I 

117TH CONGRESS 

2D SESSION H. R. 6823 

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 HOUSE OF REPRESENTATIVES 

FEBRUARY 25, 2022 

Ms. BROWNLEY (for herself and Mr. BERGMAN) introduced the following bill; 

which was 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. Increase to expenditure cap for noninstitutional care alternatives to 

nursing home care. 

Sec. 3. Coordination with Program of All-Inclusive Care for the Elderly. 

Sec. 4. Home and community based services: programs. 

Sec. 5. Coordination with Program of Comprehensive Assistance for Family 

Caregivers. 

Sec. 6. Development of centralized website for program information. 

Sec. 7. Improvements relating to Home Maker and Home Health Aide program. 

Sec. 8. Reviews and other improvements relating to home and community based 

services. 

Sec. 9. Definitions. 

3 SEC. 2. INCREASE OF EXPENDITURE CAP FOR NONINSTITU4 TIONAL CARE ALTERNATIVES TO NURSING 

5 HOME CARE. 

6 (a) INCREASE OF EXPENDITURE CAP.—Section 

7 1720C(d) of title 38, United States Code, is amended— 

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

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

10 cost’’; 

11 (2) by striking ‘‘65 percent’’ and inserting ‘‘100 

12 percent’’; and 

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

14 paragraph: 

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

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

17 under the program may exceed 100 percent of the cost 

18 that would otherwise have been incurred as specified in 


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1 paragraph (1) if the Secretary determines such higher 

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

3 (b) APPLICABILITY.—The amendments made by sub4 section (a) shall apply with respect to fiscal years begin5 ning on or after the date of the enactment of this Act. 

6 SEC. 3. COORDINATION WITH PROGRAM OF ALL-INCLUSIVE 

7 CARE FOR THE ELDERLY. 

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

9 amended by section 2, is further amended by adding at 

10 the end the following new subsection: 

11 ‘‘(f) In furnishing services to a veteran under the pro12 gram conducted pursuant to subsection (a), if a medical 

13 center of the Department through which such program is 

14 administered is located in a geographic area in which serv15 ices are available to the veteran under a PACE program 

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

17 1934(a)(2) of the Social Security Act (42 U.S.C. 

18 1395eee(a)(2); 1396u–4(a)(2))), the Secretary shall estab19 lish a partnership with the PACE program operating in 

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

21 SEC. 4. HOME AND COMMUNITY BASED SERVICES: PRO22 GRAMS. 

23 (a) PROGRAMS.—Chapter 17 of title 38, United 

24 States Code, is amended by inserting after section 1720J 


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1 the following new section (and conforming the table of sec2 tions at the beginning of such chapter accordingly): 

3 ‘‘§ 1720K. Home and community based services: pro4 grams 

5 ‘‘(a) IN GENERAL.—In furnishing noninstitutional al6 ternatives to nursing home care pursuant to the authority 

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

8 this chapter or other provision of law administered by the 

9 Secretary of Veterans Affairs), the Secretary shall carry 

10 out each of the programs specified in this section in ac11 cordance with such relevant authorities except as other12 wise provided in this section. 

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

14 Secretary of Veterans Affairs, in collaboration with the 

15 Secretary of Health and Human Services, shall carry out 

16 a program to be known as the ‘Veteran Directed Care pro17 gram’ under which the Secretary of Veterans Affairs may 

18 enter into agreements with the providers described in 

19 paragraph (2) to provide to eligible veterans funds to ob20 tain such in-home care services and related items as may 

21 be determined appropriate by the Secretary of Veterans 

22 Affairs and selected by the veteran, including through the 

23 veteran hiring individuals to provide such services and 

24 items or directly purchasing such services and items. 


