct a pilot program under which the Admin- istrator’’ before ‘‘may contract’’ in first sentence, and struck out second sentence relating to the planning, designing, and conducting of a pilot program by the Chief Medical Director so as to demonstrate any med- ical advantages and cost effectiveness that might re- sult from furnishing care and services to disabled vet- erans in contract facilities as authorized by this sec- tion, rather than in facilities over which the Adminis- trator had jurisdiction. Subsec. (e). Pub. L. 99–166, § 101(a)(2), substituted ‘‘September 30, 1988’’ for ‘‘October 31, 1985’’. Pub. L. 99–108 substituted ‘‘October 31, 1985’’ for ‘‘the last day of the fifth fiscal year following the fiscal year in which the pilot program authorized by such sub- section is initiated’’. Subsec. (f). Pub. L. 99–166, § 101(a)(3), amended subsec. (f) generally. Prior to amendment, subsec. (f) read as follows: ‘‘Not later than March 31, 1984, the Adminis- trator shall report to the Committee on Veterans’ Af- fairs of the Senate and House of Representatives on the findings and recommendations of the Administrator pertaining to the operation through September 30, 1983, of the pilot program authorized by this section.’’ 1982—Subsec. (d)(1). Pub. L. 97–258 substituted ‘‘sec- tions 1535 and 1536 of title 31’’ for ‘‘the Act of March 4, 1915 (31 U.S.C 686)’’ after ‘‘provisions of’’. Subsec. (f). Pub. L. 97–251 substituted ‘‘March 31, 1984’’ and ‘‘September 30, 1983’’ for ‘‘March 31, 1983’’ and ‘‘September 30, 1982’’, respectively. 1979—Subsec. (a)(1). Pub. L. 96–128, § 501(c)(1), sub- stituted ‘‘treatment facilities for’’ for ‘‘treatment fa- cilities of’’. Subsec. (d)(2). Pub. L. 96–128, § 501(c)(2), substituted ‘‘such request unless’’ for ‘‘such request, unless’’. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1979 AMENDMENT Amendment by Pub. L. 96–128 effective Nov. 28, 1979, see section 601(b) of Pub. L. 96–128, set out as a note under section 1114 of this title. EFFECTIVE DATE Section effective Oct. 1, 1979, see section 107 of Pub. L. 96–22, set out as an Effective Date of 1979 Amend- ment note under section 1701 of this title. PILOT PROGRAM ON AWARD OF GRANTS FOR SUBSTANCE USE DISORDER RECOVERY FOR HOMELESS VETERANS Pub. L. 117–328, div. U, title III, § 311, Dec. 29, 2022, 136 Stat. 5475, provided that: Page 414 TITLE 38—VETERANS’ BENEFITS § 1720A ‘‘(a) PILOT PROGRAM REQUIRED.—Not later than 270 days after the date of the enactment of this Act [Dec. 29, 2022], the Secretary of Veterans Affairs shall com- mence carrying out a pilot program under which the Secretary shall award grants to eligible entities for the provision or coordination of services for recovery from substance use disorder for veterans who are homeless, were previously homeless and are transitioning to per- manent housing, or are at risk of becoming homeless. ‘‘(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) AWARD OF GRANTS.— ‘‘(1) IN GENERAL.—In carrying out the pilot pro- gram, the Secretary shall award a grant to an eligible entity for each veteran with substance use disorder participating in the pilot program for which the eligi- ble entity is providing or coordinating the provision of recovery services for substance use disorder under the pilot program. ‘‘(2) INTERVALS OF PAYMENT AND MAXIMUM AMOUNTS.—The Secretary may establish intervals of payment for the administration of grants under this section and a maximum amount to be awarded, in ac- cordance with the services being provided and the du- ration of such services. ‘‘(3) PREFERENCE.—In awarding grants under para- graph (1), the Secretary shall give preference to eligi- ble entities providing or coordinating the provision of recovery services for substance use disorder for vet- erans with substance-use dependency who face bar- riers in accessing substance-use recovery services from the Department of Veterans Affairs. ‘‘(4) EQUITABLE DISTRIBUTION.—The Secretary shall ensure that, to the extent practicable, grant amounts awarded under paragraph (1) are equitably distributed across geographic regions, including rural and Tribal communities. ‘‘(5) REPORT ON SERVICES PROVIDED.—The Secretary shall require each eligible entity awarded a grant under paragraph (1) to submit to the Secretary a re- port that describes the services provided or coordi- nated with amounts under such grant. ‘‘(e) REQUIREMENTS FOR RECEIPT OF GRANTS.