1.This Act may be cited as the
Caregiver Assistance and Resource
Enhancement Act
.
2.Support Services
for Caregivers
(a)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)
(1)Subchapter II of
chapter 17 of title 38,
United States Code, is amended by adding at the end the following new
section:
1720G.Support
services for caregivers and family caregivers
(a)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)(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)(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 servicesThe 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)(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)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)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)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.
3.Counseling and mental
health services for caregivers and family caregivers
(a)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)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.
.
4.Respite care to
assist family caregiversSection 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.
.
5.Medical care for
family caregiversSection 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.
.
6.Lodging and
subsistence for family caregiversSection 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.
.
7.Survey on
caregivers and family caregivers
(a)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)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)The
Secretary shall consider the findings of the survey when carrying out programs
related to caregivers and family caregivers.
(d)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)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.
Lorraine C. Miller,
Clerk.