IB 
Union Calendar No. 671 
115TH CONGRESS 
2D SESSION 
H. R. 5693 
[Report No. 115–868] 
To amend title 38, United States Code, to authorize the Secretary of Veterans 
Affairs to enter into contracts and agreements for the placement of 
veterans in non-Department medical foster homes for certain veterans 
who are unable to live independently. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 7, 2018 
Mr. HIGGINS of Louisiana introduced the following bill; which was referred 
to the Committee on Veterans’ Affairs 
JULY 24, 2018 
Additional sponsors: Mrs. RADEWAGEN, Miss GONZA´LEZ-COLO´N of Puerto 
Rico, Mr. CORREA, and Ms. BROWNLEY of California 
JULY 24, 2018 
Reported with amendments, committed to the Committee of the Whole House 
on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on May 7, 2018] 
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A BILL 
To amend title 38, United States Code, to authorize the 
Secretary of Veterans Affairs to enter into contracts 
and agreements for the placement of veterans in non- 
Department medical foster homes for certain veterans 
who are unable to live independently. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Long-Term Care Vet-
erans Choice Act’’. 
SEC. 2. SECRETARY OF VETERANS AFFAIRS CONTRACT AU-
THORITY FOR PLACEMENT OF VETERANS IN 
NON-DEPARTMENT MEDICAL FOSTER HOMES. 
(a) AUTHORITY.—Section 1720 of title 38, United 
States Code, is amended by adding at the end the following 
new subsection: 
‘‘(h)(1) During the three-year period beginning on Oc-
tober 1, 2019, and subject to paragraph (2), at the request 
of a veteran for whom the Secretary is required to provide 
nursing home care under section 1710A of this title, the Sec-
retary may place the veteran in a medical foster home that 
meets Department standards, at the expense of the United 
States, pursuant to a contract, agreement, or other arrange-
ment entered into between the Secretary and the medical 
foster home for such purpose. A veteran who is placed in 
a medical foster home under this subsection shall agree, as 
a condition of such placement, to accept home health serv-
ices furnished by the Secretary under section 1717 of this 
title. 
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‘‘(2) In any year, not more than a daily average of 
900 veterans placed in a medical foster home, whether 
placed before or after the date of the enactment of this sub-
section, may have their care covered at the expense of the 
United States under subsection (a). 
‘‘(3) In this subsection, the term ‘medical foster home’ 
means a home designed to provide non-institutional, long- 
term, supportive care for veterans who are unable to live 
independently and prefer a family setting.’’. 
(b) EFFECTIVE DATE.—Subsection (h) of title 38, 
United States Code, as added by subsection (a), shall take 
effect on October 1, 2019. 
SEC. 3. ESTABLISHMENT OF VETERANS ECONOMIC OPPOR-
TUNITY AND TRANSITION ADMINISTRATION. 
(a) VETERANS ECONOMIC OPPORTUNITY AND TRANSI-
TION ADMINISTRATION.— 
(1) IN GENERAL.—Part V of title 38, United 
States Code, is amended by adding at the end the fol-
lowing new chapter: 
‘‘CHAPTER 80—VETERANS ECONOMIC OP-
PORTUNITY AND TRANSITION ADMIN-
ISTRATION 
‘‘Sec. 
‘‘8001. Organization of Administration. 
‘‘8002. Functions of Administration. 
‘‘8003. Annual report to Congress. 
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‘‘§ 8001. Organization of Administration 
‘‘(a) VETERANS ECONOMIC OPPORTUNITY AND TRAN-
SITION ADMINISTRATION.—There is in the Department of 
Veterans Affairs a Veterans Economic Opportunity and 
Transition Administration. The primary function of the 
Veterans Economic Opportunity and Transition Adminis-
tration is the administration of the programs of the Depart-
ment that provide assistance related to economic oppor-
tunity to veterans and their dependents and survivors. 
‘‘(b) UNDER SECRETARY
FOR ECONOMIC OPPOR-
TUNITY AND TRANSITION.—The Veterans Economic Oppor-
tunity and Transition Administration is under the Under 
Secretary for Veterans Economic Opportunity and Transi-
tion, who is directly responsible to the Secretary for the op-
erations of the Administration. 
‘‘§ 8002. Functions of Administration 
‘‘The Veterans Economic Opportunity and Transition 
Administration is responsible for the administration of the 
following programs of the Department: 
‘‘(1) Vocational rehabilitation and employment 
programs. 
‘‘(2) Educational assistance programs. 
‘‘(3) Veterans’ housing loan and related pro-
grams. 
‘‘(4) The verification of small businesses owned 
and controlled by veterans pursuant to subsection (f) 
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of section 8127 of this title, including the administra-
tion of the database of veteran-owned businesses de-
scribed in such subsection. 