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

2 the following: 

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

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

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

6 ‘‘(3) In carrying out the Veteran Directed Care pro7 gram, the Secretary of Veterans Affairs shall— 

8 ‘‘(A) administer such program through each 

9 medical center of the Department of Veterans Af10 fairs; 

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

12 American Samoa, Guam, the Commonwealth of the 

13 Northern Mariana Islands, the Commonwealth of 

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

15 and any other territory or possession of the United 

16 States; and 

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

18 eligible veterans who are Native American veterans 

19 receiving care and services furnished by the Indian 

20 Health Service, a tribal health program, an Urban 

21 Indian organization, or (in the case of a Native Ha22 waiian veteran) a Native Hawaiian health care sys23 tem. 

24 ‘‘(4) If a veteran participating in the Veteran Di25 rected Care program is catastrophically disabled, the vetVerDate Sep 11 2014 20:47 Mar 02, 2022 Jkt 029200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H6823.IH H6823

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1 eran may continue to use funds under the program during 

2 a period of hospitalization in the same manner that the 

3 veteran would be authorized to use such funds under the 

4 program if the veteran were not hospitalized. 

5 ‘‘(c) HOME MAKER AND HOME HEALTH AIDE PRO6 GRAM.—(1) The Secretary shall carry out a program to 

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

8 program’ under which the Secretary may enter into agree9 ments with home health agencies to provide to eligible vet10 erans such home health aide services as may be deter11 mined appropriate by the Secretary. 

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

13 Health Aide program, the Secretary shall ensure the avail14 ability of such program— 

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

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

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

18 subparagraph (C) of such subsection. 

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

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

21 ‘Home Based Primary Care program’ under which the 

22 Secretary may furnish to eligible veterans in-home health 

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

24 the Department. 


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

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

3 the ‘Purchased Skilled Home Care program’ under which 

4 the Secretary may furnish to eligible veterans such in5 home care services as may be determined appropriate and 

6 selected by the Secretary for the veteran. 

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

8 resident caregiver of a veteran participating in a program 

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

10 shall— 

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

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

13 title, provide to such caregiver the option of enroll14 ing in the program of general caregiver support serv15 ices under such section; 

16 ‘‘(B) provide to such caregiver not fewer than 

17 14 days of covered respite care each year; and 

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

19 extent practicable, in connection with in-person serv20 ices provided under the program in which the vet21 eran is participating), a wellness check of such care22 giver. 

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

24 days of covered respite care each year to any resident careVerDate Sep 11 2014 20:47 Mar 02, 2022 Jkt 029200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H6823.IH H6823

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1 giver who provides services funded under the Veteran Di2 rected Care program under subsection (b). 

3 ‘‘(3) Covered respite care provided to a resident care4 giver of a veteran under paragraph (1) or (2), as the case 

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

6 respectively, if such extension is requested by the resident 

7 caregiver or veteran and determined medically appropriate 

8 by the Secretary. 

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

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

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

12 have the meanings given those terms in section 102 

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

14 3002). 

15 ‘‘(2) The terms ‘caregiver’ and ‘family care16 giver’, with respect to a veteran, have the meanings 

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

18 of section 1720G of this title with respect to an eli19 gible veteran under subsection (a) of such section or 

20 a covered veteran under subsection (b) of such sec21 tion, as the case may be. 

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

23 has the meaning given that term in section 702 of 

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


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

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

3 that— 

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

5 veteran commensurate with the care provided 

6 by the caregiver; 

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

8 ‘‘(C) includes in-home care. 

9 ‘‘(5) The term ‘eligible veteran’ means any vet10 eran— 

11 ‘‘(A) for whom the Secretary determines 

12 participation in a specific program under this 

13 section is medically necessary to promote, pre14 serve, or restore the health of the veteran; and 

15 ‘‘(B) who absent such participation would 

16 be at increased risk for hospitalization, place17 ment in a nursing home, or emergency room 

18 care. 

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

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

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

22 ‘‘(7) The term ‘home health aide’ means an in23 dividual employed by a home health agency to pro24 vide in-home care services. 


