Collapse to view only § 8134. General regulations
- § 8131. Definitions
- § 8132. Declaration of purpose
- § 8133. Authorization of appropriations
- § 8134. General regulations
- § 8135. Applications with respect to projects; payments
- § 8136. Recapture provisions
- § 8137. State control of operations
- § 8138. Treatment of certain health facilities as State homes
§ 8131. Definitions
For the purpose of this subchapter—
(1) The veteran population of each State shall be determined on the basis of the latest figures certified by the Department of Commerce.
(2) The term “State” includes each Indian tribe (as defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304)) but does not include any possession of the United States.
(3) The term “construction” means the construction of new domiciliary or nursing home buildings, the expansion, remodeling, or alteration of existing buildings for the provision of domiciliary, nursing home, adult day health, or hospital care in State homes, and the provision of initial equipment for any such buildings.
(4) The term “cost of construction” means the amount found by the Secretary to be necessary for a construction project, including architect fees, but excluding land acquisition costs.
(Added Pub. L. 88–450, § 4(a), Aug. 19, 1964, 78 Stat. 501, § 5031; amended Pub. L. 94–581, title II, § 206(b), Oct. 21, 1976, 90 Stat. 2859; Pub. L. 95–62, § 3(1), (2), July 5, 1977, 91 Stat. 262; Pub. L. 99–576, title II, § 224(d), Oct. 28, 1986, 100 Stat. 3263; renumbered § 8131, Pub. L. 102–40, title IV, § 402(b)(1), May 7, 1991, 105 Stat. 238; Pub. L. 102–83, § 4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 104–262, title III, § 342(b)(1), Oct. 9, 1996, 110 Stat. 3206; Pub. L. 116–315, title III, § 3004(c)(1), Jan. 5, 2021, 134 Stat. 4992.)
§ 8132. Declaration of purpose
The purpose of this subchapter is to assist the States to construct State home facilities (or to acquire facilities to be used as State home facilities) for furnishing domiciliary or nursing home care to veterans, and to expand, remodel, or alter existing buildings for furnishing domiciliary, nursing home, adult day health, or hospital care to veterans in State homes.
(Added Pub. L. 88–450, § 4(a), Aug. 19, 1964, 78 Stat. 501, § 5032; amended Pub. L. 94–581, title II, § 206(b), Oct. 21, 1976, 90 Stat. 2859; Pub. L. 95–62, § 3(3), July 5, 1977, 91 Stat. 262; Pub. L. 98–528, title I, § 105(1), Oct. 19, 1984, 98 Stat. 2689; renumbered § 8132, Pub. L. 102–40, title IV, § 402(b)(1), May 7, 1991, 105 Stat. 238; Pub. L. 104–262, title III, § 342(b)(2), Oct. 9, 1996, 110 Stat. 3206; Pub. L. 116–315, title III, § 3004(c)(2), Jan. 5, 2021, 134 Stat. 4992.)
§ 8133. Authorization of appropriations
(a) There are hereby authorized to be appropriated such sums as are necessary to carry out this subchapter. Sums appropriated pursuant to this section shall be used for making grants to States which have submitted, and have had approved by the Secretary, applications for carrying out the purposes and meeting the requirements of this subchapter.
(b) Sums appropriated pursuant to subsection (a) of this section shall remain available until expended.
(Added Pub. L. 88–450, § 4(a), Aug. 19, 1964, 78 Stat. 501, § 5033; amended Pub. L. 89–311, § 7(a), Oct. 31, 1965, 79 Stat. 1157; Pub. L. 90–432, § 2, July 26, 1968, 82 Stat. 448; Pub. L. 93–82, title IV, § 403(c), Aug. 2, 1973, 87 Stat. 196; Pub. L. 95–62, § 3(4), July 5, 1977, 91 Stat. 262; Pub. L. 96–151, title I, § 101(a), Dec. 20, 1979, 93 Stat. 1092; Pub. L. 97–251, § 8, Sept. 8, 1982, 96 Stat. 716; Pub. L. 99–576, title II, § 224(a), Oct. 28, 1986, 100 Stat. 3262; Pub. L. 101–110, § 1(c), Oct. 6, 1989, 103 Stat. 682; Pub. L. 101–237, title II, § 201(b), Dec. 18, 1989, 103 Stat. 2066; renumbered § 8133, Pub. L. 102–40, title IV, § 402(b)(1), May 7, 1991, 105 Stat. 238; Pub. L. 102–83, § 4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 102–585, title IV, § 402, Nov. 4, 1992, 106 Stat. 4954.)
