Long-Term Care Veterans Choice Act
Bill: H.R.7158 | Sponsor: Rep. Higgins, Clay (R-LA)
Policy area: Armed Forces and National Security

Summary:
Long-Term Care Veterans Choice Act
This bill authorizes the Department of Veterans Affairs (VA) to enter into contracts to pay for specified veterans (i.e., certain veterans who have service-connected disabilities and require nursing home care) to be placed in medical foster homes at their request. A medical foster home is a home designed to provide non-institutional, long-term, supportive care for veterans who are unable to live independently and prefer a family setting.
Veterans receiving such care must agree, as a condition of payment for their care, to accept home health services furnished by the VA.
Under the bill, no more than a daily average of 900 veterans may have their care in a medical foster home covered by the VA.
The VA must create a monitoring system to assess its workload in carrying out the medical foster home payments. Additionally, the Government Accountability Office must submit to Congress reports that assess the implementation of this program and provide recommendations for improvements.
The bill also extends certain loan fee rates through February 15, 2031, under the VA's home loan program.

To amend title 38, United States Code, to authorize the Secretary of 
Veterans Affairs to enter into contracts and agreements for the payment 
of care in non-Department of Veterans Affairs medical foster homes for 
 certain veterans who are unable to live independently, and for other 
                               purposes.


 


    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Long-Term Care Veterans Choice 
Act''.

SEC. 2. SECRETARY OF VETERANS AFFAIRS CONTRACT AUTHORITY FOR PAYMENT OF 
              CARE FOR VETERANS IN NON-DEPARTMENT OF VETERANS AFFAIRS 
              MEDICAL FOSTER HOMES.

    (a) Authority.--
            (1) In general.--Section 1720 of title 38, United States 
        Code, is amended by adding at the end the following new 
        subsection:
    ``(h)(1) During the five-year period beginning on the date of the 
enactment of the Long-Term Care Veterans Choice Act, and subject to 
paragraph (3)--
            ``(A) at the request of a veteran for whom the Secretary is 
        required to provide nursing home care under section 1710A of 
        this title, the Secretary may place the veteran in a medical 
        foster home that meets Department standards, at the expense of 
        the United States, pursuant to a contract, agreement, or other 
        arrangement entered into between the Secretary and the medical 
        foster home for such purpose; and
            ``(B) the Secretary may pay for care of a veteran placed in 
        a medical foster home before such date of enactment, if the 
        home meets Department standards, pursuant to a contract, 
        agreement, or other arrangement entered into between the 
        Secretary and the medical foster home for such purpose.
    ``(2) A veteran on whose behalf the Secretary pays for care in a 
medical foster home under paragraph (1) shall agree, as a condition of 
such payment, to accept home health services furnished by the Secretary 
under section 1717 of this title.
    ``(3) In any year, not more than a daily average of 900 veterans 
receiving care in a medical foster home, whether placed before, on, or 
after the date of the enactment of the Long-Term Care Veterans Choice 
Act, may have their care covered at the expense of the United States 
under paragraph (1).
    ``(4) The prohibition under section 1730(b)(3) of this title shall 
not apply to a veteran whose care is covered at the expense of the 
United States under paragraph (1).
    ``(5) In this subsection, the term `medical foster home' means a 
home designed to provide non-institutional, long-term, supportive care 
for veterans who are unable to live independently and prefer a family 
setting.''.
            (2) Effective date.--Subsection (h) of section 1720 of 
        title 38, United States Code, as added by paragraph (1), shall 
        take effect 90 days after the date of the enactment of this 
        Act.
    (b) Ongoing Monitoring of Medical Foster Home Program.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        create a system to monitor and assess the workload for the 
        Department of Veterans Affairs in carrying out the authority 
        under section 1720(h) of title 38, United States Code, as added 
        by subsection (a)(1), including by tracking--
                    (A) requests by veterans to be placed in a medical 
                foster home under such section;
                    (B) denials of such requests, including the reasons 
                for such denials;
                    (C) the total number of medical foster homes 
                applying to participate under such section, 
                disaggregated by those approved and those denied 
                approval by the Department to participate;
                    (D) veterans receiving care at a medical foster 
                home at the expense of the United States; and
                    (E) veterans receiving care at a medical foster 
                home at their own expense.
            (2) Report.--Based on the monitoring and assessments 
        conducted under paragraph (1), the Secretary shall identify and 
        submit to Congress a report on such modifications to 
        implementing section 1720(h) of title 38, United States Code, 
        as added by subsection (a)(1), as the Secretary considers 
        necessary to ensure the authority under such section is 
        functioning as intended and care is provided to veterans under 
        such section as intended.
            (3) Medical foster home defined.--In this subsection, the 
        term ``medical foster home'' has the meaning given that term in 
        section 1720(h) of title 38, United States Code, as added by 
        subsection (a)(1).
    (c) Comptroller General Report.--Not later than each of three years 
and six years after the date of the enactment of this Act, the 
Comptroller General of the United States shall submit to Congress a 
report--
            (1) assessing the implementation of this section and the 
        amendments made by this section;
            (2) assessing the impact of the monitoring and 
        modifications under subsection (b) on care provided under 
        section 1720(h) of title 38, United States Code, as added by 
        subsection (a)(1); and
            (3) setting forth recommendations for improvements to the 
        implementation of such section, as the Comptroller General 
        considers appropriate.
    (d) Modification of Certain Housing Loan Fee.--The loan fee table 
in section 3729(b)(2) of title 38, United States Code, is amended by 
striking ``January 14, 2031'' each place it appears and inserting 
``February 15, 2031''.

SEC. 3. DETERMINATION OF BUDGETARY EFFECTS.

    The budgetary effects of this Act, for the purpose of complying 
with the Statutory Pay-As-You-Go Act of 2010, shall be determined by 
reference to the latest statement titled ``Budgetary Effects of PAYGO 
Legislation'' for this Act, submitted for printing in the Congressional 
Record by the Chairman of the House Budget Committee, provided that 
such statement has been submitted prior to the vote on passage.

            Passed the House of Representatives December 1, 2022.

            Attest:

                                             CHERYL L. JOHNSON,

                                                                 Clerk.