Title 38 — Veterans’ Benefits
Part II · Chapter 17 — Hospital, Nursing Home, Domiciliary, and Medical Care
§ 1720C. Noninstitutional alternatives to nursing home care
Statutory text
The Secretary may furnish medical, rehabilitative, and health-related services in noninstitutional settings for veterans who are eligible under this chapter for, and are in need of, nursing home care. The Secretary shall give priority for participation in such program to veterans who—
are in receipt of, or are in need of, nursing home care primarily for the treatment of a service-connected disability; or
have a service-connected disability rated at 50 percent or more.
Under the program conducted pursuant to subsection (a), the Secretary shall (A) furnish appropriate health-related services solely through contracts with appropriate public and private agencies that provide such services, and (B) designate Department health-care employees to furnish case management services to veteran furnished services under the program.
For the purposes of paragraph (1), the term “case management services” includes the coordination and facilitation of all services furnished to a veteran by the Department of Veterans Affairs, either directly or through contract, including assessment of needs, planning, referral (including referral for services to be furnished by the Department, either directly or through a contract, or by an entity other than the Department), monitoring, reassessment, and followup.
The Secretary may provide in-kind assistance (through the services of Department of Veterans Affairs employees and the sharing of other Department resources) to a facility furnishing services to veterans under subsection (b)(1)(A). Any such in-kind assistance shall be provided under a contract between the Department and the facility concerned. The Secretary may provide such assistance only for use solely in the furnishing of appropriate services under this section and only if, under such contract, the Department receives reimbursement for the full cost of such assistance (including the cost of services and supplies and normal depreciation and amortization of equipment). Such reimbursement may be made by reduction in the charges to the United States or by payment to the United States. Any funds received through such reimbursement shall be credited to funds allotted to the Department facility that provided the assistance.
Except as provided in paragraph (2), the total cost of providing services or in-kind assistance in the case of any veteran for any fiscal year under the program may not exceed 100 percent of the cost that would have been incurred by the Department during that fiscal year if the veteran had been furnished, instead, nursing home care under section 1710 of this title during that fiscal year.
The total cost of providing services or in-kind assistance in the case of any veteran described in subparagraph (B) for any fiscal year under the program may exceed 100 percent of the cost that would otherwise have been incurred as specified in paragraph (1) if the Secretary determines, based on a consideration of clinical need, geographic market factors, and such other matters as the Secretary may prescribe through regulation, that such higher total cost is in the best interest of the veteran.
A veteran described in this subparagraph is a veteran with amyotrophic lateral sclerosis, a spinal cord injury, or a condition the Secretary determines to be similar to such conditions.
The authority of the Secretary to enter into contracts under this section shall be effective for any fiscal year only to the extent that appropriations are available.
In furnishing services to a veteran under the program conducted pursuant to subsection (a), if a medical center of the Department through which such program is administered is located in a geographic area in which services are available to the veteran under a PACE program (as such term is defined in sections 1894(a)(2) and 1934(a)(2) of the Social Security Act (42 U.S.C. 1395eee(a)(2); 1396u–4(a)(2))), the Secretary shall seek to enter into an agreement with the PACE program operating in that area for the furnishing of such services.
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.
