II 

117TH CONGRESS 

2D SESSION S. 3854 

To amend title 38, United States Code, to improve certain programs of 

the Department of Veterans Affairs for home and community based 

services for veterans, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 16, 2022 

Mr. MORAN (for himself, Ms. HASSAN, and Mr. TESTER) 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 improve certain 

programs of the Department of Veterans Affairs for 

home and community based services for veterans, 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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Elizabeth Dole Home and Community Based Services for 

6 Veterans and Caregivers Act of 2022’’ or the ‘‘Elizabeth 

7 Dole Home Care Act’’. 


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1 (b) TABLE OF CONTENTS.—The table of contents for 

2 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Definitions. 

Sec. 3. Increase of expenditure cap for noninstitutional care alternatives to 

nursing home care. 

Sec. 4. Coordination with Program of All-Inclusive Care for the Elderly. 

Sec. 5. Home and community based services: programs. 

Sec. 6. Coordination with assistance and support services for caregivers. 

Sec. 7. Development of centralized website for program information. 

Sec. 8. Improvements relating to Home Maker and Home Health Aide program. 

Sec. 9. Reviews and other improvements relating to home and community based 

services. 

3 SEC. 2. DEFINITIONS. 

4 In this Act: 

5 (1) CAREGIVER; FAMILY CAREGIVER.—The 

6 terms ‘‘caregiver’’ and ‘‘family caregiver’’ have the 

7 meanings given those terms under section 1720K(g) 

8 of title 38, United States Code (as added by section 

9 5(a)(1)). 

10 (2) COVERED PROGRAM.—The term ‘‘covered 

11 program’’— 

12 (A) means any program of the Department 

13 for home and community based services; and 

14 (B) includes the programs specified in sec15 tion 1720K of title 38, United States Code (as 

16 added by section 5(a)(1)). 

17 (3) DEPARTMENT.—The term ‘‘Department’’ 

18 means the Department of Veterans Affairs. 


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1 (4) HOME AND COMMUNITY BASED SERV2 ICES.—The term ‘‘home and community based serv3 ices’’— 

4 (A) means the services referred to in sec5 tion 1701(6)(E) of title 38, United States Code; 

6 and 

7 (B) includes services furnished under a 

8 program specified in section 1720K of such title 

9 (as added by section 5(a)(1)). 

10 (5) HOME BASED PRIMARY CARE PROGRAM; 

11 HOME MAKER AND HOME HEALTH AIDE PROGRAM; 

12 VETERAN DIRECTED CARE PROGRAM.—The terms 

13 ‘‘Home Based Primary Care program’’, ‘‘Home 

14 Maker and Home Health Aide program’’, and ‘‘Vet15 eran Directed Care program’’ mean the programs of 

16 the Department specified in subsections (d), (c), and 

17 (b) of such section 1720K, respectively. 

18 (6) HOME HEALTH AGENCY; HOME HEALTH

19 AIDE; NATIVE AMERICAN VETERAN, TRIBAL HEALTH

20 PROGRAM; URBAN INDIAN ORGANIZATION.—The 

21 terms ‘‘home health agency’’, ‘‘home health aide’’, 

22 ‘‘Native American veteran’’, ‘‘tribal health pro23 gram’’, and ‘‘Urban Indian organization’’ have the 

24 meanings given those terms in subsection (g) of such 

25 section 1720K. 


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1 (7) SECRETARY.—The term ‘‘Secretary’’ means 

2 the Secretary of Veterans Affairs. 

3 (8) VETERANS SERVICE ORGANIZATION.—The 

4 term ‘‘veterans service organization’’ means any or5 ganization recognized by the Secretary under section 

6 5902 of title 38, United States Code. 

