IB 
Union Calendar No. 228 
118TH CONGRESS 
1ST SESSION 
H. R. 542 
[Report No. 118–284] 
To amend title 38, United States Code, to improve certain programs of 
the Department of Veterans Affairs for home and community based 
services for veterans, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 26, 2023 
Ms. BROWNLEY (for herself and Mr. BERGMAN) introduced the following bill; 
which was referred to the Committee on Veterans’ Affairs 
NOVEMBER 29, 2023 
Additional sponsors: Ms. DAVIDS of Kansas, Ms. DEAN of Pennsylvania, Mr. 
MCGOVERN, Ms. KUSTER, Ms. LOIS FRANKEL of Florida, Mr. KILMER, 
Ms. BARRAGA´N, Mr. GOTTHEIMER, Mr. LIEU, Mrs. DINGELL, Mrs. 
CHERFILUS-MCCORMICK, Mr. KILDEE, Ms. MATSUI, Mr. TRONE, Mr. 
SABLAN, Ms. UNDERWOOD, Mr. LYNCH, Mr. CICILLINE, Mr. CASAR, Mr. 
SWALWELL, Ms. SHERRILL, Ms. BUDZINSKI, Ms. NORTON, Mr. MRVAN, 
Ms. CARAVEO, Mr. MORELLE, Ms. WILD, Mrs. NAPOLITANO, Ms. 
STRICKLAND, Mr. LATURNER, Mr. EVANS, Mr. LANDSMAN, Mr. LEVIN, 
Mrs. HAYES, Ms. DELBENE, Mr. DELUZIO, Ms. SCHAKOWSKY, Ms. 
TITUS, Ms. ROSS, Mr. MAGAZINER, Mr. LARSEN of Washington, Ms. 
WILLIAMS of Georgia, Ms. ESCOBAR, Mr. CASTRO of Texas, Mr. 
MOSKOWITZ, Ms. SALINAS, Mr. MCGARVEY, Mrs. GONZA´LEZ-COLO´N, Ms. 
JACOBS, Mr. FROST, Mr. CROW, Mrs. RADEWAGEN, Mr. RYAN, Mr. VAN 
DREW, Mr. CARBAJAL, Ms. MOORE of Wisconsin, Mr. VAN ORDEN, Mr. 
VALADAO, Mrs. KIGGANS of Virginia, Ms. WEXTON, Ms. TOKUDA, Mr. 
ALLRED, Mrs. RAMIREZ, Mr. STANTON, Mr. MIKE GARCIA of California, 
Mr. HUIZENGA, Mr. MOULTON, Mr. FITZPATRICK, Mr. NEGUSE, Mr. 
ROUZER, Mr. KEATING, Mr. TONKO, Mr. CARL, Mr. TAKANO, and Mrs. 
FLETCHER 
NOVEMBER 29, 2023 
Reported with an amendment, committed to the Committee of the Whole 
House on the State of the Union, and ordered to be printed 
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[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 January 26, 2023] 
A BILL 
To amend title 38, United States Code, to improve certain 
programs of the Department of Veterans Affairs for 
home and community based services for veterans, and 
for other purposes. 
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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; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Elizabeth Dole Home- and Community-Based Services for 
Veterans and Caregivers Act of 2023’’ or the ‘‘Elizabeth 
Dole Home Care Act of 2023’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Increase of expenditure cap for noninstitutional care alternatives to nurs-
ing home care. 
Sec. 3. Coordination with Program of All-Inclusive Care for the Elderly. 
Sec. 4. Home- and community-based services: programs. 
Sec. 5. Coordination with assistance and support services for caregivers. 
Sec. 6. Development of centralized website for program information. 
Sec. 7. Improvements relating to Homemaker and Home Health Aide program. 
Sec. 8. Reviews and other improvements relating to home- and community-based 
services. 
Sec. 9. Modification of certain housing loan fees. 
Sec.10. Definitions. 
SEC. 2. INCREASE OF EXPENDITURE CAP FOR NONINSTITU-
TIONAL CARE ALTERNATIVES TO NURSING 
HOME CARE. 
(a) INCREASE
OF
EXPENDITURE
CAP.—Section 
1720C(d) of title 38, United States Code, is amended— 
(1) by striking ‘‘The total cost’’ and inserting 
‘‘(1) Except as provided in paragraph (2), the total 
cost’’; 
(2) by striking ‘‘65 percent’’ and inserting ‘‘100 
percent’’; and 
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(3) by adding at the end the following new para-
graph: 
‘‘(2)(A) The total cost of providing services or in-kind 
assistance in the case of any veteran described in subpara-
graph (B) for any fiscal year under the program may ex-
ceed 100 percent of the cost that would otherwise have been 
incurred as specified in paragraph (1) if the Secretary de-
termines, based on a consideration of clinical need, geo-
graphic market factors, and such other matters as the Sec-
retary may prescribe through regulation, that such higher 
total cost is in the best interest of the veteran. 
