117TH CONGRESS 

2D SESSION H. R. 7158 

AN ACT 

To amend title 38, United States Code, to authorize the 

Secretary of Veterans Affairs to enter into contracts 

and agreements for the payment of care in non-Department of Veterans Affairs medical foster homes for certain veterans who are unable to live independently, and 

for other purposes. 
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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 ‘‘Long-Term Care Vet5 erans Choice Act’’. 

6 SEC. 2. SECRETARY OF VETERANS AFFAIRS CONTRACT AU7 THORITY FOR PAYMENT OF CARE FOR VET8 ERANS IN NON-DEPARTMENT OF VETERANS 

9 AFFAIRS MEDICAL FOSTER HOMES. 

10 (a) AUTHORITY.— 

11 (1) IN GENERAL.—Section 1720 of title 38, 

12 United States Code, is amended by adding at the 

13 end the following new subsection: 

14 ‘‘(h)(1) During the five-year period beginning on the 

15 date of the enactment of the Long-Term Care Veterans 

16 Choice Act, and subject to paragraph (3)— 

17 ‘‘(A) at the request of a veteran for whom the 

18 Secretary is required to provide nursing home care 

19 under section 1710A of this title, the Secretary may 

20 place the veteran in a medical foster home that 

21 meets Department standards, at the expense of the 

22 United States, pursuant to a contract, agreement, or 

23 other arrangement entered into between the Sec24 retary and the medical foster home for such purpose; 

25 and 
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1 ‘‘(B) the Secretary may pay for care of a vet2 eran placed in a medical foster home before such 

3 date of enactment, if the home meets Department 

4 standards, pursuant to a contract, agreement, or 

5 other arrangement entered into between the Sec6 retary and the medical foster home for such purpose. 

7 ‘‘(2) A veteran on whose behalf the Secretary pays 

8 for care in a medical foster home under paragraph (1) 

9 shall agree, as a condition of such payment, to accept 

10 home health services furnished by the Secretary under sec11 tion 1717 of this title. 

12 ‘‘(3) In any year, not more than a daily average of 

13 900 veterans receiving care in a medical foster home, 

14 whether placed before, on, or after the date of the enact15 ment of the Long-Term Care Veterans Choice Act, may 

16 have their care covered at the expense of the United States 

17 under paragraph (1). 

18 ‘‘(4) The prohibition under section 1730(b)(3) of this 

19 title shall not apply to a veteran whose care is covered 

20 at the expense of the United States under paragraph (1). 

21 ‘‘(5) In this subsection, the term ‘medical foster 

22 home’ means a home designed to provide non-institutional, 

23 long-term, supportive care for veterans who are unable to 

24 live independently and prefer a family setting.’’. 
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1 (2) EFFECTIVE DATE.—Subsection (h) of sec2 tion 1720 of title 38, United States Code, as added 

3 by paragraph (1), shall take effect 90 days after the 

4 date of the enactment of this Act. 

5 (b) ONGOING MONITORING OF MEDICAL FOSTER

6 HOME PROGRAM.— 

7 (1) IN GENERAL.—The Secretary of Veterans 

8 Affairs shall create a system to monitor and assess 

9 the workload for the Department of Veterans Affairs 

10 in carrying out the authority under section 1720(h) 

11 of title 38, United States Code, as added by sub12 section (a)(1), including by tracking— 

13 (A) requests by veterans to be placed in a 

14 medical foster home under such section; 

15 (B) denials of such requests, including the 

16 reasons for such denials; 

17 (C) the total number of medical foster 

18 homes applying to participate under such sec19 tion, disaggregated by those approved and those 

20 denied approval by the Department to partici21 pate; 

22 (D) veterans receiving care at a medical 

23 foster home at the expense of the United 

24 States; and 
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1 (E) veterans receiving care at a medical 

2 foster home at their own expense. 

3 (2) REPORT.—Based on the monitoring and as4 sessments conducted under paragraph (1), the Sec5 retary shall identify and submit to Congress a report 

6 on such modifications to implementing section 

7 1720(h) of title 38, United States Code, as added by 

8 subsection (a)(1), as the Secretary considers nec9 essary to ensure the authority under such section is 

10 functioning as intended and care is provided to vet11 erans under such section as intended. 

12 (3) MEDICAL FOSTER HOME DEFINED.—In this 

13 subsection, the term ‘‘medical foster home’’ has the 

14 meaning given that term in section 1720(h) of title 

15 38, United States Code, as added by subsection 

16 (a)(1). 

17 (c) COMPTROLLER GENERAL REPORT.—Not later 

18 than each of three years and six years after the date of 

19 the enactment of this Act, the Comptroller General of the 

20 United States shall submit to Congress a report— 

21 (1) assessing the implementation of this section 

22 and the amendments made by this section; 

23 (2) assessing the impact of the monitoring and 

24 modifications under subsection (b) on care provided 
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1 under section 1720(h) of title 38, United States 

2 Code, as added by subsection (a)(1); and 

3 (3) setting forth recommendations for improve4 ments to the implementation of such section, as the 

5 Comptroller General considers appropriate. 

6 (d) MODIFICATION OF CERTAIN HOUSING LOAN

7 FEE.—The loan fee table in section 3729(b)(2) of title 38, 

8 United States Code, is amended by striking ‘‘January 14, 

9 2031’’ each place it appears and inserting ‘‘February 15, 

10 2031’’. 

11 SEC. 3. DETERMINATION OF BUDGETARY EFFECTS. 

12 The budgetary effects of this Act, for the purpose of 

13 complying with the Statutory Pay-As-You-Go Act of 2010, 

14 shall be determined by reference to the latest statement 

15 titled ‘‘Budgetary Effects of PAYGO Legislation’’ for this 

16 Act, submitted for printing in the Congressional Record 

17 by the Chairman of the House Budget Committee, pro18 vided that such statement has been submitted prior to the 

19 vote on passage. 

Passed the House of Representatives December 1, 

2022. 

Attest: 

Clerk. 

117TH CONGRESS 

2D SESSION H. R. 7158 

AN ACT 

To amend title 38, United States Code, to authorposes. unable to live independently, and for other pur- ical foster homes for certain veterans who are care in non-Department of Veterans Affairs med- into contracts and agreements for the payment of ize the Secretary of Veterans Affairs to enter