7 SEC. 3. INCREASE OF EXPENDITURE CAP FOR NONINSTITU8 TIONAL CARE ALTERNATIVES TO NURSING 

9 HOME CARE. 

10 (a) INCREASE OF EXPENDITURE CAP.—Section 

11 1720C(d) of title 38, United States Code, is amended— 

12 (1) by striking ‘‘The total cost’’ and inserting 

13 ‘‘(1) Except as provided in paragraph (2), the total 

14 cost’’; 

15 (2) in paragraph (1), as designated by para16 graph (1), by striking ‘‘65 percent’’ and inserting 

17 ‘‘100 percent’’; and 

18 (3) by adding at the end the following new 

19 paragraph: 

20 ‘‘(2) The total cost of providing services or in-kind 

21 assistance in the case of any veteran for any fiscal year 

22 under the program may exceed 100 percent of the cost 

23 that would otherwise have been incurred as specified in 

24 paragraph (1) if the Secretary determines such higher 

25 total cost is in the best interest of the veteran.’’. 


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1 (b) APPLICABILITY.—The amendments made by sub2 section (a) shall apply with respect to any fiscal year be3 ginning on or after the date of the enactment of this Act. 

4 SEC. 4. COORDINATION WITH PROGRAM OF ALL-INCLUSIVE 

5 CARE FOR THE ELDERLY. 

6 Section 1720C of title 38, United States Code, as 

7 amended by section 3, is further amended by adding at 

8 the end the following new subsection: 

9 ‘‘(f) In furnishing services to a veteran under the pro10 gram conducted pursuant to subsection (a), if a medical 

11 center of the Department through which such program is 

12 administered is located in a geographic area in which serv13 ices are available to the veteran under a PACE program 

14 (as such term is defined in sections 1894(a)(2) and 

15 1934(a)(2) of the Social Security Act (42 U.S.C. 

16 1395eee(a)(2); 1396u–4(a)(2))), the Secretary shall estab17 lish a partnership with the PACE program operating in 

18 that area for the furnishing of such services.’’. 

19 SEC. 5. HOME AND COMMUNITY BASED SERVICES: PRO20 GRAMS. 

21 (a) PROGRAMS.— 

22 (1) IN GENERAL.—Subchapter II of chapter 17 

23 of title 38, United States Code, is amended by in24 serting after section 1720J the following new sec25 tion: 


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1 ‘‘§ 1720K. Home and community based services: pro2 grams 

3 ‘‘(a) IN GENERAL.—In furnishing noninstitutional al4 ternatives to nursing home care under the authority of 

5 section 1720C of this title (or any other authority under 

6 this chapter or other provision of law administered by the 

7 Secretary of Veterans Affairs), the Secretary shall carry 

8 out each of the programs specified in this section in ac9 cordance with such relevant authorities except as other10 wise provided in this section. 

11 ‘‘(b) VETERAN DIRECTED CARE PROGRAM.—(1) The 

12 Secretary of Veterans Affairs, in collaboration with the 

13 Secretary of Health and Human Services, shall carry out 

14 a program to be known as the ‘Veteran Directed Care pro15 gram’ under which the Secretary of Veterans Affairs may 

16 enter into agreements with the providers described in 

17 paragraph (2) to provide to eligible veterans funds to ob18 tain such in-home care services and related items as may 

19 be determined appropriate by the Secretary of Veterans 

20 Affairs and selected by the veteran, including through the 

21 veteran hiring individuals to provide such services and 

22 items or directly purchasing such services and items. 

23 ‘‘(2) The providers described in this paragraph are 

24 the following: 

25 ‘‘(A) An Aging and Disability Resource Center, 

26 an area agency on aging, or a State agency. 


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1 ‘‘(B) A center for independent living. 

2 ‘‘(3) In carrying out the Veteran Directed Care pro3 gram, the Secretary of Veterans Affairs shall— 

4 ‘‘(A) administer such program through each 

5 medical center of the Department of Veterans Af6 fairs; 

7 ‘‘(B) ensure the availability of such program in 

8 American Samoa, Guam, the Commonwealth of the 

9 Northern Mariana Islands, the Commonwealth of 

10 Puerto Rico, the Virgin Islands of the United States, 

11 and any other territory or possession of the United 

12 States; and 

13 ‘‘(C) ensure the availability of such program for 

14 eligible veterans who are Native American veterans 

15 receiving care and services furnished by the Indian 

16 Health Service, a tribal health program, an Urban 

17 Indian organization, or (in the case of a Native Ha18 waiian veteran) a Native Hawaiian health care sys19 tem. 

20 ‘‘(4) If a veteran participating in the Veteran Di21 rected Care program is catastrophically disabled, the vet22 eran may continue to use funds under the program during 

23 a period of hospitalization in the same manner that the 

24 veteran would be authorized to use such funds under the 

25 program if the veteran were not hospitalized. 


