38 U.S.C. § 1720G — Assistance and support services for

Page 433 TITLE 38—VETERANS’ BENEFITS § 1720G Veterans Affairs shall ensure that the peer support counseling program required by section 1720F(j) of title 38, United States Code, as amended by this subsection, commences at each Department of Veterans Affairs medical center not later than 270 days after the date of the enactment of this Act [Jan. 2, 2013].’’ SENSE OF CONGRESS Pub. L. 110–110, § 2, Nov. 5, 2007, 121 Stat. 1031, pro- vided that: ‘‘It is the sense of Congress that— ‘‘(1) suicide among veterans suffering from post- traumatic stress disorder (in this section referred to as ‘PTSD’) is a serious problem; and ‘‘(2) the Secretary of Veterans Affairs should take into consideration the special needs of veterans suf- fering from PTSD and the special needs of elderly veterans who are at high risk for depression and expe- rience high rates of suicide in developing and imple- menting the comprehensive program under this Act [enacting this section and provisions set out as a note under section 101 of this title].’’ § 1720G. Assistance and support services for caregivers (a) PROGRAM OF COMPREHENSIVE ASSISTANCE FOR FAMILY CAREGIVERS.—(1)(A) The Secretary shall establish a program of comprehensive as- sistance for family caregivers of eligible vet- erans. (B) The Secretary shall only provide support under the program required by subparagraph (A) to a family caregiver of an eligible veteran if the Secretary determines it is in the best inter- est of the eligible veteran to do so. (2) For purposes of this subsection, an eligible veteran is any individual who— (A) is a veteran or member of the Armed Forces undergoing medical discharge from the Armed Forces; (B) for assistance provided under this sub- section— (i) before the date on which the Secretary submits to Congress a certification that the Department has fully implemented the in- formation technology system required by section 162(a) of the Caring for Our Veterans Act of 2018, has a serious injury (including traumatic brain injury, psychological trau- ma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, air, or space service on or after September 11, 2001; (ii) during the 2-year period beginning on the date on which the Secretary submitted to Congress the certification described in clause (i), has a serious injury (including traumatic brain injury, psychological trau- ma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, air, or space service— (I) on or before May 7, 1975; or (II) on or after September 11, 2001; or (iii) after the date that is 2 years after the date on which the Secretary submits to Con- gress the certification described in clause (i), has a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, air, or space service; and (C) is in need of personal care services be- cause of— (i) an inability to perform one or more ac- tivities of daily living; (ii) a need for supervision or protection based on symptoms or residuals of neuro- logical or other impairment or injury; (iii) a need for regular or extensive in- struction or supervision without which the ability of the veteran to function in daily life would be seriously impaired; or (iv) such other matters as the Secretary considers appropriate. (3)(A) As part of the program required by para- graph (1), the Secretary shall provide to family caregivers of eligible veterans the following as- sistance: (i) To each family caregiver who is approved as a provider of personal care services for an eligible veteran under paragraph (6)— (I) such instruction, preparation, and training as the Secretary considers appro- priate for the family caregiver to provide personal care services to the eligible vet- eran; (II) ongoing technical support consisting of information and assistance to address, in a timely manner, the routine, emergency, and specialized caregiving needs of the fam- ily caregiver in providing personal care serv- ices to the eligible veteran; (III) counseling; and (IV) lodging and subsistence under section 111(e) of this title. (ii) To each family caregiver who is des- ignated as the primary provider of personal care services for an eligible veteran under paragraph (7)— (I) the assistance described in clause (i); (II) such mental health services as the Sec- retary determines appropriate; (III) covered respite care of not less than 30 days annually; (IV) medical care under section 1781 of this title; (V) a monthly personal caregiver stipend; and (VI) through the use of contracts with, or the provision of grants to, public or private entities— (aa) financial planning services relating to the needs of injured veterans and their caregivers; and (bb) legal services, including legal advice and consultation, relating to the needs of injured veterans and their caregivers. (B)(i) The amount of the monthly personal caregiver stipend provided under subparagraph (A)(ii)(V) shall be determined in accordance with a schedule established by the Secretary that specifies stipends based upon the amount and degree of personal care services provided. (ii) The Secretary shall ensure, to the extent practicable, that the schedule required by clause (i) specifies that the amount of the monthly per- sonal caregiver stipend provided to a primary provider of personal care services for the provi- sion of personal care services to an eligible vet- eran is not less than the monthly amount a commercial home health care entity would pay an individual in the geographic area of the eligi- ble veteran to provide equivalent personal care services to the eligible veteran. Page 434 TITLE 38—VETERANS’ BENEFITS § 1720G (iii) In determining the amount and degree of personal care services provided under clause (i) with respect to an eligible veteran whose need for personal care services is based in whole or in part on a need for supervision or protection under paragraph (2)(C)(ii) or regular instruction or supervision under paragraph (2)(C)(iii), the Secretary shall take into account the following: (I) The assessment by the family caregiver of the needs and limitations of the veteran. (II) The extent to which the veteran can function safely and independently in the ab- sence of such supervision, protection, or in- struction. (III) The amount of time required for the family caregiver to provide such supervision, protection, or instruction to the veteran. (iv) If personal care services are not available from a commercial home health entity in the geographic area of an eligible veteran, the amount of the monthly personal caregiver sti- pend payable under the schedule required by clause (i) with respect to the eligible veteran shall be determined by taking into consider- ation the costs of commercial providers of per- sonal care services in providing personal care services in geographic areas other than the geo- graphic area of the eligible veteran with similar costs of living. (C) In providing instruction, preparation, and training under subparagraph (A)(i)(I) and tech- nical support under subparagraph (A)(i)(II) to each family caregiver who is approved