§ 8134. General regulations
(a)
(1) The Secretary shall prescribe regulations for the purposes of this subchapter.
(2) In those regulations, the Secretary shall prescribe for each State the number of nursing home and domiciliary beds for which assistance under this subchapter may be furnished. Such regulations shall be based on projected demand for such care 10 years after the date of the enactment of the Veterans Millennium Health Care and Benefits Act by veterans who at such time are 65 years of age or older and who reside in that State. In determining such projected demand, the Secretary shall take into account travel distances for veterans and their families.
(3)
(A) In those regulations, the Secretary shall establish criteria under which the Secretary shall determine, with respect to an application for assistance under this subchapter for a project described in subparagraph (B) which is from a State that has a need for additional beds as determined under subsections (a)(2) and (d)(1), whether the need for such beds is most aptly characterized as great, significant, or limited. Such criteria shall take into account the availability of beds already operated by the Secretary and other providers which appropriately serve the needs which the State proposes to meet with its application.
(B) This paragraph applies to a project for the construction or acquisition of a new State home facility, a project to increase the number of beds available at a State home facility, and a project to replace beds at a State home facility.
(4) The Secretary shall review and, as necessary, revise regulations prescribed under paragraphs (2) and (3) not less often than every four years.
(b) The Secretary shall prescribe the following by regulation:
(1) General standards of construction, repair, and equipment for facilities constructed or acquired with assistance received under this subchapter.
(2) General standards for the furnishing of care in facilities which are constructed or acquired with assistance received under this subchapter, which standards shall be no less stringent than those standards prescribed by the Secretary pursuant to
(c) The Secretary may inspect any State facility constructed or acquired with assistance received under this subchapter at such times as the Secretary deems necessary to insure that such facility meets the standards prescribed under subsection (b)(2).
(d)
(1) In prescribing regulations to carry out this subchapter, the Secretary shall provide that in the case of a State that seeks assistance under this subchapter for a project described in subsection (a)(3)(B), the determination of the unmet need for beds for State homes in that State shall be reduced by the number of beds in all previous applications submitted by that State under this subchapter, including beds which have not been recognized by the Secretary under section 1741 of this title.
(2)
(A) Financial assistance under this subchapter for a renovation project may only be provided for a project for which the total cost of construction is in excess of $400,000 (as adjusted from time-to-time in such regulations to reflect changes in costs of construction).
(B) For purposes of this paragraph, a renovation project is a project to remodel or alter existing buildings for which financial assistance under this subchapter may be provided and does not include maintenance and repair work which is the responsibility of the State.
(Added Pub. L. 88–450, § 4(a), Aug. 19, 1964, 78 Stat. 502, § 5034; amended Pub. L. 89–311, § 7(b), Oct. 31, 1965, 79 Stat. 1157; Pub. L. 93–82, title IV, § 403(d), Aug. 2, 1973, 87 Stat. 196; Pub. L. 94–581, title I, § 107(b), title II, § 206(b), Oct. 21, 1976, 90 Stat. 2847, 2859; Pub. L. 95–62, § 3(5), (6), July 5, 1977, 91 Stat. 262; Pub. L. 96–330, title IV, § 404, Aug. 26, 1980, 94 Stat. 1052; Pub. L. 98–528, title I, § 105(2), Oct. 19, 1984, 98 Stat. 2689; renumbered § 8134, Pub. L. 102–40, title IV, § 402(b)(1), May 7, 1991, 105 Stat. 238; Pub. L. 102–54, § 14(f)(6), June 13, 1991, 105 Stat. 288; Pub. L. 102–83, §§ 4(b)(1), (2)(E), 5(c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 106–117, title II, § 207(a), Nov. 30, 1999, 113 Stat. 1564.)
§ 8135. Applications with respect to projects; payments
(a) Any State desiring to receive assistance for a project for construction of State home facilities (or acquisition of a facility to be used as a State home facility) must submit to the Secretary an application. Such application shall set forth the following:
(1) The amount of the grant requested with respect to such project which may not exceed 65 percent of the estimated cost of construction (or of the estimated cost of facility acquisition and construction) of such project.
(2) A description of the site for such project.
(3) Plans and specifications for such project in accordance with regulations prescribed by the Secretary pursuant to section 8134(a)(2) of this title.
(4) Reasonable assurance that upon completion of such project the facilities will be used principally to furnish to veterans the level of care for which such application is made and that not more than 25 percent of the bed occupancy at any one time will consist of patients who are not receiving such level of care as veterans.
(5) Reasonable assurance that title to such site is or will be vested solely in the applicant, a State home, or another agency or instrumentality of the State.