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1 ‘‘(c) HOME MAKER AND HOME HEALTH AIDE PRO2 GRAM.—(1) The Secretary shall carry out a program to 

3 be known as the ‘Home Maker and Home Health Aide 

4 program’ under which the Secretary may enter into agree5 ments with home health agencies to provide to eligible vet6 erans such home health aide services as may be deter7 mined appropriate by the Secretary. 

8 ‘‘(2) In carrying out the Home Maker and Home 

9 Health Aide program, the Secretary shall ensure the avail10 ability of such program— 

11 ‘‘(A) in the locations specified in subparagraph 

12 (B) of subsection (b)(3); and 

13 ‘‘(B) for the veteran populations specified in 

14 subparagraph (C) of such subsection. 

15 ‘‘(d) HOME BASED PRIMARY CARE PROGRAM.—The 

16 Secretary shall carry out a program to be known as the 

17 ‘Home Based Primary Care program’ under which the 

18 Secretary may furnish to eligible veterans in-home health 

19 care, the provision of which is overseen by a physician of 

20 the Department. 

21 ‘‘(e) PURCHASED SKILLED HOME CARE PROGRAM.— 

22 The Secretary shall carry out a program to be known as 

23 the ‘Purchased Skilled Home Care program’ under which 

24 the Secretary may furnish to eligible veterans such inVerDate Sep 11 2014 19:57 Mar 17, 2022 Jkt 029200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S3854.IS S3854

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1 home care services as may be determined appropriate and 

2 selected by the Secretary for the veteran. 

3 ‘‘(f) CAREGIVER SUPPORT.—(1) With respect to a 

4 resident caregiver of a veteran participating in a program 

5 under this section who is a family caregiver, the Secretary 

6 shall— 

7 ‘‘(A) if the veteran meets the requirements of 

8 a covered veteran under section 1720G(b) of this 

9 title, provide to such caregiver the option of enroll10 ing in the program of general caregiver support serv11 ices under such section; 

12 ‘‘(B) subject to paragraph (2), provide to such 

13 caregiver not fewer than 14 days of covered respite 

14 care each year; and 

15 ‘‘(C) conduct on an annual basis (and, to the 

16 extent practicable, in connection with in-person serv17 ices provided under the program in which the vet18 eran is participating), a wellness check of such care19 giver. 

20 ‘‘(2) The Secretary shall provide not fewer than 30 

21 days of covered respite care each year to any resident care22 giver who provides services funded under the Veteran Di23 rected Care program under subsection (b). 

24 ‘‘(3) Covered respite care provided to a resident care25 giver of a veteran under paragraph (1) or (2), as the case 


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1 may be, may exceed 14 days annually or 30 days annually, 

2 respectively, if an extension is requested by the resident 

3 caregiver or veteran and determined medically appropriate 

4 by the Secretary. 

5 ‘‘(g) DEFINITIONS.—In this section: 

6 ‘‘(1) The terms ‘Aging and Disability Resource 

7 Center’, ‘area agency on aging’, and ‘State agency’ 

8 have the meanings given those terms in section 102 

9 of the Older Americans Act of 1965 (42 U.S.C. 

10 3002). 

11 ‘‘(2) The terms ‘caregiver’ and ‘family care12 giver’, with respect to a veteran, have the meanings 

13 given those terms, respectively, under subsection (e) 

14 of section 1720G of this title with respect to an eli15 gible veteran under subsection (a) of such section or 

16 a covered veteran under subsection (b) of such sec17 tion, as the case may be. 

18 ‘‘(3) The term ‘center for independent living’ 

19 has the meaning given that term in section 702 of 

20 the Rehabilitation Act of 1973 (29 U.S.C. 796a). 

21 ‘‘(4) The term ‘covered respite care’ means, 

22 with respect to a caregiver of a veteran, respite care 

23 that— 


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1 ‘‘(A) includes 24-hour per day care of the 

2 veteran commensurate with the care provided 

3 by the caregiver; 

4 ‘‘(B) is medically and age-appropriate; and 

5 ‘‘(C) includes in-home care services. 