as a pro- vider of personal care services for an eligible veteran under paragraph (6), the Secretary shall periodically evaluate the needs of the eligible veteran and the skills of the family caregiver of such veteran to determine if additional instruc- tion, preparation, training, or technical support under those subparagraphs is necessary. (4) An eligible veteran and a family member of the eligible veteran seeking to participate in the program required by paragraph (1) shall jointly submit to the Secretary an application therefor in such form and in such manner as the Sec- retary considers appropriate. (5) For each application submitted jointly by an eligible veteran and family member, the Sec- retary shall evaluate (in collaboration with the primary care team for the eligible veteran to the maximum extent practicable)— (A) the eligible veteran— (i) to identify the personal care services required by the eligible veteran; and (ii) to determine whether such require- ments could be significantly or substantially satisfied through the provision of personal care services from a family member; and (B) the family member to determine the amount of instruction, preparation, and train- ing, if any, the family member requires to pro- vide the personal care services required by the eligible veteran— (i) as a provider of personal care services for the eligible veteran; and (ii) as the primary provider of personal care services for the eligible veteran. (6)(A) The Secretary shall provide each family member of an eligible veteran who makes a joint application under paragraph (4) the instruction, preparation, and training determined to be re- quired by such family member under paragraph (5)(B). (B) Upon the successful completion by a fam- ily member of an eligible veteran of instruction, preparation, and training under subparagraph (A), the Secretary shall approve the family member as a provider of personal care services for the eligible veteran. (C) The Secretary shall, subject to regulations the Secretary shall prescribe, provide for nec- essary travel, lodging, and per diem expenses in- curred by a family member of an eligible vet- eran in undergoing instruction, preparation, and training under subparagraph (A). (D) If the participation of a family member of an eligible veteran in instruction, preparation, and training under subparagraph (A) would interfere with the provision of personal care services to the eligible veteran, the Secretary shall, subject to regulations as the Secretary shall prescribe and in consultation with the vet- eran, provide respite care to the eligible veteran during the provision of such instruction, prepa- ration, and training to the family member so that the family member can participate in such instruction, preparation, and training without interfering with the provision of such services to the eligible veteran. (7)(A) For each eligible veteran with at least one family member who is described by subpara- graph (B), the Secretary shall designate one family member of such eligible veteran as the primary provider of personal care services for such eligible veteran. (B) A primary provider of personal care serv- ices designated for an eligible veteran under subparagraph (A) shall be selected from among family members of the eligible veteran who— (i) are approved under paragraph (6) as a pro- vider of personal care services for the eligible veteran; (ii) elect to provide the personal care serv- ices to the eligible veteran that the Secretary determines the eligible veteran requires under paragraph (5)(A)(i); (iii) have the consent of the eligible veteran to be the primary provider of personal care services for the eligible veteran; and (iv) are considered by the Secretary as com- petent to be the primary provider of personal care services for the eligible veteran. (C) An eligible veteran receiving personal care services from a family member designated as the primary provider of personal care services for the eligible veteran under subparagraph (A) may, in accordance with procedures the Sec- retary shall establish for such purposes, revoke consent with respect to such family member under subparagraph (B)(iii). (D) If a family member designated as the pri- mary provider of personal care services for an eligible veteran under subparagraph (A) subse- quently fails to meet any requirement set forth in subparagraph (B), the Secretary— (i) shall immediately revoke the family member’s designation under subparagraph (A); and (ii) may designate, in consultation with the eligible veteran, a new primary provider of personal care services for the eligible veteran under such subparagraph. Page 435 TITLE 38—VETERANS’ BENEFITS § 1720G (E) The Secretary shall take such actions as may be necessary to ensure that the revocation of a designation under subparagraph (A) with re- spect to an eligible veteran does not interfere with the provision of personal care services re- quired by the eligible veteran. (8) If an eligible veteran lacks the capacity to make a decision under this subsection, the Sec- retary may, in accordance with regulations and policies of the Department regarding appoint- ment of guardians or the use of powers of attor- ney, appoint a surrogate for the eligible veteran who may make decisions and take action under this subsection on behalf of the eligible veteran. (9)(A) The Secretary shall monitor the well- being of each eligible veteran receiving personal care services under the program required by paragraph (1). (B) The Secretary shall document each finding the Secretary considers pertinent to the appro- priate delivery of personal care services to an el- igible veteran under the program. (C) The Secretary shall establish procedures to ensure appropriate follow-up regarding findings described in subparagraph (B). Such procedures may include the following: (i) Visiting an eligible veteran in the eligible veteran’s home to review directly the quality of personal care services provided to the eligi- ble veteran. (ii) Taking such corrective action with re- spect to the findings of any review of the qual- ity of personal care services provided an eligi- ble veteran as the Secretary considers appro- priate, which may include— (I) providing additional training to a fam- ily caregiver; and (II) suspending or revoking the approval of a family caregiver under paragraph (6) or the designation of a family caregiver under paragraph (7). (10) The Secretary shall carry out outreach to inform eligible veterans and family members of eligible veterans of the program required by paragraph (1) and the benefits of participating in the program. (11)(A) In providing assistance under this sub- section to family caregivers of eligible veterans, the Secretary may enter into contracts, pro- vider agreements, and memoranda of under- standing with Federal agencies, States, and pri- vate, nonprofit, and other entities to provide such assistance to such family caregivers. (B) The Secretary may provide assistance under this paragraph only if such assistance is reasonably accessible to the family