a plan for carrying out section 1720G of title 38, United 
States Code, as added by subsection (b) of this section. 
(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 Sec-
retary shall submit to the Committee on Veterans’ Affairs 
of the House of Representatives and the Committee on Vet-
erans’ Affairs of the Senate a report describing the imple-
mentation 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 fol-
lowing new paragraph (2): 
‘‘(2) a caregiver or family caregiver of a veteran; 
or’’. 
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(b) CLERICAL AMENDMENT.—The table of sections at 
the beginning of chapter 17 of title 38, United States 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 care-
giver.’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(d) In furnishing respite care services under this sec-
tion, 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 respect 
to the age of the veteran.’’. 
SEC. 5. MEDICAL CARE FOR FAMILY CAREGIVERS. 
Section 1781 of title 38, United States Code, is amend-
ed— 
(1) in subsection (a)— 
(A) in paragraph (2), by striking ‘‘and’’ at 
the end; 
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(B) in paragraph (3), by inserting ‘‘and’’ 
at the end; and 
(C) by inserting after paragraph (3) the fol-
lowing 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 deter-
mines that the family caregiver is not entitled to care or 
services under a health-plan contract as defined under sec-
tion 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 requirement 
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— 
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‘‘(i) was deployed in support of Operation 
Enduring Freedom or Operation Iraqi Freedom; 
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 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 
physician employed by the Department (or, 
in areas where no such physician is avail-
able, by a physician carrying out such func-
tion under a contract or fee arrangement), 
to be unable to carry out the activities (in-
cluding instrumental activities) of daily liv-
ing; 
‘‘(B) with respect to such veteran, meets the defi-
nition of the term ‘family caregiver’ under section 
1701(12) of this title; and 
‘‘(C) is designated by such veteran as the pri-
mary family caregiver for such veteran. 
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‘‘(3) The authority of the Secretary to provide medical 
care to a family caregiver under this section shall expire 
on October 1, 2012.’’. 
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 para-
graphs: 
‘‘(2) Without regard to whether a covered veteran enti-
tled to mileage under this section requires an attendant in 
order to perform such travel, an attendant of such covered 
veteran may be allowed expenses of travel (including lodg-
ing and subsistence) upon the same basis as such veteran 
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 provi-
sions— 
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‘‘(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 
‘‘(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 re-
quire 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 physi-
cian carrying out such function under a contract 
or fee arrangement), to be unable to carry out 
the activities (including instrumental activities) 
of daily living.’’. 
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(7) The employment status of caregivers and 
family caregivers. 
(8) Incidents of significant life changes related to 
being a caregiver or family caregiver, including un-
employment and disenrollment from a course of edu-
cation. 
(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 Veterans 
Integrated Service Network. 
(c) FINDINGS.—The Secretary shall consider the find-
ings 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 sub-
mit to the Committee on Veterans’ Affairs of the House of 
Representatives and the Committee on Veterans’ Affairs of 
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the Senate a report on caregivers and family caregivers. 
Each such report shall include— 
(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 ap-
propriate. 
(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 meaning 
given such term in section 1701(12) of title 38, 
United States Code, as added by section 2(a) of this 
Act. 
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Union Calendar No. 122 
111TH CONGRESS 
1ST SESSION 
H. R. 3155 
[Report No. 111–224] 
A BILL 
To amend title 38, United States Code, to provide 
certain caregivers of veterans with training, sup-
port, and medical care, and for other purposes. 
JULY 23, 2009 
Reported with an amendment, committed to the Com-
mittee of the Whole House on the State of the Union, 
and ordered to be printed 
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