I 118th CONGRESS 1st Session H. R. 4518 IN THE HOUSE OF REPRESENTATIVES July 10, 2023 Mr. Davis of North Carolina (for himself, Mrs. Kiggans of Virginia , and Mr. Ciscomani ) introduced the following bill; which was referred to the Committee on Veterans' Affairs A BILL To amend title 38, United States Code, to modify the program of comprehensive assistance for family caregivers of veterans, and for other purposes.

1. Short title This Act may be cited as the Veteran Caregiver Application and Appeals Reform Act of 2023 or the CARE Act of 2023 . 2. Modification of program of comprehensive assistance for family caregivers of veterans (a) In general Subsection (a) of section 1720G of title 38, United States Code, is amended— (1) in paragraph (5), in the matter preceding subparagraph (A), by inserting and relevant medical specialists after primary care team ; (2) in paragraph (12)— (A) in subparagraph (A), by inserting , which shall include all criteria used to determine eligibility for such assistance and, in the case of a completed evaluation, how those criteria were used to evaluate information provided in assessments to determine such eligibility before the period at the end; and (B) in subparagraph (C)(i), by inserting or who is being reassessed for eligibility to continue in such program after paragraph (1) ; and (3) by adding at the end the following new paragraph: (14) (A) Not less frequently than annually, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a comprehensive report on the program required by paragraph (1) that includes the following: (i) The number of applications received for such program during the one-year period preceding the report. (ii) The number of approvals of such applications during such period, disaggregated by race, gender, era of service, and branch of service. (iii) The number of denials of such applications during such period, disaggregated by race, gender, era of service, and branch of service. (iv) The number of reassessments conducted for such program during such period. (v) An identification of each decision made with respect to a reassessment conducted for such program during such period, disaggregated by decisions resulting in— (I) disenrollment, including removal, discharge, or voluntary withdrawal; (II) tier reduction; and (III) continuation at current tier. (vi) The number of appeals of decisions made with respect to such program during such period, disaggregated by type of appeal. (vii) With respect to each appeal identified under clause (vi), the decision rendered, if any. (viii) A description of all tools used in assessments conducted for such program, including an explanation of how and by whom those tools are administered. (ix) A description of procedures used under such program for reviewing and integrating clinical records from health care providers and an explanation of how those records are used in eligibility determinations for such program. (x) A description of procedures available under such program for health care providers, including providers in the private sector and providers under the Veterans Community Care Program under section 1703 of this title, to communicate medical opinions to the assessment teams determining eligibility for such program. (xi) A description of information technology systems and processes used under such program to upload and integrate all clinical records from all non-Department providers, including providers in the private sector and providers under the Veterans Community Care Program. (B) Each report required by subparagraph (A) shall— (i) ensure that all data included in the report— (I) relating to a decision made under the program required by paragraph (1), are disaggregated by the specific reason for the decision; and (II) with respect to a veteran, include comprehensive demographic information of the veteran, including the time period of the injuries, if any, of the veteran and the Veterans Integrated Service Network in which the veteran is located; and (ii) with respect to eligibility determinations made during the period covered by the report relating to a serious injury of a veteran, specify— (I) how many such determinations relate to the ability of the veteran to perform activities of daily living; and (II) how many such determinations relate to the need of a veteran for supervision and protection. . (b) Rule of construction Subsection (c) of such section is amended— (1) by striking (1) A decision and all that follows through (2) Nothing in this section and inserting Nothing in this section ; and (2) by redesignating subparagraphs (A) and (B) as paragraphs (1) and (2), respectively. 3. Recognition of organizations and individuals to assist veterans, family members, and caregivers navigating programs and services of Veterans Health Administration (a) In general Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall establish a process through which the Department of Veterans Affairs may recognize organizations and individuals to assist a veteran, a family member of a veteran, or a caregiver of a veteran (as defined in section 1720G(d) of title 38, United States Code) in navigating the programs and services of the Veterans Health Administration. (b) Solicitation of feedback The Secretary shall solicit feedback and recommendations in the creation of the process under subsection (a) from such organizations as the Secretary may consider relevant. (c) Limitation The Secretary may not recognize an organization or individual pursuant to the process established under subsection (a) unless the organization or individual has certified to the Secretary that no fee or compensation of any nature will be charged to any individual for services rendered in providing assistance pursuant to such subsection.