caregiver and is substantially equivalent or better in qual- ity to similar services provided by the Depart- ment. (C) The Secretary may provide fair compensa- tion to Federal agencies, States, and other enti- ties that provide assistance under this para- graph. (12)(A) The Secretary shall notify the individ- uals described in subparagraph (C) regarding de- cisions affecting the furnishing of assistance under this subsection using standardized letters, as the Secretary determines such notifications and letters to be appropriate, which shall in- clude all criteria used to determine eligibility for such assistance and, in the case of a com- pleted evaluation, how such criteria were used to evaluate information provided in assessments to determine such eligibility. (B) A notification provided under subpara- graph (A) shall include the elements required for notices of decisions under section 5104(b) of this title to the extent that those elements apply to such notification, unless, not later than 60 days after the date of the enactment of the Trans- parency and Effective Accountability Measures for Veteran Caregivers Act, the Secretary deter- mines that it would not be feasible to include such elements in such notifications and submits to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report setting forth the reasons for such determination. (C) The individuals described in this subpara- graph shall include— (i) an individual who— (I) submits an application for the program established under paragraph (1); or (II) is being reassessed for eligibility to continue in such program. (ii) an individual determined by the Sec- retary to be an eligible veteran pursuant to such an application; and (iii) a family caregiver of an eligible veteran who is— (I) approved as a provider of personal care services under paragraph (6)(B); or (II) designated as a primary provider of personal care services under paragraph (7)(A). (13)(A) If the Secretary determines that a vet- eran receiving services under the program estab- lished under paragraph (1) is no longer eligible for such program solely because of improvement in the condition of the veteran— (i) the effective date of discharge of the vet- eran from the program shall be not earlier than the date that is 60 days after the date on which the Secretary provides notice of such lack of eligibility under paragraph (12)(A) to the relevant individuals described in para- graph (12)(C); and (ii) the Secretary shall extend benefits under the program established under paragraph (1) for a family caregiver of the veteran described in paragraph (12)(C)(iii), including stipends under paragraph (3)(A)(ii)(V), if such an exten- sion is determined appropriate by the Sec- retary, for a 90-day period following discharge of the veteran from the program. (B) This paragraph shall not be construed to limit the authority of the Secretary— (i) to prescribe regulations addressing other bases for— (I) the discharge of a veteran from the pro- gram established under paragraph (1); or (II) the revocation of the designation of a family caregiver of a veteran as a primary provider of personal care services under paragraph (7)(A); or (ii) to provide advance notice and extended benefits under the program, as appropriate, if another basis for discharge of a veteran de- scribed in subclause (I) of clause (i) or revoca- tion of a designation described in subclause (II) of such clause applies. Page 436 TITLE 38—VETERANS’ BENEFITS § 1720G (14)(A) In the case of a veteran or caregiver who seeks services under this subsection and is denied such services, or a veteran or the family caregiver of a veteran who is discharged from the program under this subsection, the Sec- retary shall— (i) if the veteran meets the requirements of a covered veteran under subsection (b), pro- vide to such caregiver the option of enrolling in the program of general caregiver support services under such subsection; (ii) assess the veteran or caregiver for par- ticipation in any other available program of the Department for home- and community- based services (including the programs speci- fied in section 1720L of this title) for which the veteran or caregiver may be eligible and, with respect to the veteran, store (and make acces- sible to the veteran) the results of such assess- ment in the electronic medical record of the veteran; and (iii) provide to the veteran or caregiver writ- ten information on any such program identi- fied pursuant to the assessment under clause (ii), including information about facilities, eli- gibility requirements, and relevant contact in- formation for each such program. (B) The Secretary shall, to the extent prac- ticable, provide to a veteran or family caregiver the option of obtaining clinically appropriate services under any other available program of the Department for home- and community-based services (including the programs specified in section 1720L of this title) for which the veteran or family caregiver may be eligible prior to dis- charging the veteran or family caregiver from the program under this subsection. (C) For each veteran or family caregiver who is discharged from the program under this sub- section, a caregiver support coordinator shall provide for a smooth and personalized transition from such program to an appropriate program of the Department for home- and community-based services (including the programs specified in section 1720L of this title), including by inte- grating caregiver support across programs. (15)(A) Not less frequently than annually, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a comprehensive report on the program required by paragraph (1) that includes, with respect to the one-year period preceding the date of the submission of such report, the following: (i) The number of applications received for such program. (ii) The number, disaggregated by race, sex, and era and branch of service in the Armed Forces of the applicant, of— (I) approvals of such applications; and (II) denials of such applications. (iii) The number of reassessments conducted for such program. (iv) An identification of each decision made with respect to a reassessment conducted for such program, disaggregated by decisions re- sulting in— (I) disenrollment, including removal, dis- charge, or voluntary withdrawal; (II) tier reduction; and (III) tier continuation. (v) The number of appeals of decisions made with respect to such program, disaggregated by type of appeal. (vi) With respect to each appeal described in clause (v), the decision rendered, if any. (vii) A description of all tools used in assess- ments conducted for such program, including an explanation of how and by whom such tools are administered. (viii) A description of procedures used under such program for reviewing and integrating clinical records from health care providers that includes an explanation of how such records are used in determinations of eligi- bility for such program. (ix) A description of procedures available under such program for health care providers to communicate medical opinions