Pilot program on the training, certification, and support of family caregivers in provision of caregiver services to certain disabled veterans and members of the Armed Forces

(a)

In general

The Secretary of Veterans Affairs shall, in collaboration with the Secretary of Defense, carry out a pilot program to assess the feasibility and advisability of providing training, certification, and support for eligible family caregivers of eligible veterans and members of the Armed Forces to provide caregiver services to such veterans and members. (b)

Duration of program

The Secretary of Veterans Affairs shall commence the pilot program not later than 180 days after the date of the enactment of this Act and shall carry out the pilot program during the two-year period beginning on the date of such commencement. (c)

Locations

(1)

In general

The pilot program shall be carried out at not fewer than 6 facilities of the Department of Veterans Affairs or the Department of Defense, or other appropriate entity, selected by the Secretary of Veterans Affairs for purposes of the pilot program. Of the facilities so selected— (A)at least one shall be a private facility with expertise in providing rehabilitative care; and (B)at least one shall be a Department of Veterans Affairs Medical Center in a rural area that serves eligible veterans. (2)

Emphasis on polytrauma centers

In selecting locations for the pilot program at facilities of the Department of Veterans Affairs, the Secretary shall give special emphasis to the polytrauma centers of the Department designated as Tier I polytrauma centers. (3)

Private facilities

The Secretary may not select a private facility as a location for the pilot program unless the facility is a licensed inpatient rehabilitation facility with significant experience in traumatic brain injury, traumatic spinal cord injury, burn, and amputee rehabilitation. (4)

Collaboration

Private facilities and facilities of the Department of Defense selected for purposes of the pilot program shall collaborate with nearby facilities of the Department of Veterans Affairs. (d)

Eligible family caregivers

(1)

In general

For purposes of this section, an eligible family caregiver of a veteran or member of the Armed Forces is a family caregiver of an eligible veteran or member of the Armed Forces who— (A)agrees to provide caregiver services to such eligible veteran or member; (B)is accepted by such eligible veteran or member as the veteran's or member's provider of caregiver services; and (C)is determined, under regulations prescribed by the Secretary of Veterans Affairs or the Secretary of Defense, as applicable, to be qualified to provide caregiver services under the pilot program. (2)

Replacement

If the Secretary of Veterans Affairs or the Secretary of Defense, as applicable, determines that a family caregiver who is determined qualified under paragraph (1)(C) to provide caregiver services to an eligible veteran or member of the Armed Forces, as the case may be, is no longer qualified to provide such services— (A)such family caregiver shall no longer be considered an eligible family caregiver for purposes of the pilot program; and (B)such Secretary may, with the agreement of the veteran or member of the Armed Forces concerned, designate as a provider of caregiver services for such veteran or member for purposes of the pilot program any other individual who qualifies as an eligible family caregiver of such veteran or member under this subsection. (3)

Limitation

The Secretary of Veterans Affairs and the Secretary of Defense may not qualify more than one concurrent family caregiver per eligible veteran or member of the Armed Forces under paragraph (1)(C). (4)

Construction

Nothing in this section may be construed to limit the authority of the Secretary of Veterans Affairs or the Secretary of Defense to deny or discontinue participation of a family caregiver in the pilot program if such action is in the best interest of the veteran or member of the Armed Forces concerned. (e)

Eligible veterans and members of the Armed Forces

For purposes of this section, an eligible veteran or member of the Armed Forces is a veteran or member of the Armed Forces— (1)who— (A)has a service-connected disability that was incurred or aggravated on or after September 11, 2001; and (B)requires caregiver services because of such service-connected disability, as determined by the Secretary of Veterans Affairs or the Secretary of Defense as applicable; (2)who is otherwise determined to be eligible for the pilot program by the Secretary of Veterans Affairs or the Secretary of Defense, as applicable. (f)

Identification and notification of eligible veterans and members of the Armed Forces

(1)

Identification and notification of eligible veterans

(A)

Identification

Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall conduct a review to identify veterans eligible to participate in the pilot program. (B)

Notification

The Secretary of Veterans Affairs shall notify each veteran who is identified as an eligible veteran pursuant to the review required by subparagraph (A) of— (i)the eligibility of the veteran to participate in the pilot program; and (ii)the means by which the veteran may be accepted for participation in the pilot program. (2)

Identification and notifications of eligible members of the Armed Forces

(A)

Identification

Not later than 180 days after the date of the enactment of this Act, the Secretary of Defense shall conduct a review to identify members of the Armed Forces eligible to participate in the pilot program. (B)

Notification

The Secretary of Defense shall notify each member of the Armed Forces who is identified as an eligible member of the Armed Forces pursuant to the review required by subparagraph (A) of— (i)the eligibility of the member to participate in the pilot program; and (ii)the means by which the member may be accepted into the pilot program. (g)

