§ 1706. Management of health care: other requirements

Legislative history

Reconstructed from this section’s Code source credit and amendment notes, resolved against the local Statutes at Large. Editorial notes are evidence, not the law that made the change.

1. 1996

   Veterans’ Health Care Eligibility Reform Act of 1996

   Pub. L. 104–262 title I § 104(a)(1) · 110 Stat. 3177

   Enacted · 38 U.S.C. § 1706

   Added Pub. L. 104–262, title I, § 104(a)(1), Oct. 9, 1996, 110 Stat. 3183

   Source evidence

   Code source credit
   Added Pub. L. 104–262, title I, § 104(a)(1), Oct. 9, 1996, 110 Stat. 3183

   Enacted provision · exact public law section
   (1) Chapter 17 is amended by inserting after section 1704 the following new sections: “§ 1705. Management of health care: patient enrollment system “(a) In managing the provision of hospital care and medical services under section 1710(a) of this title, the Secretary, in accordance with regulations the Secretary shall prescribe, shall establish and operate a system of annual patient enrollment. The Secretary shall manage the enrollment of veterans in accordance with the following priorities, in the order listed: “(1) Veterans with service-connected disabilities rated 50 percent or greater. “(2) Veterans with service-connected disabilities rated 30 percent or 40 percent. “(3) Veterans who are former prisoners of war, veterans with service-connected disabilities rated 10 percent or 20 percent, and veterans described in subparagraphs (B) and (C) of section 1710(a)(2) of this title. “(4) Veterans who are in receipt of increased pension based on a need of regular aid and attendance or by reason of being permanently housebound and other veterans who are catastrophically disabled. “(5) Veterans not covered by paragraphs (1) through (4) who are unable to defray the expenses of necessary care as determined under section 1722(a) of this title. “(6) All other veterans eligible for hospital care, medical services, and nursing home care under section 1710(a)(2) of this title. “(7) Veterans described in section 1710(a)(3) of this title. “(b) In the design of an enrollment system under subsection (a), the Secretary— “(1) shall ensure that the system will be managed in a manner to ensure that the provision of care to enrollees is timely and acceptable in quality; “(2) may establish additional priorities within each priority group specified in subsection (a), as the Secretary determines necessary; and “(3) may provide for exceptions to the specified priorities where dictated by compelling medical reasons. “(c) (1) Effective on October 1, 1998, the Secretary may not provide hospital care or medical services to a veteran under paragraph (2) or (3) of section 1710(a) of this title unless the veteran enrolls in the system of patient enrollment established by the Secretary under subsection (a). “(2) The Secretary shall provide hospital care and medical services under section 1710(a)(1) of this title, and under subparagraph (B) of section 1710(a)(2) of this title, for the 12-month period following such veteran’s discharge or release from service, to any veteran referred to in such sections for a disability specified in the applicable subparagraph of such section, notwithstanding the failure of the veteran to enroll in the system of patient enrollment referred to in subsection (a) of this section. “§ 1706. Management of health care: other requirements “(a) In managing the provision of hospital care and medical services under section 1710(a) of this title, the Secretary shall, to the extent feasible, design, establish and manage health care programs in such a manner as to promote cost-effective delivery of health care services in the most clinically appropriate setting. “(b) (1) In managing the provision of hospital care and medical services under such section, the Secretary shall ensure that the Department maintains its capacity to provide for the specialized treatment and rehabilitative needs of disabled veterans (including veterans with spinal cord dysfunction, blindness, amputations, and mental illness) within distinct programs or facilities of the Department that are dedicated to the specialized needs of those veterans in a manner that (A) affords those veterans reasonable access to care and services for those specialized needs, and (B) ensures that overall capacity of the Department to provide such services is not reduced below the capacity of the Department, nationwide, to provide those services, as of the date of the enactment of this section. The Secretary shall carry out this paragraph in consultation with the Advisory Committee on Prosthetics and Special Disabilities Programs and the Committee on Care of Severely Chronically Mentally Ill Veterans. “(2) Not later than April 1, 1997, April 1, 1998, and April 1, 1999, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the Secretary’s compliance, by facility and by service-network, with the requirements of this subsection.”.