(6) Reasonable assurance that adequate financial support will be available for the construction of the project (or for facility acquisition and construction of the project) by July 1 of the fiscal year for which the application is approved and for its maintenance and operation when complete.
(7) Reasonable assurance that the State will make such reports in such form and containing such information as the Secretary may from time to time reasonably require, and give the Secretary, upon demand, access to the records upon which such information is based.
(8) Reasonable assurance that the rates of pay for laborers and mechanics engaged in construction of the project will be not less than the prevailing local wage rates for similar work as determined in accordance with sections 3141–3144, 3146, and 3147 of title 40.
(9) In the case of a project for acquisition of a facility, reasonable assurance that the estimated total cost of acquisition of the facility and of any expansion, remodeling, and alteration of the acquired facility will not be greater than the estimated cost of construction of an equivalent new facility.
(b)
(1) Any State seeking to receive assistance under this subchapter for a project that would involve construction or acquisition of either nursing home or domiciliary facilities shall include with its application under subsection (a) the following:
(A) Documentation (i) that the site for the project is in reasonable proximity to a sufficient concentration and population of veterans who are 65 years of age and older, and (ii) that there is a reasonable basis to conclude that the facilities when complete will be fully occupied.
(B) A financial plan for the first three years of operation of such facilities.
(C) A five-year capital plan for the State home program for that State.
(2) Failure to provide adequate documentation under paragraph (1)(A) or to provide an adequate financial plan under paragraph (1)(B) shall be a basis for disapproving the application.
(c)
(1) Upon receipt of an application under subsection (a) for financial assistance under this subchapter, the Secretary—
(A) shall determine whether the application meets the requirements of this section and of the regulations prescribed under section 8134 of this title;
(B) shall notify the State submitting the application whether the application conforms with those requirements and, if it does not, of the actions necessary to bring the application into conformance with those requirements; and
(C) shall determine the priority of the project described in the application in accordance with the provisions of this subsection.
(2) Subject to paragraphs (3) and (5)(C) of this subsection, the Secretary shall accord priority to applications in the following order:
(A) An application from a State that has made sufficient funds available for the project for which the grant is requested so that such project may proceed upon approval of the grant without further action required by the State to make such funds available for such purpose.
(B) An application from a State for a project at an existing facility to remedy a condition or conditions that have been cited by an accrediting institution, by the Secretary, or by a local licensing or approving body of the State as being threatening to the lives or safety of the patients in the facility.
(C) An application from a State that has not previously applied for award of a grant under this subchapter for construction or acquisition of a State nursing home.
(D) An application for construction or acquisition of a nursing home or domiciliary from a State that the Secretary determines, in accordance with regulations under this subchapter, has a great need for the beds to be established at such home or facility.
(E) An application from a State for renovations to a State home facility other than renovations described in subparagraph (B).
(F) An application for construction or acquisition of a nursing home or domiciliary from a State that the Secretary determines, in accordance with regulations under this subchapter, has a significant need for the beds to be established at such home or facility.
(G) An application that meets other criteria as the Secretary determines appropriate and has established in regulations.
(H) An application for construction or acquisition of a nursing home or domiciliary from a State that the Secretary determines, in accordance with regulations under this subchapter, has a limited need for the beds to be established at such home or facility.
(3) In according priorities to projects under paragraph (2) of this subsection, the Secretary—
(A) may not accord any priority to a project for the construction or acquisition of a hospital; and
(B) may not accord any priority to a project which would expand a State’s capacity to furnish hospital care in a State home.
(4) The Secretary shall establish a list of approved projects (including projects that have been conditionally approved under paragraph (6) of this subsection), in the order of their priority, as of August 15 of each year. The Secretary shall award grants in the order of their priority on the list during the fiscal year beginning on October 1 of the calendar year in which the list was made.
(5)
(A) The Secretary shall defer approval of an application that otherwise meets the requirements of this section if the State submitting the application does not, by the July 1 deadline (as defined in subparagraph (D) of this paragraph), demonstrate to the satisfaction of the Secretary that the State has provided adequate financial support for construction of the project.
(B) In a case in which approval of an application is deferred under subparagraph (A) of this paragraph, the Secretary shall select for award of a grant or grants under this subsection an application or applications which would not have been approved during the fiscal year but for the deferral and to which the Secretary accords the highest priority under paragraph (2) of this subsection.
(C) An application deferred in accordance with the requirements of this paragraph shall be accorded priority in any subsequent fiscal year ahead of applications that had not been approved before the first day of the fiscal year in which the deferred application was first approved.
