29–010 

Calendar No. 186 

113TH CONGRESS REPORT " ! SENATE 1st Session 113–107 

CAREGIVERS EXPANSION AND IMPROVEMENT 

ACT OF 2013 

SEPTEMBER 17, 2013.—Ordered to be printed 

Mr. SANDERS, from the Committee on Veterans’ Affairs, 

submitted the following 

R E P O R T 

together with 

MINORITY VIEWS 

[To accompany S. 851] 

The Committee on Veterans’ Affairs (hereinafter, ‘‘the Committee’’), to which was referred the bill (S. 851), to extend to all 

veterans with a serious service-connected injury eligibility to participate in the family caregiver services program, having considered 

the same, reports favorably thereon without amendment, and recommends that the bill do pass. 

INTRODUCTION

On April 25, 2013, Chairman Sanders introduced S. 851, the proposed ‘‘Caregivers Expansion and Improvement Act of 2013.’’ S. 851 

would expand a national program for the caregivers of seriously injured veterans to provide them with a tax-free monthly stipend, reimbursement for travel expenses, health insurance, mental health 

services, counseling, training, and respite care. 

COMMITTEE HEARING

On May 9, 2013, the Committee held a hearing on pending 

health care legislation, which included discussion of S. 851. Testimony on S. 851 was offered by: Robert L. Jesse, MD, PhD, Principal Deputy Under Secretary for Health, Department of Veterans 

Affairs; Rick Weidman, Executive Director for Policy and GovernVerDate Mar 15 2010 05:56 Sep 19, 2013 Jkt 029010 PO 00000 Frm 00001 Fmt 6659 Sfmt 6602 E:\HR\OC\SR107.XXX SR107

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ment Affairs, Vietnam Veterans of America; and Heather Ansley, 

Esq., MSW, Vice President for Veterans Policy, VetsFirst. 

COMMITTEE MEETING

After carefully reviewing the testimony from the foregoing hearing, the Committee met in open session on July 24, 2013, to consider, among other legislation, S. 851. The Committee voted, by 

voice vote, to report favorably S. 851 to the Senate. 

SUMMARY OF S. 851 AS REPORTED

S. 851 (hereinafter, ‘‘the Committee bill’’) would expand the program of support for caregivers of seriously injured veterans to caregivers of veterans of all eras. 

BACKGROUND AND DISCUSSION

In 2006, then-Ranking Member Daniel K. Akaka introduced S. 

2753, to improve caregiver assistance services for veterans. During 

the May 11, 2006, hearing on this legislation, Senator Akaka stated, ‘‘Ensuring caregivers have the support and tools they need to 

care for their family members makes economic sense, and more importantly, makes policy sense.’’ Senator Akaka’s bill was included 

as part of legislation Congress passed and the President signed 

into law—Public Law (hereinafter, ‘‘P.L.’’) 109–461, the ‘‘Veterans 

Benefits, Health Care, and Information Technology Act of 2006.’’ 

The law authorized $5 million for each of the fiscal years 2007 and 

2008 for the Department of Veterans Affairs (hereinafter, ‘‘VA’’) to 

carry out pilot caregiver assistance programs. VA began 8 caregiver 

assistance pilot programs in October 2007. 

The pilot programs provided a number of lessons learned, including the need for a multi-modality approach, effective communication, and caregiver education and support. According to the report 

from VA to Congress required by P.L. 109–461, ‘‘[r]espite is a key 

component of programs that reduced caregiver stress and burden.’’ 

The report also states many ‘‘elements of the caregiver pilots can 

easily serve rural and difficult to access populations,’’ citing that 

‘‘caregiver education, training, and support services do not require 

face-to-face contact’’ but can be provided through ‘‘[w]eb based 

training and resource information, telephone support groups, and 

telehealth equipment.’’ Overall, the pilots were found to ‘‘result in 

a healthier caregiver, improved care for the veteran and a better 

quality of life for both.’’ 

