I 
118TH CONGRESS 
1ST SESSION H. R. 5002 
To direct the Secretary of Veterans Affairs to carry out a pilot program 
for the cognitive care of veterans, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 27, 2023 
Mrs. HARSHBARGER introduced the following bill; which was referred to the 
Committee on Veterans’ Affairs 
A BILL 
To direct the Secretary of Veterans Affairs to carry out 
a pilot program for the cognitive care of veterans, and 
for other purposes. 
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 ‘‘Innovative Cognitive 
Care for Veterans Act of 2023’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) According to a 2020 study by the Office of 
the Assistant Deputy Under Secretary for Health 
for Policy and Planning of the Department of Vet-
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erans Affairs, it is projected that the number of vet-
erans with Alzheimer’s dementia will increase by 
28.9 percent between fiscal year 2021 and fiscal 
year 2033, amounting to an estimated 48,000 new 
patients with cognitive impairments. 
(2) The cost of expenditures of the Department 
of Veterans Affairs for long-term care is growing 
rapidly, as demonstrated by a 2020 Government Ac-
countability Office report that estimates such ex-
penditures 
are 
projected 
to 
double 
to 
$14,300,000,000 by 2037. 
(3) As described in the report specified in para-
graph (2), the Department of Veterans Affairs also 
faces both a current and incoming workforce short-
age, in addition to other challenges relating to the 
provision of long-term care services to the more than 
2,800,000 estimated veterans who are enrolled in 
the patient enrollment system of the Department es-
tablished and operated under section 1705(a) of title 
38, United States Code, and live in rural areas. 
(4) As observed by the Secretary of Veterans 
Affairs, veterans can also be prone to unique factors 
that increase the risk for future cognitive impair-
ment. For example, it has been found that veterans 
who served during the Vietnam era and, while so 
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serving, were exposed to Agent Orange are nearly 
twice as likely as those without such exposure to re-
ceive a diagnosis of dementia. 
(5) According to the Department of Veterans 
Affairs, more than 185,000 veterans enrolled in the 
health care system of the Department of Veterans 
Affairs have been diagnosed with at least one trau-
matic brain injury. Traumatic brain injury often af-
fects the cognitive abilities of an individual and can 
disrupt normal brain function. Veterans with a trau-
matic brain injury are also 60 percent more likely to 
develop Alzheimer’s Disease or other forms of de-
mentia. 
(6) This data compels the United States Gov-
ernment to do more for veterans and their cognitive 
care. 
SEC. 3. PILOT PROGRAM OF DEPARTMENT OF VETERANS 
AFFAIRS FOR ADDRESSING COGNITIVE DIS-
ORDERS AMONG VETERANS. 
(a) PILOT PROGRAM.— 
(1) PILOT PROGRAM.—Not later than 180 days 
after the date of the enactment of this Act, the Sec-
retary of Veterans Affairs shall carry out, as a part 
of the Veterans Community Care Program under 
section 1703 of title 38, and in accordance with the 
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requirements of such program, a pilot program (in 
this section referred to as the ‘‘pilot program’’) 
under which the Secretary may enter into agree-
ments with eligible entities to furnish to partici-
pating veterans telehealth, virtual training tools for 
home health aides, and other innovative services, 
that slow the progression of cognitive disorders. 
(2) VETERANS CARE AGREEMENTS.—In enter-
ing into agreements under paragraph (1), the Sec-
retary may enter into a Veterans Care Agreement 
under section 1703A of title 38, United States Code, 
consistent with the requirements of such section. 
(b) SELECTION OF ENTITIES.— 
(1) ELIGIBLE ENTITIES.—An entity is eligible 
for entry into an agreement under the pilot program 
if the entity— 
(A) furnishes telehealth, virtual training 
tools for home health aides, or other innovative 
services, that slow the progression of cognitive 
disorders; and 
(B) meets such other requirements as the 
Secretary may prescribe. 