(D) For the purposes of this paragraph, the term “July 1 deadline” means July 1 of the fiscal year in which the State is notified by the Secretary of the availability of funding for a grant for such project.
(6)
(A) The Secretary may conditionally approve a project under this section, conditionally award a grant for the project, and obligate funds for the grant if the Secretary determines that the application for the grant is sufficiently complete to warrant awarding the grant and that, based on assurances provided by the State submitting the application, the State will complete the application and meet all the requirements referred to in paragraph (1)(A) of this subsection by the date, not later than 180 days after the date of the conditional approval, specified by the Secretary.
(B) If a State does not complete the application and meet all the requirements referred to in such paragraph by the date specified by the Secretary under subparagraph (A) of this paragraph, the Secretary shall rescind the conditional approval and award under such subparagraph and deobligate the funds previously obligated in connection with the application. In the event the Secretary rescinds conditional approval of a project under this subparagraph, the Secretary may not further obligate funds for the project during the fiscal year in which the Secretary rescinds such approval.
(7)
(A) Subject to subparagraph (B) of this paragraph, the Secretary may increase the amount of any grant awarded to any State for a project under this section by an amount by which the Secretary determines that the estimated cost of the construction or acquisition has increased from the estimated cost on which the Secretary based the determination to award the grant, without regard to the position of such project on the list established under paragraph (4) of this subsection, if the Secretary determines that the grant was awarded before the State entered into a contract for the construction or acquisition provided for in such project.
(B) A grant may not be increased under subparagraph (A) of this paragraph by more than 10 percent of the amount of the grant initially awarded for such project, and the amount of such grant, as increased, may not exceed 65 percent of the cost of the project.
(d) No application submitted to the Secretary under this section shall be disapproved until the Secretary has afforded the applicant notice and an opportunity for a hearing.
(e) The amount of a grant under this subchapter shall be paid to the applicant or, if designated by the applicant, the State home for which such project is being carried out or any other agency or instrumentality of the applicant. Such amount shall be paid, in advance or by way of reimbursement, and in such installments consistent with the progress of the project as the Secretary may determine and certify for payment to the Secretary of the Treasury. Funds paid under this section for an approved project shall be used solely for carrying out such project as so approved.
(f) Any amendment of any application, whether or not approved, shall be subject to approval in the same manner as an original application.
(Added Pub. L. 88–450, § 4(a), Aug. 19, 1964, 78 Stat. 502, § 5035; amended Pub. L. 89–311, § 7(a), Oct. 31, 1965, 79 Stat. 1157; Pub. L. 93–82, title IV, § 403(e), Aug. 2, 1973, 87 Stat. 196; Pub. L. 94–581, title II, §§ 206(b), 210(e)(10), Oct. 21, 1976, 90 Stat. 2859, 2865; Pub. L. 95–62, § 3(7)–(12), July 5, 1977, 91 Stat. 262, 263; Pub. L. 97–295, § 4(92), Oct. 12, 1982, 96 Stat. 1313; Pub. L. 98–528, title I, § 105(3), Oct. 19, 1984, 98 Stat. 2689; Pub. L. 99–166, title II, § 205, Dec. 3, 1985, 99 Stat. 953; Pub. L. 99–576, title II, § 224(b), (c), Oct. 28, 1986, 100 Stat. 3262, 3263; Pub. L. 100–322, title II, § 206, May 20, 1988, 102 Stat. 513; renumbered § 8135 and amended Pub. L. 102–40, title IV, § 402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102–54, § 14(f)(7), June 13, 1991, 105 Stat. 288; Pub. L. 102–83, § 4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 102–585, title IV, §§ 403(a), 404(a), Nov. 4, 1992, 106 Stat. 4954; Pub. L. 103–446, title XII, § 1201(d)(18), Nov. 2, 1994, 108 Stat. 4684; Pub. L. 104–262, title III, § 342(b)(3), Oct. 9, 1996, 110 Stat. 3206; Pub. L. 106–117, title II, § 207(b), Nov. 30, 1999, 113 Stat. 1565; Pub. L. 107–217, § 3(j)(4), Aug. 21, 2002, 116 Stat. 1300.)
