[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1815 Introduced in House (IH)]
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118th CONGRESS
1st Session
H. R. 1815
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
March 27, 2023
Ms. Slotkin (for herself, Mr. Steil, Mr. Trone, and Ms. Kuster)
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 subsection (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 regions with the top three
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 the Veterans Integrated
Service Networks 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 such 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 a rate agreed to
by the Secretary and the State home.
(B) Community assisted living facilities.--In the
case of a facility participating in the pilot program
under subsection (a)(1) that is a community assisted
living facility, the Secretary shall--
(i) 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; and
(ii) re-evaluate payment rates annually to
account for current economic conditions and
current costs of assisted living services.
(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 such veterans in, other extended care services
based on their preferences and best medical interest.
(e) Determination of Quality.--The Secretary shall determine a
method for assessment of quality of care provided to veterans
participating in the pilot program under subsection (a)(1) and shall
communicate that method to providers of services under the pilot
program.
(f) Annual Report.--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 Committee on Veterans' Affairs of the Senate and
the Committee on Veterans' Affairs of the House of Representatives a
report on the pilot program, including--
(1) 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;
(2) the number of participants in the pilot program,
disaggregated by facility;
(3) general demographic information of participants in the
pilot program, including average age, gender, and race or
ethnicity;
(4) disability status of participants in the pilot program;
(5) 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;
(6) 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;
(7) aggregated feedback from participants in the pilot
program, including from veteran resident surveys and
interviews; and
(8) such other matters the Secretary considers appropriate.
(g) Final Report.--Not later than four years after the initiation
of the pilot program under subsection (a)(1), or not later than seven
years after the initiation of the pilot program if the pilot program is
extended under subsection (a)(2), the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives a report on the pilot
program that--
(1) includes the matters required under paragraphs (1)
through (8) of subsection (f);
(2) includes recommendations on whether the model studied
in the pilot program should be continued or adopted throughout
the Department; and
(3) indicates whether the Secretary requests action by
Congress to make the pilot program permanent.
(h) Report by Inspector General.--
(1) In general.--Not later than three 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 and the Committees on Veterans' Affairs
of the House of Representatives and the Senate a report on the
pilot program.
(2) Elements.--The report required by paragraph (1) shall
include an assessment of--
(A) the quality of care provided to veterans at
facilities participating in the pilot program, measured
pursuant to the method determined under subsection (e);
(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 required by 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.
(i) Definitions.--In this section:
(1) The term ``assisted living services'' means services of
a facility in providing room, board, and personal care for and
supervision of residents for their health, safety, and welfare.
(2) The term ``eligible veteran'' means a veteran who--
(A)(i) is already receiving nursing home level care
paid for by the Department;
(ii) is eligible to receive nursing home level care
paid for by the Department pursuant to section 1710A of
title 38, United States Code; or
(iii) requires a higher level of care than the
domiciliary care provided by the Department but does
not meet the requirements for nursing home level care
provided by the Department pursuant to such section;
and
(B)(i) is eligible for assisted living services, as
determined by the Secretary; or
(ii) meets such additional criteria for eligibility
for the pilot program under subsection (a)(1) as the
Secretary may establish.
(3) The term ``State home'' has the meaning given that term
in section 101 of title 38, United States Code.
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