— ‘‘(1) NOTIFICATION THAT SERVICES ARE FROM DEPART- MENT.—Each entity receiving a grant under this sec- tion shall notify the recipients of services provided pursuant to grant amounts that such services are being paid for, in whole or in part, by the Depart- ment. ‘‘(2) COORDINATION.—An entity receiving a grant under this section shall— ‘‘(A) coordinate with the Secretary with respect to the provision of clinical services to eligible indi- viduals or any other provisions of law regarding the delivery of health care by the Secretary; ‘‘(B) inform each veteran who receives assistance under this section from the entity of the ability of the veteran to apply for enrollment in the patient enrollment system of the Department under section 1705(a) of title 38, United States Code; and ‘‘(C) if such a veteran wishes to so enroll, inform the veteran of a point of contact at the Department who can assist the veteran in such enrollment. ‘‘(f) GRANT APPLICATION.— ‘‘(1) IN GENERAL.—An eligible entity seeking the award of a grant under this section shall submit to the Secretary an application therefor in such form, in such manner, and containing such commitments and information as the Secretary considers necessary to carry out this section. ‘‘(2) CONTENTS OF APPLICATION.—Each application submitted by an eligible entity under paragraph (1) shall contain the following: ‘‘(A) A description of the recovery services for substance use disorder proposed to be provided by the eligible entity under the pilot program and the identified need for those services. ‘‘(B) A description of the types of veterans with substance use disorder proposed to be provided such recovery services. ‘‘(C) An estimate of the number of veterans with substance use disorder proposed to be provided such recovery services. ‘‘(D) Evidence of the experience of the eligible en- tity in providing such recovery services to veterans with substance use disorder. ‘‘(E) A description of the managerial capacity of the eligible entity— ‘‘(i) to assess continually the needs of veterans with substance use disorder for such recovery services; ‘‘(ii) to coordinate the provision of such recov- ery services with services provided by the Depart- ment; and ‘‘(iii) to tailor such recovery services to the needs of veterans with substance use disorder. ‘‘(3) CRITERIA FOR SELECTION.— ‘‘(A) IN GENERAL.—The Secretary shall establish criteria for the selection of eligible entities to be awarded grants under this section. ‘‘(B) ELEMENTS.—Criteria established under sub- paragraph (A) with respect to an eligible entity shall include the following: ‘‘(i) Relevant accreditation as may be required by each State in which the eligible entity oper- ates. ‘‘(ii) Experience coordinating care or providing treatment for veterans or members of the Armed Forces. ‘‘(g) PARTICIPATION.—Participation by a veteran in the pilot program shall not affect any eligibility status or requirements for such veteran with respect to other benefits or services provided by the Department. ‘‘(h) TECHNICAL ASSISTANCE.— ‘‘(1) IN GENERAL.—The Secretary shall provide training and technical assistance to eligible entities awarded grants under this section regarding the plan- ning, development, and provision of recovery services for substance use disorder under this section. ‘‘(2) PROVISION OF TRAINING.—The Secretary may provide the training required under paragraph (1) di- rectly or through grants or contracts with such pub- lic or nonprofit private entities as the Secretary con- siders appropriate for purposes of this section, includ- ing through grants awarded under section 2064 of title 38, United States Code. ‘‘(i) COLLECTION OF INFORMATION.—To the extent prac- ticable, the Secretary may collect information from an eligible entity awarded a grant under this section relat- ing to a substance use disorder of a veteran partici- pating in the pilot program for inclusion in the elec- tronic health record of the Department for such vet- eran for the sole purpose of improving care provided to such veteran. ‘‘(j) STUDY ON EFFECTIVENESS OF PILOT PROGRAM.— ‘‘(1) IN GENERAL.—The Secretary shall conduct a study on the effectiveness of the pilot program in meeting the needs of veterans with substance use dis- order. ‘‘(2) COMPARISON.