I 
116TH CONGRESS 
1ST SESSION H. R. 4532 
To amend title 38, United States Code, to authorize the Secretary of Veterans 
Affairs to make certain grants to assist nursing homes for veterans 
located on tribal lands. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 26, 2019 
Mr. O’HALLERAN (for himself, Mr. COLE, and Mr. GALLEGO) introduced the 
following bill; which was referred to the Committee on Veterans’ Affairs 
A BILL 
To amend title 38, United States Code, to authorize the 
Secretary of Veterans Affairs to make certain grants 
to assist nursing homes for veterans located on tribal 
lands. 
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 ‘‘Nursing Home Care 
for Native American Veterans Act’’. 
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SEC. 2. GRANTS FOR STATE HOMES LOCATED ON TRIBAL 
LANDS. 
(a) STATE HOME DEFINED.—Section 101(19) of 
title 38, United States Code, is amended by inserting ‘‘or 
Indian tribe (as defined in section 4 of the Indian Self- 
Determination and Education Assistance Act (25 U.S.C. 
5304))’’ after ‘‘(other than a possession)’’. 
(b) PAYMENTS TO STATE HOMES.—Section 1741 of 
title 38, United States Code, is amended by adding at the 
end the following new subsection: 
‘‘(h) In this subchapter, the term ‘State’ means each 
of the several States and each Indian tribe (as defined 
in section 4 of the Indian Self-Determination and Edu-
cation Assistance Act (25 U.S.C. 5304)).’’. 
(c) STATE HOME CONSTRUCTION.— 
(1) IN GENERAL.—Section 8131(2) of title 38, 
United States Code, is amended by inserting ‘‘in-
cludes each Indian tribe (as defined in section 4 of 
the Indian Self-Determination and Education Assist-
ance Act (25 U.S.C. 5304)) but’’ before ‘‘does not’’. 
(2) CONFORMING AMENDMENT.—Section 8132 
of such title is amended by striking ‘‘several’’. 
(d) ADDITIONAL LEGISLATIVE OR ADMINISTRATIVE 
ACTION.— 
(1) CONSULTATION WITH INDIAN TRIBES.—Not 
later than 180 days after the date of the enactment 
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of this Act, the Secretary of Veterans Affairs shall 
consult with Indian tribes to determine if any legis-
lative or administrative action is necessary to modify 
the State home program to function efficiently in 
support of State homes operated by Indian tribes 
pursuant to the amendments made by this section. 
(2) REPORT TO CONGRESS.—Not later than 90 
days after completing consultations under paragraph 
(1), the Secretary shall submit to the appropriate 
committees of Congress a report recommending leg-
islative action that the Secretary considers appro-
priate to modify the State home program described 
in such paragraph in light of those consultations. 
(3) MODIFICATIONS.—Not later than 180 days 
after completing consultations under paragraph (1), 
the Secretary shall make any modifications to regu-
lations implementing the State home program, for 
which legislative action is not necessary, as the Sec-
retary considers appropriate in light of those con-
sultations. 
(e) TECHNICAL SUPPORT
AND ASSISTANCE.—The 
Secretary of Veterans Affairs shall provide technical sup-
port and assistance to Indian tribes in carrying out the 
State home program at State homes operated by Indian 
tribes pursuant to the amendments made by this section. 
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(f) DEFINITIONS.—In this section: 
(1) 
APPROPRIATE
COMMITTEES
OF
CON-
GRESS.—The term ‘‘appropriate committees of Con-
gress’’ means— 
(A) the Committee on Veterans’ Affairs 
and the Committee on Indian Affairs of the 
Senate; and 
(B) the Committee on Veterans’ Affairs 
and the Subcommittee for Indigenous Peoples 
of the United States of the Committee on Nat-
ural Resources of the House of Representatives. 
(2) INDIAN TRIBE.—The term ‘‘Indian tribe’’ 
has the meaning given that term in section 4 of the 
Indian Self-Determination and Education Assistance 
Act (25 U.S.C. 5304). 
(3) STATE HOME.—The term ‘‘State home’’ has 
the meaning given that term in section 101(19) of 
title 38, United States Code. 
(4) STATE HOME PROGRAM.—The term ‘‘State 
home program’’ means the program of the Depart-
ment of Veterans Affairs for which payments are 
made under subchapter V of chapter 17 of title 38, 
United States Code, and assistance is provided 
under subchapter III of chapter 81 of such title. 
Æ 
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