Title: RESPECT Act of 2022
Policy area: Armed Forces and National Security

Summary:
Reinforcing Enhanced Support through Promoting Equity for Caregivers Act of 2022 or the RESPECT Act of 2022
This bill implements various changes to the Program of Comprehensive Assistance for Family Caregivers, including by expanding program eligibility to family caregivers of veterans who are in need of personal care services due to a diagnosed mental illness or history of suicidal ideation within the past three years that puts the veteran at risk of self-harm.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 3964 Introduced in Senate (IS)]

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117th CONGRESS
  2d Session
                                S. 3964

 To amend title 38, United States Code, to modify the family caregiver 
   program of the Department of Veterans Affairs to include services 
  related to mental health and neurological disorders, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 30, 2022

   Mr. Moran introduced the following bill; which was read twice and 
             referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
 To amend title 38, United States Code, to modify the family caregiver 
   program of the Department of Veterans Affairs to include services 
  related to mental health and neurological disorders, 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 ``Reinforcing Enhanced Support through 
Promoting Equity for Caregivers Act of 2022'' or the ``RESPECT Act of 
2022''.

SEC. 2. MODIFICATION OF FAMILY CAREGIVER PROGRAM OF DEPARTMENT OF 
              VETERANS AFFAIRS TO INCLUDE SERVICES RELATED TO MENTAL 
              HEALTH AND NEUROLOGICAL DISORDERS.

    (a) In General.--Section 1720G of title 38, United States Code, is 
amended--
            (1) in subsection (a)--
                    (A) in paragraph (2)(C)--
                            (i) in clause (iii), by striking ``; or'' 
                        and inserting a semicolon;
                            (ii) by redesignating clause (iv) as clause 
                        (v); and
                            (iii) by inserting after clause (iii) the 
                        following new clause (iv):
                    ``(iv) a diagnosed mental illness or history of 
                suicidal ideation within the past three years that puts 
                the veteran at risk of self-harm; or'';
                    (B) in paragraph (3)--
                            (i) in subparagraph (A)(ii)(VI)--
                                    (I) in item (aa), by striking ``; 
                                and'' and inserting a semicolon;
                                    (II) in item (bb), by striking the 
                                period at the end and inserting ``; 
                                and''; and
                                    (III) by adding at the end the 
                                following new item:
                            ``(cc) mental health treatment and 
                        counseling services.''; and
                            (ii) in subparagraph (C)--
                                    (I) in clause (iii)--
                                            (aa) in the matter 
                                        preceding subclause (I)--

                                                    (AA) by striking 
                                                ``or regular 
                                                instruction'' and 
                                                inserting ``, regular 
                                                instruction''; and

                                                    (BB) by inserting 
                                                ``or a diagnosis of 
                                                mental illness or 
                                                history of suicidal 
                                                ideation that puts the 
                                                veteran at risk of 
                                                self-harm under 
                                                paragraph (2)(C)(iv),'' 
                                                before ``the Secretary 
                                                shall'';

                                            (bb) in subclause (II), by 
                                        inserting before the period at 
                                        the end the following: ``, or 
                                        assistance relating to the risk 
                                        of self-harm of the veteran, as 
                                        the case may be''; and
                                            (cc) in subclause (III), by 
                                        striking ``such supervision, 
                                        protection, or instruction to 
                                        the veteran'' and inserting 
                                        ``to the veteran such 
                                        supervision, protection, or 
                                        instruction, or assistance 
                                        relating to the risk of self-
                                        harm of the veteran, as the 
                                        case may be''; and
                                    (II) by adding at the end the 
                                following new clauses:
    ``(v)(I) For purposes of determining the amount and degree of 
personal care services provided under clause (i) with respect to a 
veteran described in subclause (II), the Secretary shall take into 
account relevant documentation evidencing the provision of personal 
care services with respect to the veteran during the preceding three-
year period.
    ``(II) A veteran described in this subclause is a veteran whose 
need for personal care services as described in paragraph (2)(C) is 
based in whole or in part on--
            ``(aa) a diagnosis of mental illness or history of suicidal 
        ideation that puts the veteran at risk of self-harm under 
        clause (iv) of such paragraph; or
            ``(bb) a neurological disorder.''; and
                    (C) by adding at the end the following new 
                paragraph:
    ``(14) The Secretary shall establish a process and requirements for 
clinicians of facilities of the Department--
            ``(A) to document incidents in which an eligible veteran 
        presents at such a facility for treatment for an emergent or 
        urgent mental health crisis or an eligible veteran is assessed 
        by such a clinician to be at risk for suicide; and
            ``(B) provide such documentation to the program established 
        under paragraph (1).''; and
            (2) in subsection (d), by adding at the end the following 
        new paragraph:
            ``(5) The term `qualified mental health professional' means 
        a psychiatrist, psychologist, licensed clinical social worker, 
        psychiatric nurse, or other licensed mental health professional 
        as the Secretary considers appropriate.''.
    (b) Timing for Establishment of Requirements and Processes.--
            (1) Report.--Not later than 180 days after the date of the 
        enactment of this Act, the Secretary of Veterans Affairs 
        shall--
                    (A) establish the process and requirements required 
                under paragraph (14) of section 1720G(a) of title 38, 
                United States Code, as added by subsection (a)(1)(C); 
                and
                    (B) submit to the Committee on Veterans' Affairs of 
                the Senate and the Committee on Veterans' Affairs of 
                the House of Representatives a description of such 
                process and requirements.
            (2) Certification.--
                    (A) In general.--Not later than one year after the 
                date of the enactment of this Act, the Secretary of 
                Veterans Affairs shall require all clinicians of 
                facilities of the Department to certify to the 
                Secretary that the clinician understands the process 
                and requirements established under paragraph (1)(A).
                    (B) Facilities of the department defined.--In this 
                paragraph, the term ``facilities of the Department'' 
                has the meaning given that term in section 1701 of 
                title 38, United States Code.