—In conducting the study required by paragraph (1), the Secretary shall compare the re- sults of the pilot program with other programs of the Department dedicated to the delivery to veterans of recovery services for substance use disorder. ‘‘(3) CRITERIA.—In making the comparison required by paragraph (2), to the extent data is available, the Secretary shall examine the following: ‘‘(A) The satisfaction of veterans targeted by the programs described in paragraph (2). ‘‘(B) The health status of such veterans, including mental health. ‘‘(C) The degree to which such programs encour- age such veterans to engage in productive activity. ‘‘(D) The number of veterans using such pro- grams, disaggregated by— ‘‘(i) veterans who have received health care pro- vided by the Department during the two-year pe- riod preceding the conduct of the study; Page 415 TITLE 38—VETERANS’ BENEFITS § 1720A ‘‘(ii) veterans who have not received health care provided by the Department during such period; ‘‘(iii) veterans eligible for health care provided by the Department, disaggregated by— ‘‘(I) veterans eligible for services from the De- partment similar to services provided under the pilot program; and ‘‘(II) veterans not eligible for such services from the Department; and ‘‘(iv) veterans ineligible for health care pro- vided by the Department. ‘‘(E) The number of veterans who are still home- less or at risk of becoming homeless one year after completion of receipt of recovery services under such programs. ‘‘(F) The number of veterans who still have a sub- stance use disorder that negatively impacts their daily living and ability to maintain independent housing 180 days after discharge from receipt of services provided under this section. ‘‘(G) The status of the discharge from the Armed Forces of veterans covered under this paragraph. ‘‘(4) REPORTS.—Not later than one year after the date on which the first grant is awarded under this section, 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 report on the results of the study required by paragraph (1). ‘‘(k) DEFINITIONS.—In this section: ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible entity’ means any of the following: ‘‘(A) An incorporated private institution or foun- dation— ‘‘(i) no part of the net earnings of which inures to the benefit of any member, founder, contrib- utor, or individual; ‘‘(ii) that has a governing board that is respon- sible for the operation of the recovery services for substance use disorder provided under this sec- tion; and ‘‘(iii) that is approved by the Secretary with re- spect to financial responsibility. ‘‘(B) A for-profit limited partnership, the sole general partner of which is an organization meeting the requirements of subparagraph (A). ‘‘(C) A corporation wholly owned and controlled by an organization meeting the requirements of subparagraph (A). ‘‘(D) A tribally designated housing entity (as de- fined in section 4 of the Native American Housing Assistance and Self-Determination Act of 1996 (25 U.S.C. 4103)). ‘‘(2) SUBSTANCE USE DISORDER.—The term ‘substance use disorder’, with respect to a veteran, means the veteran has been diagnosed with, or is seeking treat- ment for, substance use disorder, as determined by the Secretary.’’ SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE Pub. L. 110–387, title I, §§ 102–105, Oct. 10, 2008, 122 Stat. 4112–4114, provided that: ‘‘SEC. 102. FINDINGS ON SUBSTANCE USE DIS- ORDERS AND MENTAL HEALTH. ‘‘Congress makes the following findings: ‘‘(1) More than 1,500,000 members of the Armed Forces have been deployed in Operation Iraqi Free- dom and Operation Enduring Freedom. The 2005 De- partment of Defense Survey of Health Related Behav- iors Among Active Duty Personnel reports that 23 percent of members of the Armed Forces on active duty acknowledge a significant problem with alcohol use disorder, with similar rates of acknowledged problems with alcohol use disorder among members of the National Guard. ‘‘(2) The effects of substance use disorder are wide ranging, including significantly increased risk of sui- cide, exacerbation of mental and physical health dis- orders, breakdown of family support, and increased risk of unemployment and homelessness. ‘‘(3) While veterans suffering from mental health conditions, chronic physical illness, and polytrauma may be at increased risk for development of a sub- stance use disorder, treatment for these veterans is complicated by