[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3155 Engrossed in House (EH)]
111th CONGRESS
1st Session
H. R. 3155
_______________________________________________________________________
AN ACT
To amend title 38, United States Code, to provide certain caregivers of
veterans with training, support, and medical care, 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 ``Caregiver Assistance and Resource
Enhancement Act''.
SEC. 2. SUPPORT SERVICES FOR CAREGIVERS.
(a) Definitions.--Section 1701 of title 38, United States Code, is
amended by adding at the end the following new paragraphs:
``(10) The term `caregiver services' means noninstitutional
extended care (as used in paragraph (6)).
``(11) The term `caregiver' means an individual who--
``(A) with respect to a disabled veteran who is
enrolled in the health care system established under
section 1705(a) of this title, provides caregiver
services to such veteran for such disability; and
``(B) is not a member of the family (including
parents, spouses, children, siblings, step-family
members, and extended family members) of such veteran.
``(12) The term `family caregiver' means an individual
who--
``(A) with respect to a disabled veteran who is
enrolled in the health care system established under
section 1705(a) of this title, provides caregiver
services to such veteran for such disability;
``(B) is a member of the family (including parents,
spouses, children, siblings, step-family members, and
extended family members) of such veteran; and
``(C) may or may not reside with such veteran.''.
(b) Support Services.--
(1) In general.--Subchapter II of chapter 17 of title 38,
United States Code, is amended by adding at the end the
following new section:
``Sec. 1720G. Support services for caregivers and family caregivers
``(a) Establishment of Program.--The Secretary shall develop and
carry out a program for caregivers and family caregivers that includes
the following:
``(1) The educational sessions, stipends, and access to
support services provided under this section.
``(2) Counseling and other services provided under section
1782 of this title.
``(3) Respite care provided under section 1720B of this
title.
``(4) With respect to family caregivers, medical care
provided under section 1781(e) of this title.
``(5) Travel expenses provided under section 111(e) of this
title.
``(b) Educational Sessions.--(1) The Secretary shall make available
educational sessions for caregivers, family caregivers, and individuals
described in paragraph (2). Such educational sessions shall--
``(A) be made available both in person and on an Internet
website;
``(B) incorporate available technology, including
telehealth technology to the extent practicable; and
``(C) teach techniques, strategies, and skills for caring
for a disabled veteran, including, at a minimum, a veteran
who--
``(i) was deployed in support of Operation Enduring
Freedom or Operation Iraqi Freedom; and
``(ii) has post-traumatic stress disorder, a
traumatic brain injury, or other severe injury or
illness.
``(2) Individuals described in this paragraph are individuals who
provide caregivers and family caregivers with support under this
chapter or through an aging network (as defined in section 102(5) of
the Older Americans Act of 1965 (42 U.S.C. 3002(5)), including--
``(A) respite care providers;
``(B) nursing care providers; and
``(C) counselors.
``(c) Stipends.--(1) The Secretary shall provide monthly stipends
to eligible family caregivers described in paragraph (2).
``(2) An eligible family caregiver described in this paragraph is a
family caregiver who--
``(A) provides caregiver services to a veteran who--
``(i) was deployed in support of Operation Enduring
Freedom or Operation Iraqi Freedom; and
``(ii) for purposes of this subsection, is
determined by the Secretary--
``(I) to have a service-connected
disability or illness that is severe;
``(II) to be in need of caregiver services,
such that without such services, the veteran
would require hospitalization, nursing home
care, or other residential institutional care;
and
``(III) based on an examination by a
physician employed by the Department (or, in
areas where no such physician is available, by
a physician carrying out such function under a
contract or fee arrangement), to be unable to
carry out the activities (including
instrumental activities) of daily living;
``(B) with respect to such veteran, meets the definition of
the term `family caregiver' under section 1701(12) of this
title;
``(C) is designated by such veteran as the primary family
caregiver for such veteran; and
``(D) is not--
``(i) employed by a home health care agency to
provide such caregiver services; or
``(ii) otherwise receiving payment for such
services.
``(3) The authority of the Secretary to provide a stipend to an
eligible family caregiver under this subsection shall expire on October
1, 2012.
``(d) Access to Support Services.--The Secretary shall provide
caregivers and family caregivers with information concerning public,
private, and non-profit agencies that offer support to caregivers. In
providing such information, the Secretary shall--
``(1) collaborate with the Assistant Secretary for Aging of
the Department of Health and Human Services in order to provide
caregivers and family caregivers access to aging and disability
resource centers under the Administration on Aging of the
Department of Health and Human Services; and
``(2) include on an Internet website that is dedicated to
caregivers and family caregivers--
``(A) a directory of services available for
caregivers and family caregivers at the county level;
and
``(B) tools that provide caregivers and family
caregivers with the ability to interact with each other
for the purpose of fostering peer support and creating
support networks.