2. 1998

   Pub. L. 105–368 § 1005(b)(2) · 112 Stat. 3315

   Substituted · 38 U.S.C. § 1706(b)(1)

   Pub. L. 105–368, § 1005(b)(2), substituted “October 9, 1996” for “the date of the enactment of this section”

   Source evidence

   Code amendment note
   Subsec. (b)(1). Pub. L. 105–368, § 1005(b)(2), substituted “October 9, 1996” for “the date of the enactment of this section”.

   Enacted provision · exact public law section
   (2) Section 1706(b)(1) is amended by striking “the date of the enactment of this section” at the end of the first sentence and inserting “October 9, 1996”.

3. 1998

   Pub. L. 105–368 § 903(a)(1) · 112 Stat. 3315

   Substituted · 38 U.S.C. § 1706(b)(2)

   Pub. L. 105–368, § 903(a)(1), substituted “April 1, 1999, April 1, 2000, and April 1, 2001” for “April 1, 1997, April 1, 1998, and April 1, 1999”

   Source evidence

   Code amendment note
   Subsec. (b)(2). Pub. L. 105–368, § 903(a)(1), substituted “April 1, 1999, April 1, 2000, and April 1, 2001” for “April 1, 1997, April 1, 1998, and April 1, 1999”.

   Enacted provision · exact public law section
   (1) in paragraph (2), by striking “April 1, 1997, April 1, 1998, and April 1, 1999” and inserting “April 1, 1999, April 1, 2000, and April 1, 2001”; and

4. 1998

   Pub. L. 105–368 § 903(a)(2) · 112 Stat. 3315

   Added · 38 U.S.C. § 1706(b)(3)

   Pub. L. 105–368, § 903(a)(2), added par. (3)

   Source evidence

   Code amendment note
   Subsec. (b)(3). Pub. L. 105–368, § 903(a)(2), added par. (3).

   Enacted provision · exact public law section
   (2) by adding at the end the following new paragraph: “(3) (A) To ensure compliance with paragraph (1), the Under Secretary for Health shall prescribe objective standards of job performance for employees in positions described in subparagraph (B) with respect to the job performance of those employees in carrying out the requirements of paragraph (1). Those job performance standards shall include measures of workload, allocation of resources, and quality-of-care indicators. “(B) Positions described in this subparagraph are positions in the Veterans Health Administration that have responsibility for allocating and managing resources applicable to the requirements of paragraph (1). “(C) The Under Secretary shall develop the job performance standards under subparagraph (A) in consultation with the Advisory Committee on Prosthetics and Special Disabilities Programs and the Committee on Care of Severely Chronically Mentally Ill Veterans.”.

5. 2001

   Pub. L. 107–95 § 8(a) · 115 Stat. 903

   Added · 38 U.S.C. § 1706(c)

   Pub. L. 107–95 added subsec. (c)

   Source evidence

   Code amendment note
   Subsec. (c). Pub. L. 107–95 added subsec. (c).

   Enacted provision · exact public law section
   (a) Access to Mental Health Services.— Section 1706 is amended by adding at the end the following new subsection: “(c) The Secretary shall ensure that each primary care health care facility of the Department develops and carries out a plan to provide mental health services, either through referral or direct provision of services, to veterans who require such services.”.

