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<dc:title>118 HR 4518 IH: Veteran Caregiver Application and Appeals Reform Act of 2023</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2023-07-10</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">118th CONGRESS</congress><session display="yes">1st Session</session><legis-num display="yes">H. R. 4518</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20230710">July 10, 2023</action-date><action-desc><sponsor name-id="D000230">Mr. Davis of North Carolina</sponsor> (for himself, <cosponsor name-id="K000399">Mrs. Kiggans of Virginia</cosponsor>, and <cosponsor name-id="C001133">Mr. Ciscomani</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HVR00">Committee on Veterans' Affairs</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To amend title 38, United States Code, to modify the program of comprehensive assistance for family caregivers of veterans, and for other purposes.</official-title></form><legis-body id="H8CACD8968F21404CB300B407A963CCD5" style="OLC"> 
<section section-type="section-one" id="HB8991F55FA3A40468EB20D924D389128"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Veteran Caregiver Application and Appeals Reform Act of 2023</short-title></quote> or the <quote><short-title>CARE Act of 2023</short-title></quote>.</text></section> <section id="H38A76F90B1F44DEC979ED1094CDC8393"><enum>2.</enum><header>Modification of program of comprehensive assistance for family caregivers of veterans</header> <subsection id="HF5539D24DCD64A4998AFA8490E8639CB"><enum>(a)</enum><header>In general</header><text>Subsection (a) of section 1720G of title 38, United States Code, is amended—</text>
<paragraph id="H3F3020F2C57F4752A96D0626F6EF4BDA"><enum>(1)</enum><text>in paragraph (5), in the matter preceding subparagraph (A), by inserting <quote>and relevant medical specialists</quote> after <quote>primary care team</quote>;</text></paragraph> <paragraph id="HD82E92FEA1B240E6A78F4B90875D76F1"><enum>(2)</enum><text>in paragraph (12)—</text>
<subparagraph id="H26067F393F4F42899BCB68653252D348"><enum>(A)</enum><text>in subparagraph (A), by inserting <quote>, which shall include all criteria used to determine eligibility for such assistance and, in the case of a completed evaluation, how those criteria were used to evaluate information provided in assessments to determine such eligibility</quote> before the period at the end; and</text></subparagraph> <subparagraph id="H599826083A6D4CE69794341CB95702EF"><enum>(B)</enum><text>in subparagraph (C)(i), by inserting <quote>or who is being reassessed for eligibility to continue in such program</quote> after <quote>paragraph (1)</quote>; and</text></subparagraph></paragraph>
<paragraph id="H48EDCB9848A34E6FAB0F8CACA1AE096D"><enum>(3)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="HA67F89488B3F408291853F1E9CD633A4"> <paragraph indent="up1" id="HF9B304FB94AB426E98121B7E5833EA30"><enum>(14)</enum> <subparagraph commented="no" display-inline="yes-display-inline" id="HD3E5C5D4D6014DBBA5ADD856E27C6DAA"><enum>(A)</enum><text>Not less frequently than annually, 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 comprehensive report on the program required by paragraph (1) that includes the following:</text>
<clause id="HB27B9896980B4F7CB33DE6335741B88D" indent="up1"><enum>(i)</enum><text>The number of applications received for such program during the one-year period preceding the report.</text></clause> <clause id="HFC44D952AB74403FB9D2BB9562E50189" indent="up1"><enum>(ii)</enum><text>The number of approvals of such applications during such period, disaggregated by race, gender, era of service, and branch of service.</text></clause>
<clause id="H8BFB59E0ABC1445F987501346622525C" indent="up1"><enum>(iii)</enum><text>The number of denials of such applications during such period, disaggregated by race, gender, era of service, and branch of service.</text></clause> <clause id="HFFBE818351C343E0A7BA3EEB40060397" indent="up1"><enum>(iv)</enum><text>The number of reassessments conducted for such program during such period.</text></clause>
<clause id="H63AE81E19C2B44D594C136C1153BA621" indent="up1"><enum>(v)</enum><text>An identification of each decision made with respect to a reassessment conducted for such program during such period, disaggregated by decisions resulting in—</text> <subclause id="H2A9144BDC5704567B241E0546F0752EC"><enum>(I)</enum><text>disenrollment, including removal, discharge, or voluntary withdrawal;</text></subclause>
<subclause id="H2BBCD31EECDB4C98BB6D2862217D18D1"><enum>(II)</enum><text>tier reduction; and</text></subclause> <subclause id="H5AF727159CC24D8FA9B63F41F934DFCC"><enum>(III)</enum><text>continuation at current tier.</text></subclause></clause>
<clause indent="up1" id="H1A3F9FFF19464D49A7ABC1BDA1BF089C"><enum>(vi)</enum><text>The number of appeals of decisions made with respect to such program during such period, disaggregated by type of appeal.</text></clause> <clause indent="up1" id="H548BB9EC0DE8400A8BBADAB94451FE4F"><enum>(vii)</enum><text>With respect to each appeal identified under clause (vi), the decision rendered, if any.</text></clause>
