Fed Regist. 1996 Nov 5;61(215):56897.
This document amends 38 CFR part 17 by adopting as a final rule the proposal to modify eligibility criteria for veterans participating by contract in the Department of Veterans Affairs' programs of alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities. Previous regulations stipulated that, prior to participation in contract care under this programs, veterans were to be provided hospital care in facilities over which the Secretary has direct jurisdiction. It was proposed to change the regulations to stipulate that, prior to participation in contract care, veterans must have been or must be receiving care (regardless of whether it was or is hospital care) by professional staff over whom the Secretary has jurisdiction (regardless of whether it is direct jurisdiction). The elimination of the requirement of "hospital care" is necessary to address changed clinical practices and continue the intended program. In the past, substance abuse treatment generally was provided in a hospital setting. Now, much substance abuse treatment also is provided in an ambulatory care or residential setting. Further, this document changes "direct jurisdiction of the Secretary" to "jurisdiction of the Secretary" to allow for continuation of any cases in which the VA has had involvement (including, among other things, fee basic care) and thereby help ensure that a complete course of treatment is provided.
本文件通过将一项提案作为最终规则,对《联邦法规汇编》第38编第17部分进行修订。该提案旨在修改退伍军人通过合同参与退伍军人事务部在住院和非住院设施中开展的酒精和药物依赖或滥用治疗与康复项目的资格标准。先前的规定要求,在参与该项目的合同制护理之前,退伍军人须在部长拥有直接管辖权的设施中接受医院护理。现提议修改规定,要求在参与合同制护理之前,退伍军人必须已经或正在接受部长拥有管辖权的专业人员的护理(无论过去或现在是否为医院护理)(无论是否为直接管辖权)。取消“医院护理”的要求对于应对临床实践的变化并继续实施预期项目是必要的。过去,药物滥用治疗通常在医院环境中提供。现在,许多药物滥用治疗也在门诊护理或住院环境中提供。此外,本文件将“部长的直接管辖权”改为“部长的管辖权”,以便继续处理退伍军人事务部曾参与的任何病例(包括但不限于费用基本护理),从而有助于确保提供完整的治疗过程。