[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 542 Engrossed in House (EH)]
<DOC>
118th CONGRESS
1st Session
H. R. 542
_______________________________________________________________________
AN ACT
To amend title 38, United States Code, to improve certain programs of
the Department of Veterans Affairs for home- and community-based
services for 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; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Elizabeth Dole
Home- and Community-Based Services for Veterans and Caregivers Act of
2023'' or the ``Elizabeth Dole Home Care Act of 2023''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Increase of expenditure cap for noninstitutional care
alternatives to nursing home care.
Sec. 3. Coordination with Program of All-Inclusive Care for the
Elderly.
Sec. 4. Home- and community-based services: programs.
Sec. 5. Coordination with assistance and support services for
caregivers.
Sec. 6. Development of centralized website for program information.
Sec. 7. Improvements relating to Homemaker and Home Health Aide
program.
Sec. 8. Reviews and other improvements relating to home- and community-
based services.
Sec. 9. Modification of certain housing loan fees.
Sec. 10. Definitions.
SEC. 2. INCREASE OF EXPENDITURE CAP FOR NONINSTITUTIONAL CARE
ALTERNATIVES TO NURSING HOME CARE.
(a) Increase of Expenditure Cap.--Section 1720C(d) of title 38,
United States Code, is amended--
(1) by striking ``The total cost'' and inserting ``(1)
Except as provided in paragraph (2), the total cost'';
(2) by striking ``65 percent'' and inserting ``100
percent''; and
(3) by adding at the end the following new paragraph:
``(2)(A) The total cost of providing services or in-kind assistance
in the case of any veteran described in subparagraph (B) for any fiscal
year under the program may exceed 100 percent of the cost that would
otherwise have been incurred as specified in paragraph (1) if the
Secretary determines, based on a consideration of clinical need,
geographic market factors, and such other matters as the Secretary may
prescribe through regulation, that such higher total cost is in the
best interest of the veteran.
``(B) A veteran described in this subparagraph is a veteran with
amyotrophic lateral sclerosis, a spinal cord injury, or a condition the
Secretary determines to be similar to such conditions.''.
(b) Applicability.--The amendments made by subsection (a) shall
apply with respect to fiscal years beginning on or after the date of
the enactment of this Act.
SEC. 3. COORDINATION WITH PROGRAM OF ALL-INCLUSIVE CARE FOR THE
ELDERLY.
Section 1720C of title 38, United States Code, as amended by
section 2, is further amended by adding at the end the following new
subsection:
``(f) In furnishing services to a veteran under the program
conducted pursuant to subsection (a), if a medical center of the
Department through which such program is administered is located in a
geographic area in which services are available to the veteran under a
PACE program (as such term is defined in sections 1894(a)(2) and
1934(a)(2) of the Social Security Act (42 U.S.C. 1395eee(a)(2); 1396u-
4(a)(2))), the Secretary shall seek to enter into an agreement with the
PACE program operating in that area for the furnishing of such
services.''.
SEC. 4. HOME- AND COMMUNITY-BASED SERVICES: PROGRAMS.
(a) Programs.--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):
``Sec. 1720K. Home- and community-based services: programs
``(a) In General.--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.
``(b) Veteran-Directed Care Program.--(1) 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.
``(2) The providers described in this paragraph are the following:
``(A) An Aging and Disability Resource Center, an area
agency on aging, or a State agency.
``(B) A center for independent living.
``(C) 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.).
``(3) In carrying out the Veteran-Directed Care program, the
Secretary of Veterans Affairs shall--
``(A) administer such program through each medical center
of the Department of Veterans Affairs;
``(B) 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
``(C) 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.
``(4) 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.
``(c) Homemaker and Home Health Aide Program.--(1) 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.
``(2) In carrying out the Homemaker and Home Health Aide program,
the Secretary shall, to the extent practicable, ensure the availability
of such program--
``(A) in the locations specified in subparagraph (B) of
subsection (b)(3); and
``(B) for the veteran populations specified in subparagraph
(C) of such subsection.
``(d) Home-Based Primary Care Program.--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.
``(e) Purchased Skilled Home Care Program.--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.
``(f) Caregiver Support.--(1) With respect to a resident eligible
caregiver of a veteran participating in a program under this section,
the Secretary shall--
``(A) 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;
``(B) provide to such caregiver covered respite care of not
less than 30 days annually; and
``(C) 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.