the need to address adequately the physical and mental symptoms associated with these conditions through appropriate medical intervention. ‘‘(4) While the Veterans Health Administration has dramatically increased health services for veterans from 1996 through 2006, the number of veterans re- ceiving specialized substance use disorder treatment services decreased 18 percent during that time. No comparable decrease in the national rate of substance use disorder has been observed during that time. ‘‘(5) While some facilities of the Veterans Health Administration provide exemplary substance use dis- order treatment services, the availability of such treatment services throughout the health care sys- tem of the Veterans Health Administration is incon- sistent. ‘‘(6) According to a 2006 report by the Government Accountability Office, the Department of Veterans Affairs significantly reduced its substance use dis- order treatment and rehabilitation services between 1996 and 2006, and the Fiscal Year 2007 National Men- tal Health Program Monitoring System report shows that little progress has been made in restoring these services to their pre-1996 levels. ‘‘SEC. 103. EXPANSION OF SUBSTANCE USE DIS- ORDER TREATMENT SERVICES PROVIDED BY DEPARTMENT OF VETERANS AFFAIRS. ‘‘(a) IN GENERAL.—The Secretary of Veterans Affairs shall ensure the provision of such services and treat- ment to each veteran enrolled in the health care sys- tem of the Department of Veterans Affairs who is in need of services and treatments for a substance use dis- order as follows: ‘‘(1) Screening for substance use disorder in all set- tings, including primary care settings. ‘‘(2) Short term motivational counseling services. ‘‘(3) Marital and family counseling. ‘‘(4) Intensive outpatient or residential care serv- ices. ‘‘(5) Relapse prevention services. ‘‘(6) Ongoing aftercare and outpatient counseling services. ‘‘(7) Opiate substitution therapy services. ‘‘(8) Pharmacological treatments aimed at reducing craving for drugs and alcohol. ‘‘(9) Detoxification and stabilization services. ‘‘(10) Coordination with groups providing peer to peer counseling. ‘‘(11) Such other services as the Secretary considers appropriate. ‘‘(b) PROVISION OF SERVICES.— ‘‘(1) ALLOCATION OF RESOURCES FOR PROVISION OF SERVICES.—The Secretary shall ensure that amounts made available for care, treatment, and services pro- vided under this section are allocated in such a man- ner that a full continuum of care, treatment, and services described in subsection (a) is available to veterans seeking such care, treatment, or services, without regard to the location of the residence of any such veterans. ‘‘(2) MANNER OF PROVISION.—The services and treat- ment described in subsection (a) may be provided to a veteran described in such subsection— ‘‘(A) at Department of Veterans Affairs medical centers or clinics; ‘‘(B) by referral to other facilities of the Depart- ment that are accessible to such veteran; or ‘‘(C) by contract or fee-for-service payments with community-based organizations for the provision of such services and treatments. ‘‘(c) ALTERNATIVES IN CASE OF SERVICES DENIED DUE TO CLINICAL NECESSITY.—If the Secretary denies the provision to a veteran of services or treatment for a substance use disorder due to clinical necessity, the Secretary shall provide the veteran such other services or treatment as are medically appropriate. Page 416 TITLE 38—VETERANS’ BENEFITS § 1720A ‘‘SEC. 104. CARE FOR VETERANS WITH MENTAL HEALTH AND SUBSTANCE USE DISORDERS. ‘‘(a) IN GENERAL.—If the Secretary of Veterans Af- fairs provides a veteran inpatient or outpatient care for a substance use disorder and a comorbid mental health disorder, the Secretary shall ensure that treatment for such disorders is provided concurrently— ‘‘(1) through a service provided by a clinician or health professional who has training and expertise in treatment of substance use disorders and mental health disorders; ‘‘(2) by separate substance use disorder and mental health disorder treatment services when there is ap- propriate coordination, collaboration, and care man- agement between such treatment services; or ‘‘(3) by a team of clinicians with appropriate exper- tise. ‘‘(b) TEAM OF CLINICIANS WITH APPROPRIATE EXPER- TISE DEFINED.