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

2 service, including a personal care service, provided to 

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

4 ‘‘(9) The terms ‘Native American’ and ‘Native 

5 American veteran’ have the meanings given those 

6 terms in section 3765 of this title. 

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

8 Hawaiian health care system’ have the meanings 

9 given those terms in section 12 of the Native Hawai10 ian Health Care Improvement Act (42 U.S.C. 

11 11711). 

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

13 caregiver, or a family caregiver, of a veteran who re14 sides with the veteran. 

15 ‘‘(12) The terms ‘tribal health programs’ and 

16 ‘Urban Indian organizations’ have the meanings 

17 given those terms in section 4 of the Indian Health 

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

19 (b) DEADLINE FOR IMPROVED ADMINISTRATION.— 

20 The Secretary of Veterans Affairs shall ensure that the 

21 Veteran Directed Care program and the Home Maker and 

22 Home Health Aide program are administered through 

23 each medical center of the Department of Veterans Affairs 

24 in accordance with section 1720K of title 38, United 


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1 States Code (as added by subsection (a)), by not later 

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

3 SEC. 5. 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 occurring on or after the date of the 

21 enactment of this Act. 

22 (b) TECHNICAL AND CONFORMING AMENDMENTS.— 

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

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

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


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1 discharged as specified in paragraph (14) of such 

2 subsection, or a covered veteran’’; and 

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

4 each place it appears and inserting ‘‘under sub5 section (a) or a veteran denied or discharged as 

6 specified in paragraph (14) of such subsection, 

7 means’’. 

8 (c) REVIEW RELATING TO CAREGIVER CONTACT.— 

9 The Secretary shall conduct a review of the capacity of 

10 the Department to establish a streamlined system for con11 tacting all caregivers enrolled in the program of general 

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

13 38, United States Code, to provide to such caregivers pro14 gram updates and alerts relating to emerging services for 

15 which such caregivers may be eligible. 

16 SEC. 6. DEVELOPMENT OF CENTRALIZED WEBSITE FOR 

17 PROGRAM INFORMATION. 

18 (a) CENTRALIZED WEBSITE.—The Secretary shall 

19 develop and maintain a centralized and publicly accessible 

20 internet website of the Department as a clearinghouse for 

21 information and resources relating to covered programs. 

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

23 shall contain the following: 

24 (1) A description of each covered program. 


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1 (2) An informational assessment tool that en2 ables users to— 

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

4 caregiver of a veteran, for any covered program; 

5 and 

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

7 assessment, on any covered program for which 

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

9 may be eligible. 

10 (3) A list of required procedures for the direc11 tors of the medical facilities of the Department to 

12 follow in determining the eligibility and suitability of 

13 veterans for participation in a covered program, in14 cluding procedures applicable to instances in which 

15 the resource constraints of a facility (or of a commu16 nity in which a facility is located) may result in the 

17 inability to address the health needs of a veteran 

18 under a covered program in a timely manner. 

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

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

21 basis. 

22 SEC. 7. IMPROVEMENTS RELATING TO HOME MAKER AND 

23 HOME HEALTH AIDE PROGRAM. 

24 (a) PILOT PROGRAM FOR COMMUNITIES WITH

25 SHORTAGE OF HOME HEALTH AIDES.— 


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

2 pilot program under which the Secretary shall pro3 vide home maker and home health aide services to 

4 veterans who reside in communities with a shortage 

5 of home health aides. 

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

7 geographic locations in which the Secretary deter8 mines there is a shortage of home health aides at 

9 which to carry out the pilot program under para10 graph (1). 

11 (3) NURSING ASSISTANTS.— 

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

13 pilot program under paragraph (1), the Sec14 retary may hire nursing assistants as new em15 ployees of the Department of Veterans Affairs, 

16 or reassign nursing assistants who are existing 

17 employees of the Department, to provide to vet18 erans in-home care services (including basic 

19 tasks authorized by the State certification of 

20 the nursing assistant) under the pilot program, 

21 in lieu of or in addition to the provision of such 

22 services through non-Department home health 

23 aides. 

