II 

109TH CONGRESS 

2D SESSION S. 2762 

To amend title 38, United States Code, to ensure appropriate payment for 

the cost of long-term care provided to veterans in State homes, and 

for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 8, 2006 

Mr. AKAKA introduced the following bill; which was read twice and referred 

to the Committee on Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to ensure appropriate 

payment for the cost of long-term care provided to veterans in State homes, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Veterans Long-Term 

5 Care Security Act of 2006’’. 


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1 SEC. 2. REQUIREMENT FOR REPORT TO CONGRESS BE2 FORE IMPLEMENTATION OF REDUCTION IN 

3 PER DIEM RATES FOR CARE PROVIDED TO 

4 VETERANS IN STATE HOMES. 

5 (a) REQUIREMENT FOR REPORT.—Subsection (c) of 

6 section 1741 of title 38, United States Code, is amended— 

7 (1) by inserting ‘‘(1)’’ after ‘‘(c)’’; and 

8 (2) by adding at the end the following new 

9 paragraph: 

10 ‘‘(2)(A) If the Secretary proposes to implement a re11 duction in payments made under this section with respect 

12 to a fiscal year the Secretary shall, not later than January 

13 1 of the preceding fiscal year, submit to the Committee 

14 on Veterans’ Affairs of the Senate and the Committee on 

15 Veterans’ Affairs of the House of Representatives a report 

16 containing a detailed justification of such proposed reduc17 tion. 

18 ‘‘(B) For purposes of this paragraph, a reduction in 

19 payments is— 

20 ‘‘(i) a lack of increase in the rates paid under 

21 subsection (a) pursuant to a determination of the 

22 Secretary under paragraph (1); or 

23 ‘‘(ii) a modification of the eligibility for vet24 erans to receive care in State homes that would, if 

25 enacted into law, result in fewer veterans eligible to 

26 receive such care in State homes. 


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1 ‘‘(C) In preparing a report under subparagraph (A), 

2 the Secretary shall consult with the heads and appropriate 

3 officials of the State and local agencies responsible for the 

4 supervision of State homes in each State in which State 

5 homes are operated, and representatives of such other or6 ganizations with expertise in State home matters as the 

7 Secretary determines appropriate. 

8 ‘‘(D) A report under subparagraph (A) shall include 

9 the following information: 

10 ‘‘(i) A specific description of the degree to 

11 which the proposed reduction in payments would ef12 fect the financial well-being of each State home. 

13 ‘‘(ii) A detailed description of the consultation 

14 with heads, officials, and representatives required 

15 under subparagraph (C), and the results of that con16 sultation. 

17 ‘‘(iii) A description of the intent of the Sec18 retary to recover grant amounts under section 

19 8136(a) of this title where a State determines, as a 

20 result of the proposed reduction in payments, to 

21 close a State home within the period prescribed 

22 under that section. 

23 ‘‘(iv) A description of the effect of the proposed 

24 reduction in payments on the long-term care needs 

25 of veterans who receive care in State homes, includVerDate Aug 31 2005 04:11 May 09, 2006 Jkt 049200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2762.IS S2762

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1 ing a description of the options for long-term care 

2 in reasonably proximate facilities available to such 

3 veterans and an assessment of the cost of the provi4 sion of care for such veterans in such facilities.’’. 

5 (b) EFFECTIVE DATE.—The amendment made by 

6 subsection (a) shall take effect on the date of enactment 

7 of this Act, and apply with respect to per diem payments 

8 made under section 1741 of title 38, United States Code, 

9 on or after such date. 

10 SEC. 3. NURSING HOME CARE AND PRESCRIPTION MEDICA11 TIONS IN STATE HOMES FOR VETERANS WITH 

12 SERVICE-CONNECTED DISABILITIES. 

13 (a) NURSING HOME CARE.—Subchapter V of chapter 

14 17 of title 38, United States Code, is amended by adding 

15 at the end the following new section: 

16 ‘‘§ 1744. Nursing home care and medications for vet17 erans with service-connected disabilities 

18 ‘‘(a)(1) The Secretary shall pay each State home for 

19 nursing home care at the applicable rate payable under 

20 section 1720 of this title for nursing home care furnished 

21 in a non-Department nursing home (as that term is de22 fined in subsection (e)(2) of such section), where such care 

23 is provided to any veteran as follows: 

24 ‘‘(A) Any veteran in need of such care for a 

25 service-connected disability. 


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1 ‘‘(B) Any veteran who— 

2 ‘‘(i) has a service-connected disability rated 

3 at 70 percent or more; and 

4 ‘‘(ii) is in need of such care. 

5 ‘‘(2) Payment by the Secretary under paragraph (1) 

6 to a State home for nursing home care provided to a vet7 eran described in that paragraph constitutes payment in 

8 full to the State home for such care furnished to that vet9 eran.’’. 