Training and certification

(1)

Provision of training and certification

(A)

Training

The Secretary of Veterans Affairs shall provide training to each eligible family caregiver participating in the pilot program in the provision of family caregiver services. The training shall utilize curricula developed under paragraph (2). (B)

Certification

Upon the successful completion by a family caregiver of training provided under paragraph (1), the Secretary of Veterans Affairs shall certify the family caregiver as a provider of family caregiver services for purposes of the pilot program. Successful completion of training shall be determined utilizing certification criteria developed under paragraph (2). (2)

Training curricula and certification criteria

(A)

In general

The Secretary of Veterans Affairs shall, in consultation with the individuals specified in subparagraph (B), develop for purposes of the pilot program the following: (i)Curricula for the training of eligible family caregivers in the provision of family caregiver services, including training on techniques, skills, and strategies for the provision of such services. (ii)Criteria for the evaluation of successful completion of such training for purposes of certification under paragraph (1)(B). (B)

Consultation

The individuals specified in this subparagraph are the following: (i)The Secretary of Defense. (ii)A representative of family caregivers or family caregiver associations. (iii)A health or medical employee of the Department of Veterans Affairs with expertise in long-term care for seriously injured veterans. (iv)A health or medical employee of the Department of Defense with expertise in long-term care for seriously injured members of the Armed Forces. (v)A psychologist or other individual with expertise in the provision of mental health care to individuals in need of home-based or nursing home care. (vi)An expert in the development of training curricula. (vii)A family member of a veteran in need of home-based or nursing home care. (viii)A family member of a member of the Armed Forces in need of home-based or nursing home care. (ix)A representative from a veterans service organization, as recognized by the Secretary of Veterans Affairs for the representation of veterans under section 5902 of title 38, United States Code. (x)Such other individuals as the Secretary of Veterans Affairs, in consultation with the Secretary of Defense, considers appropriate. (C)

Scope of curricula

The Secretary of Veterans Affairs shall ensure that the curricula developed under subparagraph (A)(i)— (i)is based on empirical research and validated techniques; and (ii)provides for training that permits recipients of the training to tailor the provision of caregiving services to the unique circumstances of the veteran or member of the Armed Forces receiving such services. (D)

Use of existing curricula

In developing curricula under subparagraph (A)(i), the Secretary of Veterans Affairs shall, to the extent practicable, utilize and expand upon training curricula developed pursuant to section 744(b) of the John Warner National Defense Authorization Act for Fiscal Year 2007 (Public Law 109–364; 120 Stat. 2309). (3)

Travel expenses

The Secretary of Veterans Affairs may provide for necessary travel, lodging, and per diem expenses incurred by a family caregiver in undergoing certification and training under paragraph (1). (h)

Payment of family caregivers

(1)

In general

An eligible family caregiver of an eligible veteran or member of the Armed Forces certified under subsection (g) in the provision of caregiver services under the pilot program shall be paid by the Department of Veterans Affairs for the provision of caregiver services to such veteran or member, as the case may be, under the pilot program. (2)

Amount of payment

Payment provided a family caregiver under paragraph (1) for care provided to a veteran or member of the Armed Forces shall be in amounts the Secretary of Veterans Affairs considers reasonable upon consideration of the following: (A)The amount of care and the intensity of the care required by the veteran or member. (B)The cost to the Department of Veterans Affairs of otherwise providing such care through another noninstitutional care provider. (C)Low-utilization payment adjustment mechanisms under the prospective payment system for home health services established under section 1895 of the Social Security Act (42 U.S.C. 1395fff) calculated for the geographic area of the family caregiver. (D)Such other factors as the Secretary considers appropriate. (3)

Coordination with State self-directed personal assistance services program

The Secretary of Veterans Affairs may provide payment under paragraph (1) to an eligible family caregiver in coordination with the self-directed personal assistance services program of the State of the family caregiver to the extent the State has elected to provide medical assistance to an eligible veteran or member of the Armed Forces under the State Medicaid program. (i)

Respite care

(1)

Review of respite care programs

The Secretary of Veterans Affairs shall review the respite care programs of the Department of Veterans Affairs and the Secretary of Defense shall review the respite care programs of the Department of Defense that are available to family caregivers to assess the adequacy, flexibility, and age-appropriateness of the facilities under such programs. The review shall include a particular focus on respite care programs for rural areas. (2)

Study on enhancement of availability of respite care

The Secretary shall carry out a study to identify appropriate options for enhancing the availability of respite care for family caregivers. The study shall include an assessment of the advisability of allowing a veteran’s primary treating physician to approve respite care in excess of 30 days to make as-needed respite care more available and convenient for family caregivers. (3)