to the teams conducting assessments to determine eligibility for such program, including health care providers in the private sector and health care providers specified in subsection (c) of section 1703 of this title. (x) A description of information technology systems and processes used under such pro- gram to upload and integrate all clinical records from all non-Department providers, in- cluding providers in the private sector and providers under the Veterans Community Care Program established under such section. (B) The Secretary shall ensure that all data included in a report under subparagraph (A)— (i) relating to a decision made under the pro- gram required by paragraph (1), are disaggregated by the specific reason for the decision; (ii) relating to a veteran, include com- prehensive demographic information of the veteran, including the time period of the inju- ries, if any, of the veteran and the Veterans Integrated Service Network in which the vet- eran is located; and (iii) with respect to eligibility determina- tions relating to a serious injury of a veteran, specify— (I) how many such determinations relate to the ability of the veteran to perform ac- tivities of daily living; and (II) how many such determinations relate to the need of a veteran for supervision and protection. (C) The Secretary shall provide the data under paragraph (B) pursuant to Federal laws and in a manner that is wholly consistent with applica- ble Federal privacy and confidentiality laws, in- cluding the Privacy Act (5 U.S.C. 552a), the Health Insurance Portability and Account- ability Act (Public Law 104–191; 42 U.S.C. 201 note) and regulations (title 45, Code of Federal Regulations, parts 160 and 164, or successor regu- lations), and sections 5701, 5705, and 7332 of this title to ensure that the provided data, or some portion of the data, will not undermine the ano- nymity of a veteran. (b) PROGRAM OF GENERAL CAREGIVER SUPPORT SERVICES.—(1) The Secretary shall establish a program of support services for caregivers of covered veterans who are enrolled in the health care system established under section 1705(a) of Page 437 TITLE 38—VETERANS’ BENEFITS § 1720G this title (including caregivers who do not reside with such veterans). (2) For purposes of this subsection, a covered veteran is any individual who needs personal care services because of— (A) an inability to perform one or more ac- tivities of daily living; (B) a need for supervision or protection based on symptoms or residuals of neuro- logical or other impairment or injury; or (C) such other matters as the Secretary shall specify. (3)(A) The support services furnished to care- givers of covered veterans under the program re- quired by paragraph (1) shall include the fol- lowing: (i) Services regarding the administering of personal care services, which, subject to sub- paragraph (B), shall include— (I) educational sessions made available both in person and on an Internet website; (II) use of telehealth and other available technologies; and (III) teaching techniques, strategies, and skills for caring for a disabled veteran; (ii) Counseling and other services under sec- tion 1782 of this title. (iii) Covered respite care of not less than 30 days annually. (iv) Information concerning the supportive services available to caregivers under this sub- section and other public, private, and non- profit agencies that offer support to care- givers. (B) If the Secretary certifies to the Commit- tees on Veterans’ Affairs of the Senate and the House of Representatives that funding available for a fiscal year is insufficient to fund the provi- sion of services specified in one or more sub- clauses of subparagraph (A)(i), the Secretary shall not be required under subparagraph (A) to provide the services so specified in the certifi- cation during the period beginning on the date that is 180 days after the date the certification is received by the Committees and ending on the last day of the fiscal year. (4) In providing information under paragraph (3)(A)(iv), the Secretary shall collaborate with the Assistant Secretary for Aging of the Depart- ment of Health and Human Services in order to provide caregivers access to aging and disability resource centers under the Administration on Aging of the Department of Health and Human Services. (5) In carrying out the program required by paragraph (1), the Secretary shall conduct out- reach to inform covered veterans and caregivers of covered veterans about the program. The out- reach shall include an emphasis on covered vet- erans and caregivers of covered veterans living in rural areas. (c) CONSTRUCTION.—(1) A decision by the Sec- retary under this section affecting the fur- nishing of assistance or support shall be consid- ered a medical determination. (2) Nothing in this section shall be construed to create— (A) an employment relationship between the Secretary and an individual in receipt of as- sistance or support under this section; or (B) any entitlement to any assistance or support provided under this section. (d) DEFINITIONS.—In this section: (1) The term ‘‘caregiver’’, with respect to an eligible veteran under subsection (a), a vet- eran denied or discharged as specified in para- graph (14) of such subsection, or a covered vet- eran under subsection (b), means an individual who provides personal care services to the vet- eran. (2) The term ‘‘covered respite care’’ means, with respect to a caregiver of a veteran, res- pite care under section 1720B of this title that— (A) is medically and age appropriate for the veteran (including 24-hour per day care of the veteran commensurate with the care provided by the caregiver); and (B) includes in-home care. (3) The term ‘‘family caregiver’’, with re- spect to an eligible veteran under subsection (a) or a veteran denied or discharged as speci- fied in paragraph (14) of such subsection, means a family member who is a caregiver of the veteran. (4) The term ‘‘family member’’, with respect to an eligible veteran under subsection (a) or a veteran denied or discharged as specified in paragraph (14) of such subsection, means an in- dividual who— (A) is a member of the family of the vet- eran, including— (i) a parent; (ii) a spouse; (iii) a child; (iv) a step-family member; and (v) an extended family member; or (B) lives with the veteran but is not a member of the family of the veteran. (5) The term ‘‘personal care services’’, with respect to an eligible veteran under subsection (a), a veteran denied or discharged as specified in paragraph (14) of such subsection, or a cov- ered veteran under subsection (b), means serv- ices that provide the veteran the following: (A) Assistance with one or more activities of daily living. (B) Supervision or protection based on symptoms or residuals of neurological or other impairment or injury. (C) Regular or extensive instruction or su- pervision without which the ability of the veteran to function in daily life would be se- riously impaired. (D) Any other non-institutional extended care (as such term is used in section 1701(6)(E) of