6. 2002

   Department of Veterans Affairs Health Care Programs Enhancement Act of 2001

   Pub. L. 107–135 § 203(a)(1) · 115 Stat. 2446

   Inserted · 38 U.S.C. § 1706(b)(1)

   Pub. L. 107–135, § 203(a)(1), inserted “(and each geographic service area of the Veterans Health Administration)” after “ensure that the Department” in introductory provisions and “(and each geographic service area of the Veterans Health Administration)” after “overall capacity of the Department” in cl. (B)

   Source evidence

   Code amendment note
   Subsec. (b)(1). Pub. L. 107–135, § 203(a)(1), inserted “(and each geographic service area of the Veterans Health Administration)” after “ensure that the Department” in introductory provisions and “(and each geographic service area of the Veterans Health Administration)” after “overall capacity of the Department” in cl. (B).

   Enacted provision · exact public law section
   (1) in paragraph (1)—

7. 2002

   Department of Veterans Affairs Health Care Programs Enhancement Act of 2001

   Pub. L. 107–135 § 203(a)(3) · 115 Stat. 2446

   Redesignated · 38 U.S.C. § 1706(b)(2)(4)

   Pub. L. 107–135, § 203(a)(3), added pars. (2) to (4). Former pars. (2) and (3) redesignated (5) and (6), respectively

   Source evidence

   Code amendment note
   Subsec. (b)(2) to (4). Pub. L. 107–135, § 203(a)(3), added pars. (2) to (4). Former pars. (2) and (3) redesignated (5) and (6), respectively.

   Enacted provision · exact public law section
   (3) by inserting after paragraph (1) the following new paragraphs: “(2) For purposes of paragraph (1), the capacity of the Department (and each geographic service area of the Veterans Health Administration) to provide for the specialized treatment and rehabilitative needs of disabled veterans (including veterans with spinal cord dysfunction, traumatic brain injury, blindness, prosthetics and sensory aids, and mental illness) within distinct programs or facilities shall be measured for seriously mentally ill veterans as follows (with all such data to be provided by geographic service area and totaled nationally): “(A) For mental health intensive community-based care, the number of discrete intensive care teams constituted to provide such intensive services to seriously mentally ill veterans and the number of veterans provided such care. “(B) For opioid substitution programs, the number of patients treated annually and the amounts expended. “(C) For dual-diagnosis patients, the number treated annually and the amounts expended. “(D) For substance-use disorder programs— “(i) the number of beds (whether hospital, nursing home, or other designated beds) employed and the average bed occupancy of such beds; “(ii) the percentage of unique patients admitted directly to outpatient care during the fiscal year who had two or more additional visits to specialized outpatient care within 30 days of their first visit, with a comparison from 1996 until the date of the report; “(iii) the percentage of unique inpatients with substance-use disorder diagnoses treated during the fiscal year who had one or more specialized clinic visits within three days of their index discharge, with a comparison from 1996 until the date of the report; “(iv) the percentage of unique outpatients seen in a facility or geographic service area during the fiscal year who had one or more specialized clinic visits, with a comparison from 1996 until the date of the report; and “(v) the rate of recidivism of patients at each specialized clinic in each geographic service area of the Veterans Health Administration. “(E) For mental health programs, the number and type of staff that are available at each facility to provide specialized mental health treatment, including satellite clinics, outpatient programs, and community-based outpatient clinics, with a comparison from 1996 to the date of the report. “(F) The number of such clinics providing mental health care, the number and type of mental health staff at each such clinic, and the type of mental health programs at each such clinic. “(G) The total amounts expended for mental health during the fiscal year. “(3) For purposes of paragraph (1), the capacity of the Department (and each geographic service area of the Veterans Health Administration) to provide for the specialized treatment and rehabilitative needs of disabled veterans within distinct programs or facilities shall be measured for veterans with spinal cord dysfunction, traumatic brain injury, blindness, or prosthetics and sensory aids as follows (with all such data to be provided by geographic service area and totaled nationally): “(A) For spinal cord injury and dysfunction specialized centers and for blind rehabilitation specialized centers, the number of staffed beds and the number of full-time equivalent employees assigned to provide care at such centers. “(B) For prosthetics and sensory aids, the annual amount expended. “(C) For traumatic brain injury, the number of patients treated annually and the amounts expended. “(4) In carrying out paragraph (1), the Secretary may not use patient outcome data as a substitute for, or the equivalent of, compliance with the requirement under that paragraph for maintenance of capacity.”.

