HR 542 RDS
(1) REPORT ON EXPANSION OF CERTAIN MEN-
TAL HEALTH SERVICES.— 
(A) REPORT.—Not later than two years 
after the date of the enactment of this Act, the 
Secretary of Veterans Affairs, in collaboration 
with the Secretary of Health and Human Serv-
ices, shall submit to the Committees on Vet-
erans’ Affairs of the House of Representatives 
and the Senate a report containing rec-
ommendations for the expansion of mental 
health services and related support to the care-
givers of veterans. 
(B) MATTERS
INCLUDED.—The report 
under subparagraph (A) shall include an assess-
ment of the feasibility and advisability of au-
thorizing access to Vet Centers by— 
(i) family caregivers enrolled in a pro-
gram under section 1720G of title 38, 
United States Code; and 
(ii) family caregivers of veterans par-
ticipating in a program specified in section 
1720K of such title, as added by section 4. 
(2) RECOMMENDATIONS.— 
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HR 542 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 the enactment of this Act) in col-
laboration 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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thority 
necessary 
to 
implement 
the 
rec-
ommendations, as determined by the Secretary. 
(C) CONSULTATION WITH SECRETARY OF 
LABOR.—In carrying out this paragraph, the 
Secretary of Veterans Affairs shall consult with 
the Secretary of Labor. 
(3) FEEDBACK
AND
RECOMMENDATIONS
ON 
CAREGIVER SUPPORT.— 
(A) 
FEEDBACK
AND
RECOMMENDA-
TIONS.—The Secretary of Veterans Affairs shall 
solicit from the entities described in subpara-
graph (B) feedback and recommendations re-
garding opportunities for the Secretary to en-
hance home- and community-based services for 
veterans and the caregivers of veterans, includ-
ing through the potential provision by the entity 
of care and respite services to veterans and 
caregivers who may not be eligible for any pro-
gram under section 1720G of title 38, United 
States Code, or section 1720K of such title (as 
added by section 4), but have a need for assist-
ance. 
(B) COVERED ENTITIES.—The entities de-
scribed in this subparagraph are veterans serv-
ice organizations and nonprofit organizations 
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with a focus on caregiver support (as deter-
mined by the Secretary). 
(4) COLLABORATION
FOR
NATIVE
AMERICAN 
VETERANS.—The Secretary of Veterans Affairs shall 
collaborate with the Director of the Indian Health 
Service and representatives from tribal health pro-
grams and Urban Indian organizations to ensure the 
availability of home- and community-based services 
for Native American veterans, including Native 
American veterans receiving health care and medical 
services under multiple health care systems. 
SEC. 9. MODIFICATION OF CERTAIN HOUSING LOAN FEES. 
The loan fee table in section 3729(b)(2) of title 38, 
United States Code, is amended by striking ‘‘November 
15, 2031’’ each place it appears and inserting ‘‘February 
4, 2032’’. 
SEC. 10. DEFINITIONS. 
In this Act: 
(1) The terms ‘‘caregiver’’ and ‘‘family care-
giver’’ have the meanings given those terms under 
section 1720K(h) of title 38, United States Code (as 
added by section 4). 
(2) The term ‘‘covered program’’— 
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(A) means any program of the Department 
of Veterans Affairs for home- and community- 
based services; and 
(B) includes the programs specified in sec-
tion 1720K of title 38, United States Code (as 
added by section 4). 
(3) The term ‘‘home- and community-based 
services’’— 
(A) means the services referred to in sec-
tion 1701(6)(E) of title 38, United States Code; 
and 
(B) includes services furnished under a 
program specified in section 1720K of such title 
(as added by section 4). 
(4) The terms ‘‘Home-Based Primary Care pro-
gram’’, ‘‘Homemaker and Home Health Aide pro-
gram’’, and ‘‘Veteran-Directed Care program’’ mean 
the programs of the Department of Veterans Affairs 
specified in subsection (d), (c), and (b) of such sec-
tion 1720K, respectively. 
(5) The terms ‘‘home health aide’’, ‘‘Native 
American’’, ‘‘Native American veteran’’, ‘‘tribal 
health programs’’, and ‘‘Urban Indian organiza-
tions’’ have the meanings given those terms in sub-
section (h) of such section 1720K. 
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HR 542 RDS
(6) The term ‘‘Vet Center’’ has the meaning 
given that term in section 1712A(h) of title 38, 
United States Code. 
(7) The term ‘‘veterans service organization’’ 
means any organization recognized by the Secretary 
under section 5902 of such title. 
Passed the House of Representatives December 5, 
2023. 
Attest: 
KEVIN F. MCCUMBER, 
Clerk. 
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