this title). (Added Pub. L. 111–163, title I, § 101(a)(1), May 5, 2010, 124 Stat. 1132; amended Pub. L. 114–58, title I, § 103, title VI, § 601(6), Sept. 30, 2015, 129 Stat. 532, 538; Pub. L. 114–228, title I, § 103, Sept. 29, 2016, 130 Stat. 937; Pub. L. 115–62, title I, § 103, Sept. 29, 2017, 131 Stat. 1161; Pub. L. 115–182, title I, § 161(a)(1)(A), (2)–(b), June 6, 2018, 132 Stat. 1438–1440; Pub. L. 115–251, title I, § 103, Sept. 29, 2018, 132 Stat. 3168; Pub. L. 116–278, § 2(b), Dec. 31, 2020, 134 Stat. 3374; Pub. L. 116–283, div. A, title IX, § 926(a)(28), Jan. 1, 2021, 134 Stat. 3830; Pub. L. 118–210, title I, §§ 124(a)(1), (3), (b), 125, Jan. 2, 2025, 138 Stat. 2730, 2731.) Page 438 TITLE 38—VETERANS’ BENEFITS § 1720G APPLICABILITY OF AMENDMENT Subsec. (a)(14) of this section, as added by section 124(a)(1) of Pub. L. 118–210, applicable with respect to denials and discharges occurring on or after the date that is 180 days after Jan. 2, 2025. See 2025 Amendment note below. Editorial Notes REFERENCES IN TEXT Section 162(a) of the Caring for Our Veterans Act of 2018, referred to in subsec. (a)(2)(B)(i), is section 162(a) of Pub. L. 115–182, June 6, 2018, 132 Stat. 1440, which is set out as a note under this section. The date of the enactment of the Transparency and Effective Accountability Measures for Veteran Care- givers Act, referred to in subsec. (a)(12)(B), is the date of enactment of Pub. L. 116–278, which was approved Dec. 31, 2020. The Health Insurance Portability and Accountability Act, referred to in subsec. (a)(15)(C), probably means the Health Insurance Portability and Accountability Act of 1996, Pub. L. 104–191, Aug. 21, 1996, 110 Stat. 1936. For complete classification of this Act to the Code, see Short Title note set out under section 201 of Title 42, The Public Health and Welfare, and Tables. AMENDMENTS 2025—Subsec. (a)(3)(A)(ii)(III). Pub. L. 118–210, § 124(b)(1)(A), amended subcl. (III) generally. Prior to amendment, subcl. (III) read as follows: ‘‘respite care of not less than 30 days annually, including 24-hour per day care of the veteran commensurate with the care provided by the family caregiver to permit extended respite;’’. Subsec. (a)(3)(B) to (D). Pub. L. 118–210, § 124(b)(1)(B), redesignated subpars. (C) and (D) as (B) and (C), respec- tively, and struck out former subpar. (B) which read as follows: ‘‘Respite care provided under subparagraph (A)(ii)(III) shall be medically and age-appropriate and include in-home care.’’ Subsec. (a)(12)(A). Pub. L. 118–210, § 125(1)(A), inserted ‘‘, which shall include all criteria used to determine eligibility for such assistance and, in the case of a com- pleted evaluation, how such criteria were used to evalu- ate information provided in assessments to determine such eligibility’’ before period at end. Subsec. (a)(12)(C)(i). Pub. L. 118–210, § 125(1)(B), sub- stituted ‘‘who—’’ for ‘‘who’’, designated remainder of existing provisions as subcl. (I), and added subcl. (II). Subsec. (a)(14). Pub. L. 118–210, § 124(a)(1), added par. (14). Subsec. (a)(15). Pub. L. 118–210, § 125(2), added par. (15). Subsec. (b)(3)(A)(iii). Pub. L. 118–210, § 124(b)(2), amended cl. (iii) generally. Prior to amendment, cl. (iii) read as follows: ‘‘Respite care under section 1720B of this title that is medically and age appropriate for the veteran (including 24-hour per day in-home care).’’ Subsec. (d)(1). Pub. L. 118–210, § 124(a)(3)(A), sub- stituted ‘‘, a veteran denied or discharged as specified in paragraph (14) of such subsection, or a covered vet- eran’’ for ‘‘or a covered veteran’’. Subsec. (d)(2). Pub. L. 118–210, § 124(b)(3), added par. (2). Former par. (2) redesignated (3). Pub. L. 118–210, § 124(a)(3)(B), substituted ‘‘under sub- section (a) or a veteran denied or discharged as speci- fied in paragraph (14) of such subsection, means’’ for ‘‘under subsection (a), means’’. Subsec. (d)(3). Pub. L. 118–210, § 124(b)(3), redesignated par. (2) as (3). Former par. (3) redesignated (4). Pub. L. 118–210, § 124(a)(3)(B), substituted ‘‘under sub- section (a) or a veteran denied or discharged as speci- fied in paragraph (14) of such subsection, means’’ for ‘‘under subsection (a), means’’ in introductory provi- sions. Subsec. (d)(4). Pub. L. 118–210, § 124(b)(3), redesignated par. (3) as (4). Former par. (4) redesignated (5). Pub. L. 118–210, § 124(a)(3)(A), substituted ‘‘, a veteran denied or discharged as specified in paragraph (14) of such subsection, or a covered veteran’’ for ‘‘or a cov- ered veteran’’. Subsec. (d)(5). Pub. L. 118–210, § 124(b)(3), redesignated par. (4) as (5). 2021—Subsec. (a)(2)(B). Pub. L. 116–283 substituted ‘‘air, or space service’’ for ‘‘or air service’’ wherever ap- pearing. 2020—Subsec. (a)(12), (13). Pub. L. 116–278 added pars. (12) and (13). 2018—Subsec. (a)(2)(B). Pub. L. 115–182, § 161(a)(1)(A), amended subpar. (B) generally. Prior to amendment, text read as follows: ‘‘has a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, or air service on or after September 11, 2001; and’’. Subsec. (a)(2)(C)(iii), (iv). Pub. L. 115–182, § 161(a)(2), added cl. (iii) and redesignated former cl. (iii) as (iv). Subsec. (a)(3)(A)(ii)(VI). Pub. L. 115–182, § 161(a)(3), added subcl. (VI). Subsec. (a)(3)(C)(iii), (iv). Pub. L. 115–182, § 161(a)(4), added cl. (iii) and redesignated former cl. (iii) as (iv). Subsec. (a)(3)(D). Pub. L. 115–182, § 161(a)(5), added subpar. (D). Subsec. (a)(5). Pub. L. 115–182, § 161(a)(6), inserted ‘‘(in collaboration with the primary care team for the eligi- ble veteran to the maximum extent practicable)’’ after ‘‘evaluate’’ in introductory provisions. Subsec. (a)(11). Pub. L. 115–182, § 161(a)(7), added par. (11). Subsec. (d)(4)(A). Pub. L. 115–182, § 161(b)(1), struck out ‘‘independent’’ before ‘‘activities of daily living’’. Subsec. (d)(4)(B) to (D). Pub. L. 115–182, § 161(b)(2), (3), added subpars. (B) and (C) and redesignated former sub- par. (B) as (D). Subsec. (e). Pub. L. 115–251 struck out subsec. (e) which authorized appropriations from fiscal years 2010 to 2019. 2017—Subsec. (e)(5). Pub. L. 115–62 added par. (5). 2016—Subsec. (e)(4). Pub. L. 114–228 added par. (4). 2015—Subsec. (a)(7)(B)(iii). Pub. L. 114–58, § 601(6), sub- stituted ‘‘have’’ for ‘‘has’’. Subsec. (e)(3). Pub. L. 114–58, § 103, added par. (3). Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 2025 AMENDMENT Pub. L. 118–210, title I, § 124(a)(2), Jan. 2, 2025, 138 Stat. 2731, provided that: ‘‘The amendments made by para- graph (1) [amending this section] shall apply with re- spect to denials and discharges occurring on or after the date that is 180 days after the date of the enact- ment of this Act [Jan. 2, 2025].’’ EFFECTIVE DATE Pub. L. 111–163, title I, § 101(a)(3), May 5, 2010, 124 Stat. 1137, provided that: ‘‘(A) IN GENERAL.—The amendments made by this subsection [enacting this section] shall take effect on the date that is 270 days after the date of the enact- ment of this Act [May 5, 2010]. ‘‘(B) IMPLEMENTATION.