In 2008, a 1-year extension of authority for these pilot programs 

was approved in P.L. 110–387, the ‘‘Veterans’ Mental Health and 

Other Care Improvements Act of 2008.’’ Additionally, the Senate 

approved S. 1963, the ‘‘Caregivers and Veterans Omnibus Health 

Services Act of 2009.’’ At the time S. 1963 was debated on the Senate floor, then-Chairman Akaka addressed those Senators concerned about the cost of the legislation, stating that ‘‘we cannot renege on the obligation to care for those who honorably serve our 

country. When we as a nation vote to send American troops to war, 

we are promising to care for them when they return. The cost of 

health care is a true cost of war and must be treated as such.’’ He 

went on to say, ‘‘To assert that this legislation requires excessive 

spending is simply wrong. This spending is critical when taking 


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1Tanielian, Terri, Rajeev Ramchand, Michael P. Fisher, Carra S. Sims, Racine Harris, and 

Margaret C. Harrell. Military Caregivers: Cornerstones of Support for Our Nation’s Wounded, 

Ill, and Injured Veterans. RAND Corporation, 2013. 

into account the sacrifices these men and women have made for the 

nation.’’ 

S. 1963 later became P.L. 111–163, the Caregivers and Veterans 

Omnibus Health Services Act of 2010 (hereinafter, ‘‘the Caregivers 

law’’), on May 5, 2010. The law reduced the burden faced by family 

caregivers of post-9/11 veterans by providing them with a tax-free 

monthly stipend, reimbursement for travel expenses, health insurance, mental health services and counseling, training, and respite 

care. Since its inception through July 2013, the law has helped 

more than 10,600 veteran caregivers and their families. 

The passage of the Caregivers law served as an important step 

in ensuring the caregivers of our newest generation of veterans received the resources necessary to provide the best possible care for 

their loved ones. However, these benefits and services were not 

made available to all veterans. Limiting eligibility for the program 

to caregivers of post-9/11 veterans created an inequity between 

caregivers of the newest generation of veterans and the tens of 

thousands of hardworking, dedicated caregivers who provide care 

to all other veterans. In September 2013, VA submitted to Congress the Expansion of Family Caregiver Assistance Report, as required by the Caregivers law. In this report, VA stated: 

Expansion of the Program of Comprehensive Assistance for 

Family Caregivers would remedy the inequity created by 

the current statutory requirements, and would further recognize the sacrifice of our Veterans from all eras and the 

needs of their family caregivers. VA believes, apart from 

resource issues that are discussed below, such an expansion is operationally feasible. 

The Congressional Budget Office estimates that approximately 

70,000 caregivers of pre-9/11 veterans could be eligible for the expanded program. 

The caregivers of veterans from other eras have spent years, 

sometimes decades, caring for severely injured veterans. While 

data related to the loss of income for veteran caregivers is limited, 

studies highlighted by the Military Caregivers report published by 

RAND in 2013 indicated approximately two-thirds of caregivers 

with jobs reported missing work.1 The other third are said to have 

reduced their hours due to their caregiving responsibilities. These 

caregivers deserve the same access to resources and services provided to caregivers of the veterans from our country’s most recent 

conflicts. 

Paralyzed Veterans of America submitted a statement for the 

record for the May 9, 2013, hearing on pending health legislation 

noting: 

No reasonable justification (other than cost considerations) 

can be provided for why pre-9/11 veterans with a serviceconnected injury or illness should be excluded from the 

comprehensive caregiver program. Catastrophically disabled veterans needs are not different simply because they 

may have been injured prior to the selected date. 


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At the same hearing, Rick Weidman of Vietnam Veterans of 

America observed: 

Many Vietnam veterans are alive today because their 

wives, or sisters, or other relatives have been taking care 

of them for decades. Heretofore there was never any recognition of the fact that these veterans would either have 

had to enter into long term care or would have been on the 

street if not for the extraordinary efforts of these family 

caregivers. Either way the additional cost to American society would have been extremely large, whether in fiscal 

cost or the societal cost of having many additional veterans 

among the homeless. 