Department of Veterans Affairs Nurse Pay Act of 1990
Pub. L. 101–366 title II § 201(a)(1) · 104 Stat. 430
Enacted · 38 U.S.C. § 1720C
Added Pub. L. 101–366, title II, § 201(a)(1), Aug. 15, 1990, 104 Stat. 437, § 620C
Source evidence
Code source credit
Added Pub. L. 101–366, title II, § 201(a)(1), Aug. 15, 1990, 104 Stat. 437, § 620CEnacted provision · exact public law section
(1) Subchapter II of chapter 17 of title 38, United States Code, is amended by adding at the end the following new section: “§ 620C. Noninstitutional alternatives to nursing home care: pilot program “(a) During the four-year period beginning on October 1, 1990, the Secretary may conduct a pilot program for the furnishing of medical, rehabilitative, and health-related services in noninstitutional settings for veterans who are eligible under this chapter for, and are in need of, nursing home care and who— “(1) are in receipt of, or are in need of, nursing home care primarily for the treatment of a service-connected disability; or “(2) have a service-connected disability rated at 50 percent or more. “(b) (1) Under the pilot program conducted pursuant to subsection (a), the Secretary shall (A) furnish appropriate health-related services solely through contracts with appropriate public and private agencies that provide such services, and (B) designate Department health-care employees to furnish case management services to veteran furnished services under the program. “(2) For the purposes of paragraph (1), the term ‘case management services’ includes the coordination and facilitation of all services furnished to a veteran by the Department of Veterans Affairs, either directly or through contract, including assessment of needs, planning, referral (including referral for services to be furnished by the Department, either directly or through a contract, or by an entity other than the Department), monitoring, reassessment, and followup. “(c) The Secretary may provide in-kind assistance (through the services of Department of Veterans Affairs employees and the sharing of other Department resources) to a facility furnishing services to veterans under subsection (b)(1)(A). Any such in-kind assistance shall be provided under a contract between the Department and the facility concerned. The Secretary may provide such assistance only for use solely in the furnishing of appropriate services under this section and only if, under such contract, the Department receives reimbursement for the full cost of such assistance (including the cost of services and supplies and normal depreciation and amortization of equipment). Such reimbursement may be made by reduction in the charges to the United States or by payment to the United States. Any funds received through such reimbursement shall be credited to funds allotted to the Department facility that provided the assistance. “(d) The total cost of providing services or in-kind assistance in the case of any veteran for any fiscal year under the pilot program may not exceed 65 percent of the cost that would have been incurred by the Department during that fiscal year if the veteran had been furnished, instead, nursing home care under section 610 of this title during that fiscal year. “(e) The authority of the Secretary to enter into contracts under this section shall be effective for any fiscal year only to the extent that appropriations are available.”.Pub. L. 102–83 § 5(a) · 105 Stat. 378
Changed · 38 U.S.C. § 1720C
Pub. L. 102–83, § 5(a), renumbered section 620C of this title as this section
Source evidence
Code amendment note
Pub. L. 102–83, § 5(a), renumbered section 620C of this title as this section.Enacted provision · exact public law section
(a) Redesignation of Sections to Conform to Chapter Numbers.— Each section contained in any of chapters 11 through 23 is redesignated by replacing the first digit of the section number with the number of the chapter containing that section. Each section contained in any of chapters 24 through 42 is redesignated so that the first two digits of the section number of that section are the same as the chapter number of the chapter containing that section.Pub. L. 102–83 § 5(c)(1) · 105 Stat. 378
Substituted · 38 U.S.C. § 1720C(d)
Pub. L. 102–83, § 5(c)(1), substituted “1710” for “610”
Source evidence
Code amendment note
Subsec. (d). Pub. L. 102–83, § 5(c)(1), substituted “1710” for “610”.Enacted provision · exact public law section
(1) Each provision of title 38, United States Code, that contains a reference to a section redesignated by subsection (a) is amended so that the reference refers to the section as redesignated.Veterans Health Programs Extension Act of 1994
Pub. L. 103–452 title I § 103(c) · 108 Stat. 4783
Substituted · 38 U.S.C. § 1720C(a)
Pub. L. 103–452, in introductory provisions, substituted “During the period through September 30, 1995,” for “During the four-year period beginning on October 1, 1990,”
Substituted · 38 U.S.C. § 1720C(a)