‘‘(5) The Transition Assistance Program under 
section 1144 of title 10. 
‘‘(6) Any other program of the Department that 
the Secretary determines appropriate. 
‘‘§ 8003. Annual report to Congress 
‘‘The Secretary shall include in the annual report to 
the Congress required by section 529 of this title a report 
on the programs administered by the Under Secretary for 
Veterans Economic Opportunity and Transition. Each such 
report shall include the following with respect to each such 
program during the fiscal year covered by that report: 
‘‘(1) The number of claims received. 
‘‘(2) The number of claims decided. 
‘‘(3) The average processing time for a claim. 
‘‘(4) The number of successful outcomes (as deter-
mined by the Secretary). 
‘‘(5) The number of full-time equivalent employ-
ees. 
‘‘(6) The amounts expended for information tech-
nology.’’. 
(2) CLERICAL
AMENDMENTS.—The tables of 
chapters at the beginning of title 38, United States 
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Code, and of part V of title 38, United States Code, 
are each amended by inserting after the item relating 
to chapter 79 the following new item: 
‘‘80. Veterans Economic Opportunity and Transition Ad-
ministration .................................................................. 8001’’. 
(b) EFFECTIVE DATE.—Chapter 80 of title 38, United 
States Code, as added by subsection (a), shall take effect 
on October 1, 2019. 
(c) FULL-TIME EMPLOYEES.—For fiscal years 2019 
and 2020, the total number of full-time equivalent employ-
ees authorized for the Veterans Benefits Administration and 
the Veterans Economic Opportunity and Transition Ad-
ministration, as established under chapter 80 of title 38, 
United States Code, as added by subsection (a), may not 
exceed 23,692. 
SEC. 4. UNDER SECRETARY FOR VETERANS ECONOMIC OP-
PORTUNITY AND TRANSITION. 
(a) UNDER SECRETARY.— 
(1) IN GENERAL.—Chapter 3 of title 38, United 
States Code, is amended by inserting after section 306 
the following new section: 
‘‘§ 306A. Under Secretary for Veterans Economic Op-
portunity and Transition 
‘‘(a) UNDER SECRETARY.—There is in the Department 
an Under Secretary for Veterans Economic Opportunity 
and Transition, who is appointed by the President, by and 
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with the advice and consent of the Senate. The Under Sec-
retary for Veterans Economic Opportunity and Transition 
shall be appointed without regard to political affiliation or 
activity and solely on the basis of demonstrated ability in— 
‘‘(1) information technology; and 
‘‘(2) the administration of programs within the 
Veterans Economic Opportunity and Transition Ad-
ministration or programs of similar content and 
scope. 
‘‘(b) RESPONSIBILITIES.—The Under Secretary for 
Veterans Economic Opportunity and Transition is the head 
of, and is directly responsible to the Secretary for the oper-
ations of, the Veterans Economic Opportunity and Transi-
tion Administration. 
‘‘(c) VACANCIES.—(1) Whenever a vacancy in the posi-
tion of Under Secretary for Veterans Economic Oppor-
tunity and Transition occurs or is anticipated, the Sec-
retary shall establish a commission to recommend individ-
uals to the President for appointment to the position. 
‘‘(2) A commission established under this subsection 
shall be composed of the following members appointed by 
the Secretary: 
‘‘(A) Three persons representing education and 
training, vocational rehabilitation, employment, real 
estate, mortgage finance and related industries, and 
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survivor benefits activities affected by the Veterans 
Economic Opportunity and Transition Administra-
tion. 
‘‘(B) Two persons representing veterans served 
by the Veterans Economic Opportunity and Transi-
tion Administration. 
‘‘(C) Two persons who have experience in the 
management of private sector benefits programs of 
similar content and scope to the economic oppor-
tunity and transition programs of the Department. 
‘‘(D) The Deputy Secretary of Veterans Affairs. 
‘‘(E) The chairman of the Veterans’ Advisory 
Committee on Education formed under section 3692 
of this title. 
‘‘(F) One person who has held the position of 
Under Secretary for Veterans Economic Opportunity 
and Transition, if the Secretary determines that it is 
desirable for such person to be a member of the com-
mission. 
‘‘(3) A commission established under this subsection 
shall recommend at least three individuals for appointment 
to the position of Under Secretary for Veterans Economic 
Opportunity and Transition. The commission shall submit 
all recommendations to the Secretary. The Secretary shall 
forward the recommendations to the President and the Com-
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mittees on Veterans’ Affairs of the Senate and House of 
Representatives with any comments the Secretary considers 
appropriate. Thereafter, the President may request the com-
mission to recommend additional individuals for appoint-
ment. 