The statements above attest to the importance of VA’s caregiver 

program and the value this program will have for caregivers of pre9/11 veterans. These statements also highlight that access to the 

program should be determined based on need, rather than the period of time the veteran served in the Armed Forces. 

Fully supporting caregiving activities not only ensures equity of 

services and benefits available to the caregivers of our most seriously injured veterans, it may also generate future cost savings. 

Supporting caregiving activities now may further enable veterans 

to remain at home rather than admitting them to a more expensive 

institutional setting, such as a nursing home. As described below, 

the cost of providing care in an institutional setting can be significantly greater than the cost of providing care in the home. 

VA is obligated to provide nursing home care for veterans who 

need such care and meet 1 of the following criteria: a service-connected disability rating of seventy percent or more; a need for nursing home care for a service-connected disability; or a rating of sixty 

percent when either unemployable or permanently and totally disabled. The Department’s fiscal year 2014 budget request included 

$4,928,496,000 for long-term institutional care for the care of an estimated 42,465 veterans per day. This amounts to an average cost 

of $116,060 per veteran a year. 

Receiving long-term care in the private sector, which is an option 

for eligible veterans, is costly as well. According to a survey conducted in 2012 by MetLife’s Mature Market Institute, the average 

cost of a private room in a nursing home in the United States was 

$90,520 per year. In contrast, as of July 2013, the cost of the annual stipend of the Caregiver program, the most expensive aspect 

of the program, is approximately $18,203 per caregiver, nearly onetenth the cost of institutional long-term care. 

Many family members are eager to give their veterans the opportunity to receive care at home by serving as caregivers. A study by 

the National Alliance for Caregivers (hereinafter, ‘‘NAC’’) in 2010 

found seventy-eight percent of veteran caregivers find their role 

fulfilling. However, the financial, physical, and mental toll on these 

caregivers can be substantial. According to a 2012 report by the 

Pew Research Center, thirty percent of adults in the United States 

serve as caregivers. A 2010 MetLife study, entitled ‘‘Working Caregivers and Employer Health Care Costs,’’ found there is an 8-percent difference in increased health care costs between caregiving 

and non-caregiving employees. This same study also found because 

stress can be an issue for caregivers, ‘‘wellness programs that offer 


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stress-management seminars and stress-reduction programs * * * 

can be helpful.’’ The findings of this report underscore the value of 

important services offered to caregivers of post-9/11 veterans 

through VA’s caregiver program, which include training, counseling 

and respite—all of which are important mechanisms to reduce 

stress—and health care services, which can improve overall 

wellness. 

The financial burdens on caregivers who leave the workforce 

without financial assistance, such as a caregiver stipend, may impact the ability of caregivers to obtain health insurance. The report 

released by the NAC in 2010 noted caregivers of veterans in households with incomes less than $50,000 have had their retirement 

plans disproportionately impacted compared to those with higher 

household incomes. 

This point was emphasized in testimony submitted to the Committee with respect to its May 9, 2013, hearing by the Disabled 

American Veterans: 

The critical care [caregivers] provide amounts to significant personal sacrifice resulting in lost professional opportunities and reduction in income. Caregiving exacts a tremendous toll on that caregiver’s health and well-being. 

Mental health concerns are often prevalent in the caregiver population as well, because many do not have access to supportive 

services. The NAC report also observed sixty-eight percent of veteran caregivers describe being highly-stressed, while another forty 

percent rate their physical strain as high due to the demands of 

their job. The same report also indicated caregivers of veterans in 

highly rural areas experience episodes of depression more frequently than those in more urban settings. 