‘‘(B) A veteran described in this subparagraph is a 
veteran with amyotrophic lateral sclerosis, a spinal cord in-
jury, or a condition the Secretary determines to be similar 
to such conditions.’’. 
(b) APPLICABILITY.—The amendments made by sub-
section (a) shall apply with respect to fiscal years beginning 
on or after the date of the enactment of this Act. 
SEC. 3. COORDINATION WITH PROGRAM OF ALL-INCLUSIVE 
CARE FOR THE ELDERLY. 
Section 1720C of title 38, United States Code, as 
amended by section 2, is further amended by adding at the 
end the following new subsection: 
‘‘(f) In furnishing services to a veteran under the pro-
gram conducted pursuant to subsection (a), if a medical 
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center of the Department through which such program is 
administered is located in a geographic area in which serv-
ices are available to the veteran under a PACE program 
(as such term is defined in sections 1894(a)(2) and 
1934(a)(2) of the Social Security Act (42 U.S.C. 
1395eee(a)(2); 1396u–4(a)(2))), the Secretary shall seek to 
enter into an agreement with the PACE program operating 
in that area for the furnishing of such services.’’. 
SEC. 4. HOME- AND COMMUNITY-BASED SERVICES: PRO-
GRAMS. 
(a) PROGRAMS.—Chapter 17 of title 38, United States 
Code, is amended by inserting after section 1720J the fol-
lowing new section (and conforming the table of sections 
at the beginning of such chapter accordingly): 
‘‘§ 1720K. Home- and community-based services: pro-
grams 
‘‘(a) IN GENERAL.—In furnishing noninstitutional al-
ternatives to nursing home care pursuant to the authority 
of section 1720C of this title (or any other authority under 
this chapter or other provision of law administered by the 
Secretary of Veterans Affairs), the Secretary shall carry out 
each of the programs specified in this section in accordance 
with such relevant authorities except as otherwise provided 
in this section. 
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‘‘(b) VETERAN-DIRECTED CARE PROGRAM.—(1) The 
Secretary of Veterans Affairs, in collaboration with the Sec-
retary of Health and Human Services, shall carry out a 
program to be known as the ‘Veteran-Directed Care pro-
gram’. Under such program, the Secretary of Veterans Af-
fairs may enter into agreements with the providers de-
scribed in paragraph (2) to provide to eligible veterans 
funds, to the extent practicable, to obtain such in-home care 
services and related items as may be determined appro-
priate by the Secretary of Veterans Affairs and selected by 
the veteran, including through the veteran hiring individ-
uals to provide such services and items or directly pur-
chasing such services and items. 
‘‘(2) The providers described in this paragraph are the 
following: 
‘‘(A) An Aging and Disability Resource Center, 
an area agency on aging, or a State agency. 
‘‘(B) A center for independent living. 
‘‘(C) An Indian tribe or tribal organization re-
ceiving assistance under title VI of the Older Ameri-
cans Act of 1965 (42 U.S.C. 3057 et seq.). 
‘‘(3) In carrying out the Veteran-Directed Care pro-
gram, the Secretary of Veterans Affairs shall— 
‘‘(A) administer such program through each 
medical center of the Department of Veterans Affairs; 
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‘‘(B) seek to ensure the availability of such pro-
gram in American Samoa, Guam, the Commonwealth 
of the Northern Mariana Islands, the Commonwealth 
of Puerto Rico, the Virgin Islands of the United 
States, and any other territory or possession of the 
United States, to the extent practicable; and 
‘‘(C) seek to ensure the availability of such pro-
gram for eligible veterans who are Native American 
veterans receiving care and services furnished by the 
Indian Health Service, a tribal health program, an 
Urban Indian organization, or (in the case of a Na-
tive Hawaiian veteran) a Native Hawaiian health 
care system, to the extent practicable. 
‘‘(4) If a veteran participating in the Veteran-Directed 
Care program is catastrophically disabled, the veteran may 
continue to use funds under the program during a period 
of hospitalization in the same manner that the veteran 
would be authorized to use such funds under the program 
if the veteran were not hospitalized. 
‘‘(c) HOMEMAKER AND HOME HEALTH AIDE PRO-
GRAM.—(1) The Secretary shall carry out a program to be 
known as the ‘Homemaker and Home Health Aide program’ 
under which the Secretary may enter into agreements with 
home health agencies to provide to eligible veterans such 
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home health aide services as may be determined appropriate 
by the Secretary. 