10 (b) PROVISION OF PRESCRIPTION MEDICINES.— 

11 Such section is further amended by adding at the end the 

12 following new subsection: 

13 ‘‘(b) The Secretary shall furnish such drugs and 

14 medicines as may be ordered on prescription of a duly li15 censed physician as specific therapy in the treatment of 

16 illness or injury to any veteran as follows: 

17 ‘‘(1) Any veteran in need of such drugs and 

18 medicines for a service-connected disability. 

19 ‘‘(2) Any veteran who— 

20 ‘‘(A) has a service-connected disability 

21 rated at 50 percent or more; 

22 ‘‘(B) is provided nursing home care that is 

23 payable under subsection (a); and 

24 ‘‘(C) is in need of such drugs and medi25 cines.’’. 


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1 (c) CONFORMING AMENDMENTS.— 

2 (1) CRITERIA FOR PAYMENT.—Section 

3 1741(a)(1) of such title is amended by striking 

4 ‘‘The’’ and inserting ‘‘Except as provided in section 

5 1744 of this title, the’’. 

6 (2) ELIGIBILITY FOR NURSING HOME CARE.— 

7 Section 1710(a)(4) of such title is amended— 

8 (A) by striking ‘‘and’’ before ‘‘the require9 ment in section 1710B of this title’’; and 

10 (B) by inserting ‘‘, and the requirement in 

11 section 1744 of this title to provide nursing 

12 home care and prescription medicines to vet13 erans with service-connected disabilities in State 

14 homes’’ after ‘‘a program of extended care serv15 ices’’. 

16 (d) CLERICAL AMENDMENT.—The table of sections 

17 at the beginning of chapter 17 of such title is amended 

18 by inserting after the item relating to section 1743 the 

19 following new item: 

‘‘1744. Nursing home care and medications for veterans with service-connected 

disabilities.’’. 

20 (e) EFFECTIVE DATE.—The amendment made by 

21 this section shall take effect on October 1, 2006. 


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1 SEC. 4. AUTHORITY TO TREAT CERTAIN HEALTH FACILI2 TIES AS STATE HOMES. 

3 (a) AUTHORITY.—Subchapter III of chapter 81 of 

4 title 38, United States Code, is amended by adding at the 

5 end the following new section: 

6 ‘‘§ 8138. Treatment of certain health facilities as State 

7 homes 

8 ‘‘(a) The Secretary may treat a health facility as a 

9 State home for purposes of subchapter V of chapter 17 

10 of this title if the following requirements are met: 

11 ‘‘(1) The facility meets the standards for the 

12 provision of nursing home care that is applicable to 

13 State homes, as prescribed by the Secretary under 

14 section 8134(b) of this title, and such other stand15 ards relating to the facility as the Secretary may re16 quire. 

17 ‘‘(2) The facility is licensed or certified by the 

18 appropriate State and local agencies charged with 

19 the responsibility of licensing or otherwise regulating 

20 or inspecting State home facilities. 

21 ‘‘(3) The State demonstrates in an application 

22 to the Secretary that, but for the treatment of a fa23 cility as a State home under this subsection, a sub24 stantial number of veterans residing in the geo25 graphic area in which the facility is located who reVerDate Aug 31 2005 04:11 May 09, 2006 Jkt 049200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2762.IS S2762

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1 quire nursing home care will not have access to such 

2 care. 

3 ‘‘(4) The Secretary determines that the treat4 ment of the facility as a State home best meets the 

5 needs of veterans for nursing home care in the geo6 graphic area in which the facility is located. 

7 ‘‘(5) The Secretary approves the application 

8 submitted by the State with respect to the facility. 

9 ‘‘(b) The Secretary may not treat a health facility as 

10 a State home under subsection (a) if the Secretary deter11 mines that such treatment would increase the number of 

12 beds allocated to the State in excess of the limit on the 

13 number of beds provided for by regulations prescribed 

14 under section 8134(a) of this title. 

15 ‘‘(c) The number of beds occupied by veterans in a 

16 health facility for which payment may be made under sub17 chapter V of chapter 17 of this title by reason of sub18 section (a) shall not exceed the number of veterans in beds 

19 in State homes that otherwise would be permitted in the 

20 State under regulations prescribed under section 8134(a) 

21 of this title. 

22 ‘‘(d) The number of beds in a health facility in a 

23 State that has been treated as a State home under sub24 section (a) shall be taken into account in determining the 


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1 unmet need for beds for State homes for the State under 

2 section 8134(d)(1) of this title.’’. 

3 (b) CLERICAL AMENDMENT.—The table of sections 

4 at the beginning of chapter 81 of such title is amended 

5 by inserting after the item relating to section 8137 the 

6 following new item: 

‘‘8138. Treatment of certain health facilities as State homes.’’. 

Æ 


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