The Caregivers law has been both popular and successful. As of 

July 2013, more than 10,600 caregivers have been approved for the 

program. According to VA, approximately 500 new family caregivers are being approved each month. These caregivers received 

an average monthly stipend between $575 and $2,254. Ninety-two 

percent of the approved caregivers are female, seventy-four percent 

of them are spouses and fifteen percent are parents. In addition, 

the majority of approved caregivers are between the ages of 26 and 

40. 

Caregivers approved for the program have taken advantage of 

many of the services available through VA. For example, the National Caregiver Support Line, created through the Caregivers law, 

received more than 85,000 calls, averaging over 150 calls per day 

as of July 8, 2013. Additionally, as of that same date, more than 

125 caregivers had participated in the Peer Support Mentoring Program. This program offers new caregivers the opportunity to be 

paired with experienced caregivers in order to share knowledge and 

skills and act as a support system. 

Finally, in VA’s report to Congress regarding the expansion of 

family caregiver assistance services, VA acknowledged the positive 

impact the program had on family caregivers and veterans alike. 

The report noted, 

Preliminary program outcomes for a small sample of program participants suggest a statistically significant decrease in the level of burden reported by approved family 


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caregivers three months after the initial home visit. An 

initial review has also shown a statistically significant decrease in average monthly inpatient utilization by eligible 

Veterans participating in the Program of Comprehensive 

Assistance for Family Caregivers. 

Based on its own assessment of the program, VA concluded: 

Expanding the Program of Comprehensive Assistance for 

Family Caregivers would allow equitable access to seriously injured Veterans from all eras (who otherwise meet 

the program’s eligibility criteria) and their approved family 

caregivers. In reality, countless families across every generation have been caregivers. Without compensation and 

with little support, these caregivers have sacrificed much 

for their Veteran and this Nation. 

Committee Bill. The Committee bill would amend section 1720G 

of title 38, United States Code, by striking ‘‘on or after September 11, 2001,’’ thus making the services and benefits available 

to caregivers of veterans of all eras. 

Removing this limitation would allow VA to waive the cost of furnishing hospital care or medical services for caregivers of veterans 

of all eras in emergency cases; authorize VA to pay for the caregivers’ lodging and subsistence, as well as the expenses of travel 

to and from a treatment facility and expenses for the duration of 

the veteran’s treatment episode at that facility; authorize VA to 

provide a tax-free monthly stipend; and ensure caregivers of veterans of all eras will be included in a national survey of family 

caregivers conducted in collaboration between VA and the Department of Defense. 

COMMITTEE BILL COST ESTIMATE

In compliance with paragraph 11(a) of rule XXVI of the Standing 

Rules of the Senate, the Committee, based on information supplied 

by the Congressional Budget Office (hereinafter, ‘‘CBO’’), estimates 

that enactment of the Committee bill would, relative to current 

law, increase discretionary spending by $510 million in fiscal year 

2014 and by $9.5 billion over the 2014–2018 period, but would not 

affect direct spending or revenues. Enactment of the Committee bill 

would not affect the budgets of state, local, or tribal governments. 

The cost estimate provided by CBO, setting forth a detailed 

breakdown of costs, follows: 

CONGRESSIONAL BUDGET OFFICE, Washington, DC, August 15, 2013. 

Hon. BERNARD SANDERS, 

Chairman, 

Committee on Veterans’ Affairs, 

U.S. Senate, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for S. 851, the Caregivers Expansion and Improvement Act of 2013. 


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If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Ann E. Futrell. 

Sincerely, 

DOUGLAS W. ELMENDORF, 

Director. 

Enclosure. 

S. 851—Caregivers Expansion and Improvement Act of 2013 

Summary: S. 851 would expand eligibility for the Family Caregivers program administered by the Department of Veterans Affairs (VA). CBO estimates that implementing the bill would cost 

$9.5 billion over the 2014–2018 period, assuming appropriation of 

the estimated amounts. Enacting S. 851 would not affect direct 

spending or revenues; therefore, pay-as-you go procedures do not 

apply. 