24 (B) RELATIONSHIP TO HOME BASED PRI25 MARY CARE PROGRAM.—Nursing assistants 


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1 hired or reassigned under subparagraph (A) 

2 may provide services to a veteran under the 

3 pilot program under paragraph (1) while serv4 ing as part of a health care team for the vet5 eran under the Home Based Primary Care pro6 gram. 

7 (4) DURATION.—The pilot program under para8 graph (1) shall be for a duration of three years. 

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

10 year after the date on which the Secretary deter11 mines the pilot program under paragraph (1) has 

12 terminated, the Secretary shall submit to the Com13 mittees on Veterans’ Affairs of the House of Rep14 resentatives and the Senate a report on the result of 

15 the pilot program. 

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

17 year after the date of the enactment of this Act, the Sec18 retary of Veterans Affairs shall submit to the Committees 

19 on Veterans’ Affairs of the House of Representatives and 

20 the Senate a report containing, with respect to the period 

21 beginning in fiscal year 2011 and ending in fiscal year 

22 2022, the following: 

23 (1) An identification of the amount of funds 

24 that were included in a budget of the Department of 

25 Veterans Affairs during such period for the provision 


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1 of in-home care to veterans under the Home Maker 

2 and Home Health Aide program but were not ex3 pended for such provision, disaggregated by medical 

4 center of the Department for which such unex5 pended funds were budgeted. 

6 (2) An identification of the number of veterans 

7 for whom, during such period, the hours during 

8 which a home health aide was authorized to provide 

9 services to the veteran under the Home Maker and 

10 Home Health Aide program were reduced for a rea11 son other than a change in the health care needs of 

12 the veteran, and a detailed description of the reasons 

13 why any such reductions may have occurred. 

14 (c) UPDATED GUIDANCE ON PROGRAM.—Not later 

15 than one year after the date of the enactment of this Act, 

16 the Secretary shall issue updated guidance for the Home 

17 Maker and Home Health Aide program. Such updated 

18 guidance shall include the following: 

19 (1) A process for the transition of veterans 

20 from the Home Maker and Home Health Aide pro21 gram to other covered programs. 

22 (2) A requirement for the directors of the med23 ical facilities of the Department to complete such 

24 process whenever a veteran with care needs has been 

25 denied services from home health agencies under the 


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1 Home Maker and Home Health Aide program as a 

2 result of the clinical needs or behavioral issues of the 

3 veteran. 

4 SEC. 8. REVIEWS AND OTHER IMPROVEMENTS RELATING 

5 TO HOME AND COMMUNITY BASED SERVICES. 

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

7 (1) REVIEW OF PROGRAMS.—The Under Sec8 retary for Health of the Department of Veterans Af9 fairs shall conduct a review of each program admin10 istered through the Office of Geriatric and Extended 

11 Care of the Department, or successor office, to— 

12 (A) ensure consistency in program man13 agement; 

14 (B) eliminate service gaps at the medical 

15 center level; and 

16 (C) ensure the availability of, and the ac17 cess by veterans to, home and community based 

18 services. 

19 (2) ASSESSMENT OF STAFFING NEEDS.—The 

20 Secretary of Veterans Affairs shall conduct an as21 sessment of the staffing needs of the Office of Geri22 atric and Extended Care of the Department of Vet23 erans Affairs, or successor office. 

24 (3) GOALS FOR GEOGRAPHIC ALIGNMENT OF

25 CARE.— 


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1 (A) ESTABLISHMENT OF GOALS.—The Di2 rector of the Office of Geriatric and Extended 

3 Care, or successor office, shall establish quan4 titative goals to enable aging or disabled vet5 erans who are not located near medical centers 

6 of the Department to access extended care serv7 ices (including by improving access to home and 

8 community based services for such veterans). 

9 (B) IMPLEMENTATION TIMELINE.—Each 

10 goal established under subparagraph (A) shall 

11 include a timeline for the implementation of the 

12 goal at each medical center of the Department. 

