[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8750 Introduced in House (IH)]
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117th CONGRESS
2d Session
H. R. 8750
To require the Secretary of Veterans Affairs to carry out a pilot
program to provide assisted living services to eligible veterans, and
for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
August 26, 2022
Ms. Slotkin (for herself, Mr. Trone, Mrs. Bice of Oklahoma, and Mr.
Steil) introduced the following bill; which was referred to the
Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To require the Secretary of Veterans Affairs to carry out a pilot
program to provide assisted living services to eligible veterans, 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 ``Expanding Veterans' Options for Long
Term Care Act''.
SEC. 2. PILOT PROGRAM ON ASSISTED LIVING SERVICES FOR VETERANS.
(a) Program.--
(1) In general.--Beginning not later than one year after
the date of the enactment of this Act, the Secretary of
Veterans Affairs shall carry out a three-year pilot program to
assess--
(A) the effectiveness of providing assisted living
services to eligible veterans, at the election of such
veterans; and
(B) the satisfaction with the pilot program of
veterans participating in the pilot program.
(2) Extension.--The Secretary may extend the duration of
the pilot program under paragraph (1) for an additional three-
year period if the Secretary, based on the results of the
reports submitted under subsections (e) and (f), determines
that it is appropriate to do so.
(b) Program Locations.--
(1) Veterans integrated service networks.--
(A) In general.--The Secretary shall select not
fewer than six Veterans Integrated Service Networks of
the Department of Veterans Affairs at which to carry
out the pilot program under subsection (a)(1).
(B) Veterans receiving nursing home care.--The
Secretary shall ensure that not fewer than three
Veterans Integrated Service Networks selected under
subparagraph (A) serve areas with the highest
percentage of veterans who are currently receiving
nursing home care through the Department and would be
eligible to receive assisted living services under the
pilot program.
(2) Facilities.--
(A) In general.--Within each Veterans Integrated
Service Network selected under paragraph (1), the
Secretary shall select facilities at which to carry out
the pilot program under subsection (a)(1).
(B) Selection criteria.--In selecting facilities
under subparagraph (A), the Secretary shall ensure
that--
(i) the locations of such facilities are in
geographically diverse areas;
(ii) not fewer than two such facilities
serve veterans in rural or highly rural areas
(as determined through the use of the Rural-
Urban Commuting Areas coding system of the
Department of Agriculture);
(iii) not fewer than one such facility is
located in each Veterans Integrated Service
Network selected under paragraph (1); and
(iv) not fewer than two such facilities are
State homes.
(c) Provision of Assisted Living Services.--
(1) Agreements.--In carrying out the pilot program under
subsection (a)(1), the Secretary may enter into agreements for
the provision of assisted living services on behalf of eligible
veterans with--
(A) a provider participating under a State plan or
waiver under title XIX of the Social Security Act (42
U.S.C. 1396 et seq.); or
(B) a State home recognized and certified under
subpart B of part 51 of title 38, Code of Federal
Regulations, or successor regulations.
(2) Standards.--The Secretary may not place, transfer, or
admit a veteran to any facility for assisted living services
under the pilot program under subsection (a)(1) unless the
Secretary determines that--
(A) the facility meets the standards for community
residential care established under sections 17.61
through 17.72 of title 38, Code of Federal Regulations,
or successor regulations, and any additional standards
of care as the Secretary may specify; or
(B) in the case of a facility that is a State home,
the State home meets the standards for care established
under subpart E of part 51 of title 38, Code of Federal
Regulations, or successor regulations, and any
additional standards of care as the Secretary may
specify.
(3) Inspection.--The Secretary shall inspect facilities at
which veterans are placed under the pilot program under
subsection (a)(1)--
(A) with respect to a facility that is a State
home, not less frequently than annually and in the same
manner as the Secretary conducts inspection of State
homes under section 1742 of title 38, United States
Code; and
(B) with respect to any other facility, not less
frequently than annually and in the same manner as the
Secretary conducts inspection of facilities under
section 1730 of such title.
