IIB 
111TH CONGRESS 
1ST SESSION H. R. 3155 
IN THE SENATE OF THE UNITED STATES 
JULY 28, 2009 
Received; read twice and referred to the Committee on Veterans’ Affairs 
AN ACT 
To amend title 38, United States Code, to provide certain 
caregivers of veterans with training, support, and medical 
care, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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vides caregiver services to such veteran for such 
disability; 
‘‘(B) is a member of the family (including 
parents, spouses, children, siblings, step-family 
members, and extended family members) of 
such veteran; and 
‘‘(C) may or may not reside with such vet-
eran.’’. 
(b) SUPPORT SERVICES.— 
(1) IN GENERAL.—Subchapter II of chapter 17 
of title 38, United States Code, is amended by add-
ing at the end the following new section: 
‘‘§ 1720G. Support services for caregivers and family 
caregivers 
‘‘(a) ESTABLISHMENT OF PROGRAM.—The Secretary 
shall develop and carry out a program for caregivers and 
family caregivers that includes the following: 
‘‘(1) The educational sessions, stipends, and ac-
cess to support services provided under this section. 
‘‘(2) Counseling and other services provided 
under section 1782 of this title. 
‘‘(3) Respite care provided under section 1720B 
of this title. 
‘‘(4) With respect to family caregivers, medical 
care provided under section 1781(e) of this title. 
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‘‘(5) Travel expenses provided under section 
111(e) of this title. 
‘‘(b) EDUCATIONAL SESSIONS.—(1) The Secretary 
shall make available educational sessions for caregivers, 
family caregivers, and individuals described in paragraph 
(2). Such educational sessions shall— 
‘‘(A) be made available both in person and on 
an Internet website; 
‘‘(B) incorporate available technology, including 
telehealth technology to the extent practicable; and 
‘‘(C) teach techniques, strategies, and skills for 
caring for a disabled veteran, including, at a min-
imum, a veteran who— 
‘‘(i) was deployed in support of Operation 
Enduring Freedom or Operation Iraqi Free-
dom; and 
‘‘(ii) has post-traumatic stress disorder, a 
traumatic brain injury, or other severe injury or 
illness. 
‘‘(2) Individuals described in this paragraph are indi-
viduals who provide caregivers and family caregivers with 
support under this chapter or through an aging network 
(as defined in section 102(5) of the Older Americans Act 
of 1965 (42 U.S.C. 3002(5)), including— 
‘‘(A) respite care providers; 
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‘‘(B) nursing care providers; and 
‘‘(C) counselors. 
‘‘(c) STIPENDS.—(1) The Secretary shall provide 
monthly stipends to eligible family caregivers described in 
paragraph (2). 
‘‘(2) An eligible family caregiver described in this 
paragraph is a family caregiver who— 
‘‘(A) provides caregiver services to a veteran 
who— 
‘‘(i) was deployed in support of Operation 
Enduring Freedom or Operation Iraqi Free-
dom; and 
‘‘(ii) for purposes of this subsection, is de-
termined by the Secretary— 
‘‘(I) to have a service-connected dis-
ability or illness that is severe; 
‘‘(II) to be in need of caregiver serv-
ices, such that without such services, the 
veteran would require hospitalization, nurs-
ing home care, or other residential institu-
tional care; and 
‘‘(III) based on an examination by a 
physician employed by the Department (or, 
in areas where no such physician is avail-
able, by a physician carrying out such 
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function under a contract or fee arrange-
ment), to be unable to carry out the activi-
ties (including instrumental activities) of 
daily living; 
‘‘(B) with respect to such veteran, meets the 
definition of the term ‘family caregiver’ under sec-
tion 1701(12) of this title; 
‘‘(C) is designated by such veteran as the pri-
mary family caregiver for such veteran; and 
‘‘(D) is not— 
‘‘(i) employed by a home health care agen-
cy to provide such caregiver services; or 
‘‘(ii) otherwise receiving payment for such 
services. 
‘‘(3) The authority of the Secretary to provide a sti-
pend to an eligible family caregiver under this subsection 
shall expire on October 1, 2012. 
‘‘(d) ACCESS
TO SUPPORT SERVICES.—The Sec-
retary shall provide caregivers and family caregivers with 
information concerning public, private, and non-profit 
agencies that offer support to caregivers. In providing 
such information, the Secretary shall— 
‘‘(1) collaborate with the Assistant Secretary 
for Aging of the Department of Health and Human 
Services in order to provide caregivers and family 
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caregivers access to aging and disability resource 
centers under the Administration on Aging of the 
Department of Health and Human Services; and 
‘‘(2) include on an Internet website that is dedi-
cated to caregivers and family caregivers— 
‘‘(A) a directory of services available for 
caregivers and family caregivers at the county 
level; and 
‘‘(B) tools that provide caregivers and fam-
ily caregivers with the ability to interact with 
each other for the purpose of fostering peer 
support and creating support networks. 