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

14 The Director of the Office of Geriatric and Extended 

15 Care, or successor office, shall establish quantitative 

16 goals to address the specialty care needs of veterans 

17 through in-home care, including by ensuring the 

18 education of home health aides and caregivers of vet19 erans in the following areas: 

20 (A) Dementia care. 

21 (B) Care for spinal cord injuries and dis22 eases. 

23 (C) Ventilator care. 

24 (D) Other speciality care areas as deter25 mined by the Secretary. 


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

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

3 Secretary shall submit to the Committees on Vet4 erans’ Affairs of the House of Representatives and 

5 the Senate a report containing the findings of the 

6 review under paragraph (1), the results of the as7 sessment under paragraph (2), and the goals estab8 lished under paragraphs (3) and (4). 

9 (b) REVIEW OF INCENTIVES AND EFFORTS RELAT10 ING TO HOME AND COMMUNITY BASED SERVICES.— 

11 (1) REVIEW.—The Secretary of Veterans Af12 fairs shall conduct a review of the following: 

13 (A) The financial and organizational incen14 tives for the directors of medical centers of the 

15 Department to establish or expand covered pro16 grams at such medical centers. 

17 (B) Any incentives for such directors to 

18 provide to veterans home and community based 

19 services in lieu of institutional care. 

20 (C) The efforts taken by the Secretary to 

21 enhance spending of the Department for ex22 tended care by shifting the balance of such 

23 spending from institutional care to home and 

24 community based services. 


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1 (D) The plan of the Under Secretary for 

2 Health of the Department to accelerate efforts 

3 to enhance spending as specified in subpara4 graph (C), to match the progress of similar ef5 forts taken by the Administrator of the Centers 

6 for Medicare & Medicaid Services with respect 

7 to spending of the Centers for Medicare & Med8 icaid Services for extended care. 

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

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

11 Secretary shall submit to the Committees on Vet12 erans’ Affairs of the House of Representatives and 

13 the Senate a report on the findings of the review 

14 under paragraph (1). 

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

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

17 the Secretary of Veterans Affairs shall conduct a review 

18 of the use, availability, and effectiveness, of the respite 

19 care services furnished by the Secretary under chapter 17 

20 of title 38, United States Code. 

21 (d) COLLABORATION TO IMPROVE HOME AND COM22 MUNITY BASED SERVICES.— 

23 (1) REPORT ON EXPANSION OF CERTAIN MEN24 TAL HEALTH SERVICES.— 


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1 (A) REPORT.—Not later than two years 

2 after the date of the enactment of this Act, the 

3 Secretary of Veterans Affairs, in collaboration 

4 with the Secretary of Health and Human Serv5 ices, shall submit to the Committees on Vet6 erans’ Affairs of the House of Representatives 

7 and the Senate a report containing rec8 ommendations for the expansion of mental 

9 health services and related support to the care10 givers of veterans. 

11 (B) MATTERS INCLUDED.—The report 

12 under subparagraph (A) shall include an assess13 ment of the feasibility and advisability of au14 thorizing access to Vet Centers by— 

15 (i) family caregivers enrolled in a pro16 gram under section 1720G of title 38, 

17 United States Code; and 

18 (ii) family caregivers of veterans par19 ticipating in a program specified in section 

20 1720K of such title, as added by section 4. 

21 (2) RECOMMENDATIONS.— 

22 (A) DEVELOPMENT.—The Secretary of 

23 Veterans Affairs shall develop recommendations 

24 as follows: 


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1 (i) With respect to home and commu2 nity based services for veterans, the Sec3 retary of Veterans Affairs shall develop 

4 recommendations regarding new services 

5 (in addition to those furnished as of the 

6 date of the enactment of this Act) in col7 laboration with the Secretary of Health 

8 and Human Services. 