6 ‘‘(5) The term ‘eligible veteran’ means any vet7 eran— 

8 ‘‘(A) for whom the Secretary determines 

9 participation in a specific program under this 

10 section is medically necessary to promote, pre11 serve, or restore the health of the veteran; and 

12 ‘‘(B) who absent such participation would 

13 be at increased risk for hospitalization, place14 ment in a nursing home, or emergency room 

15 care. 

16 ‘‘(6) The term ‘home health agency’ has the 

17 meaning given that term in section 1861(o) of the 

18 Social Security Act (42 U.S.C. 1395x(o)). 

19 ‘‘(7) The term ‘home health aide’ means an in20 dividual employed by a home health agency to pro21 vide in-home care services. 

22 ‘‘(8) The term ‘in-home care service’ means any 

23 service, including a personal care service, provided to 

24 enable the recipient of such service to live at home. 


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1 ‘‘(9) The term ‘Native American veteran’ has 

2 the meaning given that term in section 3765 of this 

3 title. 

4 ‘‘(10) The terms ‘Native Hawaiian’ and ‘Native 

5 Hawaiian health care system’ have the meanings 

6 given those terms in section 12 of the Native Hawai7 ian Health Care Improvement Act (42 U.S.C. 

8 11711). 

9 ‘‘(11) The term ‘resident caregiver’ means a 

10 caregiver or a family caregiver of a veteran who re11 sides with the veteran. 

12 ‘‘(12) The terms ‘tribal health program’ and 

13 ‘Urban Indian organization’ have the meanings 

14 given those terms in section 4 of the Indian Health 

15 Care Improvement Act (25 U.S.C. 1603).’’. 

16 (2) CLERICAL AMENDMENT.—The table of sec17 tions at the beginning of such subchapter is amend18 ed by inserting after the item relating to section 

19 1720J the following new item: 

‘‘1720K. Home and community based services: programs.’’. 

20 (b) DEADLINE FOR IMPROVED ADMINISTRATION.— 

21 The Secretary shall ensure that the Veteran Directed Care 

22 program and the Home Maker and Home Health Aide 

23 program are administered through each medical center of 

24 the Department in accordance with section 1720K of title 

25 38, United States Code (as added by subsection (a)(1)), 


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1 by not later than two years after the date of the enactment 

2 of this Act. 

3 SEC. 6. COORDINATION WITH ASSISTANCE AND SUPPORT 

4 SERVICES FOR CAREGIVERS. 

5 (a) COORDINATION WITH PROGRAM OF COMPREHEN6 SIVE ASSISTANCE FOR FAMILY CAREGIVERS.— 

7 (1) COORDINATION.—Section 1720G(a) of title 

8 38, United States Code, is amended by adding at 

9 the end the following new paragraph: 

10 ‘‘(14)(A) In the case of a veteran or caregiver who 

11 seeks services under this subsection and is denied such 

12 services, or a veteran or the family caregiver of a veteran 

13 who is discharged from the program under this subsection, 

14 the Secretary shall— 

15 ‘‘(i) if the veteran meets the requirements of a 

16 covered veteran under subsection (b), provide to 

17 such caregiver the option of enrolling in the program 

18 of general caregiver support services under such sub19 section; 

20 ‘‘(ii) assess the veteran or caregiver for partici21 pation in any other available program of the Depart22 ment for home and community based services (in23 cluding the programs specified in section 1720K of 

24 this title) for which the veteran or caregiver may be 

25 eligible and, with respect to the veteran, store (and 


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1 make accessible to the veteran) the results of such 

2 assessment in the electronic medical record of the 

3 veteran; and 

4 ‘‘(iii) provide to the veteran or caregiver written 

5 information on any such program identified pursu6 ant to the assessment under clause (ii), including in7 formation about facilities, eligibility requirements, 

8 and relevant contact information for each such pro9 gram. 

10 ‘‘(B) For each veteran or family caregiver who is dis11 charged from the program under this subsection, a care12 giver support coordinator shall provide for a smooth and 

13 personalized transition from such program to an appro14 priate program of the Department for home and commu15 nity based services (including the programs specified in 

16 section 1720K of this title), including by integrating care17 giver support across programs.’’. 