(2) PRIORITY.—In selecting eligible entities for 
entry into an agreement under the pilot program, 
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the Secretary shall give priority to eligible entities 
with— 
(A) demonstrated experience in— 
(i) providing assistance to individuals 
with cognitive disorders; 
(ii) addressing behavioral and tem-
perament issues, including through inter-
active engagement and stimulation solu-
tions; 
(iii) caregiver or home health aid 
training; and 
(iv) working in the field of cognitive 
disorders, including through the treatment 
of, or rehabilitation for, traumatic brain 
injury or neurodegenerative conditions; and 
(B) the ability to provide services under 
the pilot program to veterans at locations other 
than a hospital, nursing home, or other medical 
facility, in accordance with subsection (d)(2). 
(3) LIST OF SELECTED ENTITIES.—The Sec-
retary shall— 
(A) publish on an internet website of the 
Department a list identifying each eligible enti-
ty with which the Secretary has entered into an 
agreement under the pilot program; and 
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(B) ensure such list is accessible to vet-
erans selected for participation in the pilot pro-
gram. 
(c) SELECTION OF VETERANS.—In selecting veterans 
for participation in the pilot program, the Secretary— 
(1) shall ensure that not more than 500 vet-
erans participate in the pilot program at any given 
time; and 
(2) may not take into consideration age or risk 
factors for cognitive disorders. 
(d) SERVICES: SELF-DIRECTED AND IN-HOME NA-
TURE.—Each veteran selected by the Secretary for partici-
pation in the pilot program— 
(1) may select, from among the entities listed 
under subsection (b)(3) that are accessible to the 
veteran, the entity from which services shall be re-
ceived by the veteran under the pilot program; and 
(2) may elect to receive services under the pilot 
program at a location that is not a traditional med-
ical setting, such as at the residence of the veteran, 
in lieu of receiving such services at a hospital, nurs-
ing home, or other medical facility. 
(e) TERMINATION.—The pilot program shall termi-
nate on the date that is five years after the date on which 
the pilot program commences. 
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(f) REPORT.—Not later than 180 days after the date 
of termination under subsection (e), the Secretary shall 
submit to the Committees on Veterans’ Affairs of the 
House of Representatives and the Senate a report on the 
pilot program. Such report shall include the following: 
(1) A detailed overview of each entity with 
which the Secretary entered into an agreement 
under the pilot program, and the services that entity 
provided to participating veterans pursuant to such 
agreement. 
(2) An identification of the types of technology 
that eligible entities with which the Secretary en-
tered into an agreement under the pilot program 
used to provide services to participating veterans 
pursuant to such agreement. 
(3) An identification of the following: 
(A) The number of veterans that partici-
pated in the pilot program. 
(B) The number of veterans that applied 
to participate in the pilot program but were not 
selected for participation as a result of the limi-
tation under subsection (c)(2). 
(C) Of the veterans who participated in the 
pilot program, the number who, for the dura-
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tion of such participation, received services 
under the pilot program. 
(D) Of the veterans who participated in 
the pilot program, the number who suffered 
traumatic brain injury while serving in the 
Armed Forces, including, for each such vet-
eran— 
(i) a classification of the traumatic 
brain injury so suffered as mild, moderate, 
or severe (as the case may be); and 
(ii) an identification of the mechanism 
of injury. 
(E) The percentage of veterans who par-
ticipated in the pilot program (disaggregated by 
type of outcome specified in clauses (i) through 
(iii)) who reported that such participation re-
sulted in the following outcomes, with respect to 
the individual veteran: 
(i) Quality of life improved. 
(ii) Quality of life was unaffected. 
(iii) Quality of life worsened. 
(F) A socioeconomic and demographic 
breakdown of veterans who participated in the 
pilot program. 
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(G) The type of housing in which the vet-
erans who participated in the pilot program re-
side. 
(H) Whether the veterans who participated 
in the pilot program have access to personal 
care services from a caregiver, and if so, wheth-
er such services were furnished by the Secretary 
(including through a non-Department of Vet-
erans Affairs health care provider providing 
such services under the laws administered by 
the Secretary). 
(I) Such other information as may be de-
termined relevant by the Secretary. 
(g) SOURCE OF FUNDS.—Amounts required to carry 
out this Act shall be derived from unobligated amounts 
appropriated to the Veterans Health Administration and 
determined appropriate by the Secretary. 
Æ 
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