9 (ii) With respect to the national short10 age of home health aides, the Secretary of 

11 Veterans Affairs shall develop rec12 ommendations regarding methods to ad13 dress such shortage in collaboration with 

14 the Secretary of Health and Human Serv15 ices and the Secretary of Labor. 

16 (B) SUBMISSION TO CONGRESS.—The Sec17 retary of Veterans Affairs shall submit to the 

18 Committees on Veterans’ Affairs of the House 

19 of Representatives and the Senate a report con20 taining the recommendations developed under 

21 subparagraph (A) and an identification of any 

22 changes in existing law or new statutory au23 thority necessary to implement the rec24 ommendations, as determined by the Secretary. 


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1 (3) FEEDBACK AND RECOMMENDATIONS ON

2 CAREGIVER SUPPORT.— 

3 (A) FEEDBACK AND RECOMMENDA4 TIONS.—The Secretary of Veterans Affairs shall 

5 solicit from the entities described in subpara6 graph (B) feedback and recommendations re7 garding opportunities for the Secretary to en8 hance home and community based services for 

9 veterans and the caregivers of veterans, includ10 ing through the potential provision by the entity 

11 of care and respite services to veterans and 

12 caregivers who may not be eligible for any pro13 gram under section 1720G of title 10, United 

14 States Code, or section 1720K of such title (as 

15 added by section 4), but have a need for assist16 ance. 

17 (B) COVERED ENTITIES.—The entities de18 scribed in this subparagraph are veterans serv19 ice organizations and nonprofit organizations 

20 with a focus on caregiver support (as deter21 mined by the Secretary). 

22 (4) COLLABORATION FOR NATIVE AMERICAN

23 VETERANS.—The Secretary of Veterans Affairs shall 

24 collaborate with the Director of the Indian Health 

25 Service and representatives from tribal health proVerDate Sep 11 2014 20:47 Mar 02, 2022 Jkt 029200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6201 E:\BILLS\H6823.IH H6823

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•HR 6823 IH

1 grams and Urban Indian organizations to ensure the 

2 availability of home and community based services 

3 for Native American veterans, including Native 

4 American veterans receiving health care and medical 

5 services under multiple health care systems. 

6 SEC. 9. DEFINITIONS. 

7 In this Act: 

8 (1) The terms ‘‘caregiver’’ and ‘‘family care9 giver’’ have the meanings given those terms under 

10 section 1720K(g) of title 38, United States Code (as 

11 added by section 4). 

12 (2) The term ‘‘covered program’’— 

13 (A) means any program of the Department 

14 of Veterans Affairs for home and community 

15 based services; and 

16 (B) includes the programs specified in sec17 tion 1720K of title 38, United States Code (as 

18 added by section 4). 

19 (3) The term ‘‘home and community based 

20 services’’— 

21 (A) means the services referred to in sec22 tion 1701(6)(E) of title 38, United States Code; 

23 and 


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•HR 6823 IH

1 (B) includes services furnished under a 

2 program specified in section 1720K of such title 

3 (as added by section 4). 

4 (4) The terms ‘‘Home Based Primary Care pro5 gram’’, ‘‘Home Maker and Home Health Aide pro6 gram’’, and ‘‘Veteran Directed Care program’’ mean 

7 the programs of the Department of Veterans Affairs 

8 specified in subsections (d), (c), and (b) of such sec9 tion 1720K, respectively. 

10 (5) The terms ‘‘home health agency’’, ‘‘home 

11 health aide’’, ‘‘Native American’’, ‘‘Native American 

12 veteran’’, ‘‘tribal health programs’’, and ‘‘Urban In13 dian organizations’’ have the meanings given those 

14 terms in subsection (g) of such section 1720K. 

15 (6) The term ‘‘Vet Center’’ has the meaning 

16 given that term in section 1712A(h) of title 38, 

17 United States Code. 

18 (7) The term ‘‘veterans service organization’’ 

19 means any organization recognized by the Secretary 

20 under section 5902 of such title. 

Æ 


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