18 (2) APPLICABILITY.—The amendments made 

19 by paragraph (1) shall apply with respect to denials 

20 and discharges described in paragraph (14) of such 

21 section, as added by paragraph (1), occurring on or 

22 after the date of the enactment of this Act. 

23 (b) TECHNICAL AND CONFORMING AMENDMENTS.— 

24 Section 1720G(d) of such title is amended— 


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1 (1) by striking ‘‘or a covered veteran’’ each 

2 place it appears and inserting ‘‘, a veteran denied or 

3 discharged as specified in paragraph (14) of such 

4 subsection, or a covered veteran’’; and 

5 (2) by striking ‘‘under subsection (a), means’’ 

6 each place it appears and inserting ‘‘under sub7 section (a) or a veteran denied or discharged as 

8 specified in paragraph (14) of such subsection, 

9 means’’. 

10 (c) REVIEW RELATING TO CAREGIVER CONTACT.— 

11 The Secretary shall conduct a review of the capacity of 

12 the Department to establish a streamlined system for con13 tacting all caregivers enrolled in the program of general 

14 caregiver support services under section 1720G(b) of title 

15 38, United States Code, to provide to such caregivers pro16 gram updates and alerts relating to emerging services for 

17 which such caregivers may be eligible. 

18 SEC. 7. DEVELOPMENT OF CENTRALIZED WEBSITE FOR 

19 PROGRAM INFORMATION. 

20 (a) CENTRALIZED WEBSITE.—The Secretary shall 

21 develop and maintain a centralized and publicly accessible 

22 internet website of the Department as a clearinghouse for 

23 information and resources relating to covered programs. 

24 (b) CONTENTS.—The website under subsection (a) 

25 shall contain the following: 


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1 (1) A description of each covered program. 

2 (2) An informational assessment tool that en3 ables users to— 

4 (A) assess the eligibility of a veteran, or a 

5 caregiver of a veteran, for any covered program; 

6 and 

7 (B) receive information, as a result of such 

8 assessment, on any covered program for which 

9 the veteran or caregiver (as the case may be) 

10 may be eligible. 

11 (3) A list of required procedures for the direc12 tors of medical facilities of the Department to follow 

13 in determining the eligibility and suitability of vet14 erans for participation in a covered program, includ15 ing procedures applicable to instances in which the 

16 resource constraints of a facility (or of a community 

17 in which a facility is located) may result in the in18 ability to address the health needs of a veteran 

19 under a covered program in a timely manner. 

20 (c) UPDATES.—The Secretary shall ensure the 

21 website under subsection (a) is updated on a periodic 

22 basis. 


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1 SEC. 8. IMPROVEMENTS RELATING TO HOME MAKER AND 

2 HOME HEALTH AIDE PROGRAM. 

3 (a) PILOT PROGRAM FOR COMMUNITIES WITH

4 SHORTAGE OF HOME HEALTH AIDES.— 

5 (1) PROGRAM.—The Secretary shall carry out a 

6 pilot program under which the Secretary shall pro7 vide home maker and home health aide services to 

8 veterans who reside in communities with a shortage 

9 of home health aides. 

10 (2) LOCATIONS.—The Secretary shall select 10 

11 geographic locations in which the Secretary deter12 mines there is a shortage of home health aides at 

13 which to carry out the pilot program under para14 graph (1). 

15 (3) NURSING ASSISTANTS.— 

16 (A) IN GENERAL.—In carrying out the 

17 pilot program under paragraph (1), the Sec18 retary may hire nursing assistants as new em19 ployees of the Department, or reassign nursing 

20 assistants who are existing employees of the 

21 Department, to provide to veterans in-home 

22 care services (including basic tasks authorized 

23 by the State certification of the nursing assist24 ant) under the pilot program, in lieu of or in 

25 addition to the provision of such services 

26 through non-Department home health aides. 