<clause indent="up1" id="H8A6D66422DDD47B3A3D2EFB8A9363213"><enum>(viii)</enum><text>A description of all tools used in assessments conducted for such program, including an explanation of how and by whom those tools are administered.</text></clause> <clause indent="up1" id="H357040F5B69C41BCB3476ED37A7D3CEC"><enum>(ix)</enum><text>A description of procedures used under such program for reviewing and integrating clinical records from health care providers and an explanation of how those records are used in eligibility determinations for such program.</text></clause>
<clause id="HC9C52679AE434A7BAC112203281598BB" indent="up1"><enum>(x)</enum><text>A description of procedures available under such program for health care providers, including providers in the private sector and providers under the Veterans Community Care Program under section 1703 of this title, to communicate medical opinions to the assessment teams determining eligibility for such program.</text></clause> <clause id="H8E8D609C6F5D4F21A8EA9B83FCE7986C" indent="up1"><enum>(xi)</enum><text>A description of information technology systems and processes used under such program to upload and integrate all clinical records from all non-Department providers, including providers in the private sector and providers under the Veterans Community Care Program.</text></clause></subparagraph>
<subparagraph indent="up1" id="HDDEAAD1C5FEF467AA642B9C3741101DA" commented="no"><enum>(B)</enum><text>Each report required by subparagraph (A) shall—</text> <clause commented="no" display-inline="no-display-inline" id="HE546936366A24CCBB70277F47E95280B"><enum>(i)</enum><text display-inline="yes-display-inline">ensure that all data included in the report—</text>
<subclause commented="no" display-inline="no-display-inline" id="H51C3ACE127FA49A9A4D85546ED6D051C"><enum>(I)</enum><text display-inline="yes-display-inline">relating to a decision made under the program required by paragraph (1), are disaggregated by the specific reason for the decision; and</text></subclause> <subclause commented="no" display-inline="no-display-inline" id="H93A84913775A41E9AA9EDEAB3D04C47E"><enum>(II)</enum><text display-inline="yes-display-inline">with respect to a veteran, include comprehensive demographic information of the veteran, including the time period of the injuries, if any, of the veteran and the Veterans Integrated Service Network in which the veteran is located; and</text></subclause></clause>
<clause commented="no" display-inline="no-display-inline" id="H4AF81143608B4B94BB220641A1026707"><enum>(ii)</enum><text display-inline="yes-display-inline">with respect to eligibility determinations made during the period covered by the report relating to a serious injury of a veteran, specify—</text> <subclause id="HC7414CB5CE104F35B37934F31C0D5B33" commented="no"><enum>(I)</enum><text>how many such determinations relate to the ability of the veteran to perform activities of daily living; and</text></subclause>
<subclause id="HBE92EB31E2AC44F09AFD5270F2460A3B" commented="no"><enum>(II)</enum><text>how many such determinations relate to the need of a veteran for supervision and protection.</text></subclause></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="H8B47C5C75FE24AF4B7BEFC8D8FA23251"><enum>(b)</enum><header>Rule of construction</header><text>Subsection (c) of such section is amended—</text>
<paragraph id="H973FA026AE8E4CE9BA9D5DA97AC752BE"><enum>(1)</enum><text>by striking <quote>(1) A decision</quote> and all that follows through <quote>(2) Nothing in this section</quote> and inserting <quote>Nothing in this section</quote>; and</text></paragraph> <paragraph id="HFEC33AAFE70E4418A96222FFE5011A4D"><enum>(2)</enum><text>by redesignating subparagraphs (A) and (B) as paragraphs (1) and (2), respectively.</text></paragraph></subsection></section>
<section id="HCED836292DB245A08603E71FA3C4EDFC"><enum>3.</enum><header>Recognition of organizations and individuals to assist veterans, family members, and caregivers navigating programs and services of Veterans Health Administration</header>
<subsection commented="no" display-inline="no-display-inline" id="H7F8381FAED614BAA94753EA37E394EF6"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall establish a process through which the Department of Veterans Affairs may recognize organizations and individuals to assist a veteran, a family member of a veteran, or a caregiver of a veteran (as defined in section 1720G(d) of title 38, United States Code) in navigating the programs and services of the Veterans Health Administration.</text></subsection> <subsection commented="no" display-inline="no-display-inline" id="HA99FD78EA1034021A08AD820BD3F4797"><enum>(b)</enum><header>Solicitation of feedback</header><text display-inline="yes-display-inline">The Secretary shall solicit feedback and recommendations in the creation of the process under subsection (a) from such organizations as the Secretary may consider relevant.</text></subsection>
<subsection commented="no" display-inline="no-display-inline" id="HF9EB6F82CA064D1CA2DDE55C1E4F1A2B"><enum>(c)</enum><header>Limitation</header><text display-inline="yes-display-inline">The Secretary may not recognize an organization or individual pursuant to the process established under subsection (a) unless the organization or individual has certified to the Secretary that no fee or compensation of any nature will be charged to any individual for services rendered in providing assistance pursuant to such subsection. </text></subsection></section> </legis-body></bill>