``(2) 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.
``(g) Rule of Construction.--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.
``(h) Definitions.--In this section:
``(1) 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).
``(2) 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.
``(3) 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).
``(4) The term `covered respite care' has the meaning given
such term in section 1720G(d) of this title.
``(5) The term `eligible veteran' means any veteran--
``(A) 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
``(B) who absent such participation would be at
increased risk for hospitalization, placement in a
nursing home, or emergency room care.
``(6) The term `home health aide' means an individual
employed by a home health agency to provide in-home care
services.
``(7) 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.
``(8) 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).
``(9) The terms `Native American' and `Native American
veteran' have the meanings given those terms in section 3765 of
this title.
``(10) 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).
``(11) 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).
``(12) The term `resident eligible caregiver' means an
individual who--
``(A) is a caregiver, or a family caregiver, of a
veteran and resides with that veteran; and
``(B) 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.''.
(b) Deadline for Improved Administration.--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.
SEC. 5. COORDINATION WITH ASSISTANCE AND SUPPORT SERVICES FOR
CAREGIVERS.
(a) Coordination With Program of Comprehensive Assistance for
Family Caregivers.--
(1) Coordination.--Section 1720G(a) of title 38, United
States Code, is amended by adding at the end the following new
paragraph:
``(14)(A) In the case of a veteran or caregiver who seeks services
under this subsection and is denied such services, or a veteran or the
family caregiver of a veteran who is discharged from the program under
this subsection, the Secretary shall--
``(i) if the veteran meets the requirements of a covered
veteran under subsection (b), provide to such caregiver the
option of enrolling in the program of general caregiver support
services under such subsection;
``(ii) assess the veteran or caregiver for participation in
any other available program of the Department for home- and
community-based services (including the programs specified in
section 1720K of this title) for which the veteran or caregiver
may be eligible and, with respect to the veteran, store (and
make accessible to the veteran) the results of such assessment
in the electronic medical record of the veteran; and
``(iii) provide to the veteran or caregiver written
information on any such program identified pursuant to the
assessment under clause (ii), including information about
facilities, eligibility requirements, and relevant contact
information for each such program.
``(B) For each veteran or family caregiver who is discharged from
the program under this subsection, a caregiver support coordinator
shall provide for a smooth and personalized transition from such
program to an appropriate program of the Department for home- and
community-based services (including the programs specified in section
1720K of this title), including by integrating caregiver support across
programs.''.
(2) Applicability.--The amendments made by paragraph (1)
shall apply with respect to denials and discharges occurring on
or after the date that is 180 days after the date of the
enactment of this Act.
(3) Technical and conforming amendments.--Section 1720G(d)
of such title is amended--
(A) by striking ``or a covered veteran'' each place
it appears and inserting ``, a veteran denied or
discharged as specified in paragraph (14) of such
subsection, or a covered veteran''; and
(B) by striking ``under subsection (a), means''
each place it appears and inserting ``under subsection
(a) or a veteran denied or discharged as specified in
paragraph (14) of such subsection, means''.
(b) Conformity of Respite Care Across Programs.--Section 1720G of
title 38, United States Code, as amended by subsection (a)(3), is
further amended--
(1) in subsection (a)(3)--
(A) by amending subparagraph (A)(ii)(III) to read
as follows:
``(III) covered respite care of not less than 30
days annually;''; and
(B) by striking subparagraph (B) and redesignating
subparagraphs (C) and (D) as subparagraphs (B) through
(C), respectively; and
(2) by amending subsection (b)(3)(A)(iii) to read as
follows:
``(iii) Covered respite care of not less than 30 days
annually.''; and
(3) in subsection (d)--
(A) by redesignating paragraphs (2) through (4) as
paragraphs (3) through (5), respectively; and
(B) by inserting after paragraph (1) the following
new paragraph:
``(2) The term `covered respite care' means, with respect
to a caregiver of a veteran, respite care under section 1720B
of this title that--
``(A) is medically and age appropriate for the
veteran (including 24-hour per day care of the veteran
commensurate with the care provided by the caregiver);
and
``(B) includes in-home care.''.
(c) Review Relating to Caregiver Contact.--The Secretary shall
conduct a review of the capacity of the Department to establish a
streamlined system for contacting all caregivers enrolled in the
program of general caregiver support services under section 1720G(b) of
title 38, United States Code, to provide to such caregivers program
updates and alerts relating to emerging services for which such
caregivers may be eligible.