S. 851 contains no intergovernmental or private-sector mandates 

as defined in the Unfunded Mandates Reform Act (UMRA). 

Estimated cost to the Federal Government: The estimated budgetary impact of S. 851 is shown in the following table. The costs 

of this legislation fall within budget function 700 (veterans benefits 

and services). 

By fiscal year, in millions of dollars— 

2014 2015 2016 2017 2018 2014– 

2018 

CHANGES IN SPENDING SUBJECT TO APPROPRIATION 

Estimated Authorization Level ............................................ 571 1,436 2,502 2,610 2,720 9,839 

Estimated Outlays .............................................................. 510 1,337 2,375 2,577 2,693 9,492 

Basis of estimate: For this estimate, CBO assumes that the legislation will be enacted near the start of fiscal year 2014, that the 

necessary amounts will be appropriated for each year, and that 

outlays will follow historical spending patterns for similar and existing programs. 

Under the Family Caregiver program, VA provides several benefits (a stipend, health care, training, and respite care) to caregivers 

of eligible veterans. Veterans who have a service-connected disability incurred on or after September 11, 2001, and are in need 

of personal care services are eligible for that program. S. 851 would 

expand the Family Caregiver program to provide those same benefits to caregivers of all such veterans, regardless of when they 

served. 

Based on information from VA on the current level of participation in the program, CBO estimates that under the bill about 

70,000 additional caregivers would become eligible for the program. 

CBO further estimates that the expanded program would be implemented gradually, with 17,000 caregivers receiving stipends in 

2014, growing to the full 70,000 by 2016. 

Under the Family Caregiver program, a stipend is provided to 

the veteran’s primary caregiver. That stipend amount varies based 

on the amount and the degree of care needed. For the current program, benefits per primary caregiver total $25,000, on average. 

CBO expects that this bill would open up the caregiver program to 

an older population with greater need for home assistance. As a result, CBO estimates higher average costs of roughly $33,000 in 


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2014 (those costs would be adjusted for inflation throughout the 

projection period). Thus, CBO estimates that implementing S. 851 

would cost $510 million in 2014 and $9.5 billion over the 2014– 

2018 period, assuming appropriations of the necessary amounts. 

Pay-As-You-Go Considerations: None. 

Intergovernmental and private-sector impact: S. 851 contains no 

intergovernmental or private-sector mandates as defined in UMRA 

and would not affect the budgets of state, local, or tribal governments. 

Estimate prepared by: Federal Costs: Ann E. Futrell; Impact on 

State, Local, and Tribal Governments: Lisa Ramirez-Branum; Impact on the Private Sector: Elizabeth Bass. 

Estimate approved by: Theresa Gullo, Deputy Assistant Director 

for Budget Analysis. 

REGULATORY IMPACT STATEMENT

In compliance with paragraph 11(b) of rule XXVI of the Standing 

Rules of the Senate, the Committee has made an evaluation of the 

regulatory impact that would be incurred in carrying out S. 851. 

The Committee finds that S. 851 would not entail any regulation 

of individuals or businesses or result in any impact on the personal 

privacy of any individuals and that the paperwork resulting from 

enactment would be minimal. 

TABULATION OF VOTES CAST IN COMMITTEE

In compliance with paragraph 7(b) of rule XXVI of the Standing 

Rules of the Senate, the following is a tabulation of votes cast in 

person or by proxy by members of the Committee on Veterans’ Affairs at its July 24, 2013, meeting. On that date, the Committee 

voted by voice vote to order reported S. 851, a bill to extend to all 

veterans with a serious service-connected injury eligibility to participate in the family caregiver services program. 