‘‘(2) In carrying out the Homemaker and Home 
Health Aide program, the Secretary shall, to the extent 
practicable, ensure the availability of such program— 
‘‘(A) in the locations specified in subparagraph 
(B) of subsection (b)(3); and 
‘‘(B) for the veteran populations specified in sub-
paragraph (C) of such subsection. 
‘‘(d) HOME-BASED PRIMARY CARE PROGRAM.—The 
Secretary shall carry out a program to be known as the 
‘Home-Based Primary Care program’ under which the Sec-
retary may furnish to eligible veterans in-home health care, 
the provision of which is overseen by a provider of the De-
partment. 
‘‘(e) PURCHASED SKILLED HOME CARE PROGRAM.— 
The Secretary shall carry out a program to be known as 
the ‘Purchased Skilled Home Care program’ under which 
the Secretary may furnish to eligible veterans such in-home 
care services as may be determined appropriate and selected 
by the Secretary for the veteran. 
‘‘(f) CAREGIVER SUPPORT.—(1) With respect to a resi-
dent eligible caregiver of a veteran participating in a pro-
gram under this section, the Secretary shall— 
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‘‘(A) if the veteran meets the requirements of a 
covered veteran under section 1720G(b) of this title, 
provide to such caregiver the option of enrolling in 
the program of general caregiver support services 
under such section; 
‘‘(B) provide to such caregiver covered respite 
care of not less than 30 days annually; and 
‘‘(C) conduct on an annual basis (and, to the ex-
tent practicable, in connection with in-person services 
provided under the program in which the veteran is 
participating), a wellness contact of such caregiver. 
‘‘(2) Covered respite care provided to a resident eligible 
caregiver of a veteran under paragraph (1) may exceed 30 
days annually if such extension is requested by the resident 
eligible caregiver or veteran and determined medically ap-
propriate by the Secretary. 
‘‘(g) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to limit the authority of the Sec-
retary to carry out programs providing home- and commu-
nity-based services under any other provision of law. 
‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) The terms ‘Aging and Disability Resource 
Center’, ‘area agency on aging’, and ‘State agency’ 
have the meanings given those terms in section 102 of 
the Older Americans Act of 1965 (42 U.S.C. 3002). 
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‘‘(2) The terms ‘caregiver’ and ‘family caregiver’, 
with respect to a veteran, have the meanings given 
those terms, respectively, under subsection (e) of sec-
tion 1720G of this title with respect to an eligible vet-
eran under subsection (a) of such section or a covered 
veteran under subsection (b) of such section, as the 
case may be. 
‘‘(3) The term ‘center for independent living’ has 
the meaning given that term in section 702 of the Re-
habilitation Act of 1973 (29 U.S.C. 796a). 
‘‘(4) The term ‘covered respite care’ has the 
meaning given such term in section 1720G(d) of this 
title. 
‘‘(5) The term ‘eligible veteran’ means any vet-
eran— 
‘‘(A) for whom the Secretary determines 
participation in a specific program under this 
section is medically necessary to promote, pre-
serve, or restore the health of the veteran; and 
‘‘(B) who absent such participation would 
be at increased risk for hospitalization, place-
ment in a nursing home, or emergency room 
care. 
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‘‘(6) The term ‘home health aide’ means an indi-
vidual employed by a home health agency to provide 
in-home care services. 
‘‘(7) The term ‘in-home care service’ means any 
service, including a personal care service, provided to 
enable the recipient of such service to live at home. 
‘‘(8) The terms ‘Indian tribe’ and ‘tribal organi-
zation’ have the meanings given those terms in section 
4 of the Indian Self-Determination and Education 
Assistance Act (25 U.S.C. 5304). 
‘‘(9) The terms ‘Native American’ and ‘Native 
American veteran’ have the meanings given those 
terms in section 3765 of this title. 
‘‘(10) The terms ‘Native Hawaiian’ and ‘Native 
Hawaiian health care system’ have the meanings 
given those terms in section 12 of the Native Hawai-
ian Health Care Improvement Act (42 U.S.C. 11711). 
‘‘(11) The terms ‘tribal health programs’ and 
‘Urban Indian organizations’ have the meanings 
given those terms in section 4 of the Indian Health 
Care Improvement Act (25 U.S.C. 1603). 
‘‘(12) The term ‘resident eligible caregiver’ 
means an individual who— 
‘‘(A) is a caregiver, or a family caregiver, 
of a veteran and resides with that veteran; and 
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‘‘(B) has not entered into a contract, agree-
ment, or other arrangement for such individual 
to act as a caregiver for that veteran unless such 
individual is a family member of the veteran or 
is furnishing caregiver services through a med-
ical foster home.’’. 