Enhancement of availability of respite care

The Secretary shall take measures to enhance the availability of respite care for family caregivers participating in the pilot program, including the following: (A)Training and certifying alternate family caregivers using the curricula developed under subsection (g)(2). (B)Paying expenses incidental to training of alternate family caregivers, including travel expenses. (C)Such other measures as the Secretary considers appropriate. (j)

Psychological and social support services

(1)

In general

The Secretary of Veterans Affairs shall, in collaboration with the Secretary of Defense, make available to each eligible family caregiver participating in the pilot program counseling and social services related to the provision by the family caregiver of caregiving services to an eligible veteran or member of the Armed Forces. Such counseling and social services shall include the following: (A)An assessment of individualized needs of the family caregiver with respect to the family caregiver's role as a family caregiver. (B)Assistance with development of a plan for long-term care of the veteran or member concerned. (C)Services and support relevant to any needs identified under subparagraph (A) provided through— (i)facilities of the Department of Veterans Affairs or the Department of Defense located in the community in which the family caregiver resides; or (ii)in the case that no such facilities are available in a timely manner, community-based organizations or publicly funded programs. (2)

Use of existing tools

In developing and administering assessments under paragraph (1)(A), the Secretary shall, to the extent practicable, use and expand upon caregiver assessment tools already developed and in use by the Department of Veterans Affairs or the Department of Defense. (k)

Reports

(1)

Two-year report

(A)

In general

Not later than two years after the date of the commencement of the pilot program, the Secretary shall, in conjunction with the Secretary of Defense, submit to the appropriate congressional committees a report on the pilot program. (B)

Contents

The report required by paragraph (1) shall include the following: (i)An assessment of the pilot program. (ii)An accounting of the costs to the Department of Veterans Affairs and the Department of Defense of the pilot program. (iii)A comparison of the costs to the Department of Veterans Affairs and the Department of Defense of the pilot program with the cost to the Departments of otherwise providing caregiver services to the veterans and members of the Armed Forces who received such services under the pilot program, including the cost of providing care to such veterans and members of the Armed Forces who would otherwise require inpatient care. (iv)The recommendations of the Secretary with respect to— (I)the feasibility and advisability of extending the pilot program or making the pilot program permanent; and (II)modifying the pilot program. (v)An assessment of the effect of the pilot program on— (I)the health of veterans receiving care under the pilot program; and (II)the financial burdens of family caregivers caused by the provision of caregiver services to veterans. (vi)Any determinations made by the Secretary under subsection (o). (2)

Bi-annual reports of medical facilities

Not later than 180 days after the date on which a medical facility is selected as a location for the pilot program and not less frequently than once every 180 days thereafter, the medical facility shall submit to the director of the Veterans Integrated Services Network (VISN) in which the facility is located a report that describes— (A)the number of veterans enrolled in the pilot program through such facility; and (B)if there is a waiting list to participate in the pilot program through such facility— (i)the number of people on such list; and (ii)the average wait time before admission into the pilot program. (l)

Funding

(1)

Costs of care provided to veterans

Any expenditure under the pilot program relating to the provision of caregiver services to a veteran shall be borne by the Department of Veterans Affairs. (2)

Costs of care provided to members of the Armed Forces

(A)

In general

The Secretary of Defense shall reimburse the Secretary of Veterans Affairs for any expenditure incurred by the Department of Veterans Affairs under the pilot program relating to the provision of caregiver services to members of the Armed Forces. (B)

Source of funds

Amounts for reimbursement under subparagraph (A) shall be derived from amounts made available to Defense Health Program for the TRICARE program. (m)

Limitation on spending

In providing for the provision of services under the pilot program, the Secretary of Veterans Affairs shall make payment for services only to the extent that payment for such services is not otherwise covered by another government or nongovernment entity or program. (n)

Construction

(1)

Employment

Nothing in this section shall be construed to create an employment relationship between a family caregiver and a veteran or member of the Armed Forces, the Department of Veterans Affairs, or the Department of Defense. (2)

Eligibility for benefits

Nothing in this section shall be construed to reduce, alter, or otherwise affect the eligibility or entitlement of a veteran, member of the Armed Forces, or dependent thereof, to any health care, disability, or other benefit to which such veteran, member, or dependent would otherwise be eligible or entitled under laws administered by the Secretary of Veterans Affairs or the Secretary of Defense. (o)

National expansion of pilot program

Not later than the completion of the two-year period described in subsection (b), the Secretary of Veterans Affairs shall, in consultation with the Secretary of Defense, expand the pilot program to provide training, certification, and support for eligible family caregivers nationwide unless the Secretary of Veterans Affairs, in consultation with the Secretary of Defense, determines that such revision would be infeasible or inadvisable.