SEC. 6. DEVELOPMENT OF CENTRALIZED WEBSITE FOR PROGRAM INFORMATION.
(a) Centralized Website.--The Secretary shall develop and maintain
a centralized and publically accessible internet website of the
Department as a clearinghouse for information and resources relating to
covered programs.
(b) Contents.--The website under subsection (a) shall contain the
following:
(1) A description of each covered program.
(2) An informational assessment tool that--
(A) explains the administrative eligibility, if
applicable, of a veteran, or a caregiver of a veteran,
for any covered program; and
(B) provides information, as a result of such
explanation, on any covered program for which the
veteran or caregiver (as the case may be) may be
eligible.
(3) A list of required procedures for the directors of the
medical facilities of the Department to follow in determining
the eligibility and suitability of veterans for participation
in a covered program, including procedures applicable to
instances in which the resource constraints of a facility (or
of a community in which a facility is located) may result in
the inability to address the health needs of a veteran under a
covered program in a timely manner.
(c) Updates.--The Secretary shall ensure the website under
subsection (a) is updated on a periodic basis.
SEC. 7. IMPROVEMENTS RELATING TO HOMEMAKER AND HOME HEALTH AIDE
PROGRAM.
(a) Pilot Program for Communities With Shortage of Home Health
Aides.--
(1) Program.--Beginning not later than 18 months after the
date of the enactment of this Act, the Secretary shall carry
out a three-year pilot program under which the Secretary shall
provide homemaker and home health aide services to veterans who
reside in communities with a shortage of home health aides.
(2) Locations.--The Secretary shall select not fewer than
five geographic locations in which the Secretary determines
there is a shortage of home health aides at which to carry out
the pilot program under paragraph (1).
(3) Nursing assistants.--
(A) In general.--In carrying out the pilot program
under paragraph (1), the Secretary may hire nursing
assistants as new employees of the Department of
Veterans Affairs, or reassign nursing assistants who
are existing employees of the Department, to provide to
veterans in-home care services (including basic tasks
authorized by the State certification of the nursing
assistant) under the pilot program, in lieu of or in
addition to the provision of such services through non-
Department home health aides.
(B) Relationship to home-based primary care
program.--Nursing assistants hired or reassigned under
subparagraph (A) may provide services to a veteran
under the pilot program under paragraph (1) while
serving as part of a health care team for the veteran
under the Home-Based Primary Care program.
(4) Report to congress.--Not later than one year after the
date on which the Secretary determines the pilot program under
paragraph (1) has terminated, the Secretary shall submit to the
Committees on Veterans' Affairs of the House of Representatives
and the Senate a report on the result of the pilot program.
(b) Report on Use of Funds.--Not later than one year after the date
of the enactment of this Act, the Secretary of Veterans Affairs shall
submit to the Committees on Veterans' Affairs of the House of
Representatives and the Senate a report containing, with respect to the
period beginning in fiscal year 2012 and ending in fiscal year 2023,
the following:
(1) An identification of the amount of funds that were
included in a budget of the Department of Veterans Affairs
during such period for the provision of in-home care to
veterans under the Homemaker and Home Health Aide program but
were not expended for such provision, disaggregated by medical
center of the Department for which such unexpended funds were
budgeted (if such disaggregation is possible).
(2) To the extent practicable, an identification of the
number of veterans for whom, during such period, the hours
during which a home health aide was authorized to provide
services to the veteran under the Homemaker and Home Health
Aide program were reduced for a reason other than a change in
the health care needs of the veteran, and a detailed
description of the reasons why any such reductions may have
occurred.
(c) Updated Guidance on Program.--Not later than one year after the
date of the enactment of this Act, the Secretary shall issue updated
guidance for the Homemaker and Home Health Aide program. Such updated
guidance shall include the following:
(1) A process for the transition of veterans from the
Homemaker and Home Health Aide program to other covered
programs.
(2) A requirement for the directors of the medical
facilities of the Department to complete such process whenever
a veteran with care needs has been denied services from home
health agencies under the Homemaker and Home Health Aide
program as a result of the clinical needs or behavioral issues
of the veteran.