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1 (B) RELATIONSHIP TO HOME BASED PRI2 MARY CARE PROGRAM.—Nursing assistants 

3 hired or reassigned under subparagraph (A) 

4 may provide services to a veteran under the 

5 pilot program under paragraph (1) while serv6 ing as part of a health care team for the vet7 eran under the Home Based Primary Care pro8 gram. 

9 (4) DURATION.—The pilot program under para10 graph (1) shall be for a duration of three years. 

11 (5) REPORT TO CONGRESS.—Not later than one 

12 year after the date on which the Secretary deter13 mines the pilot program under paragraph (1) has 

14 terminated, the Secretary shall submit to the Com15 mittee on Veterans’ Affairs of the Senate and the 

16 Committee on Veterans’ Affairs of the House of 

17 Representatives a report on the result of the pilot 

18 program. 

19 (b) REPORT ON USE OF FUNDS.—Not later than one 

20 year after the date of the enactment of this Act, the Sec21 retary shall submit to the Committee on Veterans’ Affairs 

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

23 the House of Representatives a report containing, with re24 spect to the period beginning in fiscal year 2011 and end25 ing in fiscal year 2022, the following: 


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1 (1) An identification of the amount of funds 

2 that were included in a budget of the Department 

3 during such period for the provision of in-home care 

4 to veterans under the Home Maker and Home 

5 Health Aide program but were not expended for the 

6 provision of such care, disaggregated by medical cen7 ter of the Department for which such unexpended 

8 funds were budgeted. 

9 (2) An identification of the number of veterans 

10 for whom, during such period, the hours during 

11 which a home health aide was authorized to provide 

12 services to the veteran under the Home Maker and 

13 Home Health Aide program were reduced for a rea14 son other than a change in the health care needs of 

15 the veteran, and a detailed description of the reasons 

16 why any such reductions may have occurred. 

17 (c) UPDATED GUIDANCE ON PROGRAM.— 

18 (1) IN GENERAL.—Not later than one year 

19 after the date of the enactment of this Act, the Sec20 retary shall issue updated guidance for the Home 

21 Maker and Home Health Aide program. 

22 (2) MATTERS TO INCLUDE.—Guidance updated 

23 under paragraph (1) shall include the following: 


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1 (A) A process for the transition of veterans 

2 from the Home Maker and Home Health Aide 

3 program to other covered programs. 

4 (B) A requirement for the directors of the 

5 medical facilities of the Department to complete 

6 such process whenever a veteran with care 

7 needs has been denied services from home 

8 health agencies under the Home Maker and 

9 Home Health Aide program as a result of the 

10 clinical needs or behavioral issues of the vet11 eran. 

12 SEC. 9. REVIEWS AND OTHER IMPROVEMENTS RELATING 

13 TO HOME AND COMMUNITY BASED SERVICES. 

14 (a) OFFICE OF GERIATRIC AND EXTENDED CARE.— 

15 (1) REVIEW OF PROGRAMS.—The Under Sec16 retary for Health of the Department shall conduct 

17 a review of each program administered through the 

18 Office of Geriatric and Extended Care of the De19 partment, or successor office, to— 

20 (A) ensure consistency in program man21 agement; 

22 (B) eliminate service gaps at the medical 

23 center level; and 


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1 (C) ensure the availability of, and the ac2 cess by veterans to, home and community based 

3 services. 

4 (2) ASSESSMENT OF STAFFING NEEDS.—The 

5 Secretary shall conduct an assessment of the staff6 ing needs of the Office of Geriatric and Extended 

7 Care of the Department, or successor office. 

8 (3) GOALS FOR GEOGRAPHIC ALIGNMENT OF

9 CARE.— 

10 (A) ESTABLISHMENT OF GOALS.—The Di11 rector of the Office of Geriatric and Extended 

12 Care, or successor office, shall establish quan13 titative goals to enable aging or disabled vet14 erans who are not located near medical centers 

15 of the Department to access extended care serv16 ices (including by improving access to home and 

17 community based services for such veterans). 

18 (B) IMPLEMENTATION TIMELINE.—Each 

19 goal established under subparagraph (A) shall 

20 include a timeline for the implementation of the 

21 goal at each medical center of the Department. 