—The Secretary of Veterans Affairs shall commence the programs required by sub- sections (a) and (b) of section 1720G of title 38, United States Code, as added by paragraph (1) of this sub- section, on the date on which the amendments made by this subsection take effect.’’ RECOGNITION OF ORGANIZATIONS AND INDIVIDUALS TO ASSIST VETERANS, FAMILY MEMBERS, AND CARE- GIVERS NAVIGATING PROGRAMS AND SERVICES OF VETERANS HEALTH ADMINISTRATION Pub. L. 118–210, title I, § 129, Jan. 2, 2025, 138 Stat. 2738, provided that: ‘‘(a) IN GENERAL.—Not later than one year after the date of the enactment of this Act [Jan. 2, 2025], the Sec- retary of Veterans Affairs shall establish a process through which the Department of Veterans Affairs may recognize organizations and individuals to assist a vet- Page 439 TITLE 38—VETERANS’ BENEFITS § 1720G eran, a family member of a veteran, or a caregiver of a veteran (as defined in section 1720G(d) of title 38, United States Code) in navigating the programs and services of the Veterans Health Administration. ‘‘(b) SOLICITATION OF FEEDBACK.—The Secretary shall solicit feedback and recommendations in the creation of the process under subsection (a) from such organiza- tions as the Secretary may consider relevant. ‘‘(c) LIMITATION.—The Secretary may not recognize an organization or individual pursuant to the process established under subsection (a) unless the organiza- tion or individual has certified to the Secretary that no fee or compensation of any nature will be charged to any individual for services rendered in providing assist- ance pursuant to such subsection.’’ [For definition of ‘‘caregiver’’ as used in section 129 of Pub. L. 118–210, set out above, see section 133 of Pub. L. 118–210, set out as a note under section 1720L of this title.] MODIFICATION OF ADMINISTRATION OF CAREGIVER PROGRAMS OF DEPARTMENT OF VETERANS AFFAIRS Pub. L. 116–278, § 2(a), Dec. 31, 2020, 134 Stat. 3373, pro- vided that: ‘‘(a) FORMAL RECOGNITION OF CAREGIVERS.— ‘‘(1) REPORT.— ‘‘(A) IN GENERAL.—Not later than 60 days after the date of the enactment of this Act [Dec. 31, 2020], the Secretary shall submit to the Committee on Vet- erans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report regarding the feasibility and advisability of formally recognizing all caregivers of veterans by identifying any caregiver of a veteran in the elec- tronic health record of the veteran. ‘‘(B) CAREGIVERS RECOGNIZED.—The recognition of caregivers described in subparagraph (A) shall in- clude recognition of— ‘‘(i) any family caregiver who is approved as a provider of personal care services for an eligible veteran under the program of comprehensive as- sistance for family caregivers under subsection (a) of section 1720G of title 38, United States Code; and ‘‘(ii) any caregiver of a covered veteran partici- pating in the program of general caregiver sup- port services under subsection (b) of such section. ‘‘(C) TIMELINE.—If the Secretary determines that formally recognizing all caregivers of veterans as described in subparagraph (A) is feasible and advis- able, the report required by such subparagraph shall include a timeline for implementing such rec- ognition. ‘‘(2) IMPLEMENTATION.—If the Secretary determines that formally recognizing all caregivers of veterans as described in paragraph (1)(A) is feasible and advis- able, the Secretary shall implement such recognition in accordance with the timeline included in the re- port required by such paragraph.’’ EDUCATION PROGRAM FOR FAMILY MEMBERS AND CARE- GIVERS OF VETERANS WITH MENTAL HEALTH DIS- ORDERS Pub. L. 116–214, title II, § 202, Dec. 5, 2020, 134 Stat. 1033, provided that: ‘‘(a) ESTABLISHMENT.—Not later than 270 days after the date of the enactment of this Act [Dec. 5, 2020], the Secretary of Veterans Affairs shall establish an edu- cation program (in this section referred to as the ‘edu- cation program’) for the education and training of care- givers and family members of eligible veterans with mental health disorders. ‘‘(b) EDUCATION PROGRAM.— ‘‘(1) IN GENERAL.—Under the education program, the Secretary shall provide a course of education to care- givers and family members of eligible veterans on matters relating to coping with mental health dis- orders in veterans. ‘‘(2) DURATION.—The Secretary shall carry out the education program during the four-year period begin- ning on the date of the commencement of the edu- cation program. ‘‘(3) SCOPE.— ‘‘(A) CAREGIVERS.—The Secretary, with respect to the component of the education program that re- lates to the education and training of caregivers, shall— ‘‘(i) include such component in the training pro- vided pursuant to the program of comprehensive assistance for family caregivers of the Depart- ment of Veterans Affairs established under sec- tion 1720G(a) of title 38, United States Code; and ‘‘(ii) make such component available on the Internet website of the Department that relates to caregiver training. ‘‘(B) FAMILY MEMBERS.—The Secretary shall carry out the component of the education program that relates to the education and training of non-care- giver family members at facilities of the Depart- ment as follows: ‘‘(i) Not less than five medical centers of the Department. ‘‘(ii) Not less than five clinics of the Depart- ment. ‘‘(iii) Not less than five Vet Centers (as defined in section 1712A(h) of title 38, United States Code). ‘‘(C) SOLICITATION OF APPLICATIONS.—In selecting locations pursuant to subparagraph (B), the Sec- retary shall solicit applications from eligible facili- ties of the Department that are interested in car- rying out the education program. ‘‘(D) CONSIDERATIONS.—In selecting locations pur- suant to subparagraph (B), the Secretary shall con- sider the feasibility and advisability of selecting lo- cations in the following areas: ‘‘(i) Rural areas. ‘‘(ii) Areas that are not in close proximity to an active duty installation. ‘‘(iii) Areas in different geographic locations. ‘‘(4) CONTRACTS.— ‘‘(A) IN GENERAL.—In carrying out the education program, the Secretary shall enter into contracts with qualified entities described in subparagraph (B) to offer the course of education described in paragraph (5) to family members and caregivers of eligible veterans and covered veterans. ‘‘(B) QUALIFIED ENTITY DESCRIBED.—A qualified entity described in this subparagraph is a non-prof- it entity with experience in mental health edu- cation and outreach, including work with children, teens, and young adults, that— ‘‘(i) uses high quality, relevant, and age-appro- priate information in educational programming, materials, and coursework, including such pro- gramming, materials, and coursework for chil- dren, teens, and young adults; and ‘‘(ii) works with agencies, departments, non- profit mental health organizations, early child- hood educators, and mental health providers to develop educational programming, materials, and coursework. ‘‘(C) PRIORITY.—In entering into contracts under this paragraph, the Secretary shall give priority to qualified entities that have demonstrated cultural competence in serving military and veteran popu- lations, and, to the extent practicable, use internet technology for the delivery of course content in an effort to expand the availability of support services, especially in rural areas. ‘‘(5) COURSE OF EDUCATION DESCRIBED.