AGENCY REPORT

On September 11, 2013, Eric K. Shinseki, Secretary, U.S. Department of Veterans Affairs, provided views on S. 851, among 

other issues. An excerpt from the Department views is reprinted 

below: 


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ENCLOSURE

VA VIEWS

* * * * * * * 

S. 851, CAREGIVERS EXPANSION AND IMPROVEMENT ACT OF 2013

The Caregivers and Veterans Omnibus Health Services Act of 

2010, Public Law (P.L.) 111–163 (the Act), signed into law on May 

5, 2010, provided expanded support and benefits for caregivers of 

eligible and covered Veterans. While the law authorized certain 

support services for caregivers of covered Veterans of all eras, other 


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benefits under the Act were authorized only for qualified family 

caregivers of eligible Veterans who incurred or aggravated a serious injury in the line of duty on or after September 11, 2001. These 

new benefits for approved family caregivers, provided under the 

Program of Comprehensive Assistance for Family Caregivers, include a monthly stipend paid directly to designated primary family 

caregivers and medical care under CHAMPVA for designated primary family caregivers who are not eligible for TRICARE and not 

entitled to care or services under a health-plan contract. 

S. 851, the Caregivers Expansion and Improvement Act of 2013, 

would remove ‘‘on or after September 11, 2001’’ from the statutory 

eligibility criteria for the Program of Comprehensive Assistance for 

Family Caregivers, and thereby expand eligibility under such program to Veterans of all eras who otherwise meet the applicable eligibility criteria. 

Recently, VA sent a report to the Committees on Veterans’ Affairs of the Senate and House of Representatives (House) (required 

by Section 101(d) of the Act) on the feasibility and advisability of 

such an expansion, as would be effected by S. 851. In that report, 

VA noted that expanding the Program of Comprehensive Assistance for Family Caregivers would allow equitable access to seriously injured Veterans from all eras (who otherwise meet the program’s eligibility criteria) and their approved family caregivers. VA 

also noted that families across every generation have been caregivers who have sacrificed much for their Veteran and this Nation. 

In the report, VA noted difficulties with making reliable projections of the cost impact of opening the Program of Comprehensive 

Assistance for Family Caregivers to eligible Veterans of all eras, 

but estimated a range of $1.8 billion to $3.8 billion in FY 2014. 

VA cannot responsibly provide a position in support of expanding 

the Program of Comprehensive Assistance for Family Caregivers 

without a realistic consideration of the resources necessary to carry 

out such an expansion, including an analysis of the future resources that must be available to fund other core direct-to-Veteran 

health care services. This is especially true as VA presses to buttress mental health services and ensure the fullest possible access 

to care in rural areas. VA is also mindful as we look ahead to the 

allocations for the Veterans Benefits and Services functions in the 

Senate-passed and House-passed FY 2014 budget resolutions (S. 

Con. Res. 8 and H. Con. Res. 25, respectively). 

We wish to make it very clear that VA believes an expansion of 

those benefits that are limited by era of service would result in equitable access to the Program of Comprehensive Assistance for 

Family Caregivers for long-deserving caregivers of those who have 

sacrificed greatly for our Nation. However, VA cannot endorse this 

measure before further engaging with Congress on these top-line 

fiscal constraints, within the context of all of VA health care programs. VA welcomes further discussion of these issues with the 

Committee. 

* * * * * * * 


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MINORITY VIEWS OF RANKING MEMBER 

HON. RICHARD BURR 

I agree with my colleagues, in principal, on expanding the Comprehensive Assistance for Family Caregivers Program; however, 

this bill would cost $9.5 billion over five years and the Majority has 

not identified an offset to pay for it. I firmly believe that legislation 

we report out of the Committee should include offsets but, more 

importantly, I believe we should only expand programs that are 

fully implemented and follow the intent of the law creating that 

program. In addition, we need to make sure a program expansion 

will not divert resources away from the Veterans Health Administration’s (VHA) principal duty—to provide health care to veterans. 