8. 2002

   Department of Veterans Affairs Health Care Programs Enhancement Act of 2001

   Pub. L. 107–135 § 203(a)(2) · 115 Stat. 2446

   1. Redesignated · 38 U.S.C. § 1706(b)(5)

      Pub. L. 107–135, § 203(a)(2), (b), redesignated par. (2) as (5)

   2. Inserted · 38 U.S.C. § 1706(b)(5)

      Pub. L. 107–135, § 203(a)(2), (b), inserted “(A)” before “Not later than”

   3. Substituted · 38 U.S.C. § 1706(b)(5)

      Pub. L. 107–135, § 203(a)(2), (b), substituted “April 1 of each year through 2004” for “April 1, 1999, April 1, 2000, and April 1, 2001”

   4. Inserted · 38 U.S.C. § 1706(b)(5)

      Pub. L. 107–135, § 203(a)(2), (b), inserted at end of subpar. (A) “Each such report shall include information on recidivism rates associated with substance-use disorder treatment.”

   5. Added · 38 U.S.C. § 1706(b)(5)

      Pub. L. 107–135, § 203(a)(2), (b), added subpars. (B) and (C)

   Source evidence

   Code amendment note
   Subsec. (b)(5). Pub. L. 107–135, § 203(a)(2), (b), redesignated par. (2) as (5), inserted “(A)” before “Not later than”, substituted “April 1 of each year through 2004” for “April 1, 1999, April 1, 2000, and April 1, 2001”, inserted at end of subpar. (A) “Each such report shall include information on recidivism rates associated with substance-use disorder treatment.”, and added subpars. (B) and (C).

   Enacted provision · exact public law section
   (2) by redesignating paragraphs (2) and (3) as paragraphs (5) and (6), respectively; and

9. 2002

   Department of Veterans Affairs Health Care Programs Enhancement Act of 2001

   Pub. L. 107–135 § 203(a)(2) · 115 Stat. 2446

   Redesignated · 38 U.S.C. § 1706(b)(6)

   Pub. L. 107–135, § 203(a)(2), redesignated par. (3) as (6)

   Source evidence

   Code amendment note
   Subsec. (b)(6). Pub. L. 107–135, § 203(a)(2), redesignated par. (3) as (6).

   Enacted provision · exact public law section
   (2) by redesignating paragraphs (2) and (3) as paragraphs (5) and (6), respectively; and

10. 2006

    Veterans Benefits, Health Care, and Information Technology Act of 2006

    Pub. L. 109–461 title II § 208(a) · 120 Stat. 3403

    Substituted · 38 U.S.C. § 1706(b)(5)(A)

    Pub. L. 109–461 substituted “2008” for “2004”

    Source evidence

    Code amendment note
    Subsec. (b)(5)(A). Pub. L. 109–461 substituted “2008” for “2004”.

    Enacted provision · exact public law section
    (a) Management of Health Care.— Section 1706(b)(5)(A) 38 USC 1706. is amended by striking “2004” and inserting “2008”.

11. 2016

    Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2017

    Pub. L. 114–223 div. A title II § 253 · 130 Stat. 857

    Struck · 38 U.S.C. § 1706(b)(5)(A)

    Pub. L. 114–223 struck out “through 2008” after “each year”

    Source evidence

    Code amendment note
    Subsec. (b)(5)(A). Pub. L. 114–223 struck out “through 2008” after “each year”.

    Enacted provision · exact public law section
    Sec. 253. Section 1706(b)(5)(A) of title 38, United States Code, is amended, in the first sentence, by striking “through 2008”.

15 of 15 references resolved to an enrolled provision