SEC. 3. REQUIREMENTS RELATING TO EVALUATIONS, ASSESSMENTS, AND 
              REASSESSMENTS RELATING TO ELIGIBILITY OF VETERANS AND 
              CAREGIVERS FOR FAMILY CAREGIVER PROGRAM.

    (a) In General.--Subsection (a) of section 1720G of title 38, 
United States Code, as amended by section 2(a)(1), is further amended 
by adding at the end the following new paragraphs:
    ``(15)(A) For purposes of conducting evaluations and assessments to 
determine eligibility of a veteran and caregiver for the program 
established under paragraph (1) or conducting reassessments to 
determine continued eligibility for such program, the Secretary shall--
            ``(i) take into account relevant documentation and medical 
        records generated by non-Department health care providers, 
        including qualified mental health professionals and 
        neurological specialists;
            ``(ii) if the caregiver of the veteran claims that the 
        serious injury or need for personal care services of the 
        veteran as described in paragraph (2) is based in whole or in 
        part on psychological trauma or another mental disorder, 
        ensure--
                    ``(I) a qualified mental health professional that 
                treats the veteran participates in the evaluation 
                process; and
                    ``(II) a qualified mental health professional 
                participates in the assessment or reassessment process; 
                and
            ``(iii) if the caregiver of the veteran claims that the 
        serious injury or need for personal care services of the 
        veteran as described in paragraph (2) is based in whole or in 
        part on a neurological disorder, ensure--
                    ``(I) a neurological specialist that treats the 
                veteran participates in the evaluation process; and
                    ``(II) a neurological specialist participates in 
                the assessment or reassessment process.
    ``(B)(i) The Secretary shall establish an appropriate time limit 
during a 24-hour period for the active participation of a veteran in an 
evaluation, assessment, or reassessment to determine eligibility of the 
veteran for the program established under paragraph (1).
    ``(ii) In determining an appropriate time limit for a veteran under 
clause (i), the Secretary shall--
            ``(I) take into consideration necessary accommodations for 
        the veteran stemming from the disability or medical condition 
        of the veteran; and
            ``(II) consult with the primary care provider, neurological 
        specialist, or qualified mental health professional that is 
        treating the veteran.
    ``(C) The Secretary shall not require the presence of a veteran 
during portions of an evaluation, assessment, or reassessment to 
determine eligibility of the veteran for the program established under 
paragraph (1) that only require the active participation of the 
caregiver.
    ``(D)(i) The Secretary shall make reasonable efforts to assist a 
caregiver and veteran in obtaining evidence necessary to substantiate 
the claims of the caregiver and veteran in the application process for 
evaluation, assessment, or reassessment for the program established 
under paragraph (1).
    ``(ii)(I) As part of the assistance provided to a caregiver or 
veteran under clause (i), the Secretary shall make reasonable efforts 
to obtain relevant private records that the caregiver or veteran 
adequately identifies to the Secretary.
    ``(II) Whenever the Secretary, after making reasonable efforts 
under subclause (I), is unable to obtain all of the relevant records 
sought, the Secretary shall notify the caregiver and veteran that the 
Secretary is unable to obtain records with respect to the claim, which 
shall include--
            ``(aa) an identification of the records the Secretary is 
        unable to obtain;
            ``(bb) a brief explanation of the efforts that the 
        Secretary made to obtain such records; and
            ``(cc) an explanation that the Secretary will make a 
        determination based on the evidence of record and that this 
        clause does not prohibit the submission of records at a later 
        date if such submission is otherwise allowed.
    ``(III) The Secretary shall make not fewer than two requests to a 
custodian of a private record in order for an effort to obtain such 
record to be treated as reasonable under subclause (I), unless it is 
made evident by the first request that a second request would be futile 
in obtaining such record.
    ``(iii) Under regulations prescribed by the Secretary, the 
Secretary--
            ``(I) shall encourage a caregiver and veteran to submit 
        relevant private medical records of the veteran to the 
        Secretary to substantiate the claims of the caregiver and 
        veteran in the application process for evaluation, assessment, 
        or reassessment for the program established under paragraph (1) 
        if such submission does not burden the caregiver or veteran; 
        and
            ``(II) may require the caregiver or veteran to authorize 
        the Secretary to obtain such relevant private medical records 
        if such authorization is required to comply with Federal, 
        State, or local law.
    ``(16)(A) The Secretary, in consultation with a health care 
provider, neurological specialist, or qualified mental health 
professional that is treating a veteran, shall waive the reassessment 
requirement for the veteran for participation in the program 
established under paragraph (1) if--
            ``(i) the serious injury of the veteran under paragraph (2) 
        is significantly caused by a degenerative or chronic condition; 
        and
            ``(ii) such condition is unlikely to improve the dependency 
        of the veteran for personal care services.
    ``(B) The Secretary shall require a health care provider, 
neurological specialist, or qualified mental health professional that 
is treating a veteran to annually certify the clinical decision of the 
provider, specialist, or professional under subparagraph (A).
    ``(C) The Secretary may rescind a waiver under subparagraph (A) 
with respect to a veteran and require a reassessment of the veteran if 
a health care provider, neurological specialist, or qualified mental 
health professional that is treating the veteran makes a clinical 
determination that the level of dependency of the veteran for personal 
care services has diminished since the last certification of the 
clinical decision of the provider, specialist, or professional under 
subparagraph (B).''.
    (b) Definition.--Subsection (d) of such section, as amended by 
section 2(a)(2), is further amended--
            (1) by redesignating paragraphs (4) and (5) as paragraphs 
        (5) and (6), respectively; and
            (2) by inserting after paragraph (3) the following new 
        paragraph (4):
            ``(4) The term `neurological specialist' means a 
        neurologist, neuropsychiatrist, physiatrist, geriatrician, 
        certified brain injury specialist, neurology nurse, neurology 
        nurse practitioner, neurology physician assistant, or such 
        other licensed medical professional as the Secretary considers 
        appropriate.''.