The Caregivers Program, crafted by this Committee with significant opposition from the Department of Veterans Affairs (VA), was 

intentionally limited to veterans of the most recent conflicts in Iraq 

and Afghanistan. As then-Chairman Akaka noted during consideration of S. 1963 in the Senate, these benefits and services were not 

made available to all veterans for three reasons: ‘‘[O]ne, the needs 

and circumstances of the newest veterans in terms of the injuries 

are different—different—from those of veterans from earlier eras; 

two, the family situation of the younger veterans is different from 

that of older veterans; and three, by targeting this initiative on a 

specific group of veterans, the likelihood of a successful undertaking is enhanced.’’ I believe the most important of those reasons 

was the belief that VA would not be able to implement a program 

of this magnitude covering veterans from all eras. Subsequently, 

VA has demonstrated that they have had trouble implementing 

even the limited program. Their rollout and management of the 

program has been flawed in several areas. 

On May 5, 2011, VA published in the Federal Register an Interim 

Final Rule for the Caregivers Program with comments due to VA 

by July 5, 2011. However, more than two years after the comment 

period has closed, VA has yet to publish a Final Rule or formally 

address the comments received. Since the start of the program two 

years ago, several problems have been brought to my attention. 

Some examples of these problems are: decisions determining eligibility for the program are inconsistent across the country; VA has 

no quality assurance program to monitor the quality, consistency, 

and timeliness of those decisions; and there is no formal process to 

appeal the decisions of eligibility for caregiver assistance. 

Our responsibility to the taxpayer is to ensure the laws enacted 

are implemented correctly, are working as Congress envisioned, 

and will not divert resources away from VA’s core mission. As VA 

states in the Expansion of Family Caregivers Assistance Program 

Report, submitted to Congress in September 2013: 

VA cannot responsibly advise the Congress on expansion of 

the Program of Comprehensive Assistance for Family 


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Caregivers without a realistic consideration of the resources necessary to carry out that expansion, a forwardlooking analysis of resources that must be available to 

fund core, direct-to-Veteran health care services, and the 

ability to provide Veterans with adequate access to those 

services. 

The report also points out: 

[E]ven using the lower of the range of projections for the 

cost of expansion discussed above, VA believes that under 

either the House-passed or Senate-passed budget framework, expansion of the Program of Comprehensive Assistance for Family Caregivers poses the risk of compromising 

resources needed for its core Veteran health care mission. 

Before spending $9.5 billion to expand this program to veterans 

of all eras, we need to ensure that VA is fulfilling the intent of 

Congress in how they are administering the current Caregivers 

Program. Expanding a flawed program now will not only exacerbate the problems currently facing the program, but could also 

draw financial resources away from other VHA programs. 


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CHANGES IN EXISTING LAW

In compliance with paragraph 12 of Rule XXVI of the Standing 

Rules of the Senate, changes in existing law made by the bill, as 

reported, are shown as follows (existing law proposed to be omitted 

is enclosed in black brackets, new matter is printed in italic, existing law in which no change is proposed is shown in roman). 

Title 38. Veterans’ Benefits 

* * * * * * * 

Part II. General Benefits 

* * * * * * * 

Chapter 17. Hospital, Nursing Home, Domiciliary, and 

Medical Care 

* * * * * * * 

Subchapter II. Hospital, Nursing Home, or Domiciliary Care 

and Medical Treatment 

* * * * * * * 

SEC. 1720G. ASSISTANCE AND SUPPORT SERVICES FOR CAREGIVERS. 

(a) PROGRAM OF COMPREHENSIVE ASSISTANCE FOR FAMILY CAREGIVERS. 

(1)(A) The Secretary shall establish a program of comprehensive assistance for family caregivers of eligible veterans. 

(B) The Secretary shall only provide support under the program required by subparagraph (A) to a family caregiver of an 

eligible veteran if the Secretary determines it is in the best interest of the eligible veteran to do so. 

(2) For purposes of this subsection, an eligible veteran is any 

individual who— 

(A) is a veteran or member of the Armed Forces undergoing medical discharge from the Armed Forces; 

(B) has a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, or air service øon or after September 11, 

2001¿; and 

* * * * * * * 

Æ 


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