(b) DEADLINE FOR IMPROVED ADMINISTRATION.—The 
Secretary of Veterans Affairs shall ensure that the Veteran- 
Directed Care program and the Homemaker and Home 
Health Aide program are administered through each med-
ical center of the Department of Veterans Affairs in accord-
ance with section 1720K of title 38, United States Code (as 
added by subsection (a)), by not later than two years after 
the date of the enactment of this Act. 
SEC. 5. COORDINATION WITH ASSISTANCE AND SUPPORT 
SERVICES FOR CAREGIVERS. 
(a) COORDINATION WITH PROGRAM OF COMPREHEN-
SIVE ASSISTANCE FOR FAMILY CAREGIVERS.— 
(1) COORDINATION.—Section 1720G(a) of title 
38, United States Code, is amended by adding at the 
end the following new paragraph: 
‘‘(14)(A) In the case of a veteran or caregiver who seeks 
services under this subsection and is denied such services, 
or a veteran or the family caregiver of a veteran who is 
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discharged from the program under this subsection, the Sec-
retary shall— 
‘‘(i) if the veteran meets the requirements of a 
covered veteran under subsection (b), provide to such 
caregiver the option of enrolling in the program of 
general caregiver support services under such sub-
section; 
‘‘(ii) assess the veteran or caregiver for partici-
pation in any other available program of the Depart-
ment for home- and community-based services (in-
cluding the programs specified in section 1720K of 
this title) for which the veteran or caregiver may be 
eligible and, with respect to the veteran, store (and 
make accessible to the veteran) the results of such as-
sessment in the electronic medical record of the vet-
eran; and 
‘‘(iii) provide to the veteran or caregiver written 
information on any such program identified pursuant 
to the assessment under clause (ii), including infor-
mation about facilities, eligibility requirements, and 
relevant contact information for each such program. 
‘‘(B) For each veteran or family caregiver who is dis-
charged from the program under this subsection, a caregiver 
support coordinator shall provide for a smooth and person-
alized transition from such program to an appropriate pro-
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gram of the Department for home- and community-based 
services (including the programs specified in section 1720K 
of this title), including by integrating caregiver support 
across programs.’’. 
(2) APPLICABILITY.—The amendments made by 
paragraph (1) shall apply with respect to denials and 
discharges occurring on or after the date that is 180 
days after the date of the enactment of this Act. 
(3) 
TECHNICAL
AND
CONFORMING
AMEND-
MENTS.—Section 1720G(d) of such title is amended— 
(A) by striking ‘‘or a covered veteran’’ each 
place it appears and inserting ‘‘, a veteran de-
nied or discharged as specified in paragraph 
(14) of such subsection, or a covered veteran’’; 
and 
(B) by striking ‘‘under subsection (a), 
means’’ each place it appears and inserting 
‘‘under subsection (a) or a veteran denied or dis-
charged as specified in paragraph (14) of such 
subsection, means’’. 
(b) CONFORMITY OF RESPITE CARE ACROSS PRO-
GRAMS.—Section 1720G of title 38, United States Code, as 
amended by subsection (a)(3), is further amended— 
(1) in subsection (a)(3)— 
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(A) by amending subparagraph (A)(ii)(III) 
to read as follows: 
‘‘(III) covered respite care of not less than 
30 days annually;’’; and 
(B) by striking subparagraph (B) and re-
designating subparagraphs (C) and (D) as sub-
paragraphs (B) and (C), respectively; and 
(2) by amending subsection (b)(3)(A)(iii) to read 
as follows: 
‘‘(iii) Covered respite care of not less than 30 
days annually.’’; and 
(3) in subsection (d)— 
(A) 
by 
redesignating 
paragraphs 
(2) 
through (4) as paragraphs (3) through (5), re-
spectively; and 
(B) by inserting after paragraph (1) the fol-
lowing new paragraph: 
‘‘(2) The term ‘covered respite care’ means, with 
respect to a caregiver of a veteran, respite care under 
section 1720B of this title that— 
‘‘(A) is medically and age appropriate for 
the veteran (including 24-hour per day care of 
the veteran commensurate with the care provided 
by the caregiver); and 
‘‘(B) includes in-home care.’’. 
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(c) REVIEW RELATING TO CAREGIVER CONTACT.—The 
Secretary shall conduct a review of the capacity of the De-
partment to establish a streamlined system for contacting 
all caregivers enrolled in the program of general caregiver 
support services under section 1720G(b) of title 38, United 
States Code, to provide to such caregivers program updates 
and alerts relating to emerging services for which such care-
givers may be eligible. 