Pub. L. 103–452, in introductory provisions, substituted “care. The Secretary shall give priority for participation in such program to veterans who” for “care and who”
Source evidence
Code amendment note
Subsec. (a). Pub. L. 103–452, in introductory provisions, substituted “During the period through September 30, 1995,” for “During the four-year period beginning on October 1, 1990,” and “care. The Secretary shall give priority for participation in such program to veterans who” for “care and who”.Enacted provision · exact public law section
(c) Pilot Program for Noninstitutional Alternatives to Nursing Home Care.— (1) Effective as of October 1, 1994, subsection (a) of section 1720C is amended by striking out “During the four-year period beginning on October 1, 1990,” and inserting in lieu thereof “During the period through September 30, 1995,”. (2) Such subsection is further amended by striking out “care and who—” and inserting in lieu thereof “care. The Secretary shall give priority for participation in such program to veterans who—”.Pub. L. 104–110 title I § 101(c) · 110 Stat. 768
Substituted · 38 U.S.C. § 1720C(a)
Pub. L. 104–110 substituted “December 31, 1997” for “September 30, 1995” in introductory provisions
Source evidence
Code amendment note
Subsec. (a). Pub. L. 104–110 substituted “December 31, 1997” for “September 30, 1995” in introductory provisions.Enacted provision · exact public law section
(c) Pilot Program for Noninstitutional Alternatives to Nursing Home Care.— Section 1720C(a) of such title is amended by striking out “September 30, 1995,” and inserting in lieu thereof “December 31, 1997,”.Pub. L. 105–114 § 206(b)(2) · 111 Stat. 2277
Struck · 38 U.S.C. § 1720C
Pub. L. 105–114, § 206(b)(2), struck out “: pilot program” after “home care” in section catchline
Source evidence
Code amendment note
Pub. L. 105–114, § 206(b)(2), struck out “: pilot program” after “home care” in section catchline.Enacted provision · exact public law section
(2) The heading for such section is amended to read as follows: “§ 1720C. Noninstitutional alternatives to nursing home care”.Pub. L. 105–114 § 206(a) · 111 Stat. 2277
Substituted · 38 U.S.C. § 1720C(a)
Pub. L. 105–114, § 206(a), substituted “The Secretary may furnish” for “During the period through December 31, 1997, the Secretary may conduct a pilot program for the furnishing of”
Source evidence
Code amendment note
Subsec. (a). Pub. L. 105–114, § 206(a), substituted “The Secretary may furnish” for “During the period through December 31, 1997, the Secretary may conduct a pilot program for the furnishing of”.Enacted provision · exact public law section
(a) Permanent Authority.— Subsection (a) of section 1720C is amended by striking out “During” and all that follows through “furnishing of” and inserting in lieu thereof “The Secretary may furnish”.Pub. L. 105–114 § 206(b)(1) · 111 Stat. 2277
Substituted · 38 U.S.C. § 1720C(b)(1)
Pub. L. 105–114, § 206(b)(1), substituted “Under the program” for “Under the pilot program”
Source evidence
Code amendment note
Subsec. (b)(1). Pub. L. 105–114, § 206(b)(1), substituted “Under the program” for “Under the pilot program”.Enacted provision · exact public law section
(1) Subsections (b)(1) and (d) of such section are amended by striking out “pilot”.Pub. L. 105–114 § 206(b)(1) · 111 Stat. 2277
Substituted · 38 U.S.C. § 1720C(d)
Pub. L. 105–114, § 206(b)(1), substituted “under the program” for “under the pilot program”
Source evidence
Code amendment note
Subsec. (d). Pub. L. 105–114, § 206(b)(1), substituted “under the program” for “under the pilot program”.Enacted provision · exact public law section
(1) Subsections (b)(1) and (d) of such section are amended by striking out “pilot”.Pub. L. 118–210 § 120(a) · 138 Stat. 2723
Amended · 38 U.S.C. § 1720C(d)
Pub. L. 118–210, § 120(a), designated existing provisions as par. (1)
Substituted · 38 U.S.C. § 1720C(d)
Pub. L. 118–210, § 120(a), substituted “Except as provided in paragraph (2), the total cost” for “The total cost”
Substituted · 38 U.S.C. § 1720C(d)
Pub. L. 118–210, § 120(a), substituted “100 percent” for “65 percent”
Added · 38 U.S.C. § 1720C(d)
Pub. L. 118–210, § 120(a), added par. (2)
Unresolved: Pub. L. 118–210 was not found in the local Statutes at Large index.
Source evidence
Code amendment note
Subsec. (d). Pub. L. 118–210, § 120(a), designated existing provisions as par. (1), substituted “Except as provided in paragraph (2), the total cost” for “The total cost” and “100 percent” for “65 percent”, and added par. (2).Effective date note
Pub. L. 118–210, title I, § 120(b), Jan. 2, 2025, 138 Stat. 2724, provided that: “The amendments made by subsection (a) [amending this section] shall apply with respect to fiscal years beginning on or after the date of the enactment of this Act [Jan. 2, 2025].”Pub. L. 118–210 § 121 · 138 Stat. 2723
Added · 38 U.S.C. § 1720C(f)
Pub. L. 118–210, § 121, added subsec. (f)
Unresolved: Pub. L. 118–210 was not found in the local Statutes at Large index.