‘‘(e) INFORMATION AND OUTREACH.—(1) The Sec-
retary shall conduct outreach to inform disabled veterans 
and the families of such veterans of the following: 
‘‘(A) Medical care, educational sessions, sti-
pends, and other services available for caregivers 
and family caregivers under this chapter. 
‘‘(B) The ability of a family caregiver to be 
trained and certified by a home health care agency 
in order to be paid by such agency for providing 
caregiver services. 
‘‘(2) Outreach under this subsection shall include, at 
a minimum, the following: 
‘‘(A) Public service announcements. 
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‘‘(B) Brochures and pamphlets. 
‘‘(C) Full use of Internet-based outreach meth-
ods, including such methods designed specifically for 
veterans and the families of such veterans who re-
side in rural areas. 
‘‘(3) With respect to a Department employee pro-
viding case management services (as defined in section 
1720C(b)(2) of this title) to a disabled veteran, the Sec-
retary shall ensure that such employee provides a care-
giver or family caregiver of such veteran with information 
on the services described in subparagraphs (A) and (B) 
of paragraph (1).’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of chapter 17 of title 38, 
United States Code, is amended by inserting after 
the item related to section 1720F the following new 
item: 
‘‘1720G. Support services for caregivers and family caregivers.’’. 
(c) PLAN.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary shall submit 
to the Committee on Veterans’ Affairs of the House of 
Representatives and the Committee on Veterans’ Affairs 
of the Senate a plan for carrying out section 1720G of 
title 38, United States Code, as added by subsection (b) 
of this section. 
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(d) REPORTS.—Not later than 180 days after the 
date on which the plan is submitted under subsection (c), 
and annually thereafter for the following five years, the 
Secretary shall submit to the Committee on Veterans’ Af-
fairs of the House of Representatives and the Committee 
on Veterans’ Affairs of the Senate a report describing the 
implementation of the plan. 
SEC. 3. COUNSELING AND MENTAL HEALTH SERVICES FOR 
CAREGIVERS AND FAMILY CAREGIVERS. 
(a) IN GENERAL.—Section 1782 of title 38, United 
States Code, is amended— 
(1) in the section heading, by adding at the end 
the following: ‘‘, caregivers, and family care-
givers’’; and 
(2) in subsection (c)— 
(A) in paragraph (1), by striking ‘‘; or’’ 
and inserting a semicolon; 
(B) by redesignating paragraph (2) as 
paragraph (3); and 
(C) by inserting after paragraph (1) the 
following new paragraph (2): 
‘‘(2) a caregiver or family caregiver of a vet-
eran; or’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 17 of title 38, United States 
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Code, is amended by striking the item relating to section 
1782 and inserting the following new item: 
‘‘1782. Counseling, training, and mental health services for immediate family 
members, caregivers, and family caregivers.’’. 
SEC. 4. RESPITE CARE TO ASSIST FAMILY CAREGIVERS. 
Section 1720B of title 38, United States Code, is 
amended— 
(1) in subsection (a), by striking ‘‘title.’’ and in-
serting ‘‘title or who receives care from a family 
caregiver.’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(d) In furnishing respite care services under this 
section, the Secretary shall ensure that such services— 
‘‘(1) fulfill the needs of the veteran receiving 
care (including 24-hour in-home respite care); and 
‘‘(2) are appropriate for the veteran with re-
spect to the age of the veteran.’’. 
SEC. 5. MEDICAL CARE FOR FAMILY CAREGIVERS. 
Section 1781 of title 38, United States Code, is 
amended— 
(1) in subsection (a)— 
(A) in paragraph (2), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (3), by inserting ‘‘and’’ 
at the end; and 
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(C) by inserting after paragraph (3) the 
following new paragraph: 
‘‘(4) in accordance with subsection (e), a family 
caregiver,’’; 
(2) in the third sentence of subsection (b), by 
striking ‘‘dependent or survivor’’ and inserting ‘‘de-
pendent, survivor, or family caregiver’’; and 
(3) by adding at the end the following new sub-
section: 
‘‘(e)(1) The Secretary shall provide medical care to 
a family caregiver under this section if the Secretary de-
termines that the family caregiver is not entitled to care 
or services under a health-plan contract as defined under 
section 1725(f)(2) of this title (determined, in the case 
of a health-plan contract as defined in subsection (f)(2)(B) 
or (f)(2)(C) of such section, without regard to any require-
ment or limitation relating to eligibility for care or services 
from any department or agency of the United States). 
