Sec. 4. Home- and community-based services: programs
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Chapter 17 of title 38, United States Code, is amended by inserting after section 1720J the following new section (and conforming the table of sections at the beginning of such chapter accordingly): In furnishing noninstitutional alternatives to nursing home care pursuant to the authority of section 1720C of this title (or any other authority under this chapter or other provision of law administered by the Secretary of Veterans Affairs), the Secretary shall carry out each of the programs specified in this section in accordance with such relevant authorities except as otherwise provided in this section.
The Secretary of Veterans Affairs, in collaboration with the Secretary of Health and Human Services, shall carry out a program to be known as the Veteran-Directed Care program . Under such program, the Secretary of Veterans Affairs may enter into agreements with the providers described in paragraph
(2)to provide to eligible veterans funds, to the extent practicable, to obtain such in-home care services and related items as may be determined appropriate by the Secretary of Veterans Affairs and selected by the veteran, including through the veteran hiring individuals to provide such services and items or directly purchasing such services and items. The providers described in this paragraph are the following: An Aging and Disability Resource Center, an area agency on aging, or a State agency. A center for independent living. An Indian tribe or tribal organization receiving assistance under title VI of the Older Americans Act of 1965 ( 42 U.S.C. 3057 et seq. ). In carrying out the Veteran-Directed Care program, the Secretary of Veterans Affairs shall— administer such program through each medical center of the Department of Veterans Affairs; seek to ensure the availability of such program in American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the Commonwealth of Puerto Rico, the Virgin Islands of the United States, and any other territory or possession of the United States, to the extent practicable; and seek to ensure the availability of such program for eligible veterans who are Native American veterans receiving care and services furnished by the Indian Health Service, a tribal health program, an Urban Indian organization, or (in the case of a Native Hawaiian veteran) a Native Hawaiian health care system, to the extent practicable. If a veteran participating in the Veteran-Directed Care program is catastrophically disabled, the veteran may continue to use funds under the program during a period of hospitalization in the same manner that the veteran would be authorized to use such funds under the program if the veteran were not hospitalized. The Secretary shall carry out a program to be known as the Homemaker and Home Health Aide program under which the Secretary may enter into agreements with home health agencies to provide to eligible veterans such home health aide services as may be determined appropriate by the Secretary. In carrying out the Homemaker and Home Health Aide program, the Secretary shall, to the extent practicable, ensure the availability of such program— in the locations specified in subparagraph
(B)of subsection (b)(3); and for the veteran populations specified in subparagraph
(C)of such subsection. The Secretary shall carry out a program to be known as the Home-Based Primary Care program under which the Secretary may furnish to eligible veterans in-home health care, the provision of which is overseen by a provider of the Department. The Secretary shall carry out a program to be known as the Purchased Skilled Home Care program under which the Secretary may furnish to eligible veterans such in-home care services as may be determined appropriate and selected by the Secretary for the veteran. With respect to a resident eligible caregiver of a veteran participating in a program under this section, the Secretary shall— if the veteran meets the requirements of a covered veteran under section 1720G(b) of this title, provide to such caregiver the option of enrolling in the program of general caregiver support services under such section; provide to such caregiver covered respite care of not less than 30 days annually; and conduct on an annual basis (and, to the extent practicable, in connection with in-person services provided under the program in which the veteran is participating), a wellness contact of such caregiver. Covered respite care provided to a resident eligible caregiver of a veteran under paragraph
(1)may exceed 30 days annually if such extension is requested by the resident eligible caregiver or veteran and determined medically appropriate by the Secretary. Nothing in this section shall be construed to limit the authority of the Secretary to carry out programs providing home- and community-based services under any other provision of law. In this section: The terms Aging and Disability Resource Center , area agency on aging , and State agency have the meanings given those terms in section 102 of the Older Americans Act of 1965 ( 42 U.S.C. 3002 ). The terms caregiver and family caregiver , with respect to a veteran, have the meanings given those terms, respectively, under subsection
(e)of section 1720G of this title with respect to an eligible veteran under subsection
(a)of such section or a covered veteran under subsection
(b)of such section, as the case may be. The term center for independent living has the meaning given that term in section 702 of the Rehabilitation Act of 1973 ( 29 U.S.C. 796a ). The term covered respite care has the meaning given such term in section 1720G(d) of this title. The term eligible veteran means any veteran— for whom the Secretary determines participation in a specific program under this section is medically necessary to promote, preserve, or restore the health of the veteran; and who absent such participation would be at increased risk for hospitalization, placement in a nursing home, or emergency room care. The term home health aide means an individual employed by a home health agency to provide in-home care services. The term in-home care service means any service, including a personal care service, provided to enable the recipient of such service to live at home. The terms Indian tribe and tribal organization have the meanings given those terms in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 5304 ). The terms Native American and Native American veteran have the meanings given those terms in section 3765 of this title. The terms Native Hawaiian and Native Hawaiian health care system have the meanings given those terms in section 12 of the Native Hawaiian Health Care Improvement Act ( 42 U.S.C. 11711 ). The terms tribal health programs and Urban Indian organizations have the meanings given those terms in section 4 of the Indian Health Care Improvement Act ( 25 U.S.C. 1603 ). The term resident eligible caregiver means an individual who— is a caregiver, or a family caregiver, of a veteran and resides with that veteran; and has not entered into a contract, agreement, or other arrangement for such individual to act as a caregiver for that veteran unless such individual is a family member of the veteran or is furnishing caregiver services through a medical foster home. . The Secretary of Veterans Affairs shall ensure that the Veteran-Directed Care program and the Homemaker and Home Health Aide program are administered through each medical center of the Department of Veterans Affairs in accordance with section 1720K of title 38, United States Code (as added by subsection (a)), by not later than two years after the date of the enactment of this Act.
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Sec. 4
Home- and community-based services: programs
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