22 (4) GOALS FOR IN-HOME SPECIALTY CARE.— 

23 The Director of the Office of Geriatric and Extended 

24 Care, or successor office, shall establish quantitative 

25 goals to address the specialty care needs of veterans 


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1 through in-home care, including by ensuring the 

2 education of home health aides and caregivers of vet3 erans in the following areas: 

4 (A) Dementia care. 

5 (B) Care for spinal cord injuries and dis6 eases. 

7 (C) Ventilator care. 

8 (D) Other speciality care areas as deter9 mined by the Secretary. 

10 (5) REPORT TO CONGRESS.—Not later than one 

11 year after the date of the enactment of this Act, the 

12 Secretary shall submit to the Committee on Vet13 erans’ Affairs of the Senate and the Committee on 

14 Veterans’ Affairs of the House of Representatives a 

15 report containing the findings of the review under 

16 paragraph (1), the results of the assessment under 

17 paragraph (2), and the goals established under para18 graphs (3) and (4). 

19 (b) REVIEW OF INCENTIVES AND EFFORTS RELAT20 ING TO HOME AND COMMUNITY BASED SERVICES.— 

21 (1) REVIEW.—The Secretary shall conduct a re22 view of the following: 

23 (A) The financial and organizational incen24 tives for the directors of medical centers of the 


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1 Department to establish or expand covered pro2 grams at such medical centers. 

3 (B) Any incentives for such directors to 

4 provide to veterans home and community based 

5 services in lieu of institutional care. 

6 (C) The efforts taken by the Secretary to 

7 enhance spending of the Department for ex8 tended care by shifting the balance of such 

9 spending from institutional care to home and 

10 community based services. 

11 (D) The plan of the Under Secretary for 

12 Health of the Department to accelerate efforts 

13 to enhance spending as specified in subpara14 graph (C), to match the progress of similar ef15 forts taken by the Administrator of the Centers 

16 for Medicare & Medicaid Services with respect 

17 to spending of the Centers for Medicare & Med18 icaid Services for extended care. 

19 (2) REPORT TO CONGRESS.—Not later than one 

20 year after the date of the enactment of this Act, the 

21 Secretary shall submit to the Committee on Vet22 erans’ Affairs of the Senate and the Committee on 

23 Veterans’ Affairs of the House of Representatives a 

24 report on the findings of the review under paragraph 

25 (1). 


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1 (c) REVIEW OF RESPITE CARE SERVICES.—Not later 

2 than two years after the date of the enactment of this Act, 

3 the Secretary shall conduct a review of the use, avail4 ability, and effectiveness of the respite care services fur5 nished by the Secretary under chapter 17 of title 38, 

6 United States Code. 

7 (d) COLLABORATION TO IMPROVE HOME AND COM8 MUNITY BASED SERVICES.— 

9 (1) FEEDBACK AND RECOMMENDATIONS ON

10 CAREGIVER SUPPORT.— 

11 (A) FEEDBACK AND RECOMMENDA12 TIONS.—The Secretary shall solicit from the en13 tities described in subparagraph (B) feedback 

14 and recommendations regarding opportunities 

15 for the Secretary to enhance home and commu16 nity based services for veterans and caregivers 

17 of veterans, including through the potential pro18 vision by the entity of care and respite services 

19 to veterans and caregivers who may not be eli20 gible for any program under section 1720G of 

21 title 38, United States Code, or section 1720K 

22 of such title (as added by section 5(a)(1)), but 

23 have a need for assistance. 

24 (B) COVERED ENTITIES.—The entities de25 scribed in this subparagraph are veterans servVerDate Sep 11 2014 19:57 Mar 17, 2022 Jkt 029200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6201 E:\BILLS\S3854.IS S3854

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25 

•S 3854 IS

1 ice organizations and nonprofit organizations 

2 with a focus on caregiver support (as deter3 mined by the Secretary). 

4 (2) COLLABORATION FOR NATIVE AMERICAN

5 VETERANS.—The Secretary shall collaborate with 

6 the Director of the Indian Health Service and rep7 resentatives from tribal health programs and Urban 

8 Indian organizations to ensure the availability of 

9 home and community based services for Native 

10 American veterans, including Native American vet11 erans receiving health care and medical services 

12 under multiple health care systems. 

Æ 


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