‘‘(2) In this subsection, a family caregiver is an indi-
vidual who— 
‘‘(A) provides caregiver services to a veteran 
who— 
‘‘(i) was deployed in support of Operation 
Enduring Freedom or Operation Iraqi Free-
dom; and 
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‘‘(ii) for purposes of this subsection, is de-
termined by the Secretary— 
‘‘(I) to have a service-connected dis-
ability or illness that is severe; 
‘‘(II) to be in need of caregiver serv-
ices, such that without such services, the 
veteran would require hospitalization, nurs-
ing home care, or other residential institu-
tional care; and 
‘‘(III) based on an examination by a 
physician employed by the Department (or, 
in areas where no such physician is avail-
able, by a physician carrying out such 
function under a contract or fee arrange-
ment), to be unable to carry out the activi-
ties (including instrumental activities) of 
daily living; 
‘‘(B) with respect to such veteran, meets the 
definition of the term ‘family caregiver’ under sec-
tion 1701(12) of this title; and 
‘‘(C) is designated by such veteran as the pri-
mary family caregiver for such veteran. 
‘‘(3) The authority of the Secretary to provide med-
ical care to a family caregiver under this section shall ex-
pire on October 1, 2012.’’. 
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SEC. 6. LODGING AND SUBSISTENCE FOR FAMILY CARE-
GIVERS. 
Section 111(e) of title 38, United States Code, is 
amended— 
(1) by striking ‘‘When’’ and inserting the fol-
lowing: ‘‘(1) Except as provided in paragraph (2), 
when’’; and 
(2) by adding at the end the following new 
paragraphs: 
‘‘(2) Without regard to whether a covered veteran en-
titled to mileage under this section requires an attendant 
in order to perform such travel, an attendant of such cov-
ered veteran may be allowed expenses of travel (including 
lodging and subsistence) upon the same basis as such vet-
eran during— 
‘‘(A) the period of time in which such veteran 
is traveling to and from a treatment facility; and 
‘‘(B) the duration of the treatment episode for 
such veteran. 
‘‘(3) The Secretary may prescribe regulations to 
carry out this subsection. Such regulations may include 
provisions— 
‘‘(A) to limit the number of attendants that 
may receive expenses of travel under paragraph (2) 
for a single treatment episode of a covered veteran; 
and 
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‘‘(B) to require such attendants to use certain 
travel services. 
‘‘(4) In this subsection, the term ‘covered veteran’ 
means a veteran who— 
‘‘(A) was deployed in support of Operation En-
during Freedom or Operation Iraqi Freedom; and 
‘‘(B) for purposes of this subsection, is deter-
mined by the Secretary— 
‘‘(i) to have a service-connected disability 
or illness that is severe; 
‘‘(ii) to be in need of caregiver services, 
such that without such services, the veteran 
would require hospitalization, nursing home 
care, or other residential institutional care; and 
‘‘(iii) based on an examination by a physi-
cian employed by the Department (or, in areas 
where no such physician is available, by a phy-
sician carrying out such function under a con-
tract or fee arrangement), to be unable to carry 
out the activities (including instrumental activi-
ties) of daily living.’’. 
SEC. 7. SURVEY ON CAREGIVERS AND FAMILY CARE-
GIVERS. 
(a) IN GENERAL.—Not later than 270 days after the 
date of the enactment of this Act, and not less than once 
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(8) Incidents of significant life changes related 
to being a caregiver or family caregiver, including 
unemployment and disenrollment from a course of 
education. 
(9) The number of family caregivers trained 
and certified through a home health care agency. 
(10) Other information the Secretary considers 
appropriate. 
(b) SURVEY SAMPLE.—In carrying out the survey re-
quired by subsection (a), the Secretary shall ensure that— 
(1) a statistically representative sample of care-
givers and family caregivers is included in the sur-
vey; and 
(2) such sample covers veterans in each Vet-
erans Integrated Service Network. 
(c) FINDINGS.—The Secretary shall consider the 
findings of the survey when carrying out programs related 
to caregivers and family caregivers. 
(d) REPORTS.—Not later than 180 days after the 
date on which each survey is completed, the Secretary 
shall submit to the Committee on Veterans’ Affairs of the 
House of Representatives and the Committee on Veterans’ 
Affairs of the Senate a report on caregivers and family 
caregivers. Each such report shall include— 
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(1) the findings of the survey required by sub-
section (a); 
(2) a summary of the services made available to 
caregivers and family caregivers by the Secretary; 
(3) the number of caregivers and family care-
givers who receive such services; 
(4) the cost to the Department of Veterans Af-
fairs of providing each such service; and 
(5) other information the Secretary considers 
appropriate. 
(e) DEFINITIONS.—In this section: 
(1) The term ‘‘caregiver’’ has the meaning 
given such term in section 1701(11) of title 38, 
United States Code, as added by section 2(a) of this 
Act. 
(2) The term ‘‘family caregiver’’ has the mean-
ing given such term in section 1701(12) of title 38, 
United States Code, as added by section 2(a) of this 
Act. 
Passed the House of Representatives July 27, 2009. 
Attest: 
LORRAINE C. MILLER, 
Clerk. 
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