SEC. 6. DEVELOPMENT OF CENTRALIZED WEBSITE FOR 
PROGRAM INFORMATION. 
(a) CENTRALIZED WEBSITE.—The Secretary shall de-
velop and maintain a centralized and publically accessible 
internet website of the Department as a clearinghouse for 
information and resources relating to covered programs. 
(b) CONTENTS.—The website under subsection (a) shall 
contain the following: 
(1) A description of each covered program. 
(2) An informational assessment tool that— 
(A) explains the administrative eligibility, 
if applicable, of a veteran, or a caregiver of a 
veteran, for any covered program; and 
(B) provides information, as a result of 
such explanation, on any covered program for 
which the veteran or caregiver (as the case may 
be) may be eligible. 
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(3) A list of required procedures for the directors 
of the medical facilities of the Department to follow 
in determining the eligibility and suitability of vet-
erans for participation in a covered program, includ-
ing procedures applicable to instances in which the 
resource constraints of a facility (or of a community 
in which a facility is located) may result in the in-
ability to address the health needs of a veteran under 
a covered program in a timely manner. 
(c) UPDATES.—The Secretary shall ensure the website 
under subsection (a) is updated on a periodic basis. 
SEC. 7. IMPROVEMENTS RELATING TO HOMEMAKER AND 
HOME HEALTH AIDE PROGRAM. 
(a) PILOT PROGRAM FOR COMMUNITIES WITH SHORT-
AGE OF HOME HEALTH AIDES.— 
(1) PROGRAM.—Beginning not later than 18 
months after the date of the enactment of this Act, the 
Secretary shall carry out a three-year pilot program 
under which the Secretary shall provide homemaker 
and home health aide services to veterans who reside 
in communities with a shortage of home health aides. 
(2) LOCATIONS.—The Secretary shall select not 
fewer than five geographic locations in which the Sec-
retary determines there is a shortage of home health 
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of the reasons why any such reductions may have oc-
curred. 
(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 program to 
other covered programs. 
(2) A requirement for the directors of the medical 
facilities of the Department to complete such process 
whenever a veteran with care needs has been denied 
services from home health agencies under the Home-
maker 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 adminis-
tered through the Office of Geriatric and Extended 
Care of the Department, or successor office, to— 
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(A) ensure consistency in program manage-
ment; 
(B) eliminate service gaps at the medical 
center level; and 
(C) ensure the availability of, and the access 
by veterans to, home- and community-based serv-
ices. 
(2) ASSESSMENT OF STAFFING NEEDS.—The Sec-
retary of Veterans Affairs shall conduct an assessment 
of the staffing needs of the Office of Geriatric and Ex-
tended Care of the Department of Veterans Affairs, or 
successor office. 
(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 veterans 
who are not located near medical centers of the 
Department to access extended care services (in-
cluding by improving access to home- and com-
munity-based services for such veterans). 
(B) 
IMPLEMENTATION
TIMELINE.—Each 
goal established under subparagraph (A) shall 
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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 veterans 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) 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 Veterans’ 
Affairs of the House of Representatives and the Senate 
a report containing the findings of the review under 
paragraph (1), the results of the assessment under 
paragraph (2), and the goals established under para-
graphs (3) and (4). 
(b) REVIEW OF INCENTIVES AND EFFORTS RELATING 
TO HOME- AND COMMUNITY-BASED SERVICES.— 
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(1) REVIEW.—The Secretary of Veterans Affairs 
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 pro-
vide to veterans home- and community-based 
services in lieu of institutional care. 
(C) The efforts taken by the Secretary to en-
hance spending of the Department for extended 
care by shifting the balance of such spending 
from institutional care to home- and commu-
nity-based services. 
(D) The plan of the Under Secretary for 
Health of the Department to accelerate efforts to 
enhance spending as specified in subparagraph 
(C), to match the progress of similar efforts taken 
by the Administrator of the Centers for Medicare 
& Medicaid Services with respect to spending of 
the Centers for Medicare & Medicaid 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 Veterans’ 
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Affairs of the House of Representatives and the Senate 
a report on the findings of the review under para-
graph (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 COMMU-
NITY-BASED SERVICES.— 
(1) REPORT ON EXPANSION OF CERTAIN MENTAL 
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 Veterans’ 
Affairs of the House of Representatives and the 
Senate a report containing recommendations for 
the expansion of mental health services and re-
lated support to the caregivers of veterans. 
(B) 
MATTERS
INCLUDED.—The 
report 
under subparagraph (A) shall include an assess-
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