``(e) Information and Outreach.--(1) The Secretary shall conduct
outreach to inform disabled veterans and the families of such veterans
of the following:
``(A) Medical care, educational sessions, stipends, and
other services available for caregivers and family caregivers
under this chapter.
``(B) The ability of a family caregiver to be trained and
certified by a home health care agency in order to be paid by
such agency for providing caregiver services.
``(2) Outreach under this subsection shall include, at a minimum,
the following:
``(A) Public service announcements.
``(B) Brochures and pamphlets.
``(C) Full use of Internet-based outreach methods,
including such methods designed specifically for veterans and
the families of such veterans who reside in rural areas.
``(3) With respect to a Department employee providing case
management services (as defined in section 1720C(b)(2) of this title)
to a disabled veteran, the Secretary shall ensure that such employee
provides a caregiver or family caregiver of such veteran with
information on the services described in subparagraphs (A) and (B) of
paragraph (1).''.
(2) Clerical amendment.--The table of sections at the
beginning of chapter 17 of title 38, United States Code, is
amended by inserting after the item related to section 1720F
the following new item:
``1720G. Support services for caregivers and family caregivers.''.
(c) Plan.--Not later than 180 days after the date of the enactment
of this Act, the Secretary shall submit to the Committee on Veterans'
Affairs of the House of Representatives and the Committee on Veterans'
Affairs of the Senate a plan for carrying out section 1720G of title
38, United States Code, as added by subsection (b) of this section.
(d) Reports.--Not later than 180 days after the date on which the
plan is submitted under subsection (c), and annually thereafter for the
following five years, the Secretary shall submit to the Committee on
Veterans' Affairs of the House of Representatives and the Committee on
Veterans' Affairs of the Senate a report describing the implementation
of the plan.
SEC. 3. COUNSELING AND MENTAL HEALTH SERVICES FOR CAREGIVERS AND FAMILY
CAREGIVERS.
(a) In General.--Section 1782 of title 38, United States Code, is
amended--
(1) in the section heading, by adding at the end the
following: ``, caregivers, and family caregivers''; and
(2) in subsection (c)--
(A) in paragraph (1), by striking ``; or'' and
inserting a semicolon;
(B) by redesignating paragraph (2) as paragraph
(3); and
(C) by inserting after paragraph (1) the following
new paragraph (2):
``(2) a caregiver or family caregiver of a veteran; or''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 17 of title 38, United States Code, is amended by striking the
item relating to section 1782 and inserting the following new item:
``1782. Counseling, training, and mental health services for immediate
family members, caregivers, and family
caregivers.''.
SEC. 4. RESPITE CARE TO ASSIST FAMILY CAREGIVERS.
Section 1720B of title 38, United States Code, is amended--
(1) in subsection (a), by striking ``title.'' and inserting
``title or who receives care from a family caregiver.''; and
(2) by adding at the end the following new subsection:
``(d) In furnishing respite care services under this section, the
Secretary shall ensure that such services--
``(1) fulfill the needs of the veteran receiving care
(including 24-hour in-home respite care); and
``(2) are appropriate for the veteran with respect to the
age of the veteran.''.
SEC. 5. MEDICAL CARE FOR FAMILY CAREGIVERS.
Section 1781 of title 38, United States Code, is amended--
(1) in subsection (a)--
(A) in paragraph (2), by striking ``and'' at the
end;
(B) in paragraph (3), by inserting ``and'' at the
end; and
(C) by inserting after paragraph (3) the following
new paragraph:
``(4) in accordance with subsection (e), a family
caregiver,'';
(2) in the third sentence of subsection (b), by striking
``dependent or survivor'' and inserting ``dependent, survivor,
or family caregiver''; and
(3) by adding at the end the following new subsection:
``(e)(1) The Secretary shall provide medical care to a family
caregiver under this section if the Secretary determines that the
family caregiver is not entitled to care or services under a health-
plan contract as defined under section 1725(f)(2) of this title
(determined, in the case of a health-plan contract as defined in
subsection (f)(2)(B) or (f)(2)(C) of such section, without regard to
any requirement or limitation relating to eligibility for care or
services from any department or agency of the United States).
``(2) In this subsection, a family caregiver is an individual who--
``(A) provides caregiver services to a veteran who--
``(i) was deployed in support of Operation Enduring
Freedom or Operation Iraqi Freedom; and
``(ii) for purposes of this subsection, is
determined by the Secretary--
``(I) to have a service-connected
disability or illness that is severe;
``(II) to be in need of caregiver services,
such that without such services, the veteran
would require hospitalization, nursing home
care, or other residential institutional care;
and
``(III) based on an examination by a
physician employed by the Department (or, in
areas where no such physician is available, by
a physician carrying out such function under a
contract or fee arrangement), to be unable to
carry out the activities (including
instrumental activities) of daily living;
``(B) with respect to such veteran, meets the definition of
the term `family caregiver' under section 1701(12) of this
title; and
``(C) is designated by such veteran as the primary family
caregiver for such veteran.