SEC. 8. REVIEWS AND OTHER IMPROVEMENTS RELATING TO HOME- AND COMMUNITY-
BASED SERVICES.
(a) Office of Geriatric and Extended Care.--
(1) Review of programs.--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--
(A) ensure consistency in program management;
(B) eliminate service gaps at the medical center
level; and
(C) ensure the availability of, and the access by
veterans to, home- and community-based services.
(2) Assessment of staffing needs.--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.
(3) Goals for geographic alignment of care.--
(A) Establishment of goals.--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).
(B) Implementation timeline.--Each goal established
under subparagraph (A) shall include a timeline for the
implementation of the goal at each medical center of
the Department.
(4) Goals for in-home specialty care.--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:
(A) Dementia care.
(B) Care for spinal cord injuries and diseases.
(C) Ventilator care.
(D) Other speciality care areas as determined by
the Secretary.
(5) Report to congress.--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).
(b) Review of Incentives and Efforts Relating to Home- and
Community-Based Services.--
(1) Review.--The Secretary of Veterans Affairs shall
conduct a review of the following:
(A) The financial and organizational incentives for
the directors of medical centers of the Department to
establish or expand covered programs at such medical
centers.
(B) Any incentives for such directors to provide to
veterans home- and community-based services in lieu of
institutional care.
(C) 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.
(D) 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.
(2) Report to congress.--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).
(c) Review of Respite Care Services.--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.
(d) Collaboration To Improve Home- and Community-Based Services.--
(1) Report on expansion of certain mental health
services.--
(A) Report.--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.
(B) Matters included.--The report under
subparagraph (A) shall include an assessment of the
feasibility and advisability of authorizing access to
Vet Centers by--
(i) family caregivers enrolled in a program
under section 1720G of title 38, United States
Code; and
(ii) family caregivers of veterans
participating in a program specified in section
1720K of such title, as added by section 4.
(2) Recommendations.--
(A) Development.--The Secretary of Veterans Affairs
shall develop recommendations as follows:
(i) 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.
(ii) 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.
(B) Submission to congress.--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.
(C) Consultation with secretary of labor.--In
carrying out this paragraph, the Secretary of Veterans
Affairs shall consult with the Secretary of Labor.
(3) Feedback and recommendations on caregiver support.--
(A) Feedback and recommendations.--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.
(B) Covered entities.--The entities described in
this subparagraph are veterans service organizations
and nonprofit organizations with a focus on caregiver
support (as determined by the Secretary).
(4) Collaboration for native american veterans.--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.
SEC. 9. MODIFICATION OF CERTAIN HOUSING LOAN FEES.
The loan fee table in section 3729(b)(2) of title 38, United States
Code, is amended by striking ``November 15, 2031'' each place it
appears and inserting ``February 4, 2032''.
SEC. 10. DEFINITIONS.
In this Act:
(1) The terms ``caregiver'' and ``family caregiver'' have
the meanings given those terms under section 1720K(h) of title
38, United States Code (as added by section 4).
(2) The term ``covered program''--
(A) means any program of the Department of Veterans
Affairs for home- and community-based services; and
(B) includes the programs specified in section
1720K of title 38, United States Code (as added by
section 4).
(3) The term ``home- and community-based services''--
(A) means the services referred to in section
1701(6)(E) of title 38, United States Code; and
(B) includes services furnished under a program
specified in section 1720K of such title (as added by
section 4).
(4) The terms ``Home-Based Primary Care program'',
``Homemaker and Home Health Aide program'', and ``Veteran-
Directed Care program'' mean the programs of the Department of
Veterans Affairs specified in subsection (d), (c), and (b) of
such section 1720K, respectively.
(5) The terms ``home health aide'', ``Native American'',
``Native American veteran'', ``tribal health programs'', and
``Urban Indian organizations'' have the meanings given those
terms in subsection (h) of such section 1720K.
(6) The term ``Vet Center'' has the meaning given that term
in section 1712A(h) of title 38, United States Code.
(7) The term ``veterans service organization'' means any
organization recognized by the Secretary under section 5902 of
such title.
Passed the House of Representatives December 5, 2023.
Attest:
Clerk.
118th CONGRESS
1st Session
H. R. 542
_______________________________________________________________________
AN ACT
To amend title 38, United States Code, to improve certain programs of
the Department of Veterans Affairs for home- and community-based
services for veterans, and for other purposes.