[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5002 Introduced in House (IH)]
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118th CONGRESS
1st Session
H. R. 5002
To direct the Secretary of Veterans Affairs to carry out a pilot
program for the cognitive care of veterans, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 27, 2023
Mrs. Harshbarger introduced the following bill; which was referred to
the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To direct the Secretary of Veterans Affairs to carry out a pilot
program for the cognitive care of 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 ``Innovative Cognitive Care for
Veterans Act of 2023''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) According to a 2020 study by the Office of the
Assistant Deputy Under Secretary for Health for Policy and
Planning of the Department of Veterans Affairs, it is projected
that the number of veterans with Alzheimer's dementia will
increase by 28.9 percent between fiscal year 2021 and fiscal
year 2033, amounting to an estimated 48,000 new patients with
cognitive impairments.
(2) The cost of expenditures of the Department of Veterans
Affairs for long-term care is growing rapidly, as demonstrated
by a 2020 Government Accountability Office report that
estimates such expenditures are projected to double to
$14,300,000,000 by 2037.
(3) As described in the report specified in paragraph (2),
the Department of Veterans Affairs also faces both a current
and incoming workforce shortage, in addition to other
challenges relating to the provision of long-term care services
to the more than 2,800,000 estimated veterans who are enrolled
in the patient enrollment system of the Department established
and operated under section 1705(a) of title 38, United States
Code, and live in rural areas.
(4) As observed by the Secretary of Veterans Affairs,
veterans can also be prone to unique factors that increase the
risk for future cognitive impairment. For example, it has been
found that veterans who served during the Vietnam era and,
while so serving, were exposed to Agent Orange are nearly twice
as likely as those without such exposure to receive a diagnosis
of dementia.
(5) According to the Department of Veterans Affairs, more
than 185,000 veterans enrolled in the health care system of the
Department of Veterans Affairs have been diagnosed with at
least one traumatic brain injury. Traumatic brain injury often
affects the cognitive abilities of an individual and can
disrupt normal brain function. Veterans with a traumatic brain
injury are also 60 percent more likely to develop Alzheimer's
Disease or other forms of dementia.
(6) This data compels the United States Government to do
more for veterans and their cognitive care.
SEC. 3. PILOT PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS FOR ADDRESSING
COGNITIVE DISORDERS AMONG VETERANS.
(a) Pilot Program.--
(1) Pilot program.--Not later than 180 days after the date
of the enactment of this Act, the Secretary of Veterans Affairs
shall carry out, as a part of the Veterans Community Care
Program under section 1703 of title 38, and in accordance with
the requirements of such program, a pilot program (in this
section referred to as the ``pilot program'') under which the
Secretary may enter into agreements with eligible entities to
furnish to participating veterans telehealth, virtual training
tools for home health aides, and other innovative services,
that slow the progression of cognitive disorders.
(2) Veterans care agreements.--In entering into agreements
under paragraph (1), the Secretary may enter into a Veterans
Care Agreement under section 1703A of title 38, United States
Code, consistent with the requirements of such section.
(b) Selection of Entities.--
(1) Eligible entities.--An entity is eligible for entry
into an agreement under the pilot program if the entity--
(A) furnishes telehealth, virtual training tools
for home health aides, or other innovative services,
that slow the progression of cognitive disorders; and
(B) meets such other requirements as the Secretary
may prescribe.
(2) Priority.--In selecting eligible entities for entry
into an agreement under the pilot program, the Secretary shall
give priority to eligible entities with--
(A) demonstrated experience in--
(i) providing assistance to individuals
with cognitive disorders;
(ii) addressing behavioral and temperament
issues, including through interactive
engagement and stimulation solutions;
(iii) caregiver or home health aid
training; and
(iv) working in the field of cognitive
disorders, including through the treatment of,
or rehabilitation for, traumatic brain injury
or neurodegenerative conditions; and
(B) the ability to provide services under the pilot
program to veterans at locations other than a hospital,
nursing home, or other medical facility, in accordance
with subsection (d)(2).
(3) List of selected entities.--The Secretary shall--
(A) publish on an internet website of the
Department a list identifying each eligible entity with
which the Secretary has entered into an agreement under
the pilot program; and
(B) ensure such list is accessible to veterans
selected for participation in the pilot program.
(c) Selection of Veterans.--In selecting veterans for participation
in the pilot program, the Secretary--
(1) shall ensure that not more than 500 veterans
participate in the pilot program at any given time; and
(2) may not take into consideration age or risk factors for
cognitive disorders.
(d) Services: Self-Directed and In-Home Nature.--Each veteran
selected by the Secretary for participation in the pilot program--
(1) may select, from among the entities listed under
subsection (b)(3) that are accessible to the veteran, the
entity from which services shall be received by the veteran
under the pilot program; and
(2) may elect to receive services under the pilot program
at a location that is not a traditional medical setting, such
as at the residence of the veteran, in lieu of receiving such
services at a hospital, nursing home, or other medical
facility.
(e) Termination.--The pilot program shall terminate on the date
that is five years after the date on which the pilot program commences.
(f) Report.--Not later than 180 days after the date of termination
under subsection (e), the Secretary shall submit to the Committees on
Veterans' Affairs of the House of Representatives and the Senate a
report on the pilot program. Such report shall include the following:
(1) A detailed overview of each entity with which the
Secretary entered into an agreement under the pilot program,
and the services that entity provided to participating veterans
pursuant to such agreement.
(2) An identification of the types of technology that
eligible entities with which the Secretary entered into an
agreement under the pilot program used to provide services to
participating veterans pursuant to such agreement.
(3) An identification of the following:
(A) The number of veterans that participated in the
pilot program.
(B) The number of veterans that applied to
participate in the pilot program but were not selected
for participation as a result of the limitation under
subsection (c)(2).
(C) Of the veterans who participated in the pilot
program, the number who, for the duration of such
participation, received services under the pilot
program.
(D) Of the veterans who participated in the pilot
program, the number who suffered traumatic brain injury
while serving in the Armed Forces, including, for each
such veteran--
(i) a classification of the traumatic brain
injury so suffered as mild, moderate, or severe
(as the case may be); and
(ii) an identification of the mechanism of
injury.
(E) The percentage of veterans who participated in
the pilot program (disaggregated by type of outcome
specified in clauses (i) through (iii)) who reported
that such participation resulted in the following
outcomes, with respect to the individual veteran:
(i) Quality of life improved.
(ii) Quality of life was unaffected.
(iii) Quality of life worsened.
(F) A socioeconomic and demographic breakdown of
veterans who participated in the pilot program.
(G) The type of housing in which the veterans who
participated in the pilot program reside.
(H) Whether the veterans who participated in the
pilot program have access to personal care services
from a caregiver, and if so, whether such services were
furnished by the Secretary (including through a non-
Department of Veterans Affairs health care provider
providing such services under the laws administered by
the Secretary).
(I) Such other information as may be determined
relevant by the Secretary.
(g) Source of Funds.--Amounts required to carry out this Act shall
be derived from unobligated amounts appropriated to the Veterans Health
Administration and determined appropriate by the Secretary.
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