—In this section, the term ‘team of clini- cians with appropriate expertise’ means a team con- sisting of the following: ‘‘(1) Clinicians and health professionals with exper- tise in treatment of substance use disorders and men- tal health disorders who act in coordination and col- laboration with each other. ‘‘(2) Such other professionals as the Secretary con- siders appropriate for the provision of treatment to veterans for substance use and mental health dis- orders. ‘‘SEC. 105. PILOT PROGRAM FOR INTERNET-BASED SUBSTANCE USE DISORDER TREATMENT FOR VETERANS OF OPERATION IRAQI FREEDOM AND OPERATION ENDURING FREEDOM. ‘‘(a) FINDINGS.—Congress makes the following find- ings: ‘‘(1) Stigma associated with seeking treatment for mental health disorders has been demonstrated to prevent some veterans from seeking such treatment at a medical facility operated by the Department of Defense or the Department of Veterans Affairs. ‘‘(2) There is a significant incidence among vet- erans of post-deployment mental health problems, es- pecially among members of a reserve component who return as veterans to civilian life. ‘‘(3) Computer-based self-guided training has been demonstrated to be an effective strategy for supplementing the care of psychological conditions. ‘‘(4) Younger veterans, especially those who served in Operation Enduring Freedom or Operation Iraqi Freedom, are comfortable with and proficient at com- puter-based technology. ‘‘(5) Veterans living in rural areas may find access to treatment for substance use disorder limited. ‘‘(6) Self-assessment and treatment options for sub- stance use disorders through an Internet website may reduce stigma and provides additional access for indi- viduals seeking care and treatment for such dis- orders. ‘‘(b) IN GENERAL.—Not later than October 1, 2009, the Secretary of Veterans Affairs shall carry out a pilot program to assess the feasibility and advisability of providing veterans who seek treatment for substance use disorders access to a computer-based self-assess- ment, education, and specified treatment program through a secure Internet website operated by the Sec- retary. Participation in the pilot program shall be available on a voluntary basis for those veterans who have served in Operation Enduring Freedom or Oper- ation Iraqi Freedom. ‘‘(c) ELEMENTS OF PILOT PROGRAM.— ‘‘(1) IN GENERAL.—In carrying out the pilot program under this section, the Secretary shall ensure that— ‘‘(A) access to the Internet website and the pro- grams available on the website by a veteran (or family member) does not involuntarily generate an identifiable medical record of that access by that veteran in any medical database maintained by the Department of Veterans Affairs; ‘‘(B) the Internet website is accessible from re- mote locations, especially rural areas; and ‘‘(C) the Internet website includes a self-assess- ment tool for substance use disorders, self-guided treatment and educational materials for such dis- orders, and appropriate information and materials for family members of veterans. ‘‘(2) CONSIDERATION OF SIMILAR PROJECTS.—In de- signing the pilot program under this section, the Sec- retary shall consider similar pilot projects of the De- partment of Defense for the early diagnosis and treat- ment of post-traumatic stress disorder and other mental health conditions established under section 741 of the John Warner National Defense Authoriza- tion Act of [for] Fiscal Year 2007 (Public Law 109–364; 120 Stat. 2304) [10 U.S.C. 1074 note]. ‘‘(3) LOCATION OF PILOT PROGRAM.—The Secretary shall carry out the pilot program through those med- ical centers of the Department of Veterans Affairs that have established Centers for Excellence for Sub- stance Abuse Treatment and Education or that have established a Substance Abuse Program Evaluation and Research Center. ‘‘(4) CONTRACT AUTHORITY.—The Secretary may enter into contracts with qualified entities or organi- zations to carry out the pilot program required under this section. ‘‘(d) DURATION OF PILOT PROGRAM.—The pilot pro- gram required by subsection (a) shall be carried out during the two-year period beginning on the date of the commencement of the pilot program. ‘‘(e) REPORT.—Not later than six months after the completion of the pilot program, the Secretary shall submit to Congress a report on the pilot program, and shall include in that report—an assessment of the feasi- bility and advisability of continuing or expanding the pilot program, of any cost savings or other benefits as- sociated with the pilot program, and any other rec- ommendations. ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to be appropriated to the Secretary of Vet- erans Affairs $1,500,000 for each of fiscal years 2010 and 2011 to carry out the pilot program under this section.’’ RATIFICATION OF ACTIONS DURING PERIOD OF EXPIRED AUTHORITY Any action taken by Secretary of Veterans Affairs before Feb. 13, 1996, under provision of law amended by title I of Pub. L. 104–110 that was taken during period beginning on date on which authority of Secretary under such provision of law expired and ending on Feb. 13, 1996, considered to have same force and effect as if such amendment had been in effect at time of that ac- tion, see section 103 of Pub. L. 104–110, set out as a note under section 1710 of this title. REPORT ON CONSOLIDATION OF CERTAIN PROGRAMS Pub. L. 104–110, title II, § 202(a), Feb. 13, 1996, 110 Stat. 770, provided that: ‘‘The Secretary of Veterans Affairs shall submit to Congress, not later than March 1, 1997, a report on the advantages and disadvantages of con- solidating into one program the following three pro- grams: ‘‘(1) The alcohol and drug abuse contract care pro- gram under section 1720A of title 38, United States Code. ‘‘(2) The program to provide community-based resi- dential care to homeless chronically mentally ill vet- erans under section 115 of the Veterans’ Benefits and Services Act of 1988 [Pub. L. 100–322] (38 U.S.C. 1712 note). ‘‘(3) The demonstration program under section 7 of Public Law 102–54 (38 U.S.C. 1718 note).’’ LOANS TO ORGANIZATIONS PROVIDING TRANSITIONAL HOUSING FOR SUBSTANCE ABUSERS Pub. L. 102–54, § 8, June 13, 1991, 105 Stat. 271, provided that: ‘‘(a) LOAN PROGRAM.—The Secretary of Veterans Af- fairs may make loans in accordance with this section to assist in the provision of transitional housing exclu- Page 417 TITLE 38—VETERANS’ BENEFITS § 1720B sively to veterans who are in (or who recently have been in) a program for the treatment of substance abuse. ‘‘(b) LOAN RECIPIENTS.—A loan under this section may only be made to a nonprofit organization under se- lection criteria promulgated by the Secretary and only to assist that organization in leasing housing units for use as a group residence for the purposes described in subsection (a). The amount of such a loan that is used with respect to any single residential unit may not ex- ceed $4,500. In making loans under this subsection, the Secretary shall, except to the extent that the Sec- retary determines that it is infeasible to do so, ensure that— ‘‘(1) each loan is repaid within two years after the date on which the loan is made; ‘‘(2) each loan is repaid through monthly install- ments and that a reasonable penalty is assessed for each failure to pay an installment by the date speci- fied in the loan agreement involved; and ‘‘(3) each loan is made only to a nonprofit private entity which agrees that, in the operation of each residence established with the assistance of the loan— ‘‘(A) the use of alcohol or any illegal drug in the residence will be prohibited; ‘‘(B) any resident who violates the prohibition in subclause (A) of this clause will be expelled from the residence; ‘‘(C) the costs of maintaining the residence, in- cluding fees for rent and utilities, will be paid by the residents; ‘‘(D) the residents will, through a majority vote of the residents, otherwise establish policies gov- erning the conditions of residence, including the manner in which applications for residence are ap- proved; and ‘‘(E) the residence will be operated solely as a res- idence for not less than six veterans. ‘‘(c) FUNDING.—Loans under this section shall be made from the special account of the General Post Fund of the Department of Veterans Affairs established for purposes of this section. The amount of such loans outstanding at any time may not exceed $100,000. Amounts received as payment of principal and interest on such loans shall be deposited in that account. The operation of the loan program under this section shall be separately accounted for, and shall be separately stated in the documents accompanying the President’s budget for each fiscal year. ‘‘(d) TERMS AND CONDITIONS.—Loans under this sec- tion shall be made on such terms and conditions, in- cluding interest, as the Secretary prescribes. ‘‘(e) REPORT.