—The course of education described in this paragraph shall consist of curriculum that includes the following: ‘‘(A) General education on different mental health disorders, including information to improve understanding of the experiences of individuals suf- fering from such disorders. ‘‘(B) Techniques for handling crisis situations and administering mental health first aid to individuals suffering from a mental health disorder. Page 440 TITLE 38—VETERANS’ BENEFITS § 1720G ‘‘(C) Techniques for coping with the stress of liv- ing with an individual suffering from a mental health disorder. ‘‘(D) Information on additional services available for family members and caregivers through the De- partment or community organizations and pro- viders related to mental health disorders. ‘‘(E) Such other matters as the Secretary con- siders appropriate. ‘‘(c) SURVEYS.— ‘‘(1) IN GENERAL.—The Secretary shall conduct a comprehensive survey of the satisfaction of individ- uals that have participated in the course of education described in subsection (b)(5). Such survey shall in- clude a solicitation of feedback on the following: ‘‘(A) The general satisfaction of those individuals with the education and assistance provided under the education program. ‘‘(B) The perceived effectiveness of the education program in providing education and assistance that is useful for those individuals. ‘‘(C) The applicability of the education program to the issues faced by those individuals. ‘‘(D) Such other matters as the Secretary con- siders appropriate. ‘‘(2) COMPILATION OF INFORMATION.—The informa- tion compiled as a result of the surveys conducted under paragraph (1) shall be— ‘‘(A) disaggregated by facility type at which the education program was carried out; and ‘‘(B) included in the annual reports under sub- section (d)(1). ‘‘(d) REPORTS.— ‘‘(1) ANNUAL REPORTS.— ‘‘(A) IN GENERAL.—Not later than one year after the date of the commencement of the education program and not later than September 30 each year thereafter until 2024, 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— ‘‘(i) the education program; and ‘‘(ii) the feasibility and advisability of expand- ing the education program to include the estab- lishment of a peer support program composed of individuals who complete the education program (in this section referred to as a ‘peer support pro- gram’). ‘‘(B) ELEMENTS.—Each report submitted under subparagraph (A) shall include the following: ‘‘(i) The number of individuals that participated in the course of education described in subsection (b)(5) during the year preceding the submission of the report. ‘‘(ii) A detailed analysis of the surveys con- ducted under subsection (c) with respect to the individuals described in clause (i). ‘‘(iii) Any plans for expansion of the education program. ‘‘(iv) An analysis of the feasibility and advis- ability of establishing a peer support program. ‘‘(v) The interim findings and conclusions of the Secretary with respect to the success of the edu- cation program and the feasibility and advis- ability of establishing a peer support program. ‘‘(2) FINAL REPORT.— ‘‘(A) IN GENERAL.—Not later than one year after the completion of the education program, the Sec- retary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a final report on the feasibility and advis- ability of continuing the education program. ‘‘(B) ELEMENTS.—The final report under subpara- graph (A) shall include the following: ‘‘(i) A detailed analysis of the surveys con- ducted under subsection (c). ‘‘(ii) An analysis of the feasibility and advis- ability of continuing the education program with- out entering into contracts for the course of edu- cation described in subsection (b)(5). ‘‘(iii) An analysis of the feasibility and advis- ability of expanding the education program. ‘‘(iv) An analysis of the feasibility and advis- ability of establishing a peer support program. ‘‘(e) MONITORING OF PROGRAM.—The Secretary shall select mental health care providers of the Department to monitor the progress of the instruction provided under the education program. ‘‘(f) DEFINITIONS.—In this section: ‘‘(1) The term ‘eligible veteran’ means a veteran who is enrolled in the health care system established under section 1705(a) of title 38, United States Code. ‘‘(2) The terms ‘caregiver’ and ‘family member’ have the meaning given those terms in section 1720G(d) of title 38, United States Code.’’ PUBLICATION IN FEDERAL REGISTER Pub. L. 115–182, title I, § 161(a)(1)(B), June 6, 2018, 132 Stat. 1439, as amended by Pub. L. 115–251, title II, § 211(b)(5), Sept. 29, 2018, 132 Stat. 3176, provided that: ‘‘Not later than 30 days after the date on which the Secretary of Veterans Affairs submits to Congress the certification described in subsection (a)(2)(B)(i) of sec- tion 1720G of title 38, United States Code, as amended by subparagraph (A) of this paragraph, the Secretary shall publish the date specified in such subsection in the Federal Register.’’ IMPLEMENTATION OF INFORMATION TECHNOLOGY SYSTEM OF DEPARTMENT OF VETERANS AFFAIRS TO ASSESS AND IMPROVE THE FAMILY CAREGIVER PROGRAM Pub. L. 115–182, title I, § 162, June 6, 2018, 132 Stat. 1440, provided that: ‘‘(a) IMPLEMENTATION OF NEW SYSTEM.— ‘‘(1) IN GENERAL.—Not later than October 1, 2018, the Secretary of Veterans Affairs shall implement an in- formation technology system that fully supports the Program and allows for data assessment and com- prehensive monitoring of the Program. ‘‘(2) ELEMENTS OF SYSTEM.—The information tech- nology system required to be implemented under paragraph (1) shall include the following: ‘‘(A) The ability to easily retrieve data that will allow all aspects of the Program (at the medical center and aggregate levels) and the workload trends for the Program to be assessed and com- prehensively monitored. ‘‘(B) The ability to manage data with respect to a number of caregivers that is more than the num- ber of caregivers that the Secretary expects to apply for the Program. ‘‘(C) The ability to integrate the system with other relevant information technology systems of the Veterans Health Administration. ‘‘(b) ASSESSMENT OF PROGRAM.—Not later than 180 days after implementing the system described in sub- section (a), the Secretary shall, through the Under Sec- retary for Health, use data from the system and other relevant data to conduct an assessment of how key as- pects of the Program are structured and carried out. ‘‘(c) ONGOING MONITORING OF AND MODIFICATIONS TO PROGRAM.— ‘‘(1) MONITORING.—The Secretary shall use the sys- tem implemented under subsection (a) to monitor and assess the workload of the Program, including monitoring and assessment of data on— ‘‘(A) the status of applications, appeals, and home visits in connection with the Program; and ‘‘(B) the use by caregivers participating in the Program of other support services under the Pro- gram such as respite care. ‘‘(2) MODIFICATIONS.