(4) Payment to certain facilities.--
(A) State homes.--In the case of a facility
participating in the pilot program under subsection
(a)(1) that is a State home, the Secretary shall pay to
the State home a per diem for each veteran
participating in the pilot program at the State home
that is--
(i) greater than the per diem for
domiciliary care at the State home, if
applicable; and
(ii) less than the per diem for nursing
home care at the State home.
(B) Community assisted living facilities.--In the
case of a facility participating in the pilot program
that is a community assisted living facility, the
Secretary shall pay to the facility an amount that is
less than the average rate paid by the Department for
placement in a community nursing home in the same
Veterans Integrated Service Network.
(d) Continuity of Care.--Upon the termination of the pilot program
under subsection (a)(1), the Secretary shall--
(1) provide to all veterans participating in the pilot
program at the time of such termination the option to continue
to receive assisted living services at the site they were
assigned to under the pilot program, at the expense of the
Department; and
(2) for such veterans who do not opt to continue to receive
such services--
(A) ensure such veterans do not experience lapses
in care; and
(B) provide such veterans with information on, and
enroll participants in, other long-term care options
based on their preferences and best medical interest.
(e) Annual Report.--
(1) In general.--Not later than one year after the
initiation of the pilot program under subsection (a)(1), and
annually thereafter for each year in which the pilot program is
carried out, the Secretary shall submit to the Committees on
Veterans' Affairs of the House of Representatives and the
Senate a report on the pilot program, including--
(A) an identification of Veterans Integrated
Services Networks and facilities of the Department
participating in the pilot program and assisted living
facilities and State homes at which veterans are placed
under the pilot program;
(B) the number of participants in the pilot
program, disaggregated by facility;
(C) general demographic information of participants
in the pilot program, including average age, gender,
and race or ethnicity;
(D) disability status of participants in the pilot
program;
(E) an identification of any barriers or challenges
to enrolling veterans in the pilot program, conducting
oversight of the pilot program, or any other barriers
or challenges;
(F) the cost of care at each assisted living
facility and State home participating in the pilot
program, including an analysis of any cost savings by
the Department when comparing that cost to the cost of
nursing home care;
(G) aggregated feedback from participants in the
pilot program; and
(H) such other matters the Secretary considers
appropriate.
(2) Final report.--As part of the final report submitted
under paragraph (1), the Secretary shall include
recommendations on whether the model studied in the pilot
program should be continued or adopted throughout the
Department.
(f) Report by Inspector General.--
(1) Report.--Not later than two years after the initiation
of the pilot program under subsection (a)(1), the Inspector
General of the Department of Veterans Affairs shall submit to
the Secretary, the Committees on Veterans' Affairs of the House
of Representatives and the Senate a report on the pilot
program.
(2) Elements.--The report under paragraph (1) shall include
an assessment of--
(A) the quality of care provided to veterans at
facilities participating in the pilot program;
(B) the oversight of such facilities, as conducted
by the Department, the Centers for Medicare & Medicaid
Services, State agencies, and other relevant entities;
and
(C) such other matters as the Inspector General
considers appropriate.
(3) Follow-up.--Not later than 90 days after the submission
of the report under paragraph (1), the Secretary shall submit
to the Committees on Veterans' Affairs of the House of
Representatives and the Senate a plan to address the
deficiencies identified in the report, if any.
(g) Definitions.--In this section:
(1) The term ``assisted living services'' means--
(A) services of a facility in providing room,
board, and personal care for and supervision of
residents for their health, safety, and welfare; and
(B) a level of care more intensive than domiciliary
care and less intensive than nursing home care.
(2) The term ``eligible veteran'' means a veteran who is
eligible for assisted living services, as determined by the
Secretary, and--
(A) is already receiving nursing home level care
paid for by the Department;
(B) is eligible to receive nursing home level care
paid for by the Department; or
(C) exceeds the requirements for domiciliary care
paid for by the Department but does not meet the
requirements for nursing home level care paid for by
the Department.
(3) The term ``State home'' has the meaning given that term
in section 101(19) of title 38, United States Code.
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