SEC. 4. REQUIREMENTS RELATING TO PROVISION OF GRANTS FOR ASSISTANCE TO 
              FAMILY CAREGIVERS OF VETERANS.

    (a) Distribution of Grants.--Section 1720G(a)(3) of title 38, 
United States Code, is amended by adding at the end the following new 
subparagraph:
    ``(E)(i) The Secretary shall distribute grants provided under 
subparagraph (A)(ii)(VI) to entities eligible for the provision of such 
a grant in geographically dispersed areas.
    ``(ii) In providing grants to entities under subparagraph 
(A)(ii)(VI), the Secretary shall provide equal consideration to 
national, regional, and local organizations, in an effort to adequately 
serve individuals in need of services provided pursuant to such a 
grant.''.
    (b) Grant Program Requirements.--
            (1) Rulemaking.--Not later than 180 days after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall begin the rulemaking process to establish a grant program 
        under each of items (aa), (bb), and (cc) of section 
        1720G(a)(3)(A)(ii)(VI) of title 38, United States Code, as 
        amended by section 2(a)(1)(B)(i), to provide grants under such 
        items.
            (2) Report.--
                    (A) In general.--Not later than one year after the 
                date on which the first grant is provided after the 
                date of the enactment of this Act under a grant program 
                established under paragraph (1), the Secretary shall 
                submit to the Committee on Veterans' Affairs of the 
                Senate and Committee on Veterans' Affairs of the House 
                of Representatives a report on the provision of grants 
                under each such program.
                    (B) Elements.--The report required by subparagraph 
                (A) shall include the following:
                            (i) An assessment of the effectiveness of 
                        the grant programs established under paragraph 
                        (1), including--
                                    (I) the number of individuals who 
                                benefitted from each grant program in 
                                each Veterans Integrated Service 
                                Network of the Department of Veterans 
                                Affairs; and
                                    (II) an assessment of the 
                                effectiveness of increasing engagement 
                                by individuals eligible for such 
                                programs in mental health care 
                                treatment and services, financial 
                                planning services, and legal services 
                                in each Veterans Integrated Service 
                                Network.
                            (ii) A list of recipients of grants under 
                        each such program and their partner 
                        organizations, if applicable, that delivered 
                        services funded by the grant and the amount of 
                        such grant received by each recipient and 
                        partner organization.
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