§ 8136. Recapture provisions
(a) If, within the 20-year period beginning on the date of the approval by the Secretary of the final architectural and engineering inspection of any project with respect to which a grant has been made under this subchapter (except that the Secretary, pursuant to regulations which the Secretary shall prescribe, may at the time of such grant provide for a shorter period than 20, but not less than seven, years, based on the magnitude of the project and the grant amount involved, in the case of the acquisition, expansion, remodeling, or alteration of existing facilities), the facilities covered by the project cease to be operated by a State, a State home, or an agency or instrumentality of a State principally for furnishing domiciliary, nursing home, or hospital care to veterans, the United States shall be entitled to recover from the State which was the recipient of the grant under this subchapter, or from the then owner of such facilities, 65 percent of the then value of such project (but in no event an amount greater than the amount of assistance provided under this subchapter), as determined by agreement of the parties or by action brought in the district court of the United States for the district in which such facilities are situated.
(b) The establishment and operation by the Secretary of an outpatient clinic in facilities described in subsection (a) shall not constitute grounds entitling the United States to any recovery under that subsection.
(Added Pub. L. 88–450, § 4(a), Aug. 19, 1964, 78 Stat. 503, § 5036; amended Pub. L. 93–82, title IV, § 403(f), Aug. 2, 1973, 87 Stat. 196; Pub. L. 94–581, title II, § 206(b), Oct. 21, 1976, 90 Stat. 2859; Pub. L. 95–62, § 3(13), July 5, 1977, 91 Stat. 263; Pub. L. 97–295, § 4(92), Oct. 12, 1982, 96 Stat. 1313; Pub. L. 98–528, title I, § 105(4), Oct. 19, 1984, 98 Stat. 2690; renumbered § 8136, Pub. L. 102–40, title IV, § 402(b)(1), May 7, 1991, 105 Stat. 238; Pub. L. 102–83, § 4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 102–585, title IV, § 405, Nov. 4, 1992, 106 Stat. 4954; Pub. L. 106–419, title II, § 222, Nov. 1, 2000, 114 Stat. 1845.)
§ 8137. State control of operations
Except as otherwise specifically provided, nothing in this subchapter shall be construed as conferring on any Federal officer or employee the right to exercise any supervision or control over the administration, personnel, maintenance, or operation of any State home for which facilities are constructed or acquired with assistance received under this subchapter.
(Added Pub. L. 88–450, § 4(a), Aug. 19, 1964, 78 Stat. 503, § 5037; amended Pub. L. 98–528, title I, § 105(5), Oct. 19, 1984, 98 Stat. 2690; renumbered § 8137, Pub. L. 102–40, title IV, § 402(b)(1), May 7, 1991, 105 Stat. 238.)
§ 8138. Treatment of certain health facilities as State homes
(a) The Secretary may treat a health facility (or certain beds in a health facility) as a State home for purposes of subchapter V of chapter 17 of this title if the following requirements are met:
(1) The facility (or certain beds in such facility) meets the standards for the provision of nursing home care that are applicable to State homes, as prescribed by the Secretary under section 8134(b) of this title, and such other standards relating to the facility (or certain beds in such facility) as the Secretary may require.
(2) The facility (or certain beds in such facility) is licensed or certified by the appropriate State and local agencies charged with the responsibility of licensing or otherwise regulating or inspecting State home facilities.
(3) The State demonstrates in an application to the Secretary that, but for the treatment of a facility (or certain beds in such facility), as a State home under this subsection, a substantial number of veterans residing in the geographic area in which the facility is located who require nursing home care will not have access to such care.
(4) The Secretary determines that the treatment of the facility (or certain beds in such facility) as a State home best meets the needs of veterans for nursing home care in the geographic area in which the facility is located.
(5) The Secretary approves the application submitted by the State with respect to the facility (or certain beds in such facility).
(b) The Secretary may not treat a health facility (or certain beds in a health facility) as a State home under subsection (a) if the Secretary determines that such treatment would increase the number of beds allocated to the State in excess of the limit on the number of beds provided for by regulations prescribed under section 8134(a) of this title.
(c) The number of beds occupied by veterans in a health facility for which payment may be made under subchapter V of chapter 17 of this title by reason of subsection (a) shall not exceed—
(1) 100 beds in the aggregate for all States; and
(2) in the case of any State, the difference between—
(A) the number of veterans authorized to be in beds in State homes in such State under regulations prescribed under section 8134(a) of this title; and
(B) the number of veterans actually in beds in State homes (other than facilities or certain beds treated as State homes under subsection (a)) in such State under regulations prescribed under such section.
(d) The number of beds in a health facility in a State that has been treated as a State home under subsection (a) shall be taken into account in determining the unmet need for beds for State homes for the State under section 8134(d)(1) of this title.
(e) The Secretary may not treat any new health facilities (or any new certain beds in a health facility) as a State home under subsection (a) after September 30, 2009.
(Added Pub. L. 109–461, title II, § 211(c)(1), Dec. 22, 2006, 120 Stat. 3420.)