HR 8371 RDS
SEC. 130. REVIEWS AND OTHER IMPROVEMENTS RELATING 
TO HOME- AND COMMUNITY-BASED SERV-
ICES. 
(a) OFFICE OF GERIATRIC AND EXTENDED CARE.— 
(1) REVIEW OF PROGRAMS.—The Under Sec-
retary for Health of the Department of Veterans Af-
fairs shall conduct a review of each program admin-
istered through the Office of Geriatric and Extended 
Care of the Department and the Caregiver Support 
Program Office of the Department, or any successor 
offices, to— 
(A) eliminate service gaps at the medical 
center level; and 
(B) ensure— 
(i) the clinical needs of veterans are 
met; 
(ii) consistency in program manage-
ment; 
(iii) the availability of, and the access 
by veterans to, home- and community- 
based services, including for veterans living 
in rural areas; and 
(iv) proper coordination between cov-
ered programs. 
(2) ASSESSMENT
OF
STAFFING
NEEDS.—The 
Secretary of Veterans Affairs shall conduct an as-
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sessment of the staffing needs of the Office of Geri-
atric and Extended Care of the Department and the 
Caregiver Support Program Office of the Depart-
ment, or any successor offices. 
(3) GOALS
FOR
GEOGRAPHIC
ALIGNMENT
OF 
CARE.— 
(A) ESTABLISHMENT OF GOALS.—The Di-
rector of the Office of Geriatric and Extended 
Care, or successor office, shall establish quan-
titative goals to enable aging or disabled vet-
erans who are not located near medical centers 
of the Department to access extended care serv-
ices (including by improving access to home- 
and community-based services for such vet-
erans). 
(B) IMPLEMENTATION
TIMELINE.—Each 
goal established under subparagraph (A) shall 
include a timeline for the implementation of the 
goal at each medical center of the Department. 
(4) GOALS FOR IN-HOME SPECIALTY CARE.— 
The Director of the Office of Geriatric and Extended 
Care, or successor office, shall establish quantitative 
goals to address the specialty care needs of veterans 
through in-home care, including by ensuring the 
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education of home health aides and caregivers of vet-
erans in the following areas: 
(A) Dementia care. 
(B) Care for spinal cord injuries and dis-
eases. 
(C) Ventilator care. 
(D) Other speciality care areas as deter-
mined by the Secretary. 
(5) INPUT
ON
GOALS.—To the extent prac-
ticable, the head of the Caregiver Support Program 
Office, or successor office, shall provide to the Direc-
tor of the Office of Geriatric and Extended Care, or 
successor office, input with respect to the establish-
ment of the goals under paragraphs (3) and (4). 
(6) REPORT TO CONGRESS.—Not later than one 
year after the date of the enactment of this Act, the 
Secretary shall submit to the Committees on Vet-
erans’ Affairs of the House of Representatives and 
the Senate a report containing the findings of the 
review under paragraph (1), the results of the as-
sessment under paragraph (2), and the goals estab-
lished under paragraphs (3) and (4). 
(b) REVIEW OF INCENTIVES AND EFFORTS RELAT-
ING TO HOME- AND COMMUNITY-BASED SERVICES.— 
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(1) REVIEW.—The Secretary of Veterans Af-
fairs shall conduct a review of the following: 
(A) The financial and organizational incen-
tives or disincentives for the directors of med-
ical centers of the Department to establish or 
expand covered programs at such medical cen-
ters. 
(B) Any incentives or disincentives for 
such directors to provide to veterans home- and 
community-based services in lieu of institutional 
care. 
(C) The efforts taken by the Secretary to 
enhance spending of the Department for ex-
tended care by balancing spending between in-
stitutional care and home- and community- 
based services consistent with the demand for 
such services. 
(D) The plan of the Under Secretary for 
Health of the Department to accelerate efforts 
to enhance spending as specified in subpara-
graph (C), to match the progress of similar ef-
forts taken by the Administrator of the Centers 
for Medicare & Medicaid Services with respect 
to spending of the Centers for Medicare & Med-
icaid Services for extended care. 
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(2) REPORT TO CONGRESS.—Not later than one 
year after the date of the enactment of this Act, the 
Secretary shall submit to the Committees on Vet-
erans’ Affairs of the House of Representatives and 
the Senate a report on the findings of the review 
under paragraph (1). 
(c) REVIEW OF RESPITE CARE SERVICES.—Not later 
than two years after the date of the enactment of this Act, 
the Secretary of Veterans Affairs shall conduct a review 
of the use, availability, cost,and effectiveness, of the res-
pite care services furnished by the Secretary under chapter 
17 of title 38, United States Code, including— 
(1) the frequency at which the Department of 
Veterans Affairs is unable to meet demand for such 
services; 
(2) a detailed description of— 
(A) the reasons the Department of Vet-
erans Affairs is unable to meet the demand for 
such services; and 
(B) any actions, or planned actions, of the 
Secretary of Veterans Affairs to ensure such 
demand is met. 
(d) COLLABORATION TO IMPROVE HOME- AND COM-
MUNITY-BASED SERVICES.— 
(1) RECOMMENDATIONS.— 
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HR 8371 RDS
(A) DEVELOPMENT.—The Secretary of 
Veterans Affairs shall develop recommendations 
as follows: 
(i) With respect to home- and commu-
nity-based services for veterans, the Sec-
retary of Veterans Affairs shall develop 
recommendations regarding new services 
(in addition to those furnished as of the 
date of enactment of this Act) in collabora-
tion with the Secretary of Health and 
Human Services. 
(ii) With respect to the national short-
age of home health aides, the Secretary of 
Veterans 
Affairs 
shall 
develop 
rec-
ommendations regarding methods to ad-
dress such shortage in collaboration with 
the Secretary of Health and Human Serv-
ices and the Secretary of Labor. 
(B) SUBMISSION TO CONGRESS.—The Sec-
retary of Veterans Affairs shall submit to the 
Committees on Veterans’ Affairs of the House 
of Representatives and the Senate a report con-
taining the recommendations developed under 
subparagraph (A) and an identification of any 
changes in existing law or new statutory au-
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