—After the end of the 15-month period beginning on the date the first loan is extended under this section, the Secretary shall issue a report on the Department’s experience under the section. The report shall include the following information: ‘‘(1) The default rate on loans extended under this section. ‘‘(2) The manner in which loan payments are col- lected. ‘‘(3) The number of facilities at which loans have been extended. ‘‘(4) The adequacy of the amount of funds in the special account referred to in subsection (c).’’ EVALUATION OF VETERANS’ ADMINISTRATION INPATIENT AND OUTPATIENT DRUG AND ALCOHOL TREATMENT PROGRAMS Pub. L. 100–690, title II, § 2501, Nov. 18, 1988, 102 Stat. 4232, directed Administrator of Veterans’ Affairs to conduct an evaluation of inpatient and outpatient drug and alcohol treatment programs operated by the Vet- erans’ Administration, such evaluation to include a de- termination of medical advantages and cost-effective- ness of such programs, taking into consideration rates of readmission and the rate of successful rehabilita- tion, and authorized appropriations for this purpose for fiscal years 1989, 1990, and 1991. RATIFICATION FOR LAPSED PERIOD Pub. L. 100–689, title V, § 502(a)(2), Nov. 18, 1988, 102 Stat. 4179, ratified actions by the Administrator of Vet- erans’ Affairs in providing, during the period beginning Oct. 1, 1988, and ending Nov. 18, 1988, for care and treat- ment and rehabilitative services under this section. § 1720B. Respite care (a) The Secretary may furnish respite care services to a veteran who is enrolled to receive care under section 1710 of this title. (b) For the purpose of this section, the term ‘‘respite care services’’ means care and services which— (1) are of limited duration; (2) are furnished on an intermittent basis to a veteran who is suffering from a chronic ill- ness and who resides primarily at home; and (3) are furnished for the purpose of helping the veteran to continue residing primarily at home. (c) In furnishing respite care services, the Sec- retary may enter into contract arrangements. (Added Pub. L. 99–576, title II, § 201(a)(1), Oct. 28, 1986, 100 Stat. 3254, § 620B; amended Pub. L. 101–237, title II, § 201(a), Dec. 18, 1989, 103 Stat. 2066; renumbered § 1720B and amended Pub. L. 102–83, §§ 4(a)(3), (4), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–585, title V, § 502, Nov. 4, 1992, 106 Stat. 4955; Pub. L. 106–117, title I, § 101(e), Nov. 30, 1999, 113 Stat. 1549.) Editorial Notes AMENDMENTS 1999—Subsec. (a). Pub. L. 106–117, § 101(e)(1), sub- stituted ‘‘enrolled’’ for ‘‘eligible’’. Subsec. (b). Pub. L. 106–117, § 101(e)(2), in introductory provisions, substituted ‘‘the term ‘respite care services’ means care and services’’ for ‘‘the term ‘respite care’ means hospital or nursing home care’’, in par. (1) sub- stituted ‘‘are’’ for ‘‘is’’, in par. (2) substituted ‘‘are’’ for ‘‘is’’ and struck out ‘‘in a Department facility’’ after ‘‘furnished’’, and in par. (3) substituted ‘‘are’’ for ‘‘is’’. Subsec. (c). Pub. L. 106–117, § 101(e)(3), added subsec. (c). 1992—Subsec. (c). Pub. L. 102–585 struck out subsec. (c) which read as follows: ‘‘The authority provided by this section terminates on September 30, 1992.’’ 1991—Pub. L. 102–83, § 5(a), renumbered section 620B of this title as this section. Subsec. (a). Pub. L. 102–83, § 5(c)(1), substituted ‘‘1710’’ for ‘‘610’’. Pub. L. 102–83, § 4(b)(1), (2)(E), substituted ‘‘Sec- retary’’ for ‘‘Administrator’’. Subsec. (b)(2). Pub. L. 102–83, § 4(a)(3), (4), substituted ‘‘Department’’ for ‘‘Veterans’ Administration’’. 1989—Subsec. (c). Pub. L. 101–237 substituted ‘‘Sep- tember 30, 1992’’ for ‘‘September 30, 1989’’. Statutory Notes and Related Subsidiaries RATIFICATION OF ACTIONS OF SECRETARY OF VETERANS AFFAIRS DURING TRANSITION PERIODS Pub. L. 101–237, title VI, § 604, Dec. 18, 1989, 103 Stat. 2097, ratified actions of the Secretary of Veterans Af- fairs in carrying out this section, section 115 of Pub. L. 100–322 [38 U.S.C. 1712 note], section 618 of Pub. L. 100–440 [5 U.S.C. 6302 note], or section 1829 [now 3729] of this title, by contract or otherwise, during the period beginning Dec. 1, 1989, and ending Dec. 18, 1989. Pub. L. 101–110, § 3(b), Oct. 6, 1989, 103 Stat. 682, rati- fied actions of the Secretary of Veterans Affairs in car- rying out this section, section 115 of Pub. L. 100–322 [38