Source evidence
Code amendment note
Subsec. (f). Pub. L. 118–210, § 121, added subsec. (f).Effective date note
Pub. L. 118–210, title I, § 120(b), Jan. 2, 2025, 138 Stat. 2724, provided that: “The amendments made by subsection (a) [amending this section] shall apply with respect to fiscal years beginning on or after the date of the enactment of this Act [Jan. 2, 2025].”
10 of 15 references resolved to an enrolled provision · 5 unresolved
Editorial Notes
Amendments1991–2025 · 5 rounds
2025
Subsec. (d). Pub. L. 118–210, § 120(a), designated existing provisions as par. (1), substituted “Except as provided in paragraph (2), the total cost” for “The total cost” and “100 percent” for “65 percent”, and added par. (2).
Subsec. (f). Pub. L. 118–210, § 121, added subsec. (f).
1997
Pub. L. 105–114, § 206(b)(2), struck out “: pilot program” after “home care” in section catchline.
Subsec. (a). Pub. L. 105–114, § 206(a), substituted “The Secretary may furnish” for “During the period through , the Secretary may conduct a pilot program for the furnishing of”.
Subsec. (b)(1). Pub. L. 105–114, § 206(b)(1), substituted “Under the program” for “Under the pilot program”.
Subsec. (d). Pub. L. 105–114, § 206(b)(1), substituted “under the program” for “under the pilot program”.
1996
Subsec. (a). Pub. L. 104–110 substituted “” for “” in introductory provisions.
1994
Subsec. (a). Pub. L. 103–452, in introductory provisions, substituted “During the period through ,” for “During the four-year period beginning on ,” and “care. The Secretary shall give priority for participation in such program to veterans who” for “care and who”.
1991
Pub. L. 102–83, § 5(a), renumbered section 620C of this title as this section.
Subsec. (d). Pub. L. 102–83, § 5(c)(1), substituted “1710” for “610”.
Statutory Notes and Related Subsidiaries
Effective Date of 2025 Amendment
Pub. L. 118–210, title I, § 120(b), , 138 Stat. 2724, provided that: “The amendments made by subsection (a) [amending this section] shall apply with respect to fiscal years beginning on or after the date of the enactment of this Act [].”
Effective Date of 1994 Amendment
Pub. L. 103–452, title I, § 103(c)(1), , 108 Stat. 4786, provided that the amendment made by that section is effective .
Ratification of Actions During Period of Expired Authority
Any action taken by Secretary of Veterans Affairs before , 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 , considered to have same force and effect as if such amendment had been in effect at time of that action, see section 103 of Pub. L. 104–110, set out as a note under section 1710 of this title.
Report to Congressional Committees
Pub. L. 101–366, title II, § 201(b), , 104 Stat. 438, as amended by Pub. L. 102–83, § 5(c)(2), , 105 Stat. 406; Pub. L. 103–452, title I, § 103(g), , 108 Stat. 4787, required the Secretary of Veterans Affairs, not later than , to submit to Congress a report setting forth the Secretary’s evaluation, findings, and conclusions regarding the conduct, through , of the pilot program required by this section and the results of the furnishing of care under the pilot program for the participating veterans.
Credits
1990–2025 · 6 acts
- 1990Added Pub. L. 101–366, title II, § 201(a)(1), , 104 Stat. 437, § 620C
- 1991renumbered § 1720C and amended Pub. L. 102–83, § 5(a), (c)(1), , 105 Stat. 406
- 1994Pub. L. 103–452, title I, § 103(c), , 108 Stat. 4786
- 1996Pub. L. 104–110, title I, § 101(c), , 110 Stat. 768
- 1997Pub. L. 105–114, title II, § 206(a)–(b)(2), , 111 Stat. 2289
- 2025Pub. L. 118–210, title I, §§ 120(a), 121, , 138 Stat. 2723, 2724.
Show as published
(Added Pub. L. 101–366, title II, § 201(a)(1), , 104 Stat. 437, § 620C; renumbered § 1720C and amended Pub. L. 102–83, § 5(a), (c)(1), , 105 Stat. 406; Pub. L. 103–452, title I, § 103(c), , 108 Stat. 4786; Pub. L. 104–110, title I, § 101(c), , 110 Stat. 768; Pub. L. 105–114, title II, § 206(a)–(b)(2), , 111 Stat. 2289; Pub. L. 118–210, title I, §§ 120(a), 121, , 138 Stat. 2723, 2724.)