[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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