—Based on the monitoring and assessment conducted under paragraph (1), the Sec- retary shall identify and implement such modifica- tions to the Program as the Secretary considers nec- essary to ensure the Program is functioning as in- tended and providing veterans and caregivers partici- pating in the Program with services in a timely man- ner. Page 441 TITLE 38—VETERANS’ BENEFITS § 1720H ‘‘(d) REPORTS.— ‘‘(1) INITIAL REPORT.— ‘‘(A) IN GENERAL.—Not later than 90 days after the date of the enactment of this Act [June 6, 2018], the Secretary shall submit to the Committee on Vet- erans’ Affairs of the Senate, the Committee on Vet- erans’ Affairs of the House of Representatives, and the Comptroller General of the United States a re- port that includes— ‘‘(i) the status of the planning, development, and deployment of the system required to be im- plemented under subsection (a), including any changes in the timeline for the implementation of the system; and ‘‘(ii) an assessment of the needs of family care- givers of veterans described in subparagraph (B), the resources needed for the inclusion of such family caregivers in the Program, and such changes to the Program as the Secretary con- siders necessary to ensure the successful expan- sion of the Program to include such family care- givers. ‘‘(B) VETERANS DESCRIBED.—Veterans described in this subparagraph are veterans who are eligible for the Program under clause (ii) or (iii) of section 1720G(a)(2)(B) of title 38, United States Code, as amended by section 161(a)(1) of this title, solely due to a serious injury (including traumatic brain in- jury, psychological trauma, or other mental dis- order) incurred or aggravated in the line of duty in the active military, naval, or air service before Sep- tember 11, 2001. ‘‘(2) NOTIFICATION BY COMPTROLLER GENERAL.—The Comptroller General shall review the report sub- mitted under paragraph (1) and notify the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives with respect to the progress of the Secretary in— ‘‘(A) fully implementing the system required under subsection (a); and ‘‘(B) implementing a process for using such sys- tem to monitor and assess the Program under sub- section (c)(1) and modify the Program as considered necessary under subsection (c)(2). ‘‘(3) FINAL REPORT.— ‘‘(A) IN GENERAL.—Not later than October 1, 2019, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate, the Committee on Veterans’ Affairs of the House of Representatives, and the Comptroller General a report on the imple- mentation of subsections (a) through (c). ‘‘(B) ELEMENTS.—The report required by subpara- graph (A) shall include the following: ‘‘(i) A certification by the Secretary that the information technology system described in sub- section (a) has been implemented. ‘‘(ii) A description of how the Secretary has im- plemented such system. ‘‘(iii) A description of the modifications to the Program, if any, that were identified and imple- mented under subsection (c)(2). ‘‘(iv) A description of how the Secretary is using such system to monitor the workload of the Program. ‘‘(e) DEFINITIONS.—In this section: ‘‘(1) ACTIVE MILITARY, NAVAL, OR AIR SERVICE.—The term ‘active military, naval, or air service’ has the meaning given that term in section 101 of title 38, United States Code. ‘‘(2) PROGRAM.—The term ‘Program’ means the pro- gram of comprehensive assistance for family care- givers under section 1720G(a) of title 38, United States Code, as amended by section 161 of this title.’’ ANNUAL EVALUATION REPORT Pub. L. 111–163, title I, § 101(c), May 5, 2010, 124 Stat. 1138, as amended by Pub. L. 115–182, title I, § 163, June 6, 2018, 132 Stat. 1442, provided that: ‘‘(1) IN GENERAL.—Not later than 2 years after the date described in subsection (a)(3)(A) [see Effective Date note above] and annually thereafter, the Sec- retary shall submit to the Committee on Veterans’ Af- fairs of the Senate and the Committee on Veterans’ Af- fairs of the House of Representatives a comprehensive report on the implementation of section 1720G of title 38, United States Code, as added by subsection (a)(1). ‘‘(2) CONTENTS.—The report required by paragraph (1) shall include the following: ‘‘(A) With respect to the program of comprehensive assistance for family caregivers required by sub- section (a)(1) of such section 1720G and the program of general caregiver support services required by sub- section (b)(1) of such section— ‘‘(i) the number of caregivers that received assist- ance under such programs; ‘‘(ii) the cost to the Department of providing as- sistance under such programs; ‘‘(iii) a description of the outcomes achieved by, and any measurable benefits of, carrying out such programs; ‘‘(iv) an assessment of the effectiveness and the efficiency of the implementation of such programs, including a description of any barriers to accessing and receiving care and services under such pro- grams; and ‘‘(v) such recommendations, including rec- ommendations for legislative or administrative ac- tion, as the Secretary considers appropriate in light of carrying out such programs. ‘‘(B) With respect to the program of comprehensive assistance for family caregivers required by such sub- section (a)(1)— ‘‘(i) a description of the outreach activities car- ried out by the Secretary under such program; ‘‘(ii) an assessment of the manner in which re- sources are expended by the Secretary under such program, particularly with respect to the provision of monthly personal caregiver stipends under para- graph (3)(A)(ii)(v) of such subsection (a); and ‘‘(iii) an evaluation of the sufficiency and consist- ency of the training provided to family caregivers under such program in preparing family caregivers to provide care to veterans under such program. ‘‘(C) With respect to the provision of general care- giver support services required by such subsection (b)(1)— ‘‘(i) a summary of the support services made available under the program; ‘‘(ii) the number of caregivers who received sup- port services under the program; ‘‘(iii) the cost to the Department of providing each support service provided under the program; and ‘‘(iv) such other information as the Secretary considers appropriate.’’ § 1720H. Mental health treatment for veterans and members of the reserve components of the Armed Forces who served in classified missions (a) ESTABLISHMENT OF STANDARDS.—(1) The Secretary shall establish standards and proce- dures to ensure that each eligible individual may access mental health care furnished by the Secretary in a manner that fully accommodates the obligation of the individual to not improp- erly disclose classified information. (2) In establishing standards and procedures under paragraph (1), the Secretary shall consult with the Secretary of Defense to ensure that such standards and procedures are consistent with the policies on classified information of the Department of Defense. (3) The Secretary shall disseminate guidance to employees of the Veterans Health Adminis- tration, including mental health professionals, on the standards and procedures established