‘‘(4) The Assistant Secretary or Deputy Assistant Sec-
retary of Veterans Affairs who performs personnel manage-
ment and labor relations functions shall serve as the execu-
tive secretary of a commission established under this sub-
section.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of such chapter is amended by 
inserting after the item relating to section 306 the fol-
lowing new item: 
‘‘306A. Under Secretary for Veterans Economic Opportunity and Transition.’’. 
(b) CONFORMING AMENDMENTS.—Title 38, United 
States Code, is further amended— 
(1) in section 306(c)(2), by striking subpara-
graphs (A) and (E) and redesignating subparagraphs 
(B), (C), (D), and (F), as subparagraphs (A) through 
(D), respectively; 
(2) in section 317(d)(2), by inserting after 
‘‘Under Secretary for Benefits,’’ the following: ‘‘the 
Under Secretary for Veterans Economic Opportunity 
and Transition,’’; 
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(3) in section 318(d)(2), by inserting after 
‘‘Under Secretary for Benefits,’’ the following: ‘‘the 
Under Secretary for Veterans Economic Opportunity 
and Transition,’’; 
(4) in section 516(e)(2)(C), by striking ‘‘Health 
and the Under Secretary for Benefits’’ and inserting 
‘‘Health, the Under Secretary for Benefits, and the 
Under Secretary for Veterans Economic Opportunity 
and Transition’’; 
(5) in section 541(a)(2)(B), by striking ‘‘Health 
and the Under Secretary for Benefits’’ and inserting 
‘‘Health, the Under Secretary for Benefits, and the 
Under Secretary for Veterans Economic Opportunity 
and Transition’’; 
(6) in section 542(a)(2)(B)(iii), by striking 
‘‘Health and the Under Secretary for Benefits’’ and 
inserting ‘‘Health, the Under Secretary for Benefits, 
and the Under Secretary for Veterans Economic Op-
portunity and Transition’’; 
(7) in section 544(a)(2)(B)(vi), by striking 
‘‘Health and the Under Secretary for Benefits’’ and 
inserting ‘‘Health, the Under Secretary for Benefits, 
and the Under Secretary for Veterans Economic Op-
portunity and Transition’’; 
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(8) in section 709(c)(2)(A), by inserting after 
‘‘Under Secretary for Benefits,’’ the following: ‘‘the 
Under Secretary for Veterans Economic Opportunity 
and Transition,’’; 
(9) in section 7701(a), by inserting after ‘‘assist-
ance’’ the following: ‘‘, other than assistance related to 
Economic Opportunity and Transition,’’; and 
(10) in section 7703, by striking paragraphs (2) 
and (3) and redesignating paragraphs (4) and (5) as 
paragraphs (2) and (3), respectively. 
(c) EFFECTIVE DATE.—Section 306A of title 38, 
United States Code, as added by subsection (a), and the 
amendments made by this section, shall take effect on Octo-
ber 1, 2019. 
SEC. 5. LOANS GUARANTEED UNDER HOME LOAN PROGRAM 
OF DEPARTMENT OF VETERANS AFFAIRS. 
The table in section 3729(b)(2) of such title is amended 
by striking the item relating to subparagraph (E) and in-
serting the following new item: 
‘‘(E)(i) Interest rate reduction refi-
nancing loan (closed before January 
1, 2019) ...............................................
0.50 
0.50 
NA
(E)(ii) Interest rate reduction refi-
nancing loan (closed on or after 
January 1, 2019, but before October 
1, 2024) ...............................................
0.75 
0.75 
NA
(E)(iii) Interest rate reduction refi-
nancing loan (closed on or after Oc-
tober 1, 2024) .....................................
0.50 
0.50 
NA’’. 
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Amend the title so as to read: ‘‘A bill to amend title 
38, United States Code, to authorize the Secretary of 
Veterans Affairs to enter into contracts and agreements 
for the placement of veterans in non-Department medical 
foster homes for certain veterans who are unable to live 
independently, to establish the Veterans Economic Op-
portunity and Transition Administration and the Under 
Secretary for Veterans Economic Opportunity and Tran-
sition of the Department of Veterans Affairs, to amend 
the interest rate for certain loans guaranteed under the 
home loan program of the Department of Veterans Af-
fairs, and for other purposes.’’. 
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Union Calendar No. 671 
115TH CONGRESS 
2D SESSION 
H. R. 5693 
[Report No. 115–868] 
A BILL 
To amend title 38, United States Code, to author-
ize the Secretary of Veterans Affairs to enter 
into contracts and agreements for the placement 
of veterans in non-Department medical foster 
homes for certain veterans who are unable to live 
independently. 
JULY 24, 2018 
Reported with amendments, committed to the Committee 
of the Whole House on the State of the Union, and or-
dered to be printed 
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