HR 542 RDS
pended for such provision, disaggregated by medical 
center of the Department for which such unex-
pended funds were budgeted (if such disaggregation 
is possible). 
(2) To the extent practicable, an identification 
of the number of veterans for whom, during such pe-
riod, the hours during which a home health aide was 
authorized to provide services to the veteran under 
the Homemaker and Home Health Aide program 
were reduced for a reason other than a change in 
the health care needs of the veteran, and a detailed 
description of the reasons why any such reductions 
may have occurred. 
(c) UPDATED GUIDANCE ON PROGRAM.—Not later 
than one year after the date of the enactment of this Act, 
the Secretary shall issue updated guidance for the Home-
maker and Home Health Aide program. Such updated 
guidance shall include the following: 
(1) A process for the transition of veterans 
from the Homemaker and Home Health Aide pro-
gram to other covered programs. 
(2) A requirement for the directors of the med-
ical facilities of the Department to complete such 
process whenever a veteran with care needs has been 
denied services from home health agencies under the 
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Homemaker and Home Health Aide program as a 
result of the clinical needs or behavioral issues of the 
veteran. 
SEC. 8. 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, or successor office, to— 
(A) ensure consistency in program man-
agement; 
(B) eliminate service gaps at the medical 
center level; and 
(C) ensure the availability of, and the ac-
cess by veterans to, home- and community- 
based services. 
(2) ASSESSMENT
OF
STAFFING
NEEDS.—The 
Secretary of Veterans Affairs shall conduct an as-
sessment of the staffing needs of the Office of Geri-
atric and Extended Care of the Department of Vet-
erans Affairs, or successor office. 
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(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 
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. 
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(C) Ventilator care. 
(D) Other speciality care areas as deter-
mined by the Secretary. 
(5) 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.— 
(1) REVIEW.—The Secretary of Veterans Af-
fairs shall conduct a review of the following: 
(A) The financial and organizational incen-
tives for the directors of medical centers of the 
Department to establish or expand covered pro-
grams at such medical centers. 
(B) Any incentives 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 shifting the balance of such 
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spending from institutional care to home- and 
community-based 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. 
(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, and effectiveness, of the respite 
care services furnished by the Secretary under chapter 17 
of title 38, United States Code. 
(d) COLLABORATION TO IMPROVE HOME- AND COM-
MUNITY-BASED SERVICES.— 
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