``(3) The authority of the Secretary to provide medical care to a
family caregiver under this section shall expire on October 1, 2012.''.
SEC. 6. LODGING AND SUBSISTENCE FOR FAMILY CAREGIVERS.
Section 111(e) of title 38, United States Code, is amended--
(1) by striking ``When'' and inserting the following: ``(1)
Except as provided in paragraph (2), when''; and
(2) by adding at the end the following new paragraphs:
``(2) Without regard to whether a covered veteran entitled to
mileage under this section requires an attendant in order to perform
such travel, an attendant of such covered veteran may be allowed
expenses of travel (including lodging and subsistence) upon the same
basis as such veteran during--
``(A) the period of time in which such veteran is traveling
to and from a treatment facility; and
``(B) the duration of the treatment episode for such
veteran.
``(3) The Secretary may prescribe regulations to carry out this
subsection. Such regulations may include provisions--
``(A) to limit the number of attendants that may receive
expenses of travel under paragraph (2) for a single treatment
episode of a covered veteran; and
``(B) to require such attendants to use certain travel
services.
``(4) In this subsection, the term `covered veteran' means a
veteran who--
``(A) was deployed in support of Operation Enduring Freedom
or Operation Iraqi Freedom; and
``(B) for purposes of this subsection, is determined by the
Secretary--
``(i) to have a service-connected disability or
illness that is severe;
``(ii) to be in need of caregiver services, such
that without such services, the veteran would require
hospitalization, nursing home care, or other
residential institutional care; and
``(iii) based on an examination by a physician
employed by the Department (or, in areas where no such
physician is available, by a physician carrying out
such function under a contract or fee arrangement), to
be unable to carry out the activities (including
instrumental activities) of daily living.''.
SEC. 7. SURVEY ON CAREGIVERS AND FAMILY CAREGIVERS.
(a) In General.--Not later than 270 days after the date of the
enactment of this Act, and not less than once in each three-year period
thereafter, the Secretary of Veterans Affairs shall design and conduct
a survey of caregivers and family caregivers. In carrying out the
survey, the Secretary shall collect the following information:
(1) The number of caregivers.
(2) The number of family caregivers.
(3) The number of veterans receiving caregiver services
from caregivers and family caregivers, including the era in
which each veteran served in the Armed Forces.
(4) The range of caregiver services provided by caregivers
and family caregivers, including--
(A) the average schedule of such services; and
(B) the average amount of time a caregiver and
family caregiver has spent providing such services.
(5) The average age of a caregiver and family caregiver.
(6) The health care coverage of caregivers and family
caregivers, including the sources of such coverage.
(7) The employment status of caregivers and family
caregivers.
(8) Incidents of significant life changes related to being
a caregiver or family caregiver, including unemployment and
disenrollment from a course of education.
(9) The number of family caregivers trained and certified
through a home health care agency.
(10) Other information the Secretary considers appropriate.
(b) Survey Sample.--In carrying out the survey required by
subsection (a), the Secretary shall ensure that--
(1) a statistically representative sample of caregivers and
family caregivers is included in the survey; and
(2) such sample covers veterans in each Veterans Integrated
Service Network.
(c) Findings.--The Secretary shall consider the findings of the
survey when carrying out programs related to caregivers and family
caregivers.
(d) Reports.--Not later than 180 days after the date on which each
survey is completed, the Secretary shall submit to the Committee on
Veterans' Affairs of the House of Representatives and the Committee on
Veterans' Affairs of the Senate a report on caregivers and family
caregivers. Each such report shall include--
(1) the findings of the survey required by subsection (a);
(2) a summary of the services made available to caregivers
and family caregivers by the Secretary;
(3) the number of caregivers and family caregivers who
receive such services;
(4) the cost to the Department of Veterans Affairs of
providing each such service; and
(5) other information the Secretary considers appropriate.
(e) Definitions.--In this section:
(1) The term ``caregiver'' has the meaning given such term
in section 1701(11) of title 38, United States Code, as added
by section 2(a) of this Act.
(2) The term ``family caregiver'' has the meaning given
such term in section 1701(12) of title 38, United States Code,
as added by section 2(a) of this Act.
Passed the House of Representatives July 27, 2009.
Attest:
Clerk.
111th CONGRESS
1st Session
H. R. 3155
_______________________________________________________________________
AN ACT
To amend title 38, United States Code, to provide certain caregivers of
veterans with training, support, and medical care, and for other
purposes.