Sec. 8. Reviews and other improvements relating to home- and community-based services
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The Under Secretary for Health of the Department of Veterans Affairs shall conduct a review of each program administered through the Office of Geriatric and Extended Care of the Department, or successor office, to— ensure consistency in program management; eliminate service gaps at the medical center level; and ensure the availability of, and the access by veterans to, home- and community-based services. The Secretary of Veterans Affairs shall conduct an assessment of the staffing needs of the Office of Geriatric and Extended Care of the Department of Veterans Affairs, or successor office.
The Director of the Office of Geriatric and Extended Care, or successor office, shall establish quantitative goals to enable aging or disabled veterans who are not located near medical centers of the Department to access extended care services (including by improving access to home- and community-based services for such veterans). Each goal established under subparagraph
(A)shall include a timeline for the implementation of the goal at each medical center of the Department. The Director of the Office of Geriatric and Extended Care, or successor office, shall establish quantitative goals to address the specialty care needs of veterans through in-home care, including by ensuring the education of home health aides and caregivers of veterans in the following areas: Dementia care. Care for spinal cord injuries and diseases. Ventilator care. Other speciality care areas as determined by the Secretary. Not later than one year after the date of the enactment of this Act, the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report containing the findings of the review under paragraph (1), the results of the assessment under paragraph (2), and the goals established under paragraphs
(3)and (4). The Secretary of Veterans Affairs shall conduct a review of the following: The financial and organizational incentives for the directors of medical centers of the Department to establish or expand covered programs at such medical centers. Any incentives for such directors to provide to veterans home- and community-based services in lieu of institutional care. The efforts taken by the Secretary to enhance spending of the Department for extended care by shifting the balance of such spending from institutional care to home- and community-based services. The plan of the Under Secretary for Health of the Department to accelerate efforts to enhance spending as specified in subparagraph (C), to match the progress of similar efforts taken by the Administrator of the Centers for Medicare & Medicaid Services with respect to spending of the Centers for Medicare & Medicaid Services for extended care. Not later than one year after the date of the enactment of this Act, the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report on the findings of the review under paragraph (1). Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs shall conduct a review of the use, availability, and effectiveness, of the respite care services furnished by the Secretary under chapter 17 of title 38, United States Code. Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs, in collaboration with the Secretary of Health and Human Services, shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report containing recommendations for the expansion of mental health services and related support to the caregivers of veterans. The report under subparagraph
(A)shall include an assessment of the feasibility and advisability of authorizing access to Vet Centers by— family caregivers enrolled in a program under section 1720G of title 38, United States Code; and family caregivers of veterans participating in a program specified in section 1720K of such title, as added by section 4 . The Secretary of Veterans Affairs shall develop recommendations as follows: With respect to home- and community-based services for veterans, the Secretary of Veterans Affairs shall develop recommendations regarding new services (in addition to those furnished as of the date of the enactment of this Act) in collaboration with the Secretary of Health and Human Services. With respect to the national shortage of home health aides, the Secretary of Veterans Affairs shall develop recommendations regarding methods to address such shortage in collaboration with the Secretary of Health and Human Services and the Secretary of Labor. The Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report containing the recommendations developed under subparagraph
(A)and an identification of any changes in existing law or new statutory authority necessary to implement the recommendations, as determined by the Secretary. In carrying out this paragraph, the Secretary of Veterans Affairs shall consult with the Secretary of Labor. The Secretary of Veterans Affairs shall solicit from the entities described in subparagraph
(B)feedback and recommendations regarding opportunities for the Secretary to enhance home- and community-based services for veterans and the caregivers of veterans, including through the potential provision by the entity of care and respite services to veterans and caregivers who may not be eligible for any program under section 1720G of title 38, United States Code, or section 1720K of such title (as added by section 4 ), but have a need for assistance. The entities described in this subparagraph are veterans service organizations and nonprofit organizations with a focus on caregiver support (as determined by the Secretary). The Secretary of Veterans Affairs shall collaborate with the Director of the Indian Health Service and representatives from tribal health programs and Urban Indian organizations to ensure the availability of home- and community-based services for Native American veterans, including Native American veterans receiving health care and medical services under multiple health care systems.