[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5002 Introduced in House (IH)]

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118th CONGRESS
  1st Session
                                H. R. 5002

   To direct the Secretary of Veterans Affairs to carry out a pilot 
  program for the cognitive care of veterans, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 27, 2023

 Mrs. Harshbarger introduced the following bill; which was referred to 
                   the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
   To direct the Secretary of Veterans Affairs to carry out a pilot 
  program for the cognitive care of 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 ``Innovative Cognitive Care for 
Veterans Act of 2023''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) According to a 2020 study by the Office of the 
        Assistant Deputy Under Secretary for Health for Policy and 
        Planning of the Department of Veterans Affairs, it is projected 
        that the number of veterans with Alzheimer's dementia will 
        increase by 28.9 percent between fiscal year 2021 and fiscal 
        year 2033, amounting to an estimated 48,000 new patients with 
        cognitive impairments.
            (2) The cost of expenditures of the Department of Veterans 
        Affairs for long-term care is growing rapidly, as demonstrated 
        by a 2020 Government Accountability Office report that 
        estimates such expenditures are projected to double to 
        $14,300,000,000 by 2037.
            (3) As described in the report specified in paragraph (2), 
        the Department of Veterans Affairs also faces both a current 
        and incoming workforce shortage, in addition to other 
        challenges relating to the provision of long-term care services 
        to the more than 2,800,000 estimated veterans who are enrolled 
        in the patient enrollment system of the Department established 
        and operated under section 1705(a) of title 38, United States 
        Code, and live in rural areas.
            (4) As observed by the Secretary of Veterans Affairs, 
        veterans can also be prone to unique factors that increase the 
        risk for future cognitive impairment. For example, it has been 
        found that veterans who served during the Vietnam era and, 
        while so serving, were exposed to Agent Orange are nearly twice 
        as likely as those without such exposure to receive a diagnosis 
        of dementia.
            (5) According to the Department of Veterans Affairs, more 
        than 185,000 veterans enrolled in the health care system of the 
        Department of Veterans Affairs have been diagnosed with at 
        least one traumatic brain injury. Traumatic brain injury often 
        affects the cognitive abilities of an individual and can 
        disrupt normal brain function. Veterans with a traumatic brain 
        injury are also 60 percent more likely to develop Alzheimer's 
        Disease or other forms of dementia.
            (6) This data compels the United States Government to do 
        more for veterans and their cognitive care.

SEC. 3. PILOT PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS FOR ADDRESSING 
              COGNITIVE DISORDERS AMONG VETERANS.

    (a) Pilot Program.--
            (1) Pilot program.--Not later than 180 days after the date 
        of the enactment of this Act, the Secretary of Veterans Affairs 
        shall carry out, as a part of the Veterans Community Care 
        Program under section 1703 of title 38, and in accordance with 
        the requirements of such program, a pilot program (in this 
        section referred to as the ``pilot program'') under which the 
        Secretary may enter into agreements with eligible entities to 
        furnish to participating veterans telehealth, virtual training 
        tools for home health aides, and other innovative services, 
        that slow the progression of cognitive disorders.
            (2) Veterans care agreements.--In entering into agreements 
        under paragraph (1), the Secretary may enter into a Veterans 
        Care Agreement under section 1703A of title 38, United States 
        Code, consistent with the requirements of such section.
    (b) Selection of Entities.--
            (1) Eligible entities.--An entity is eligible for entry 
        into an agreement under the pilot program if the entity--
                    (A) furnishes telehealth, virtual training tools 
                for home health aides, or other innovative services, 
                that slow the progression of cognitive disorders; and
                    (B) meets such other requirements as the Secretary 
                may prescribe.
            (2) Priority.--In selecting eligible entities for entry 
        into an agreement under the pilot program, the Secretary shall 
        give priority to eligible entities with--
                    (A) demonstrated experience in--
                            (i) providing assistance to individuals 
                        with cognitive disorders;
                            (ii) addressing behavioral and temperament 
                        issues, including through interactive 
                        engagement and stimulation solutions;
                            (iii) caregiver or home health aid 
                        training; and
                            (iv) working in the field of cognitive 
                        disorders, including through the treatment of, 
                        or rehabilitation for, traumatic brain injury 
                        or neurodegenerative conditions; and
                    (B) the ability to provide services under the pilot 
                program to veterans at locations other than a hospital, 
                nursing home, or other medical facility, in accordance 
                with subsection (d)(2).
            (3) List of selected entities.--The Secretary shall--
                    (A) publish on an internet website of the 
                Department a list identifying each eligible entity with 
                which the Secretary has entered into an agreement under 
                the pilot program; and
                    (B) ensure such list is accessible to veterans 
                selected for participation in the pilot program.
    (c) Selection of Veterans.--In selecting veterans for participation 
in the pilot program, the Secretary--
            (1) shall ensure that not more than 500 veterans 
        participate in the pilot program at any given time; and
            (2) may not take into consideration age or risk factors for 
        cognitive disorders.
    (d) Services: Self-Directed and In-Home Nature.--Each veteran 
selected by the Secretary for participation in the pilot program--
            (1) may select, from among the entities listed under 
        subsection (b)(3) that are accessible to the veteran, the 
        entity from which services shall be received by the veteran 
        under the pilot program; and
            (2) may elect to receive services under the pilot program 
        at a location that is not a traditional medical setting, such 
        as at the residence of the veteran, in lieu of receiving such 
        services at a hospital, nursing home, or other medical 
        facility.
    (e) Termination.--The pilot program shall terminate on the date 
that is five years after the date on which the pilot program commences.
    (f) Report.--Not later than 180 days after the date of termination 
under subsection (e), the Secretary shall submit to the Committees on 
Veterans' Affairs of the House of Representatives and the Senate a 
report on the pilot program. Such report shall include the following:
            (1) A detailed overview of each entity with which the 
        Secretary entered into an agreement under the pilot program, 
        and the services that entity provided to participating veterans 
        pursuant to such agreement.
            (2) An identification of the types of technology that 
        eligible entities with which the Secretary entered into an 
        agreement under the pilot program used to provide services to 
        participating veterans pursuant to such agreement.
            (3) An identification of the following:
                    (A) The number of veterans that participated in the 
                pilot program.
                    (B) The number of veterans that applied to 
                participate in the pilot program but were not selected 
                for participation as a result of the limitation under 
                subsection (c)(2).
                    (C) Of the veterans who participated in the pilot 
                program, the number who, for the duration of such 
                participation, received services under the pilot 
                program.
                    (D) Of the veterans who participated in the pilot 
                program, the number who suffered traumatic brain injury 
                while serving in the Armed Forces, including, for each 
                such veteran--
                            (i) a classification of the traumatic brain 
                        injury so suffered as mild, moderate, or severe 
                        (as the case may be); and
                            (ii) an identification of the mechanism of 
                        injury.
                    (E) The percentage of veterans who participated in 
                the pilot program (disaggregated by type of outcome 
                specified in clauses (i) through (iii)) who reported 
                that such participation resulted in the following 
                outcomes, with respect to the individual veteran:
                            (i) Quality of life improved.
                            (ii) Quality of life was unaffected.
                            (iii) Quality of life worsened.
                    (F) A socioeconomic and demographic breakdown of 
                veterans who participated in the pilot program.
                    (G) The type of housing in which the veterans who 
                participated in the pilot program reside.
                    (H) Whether the veterans who participated in the 
                pilot program have access to personal care services 
                from a caregiver, and if so, whether such services were 
                furnished by the Secretary (including through a non-
                Department of Veterans Affairs health care provider 
                providing such services under the laws administered by 
                the Secretary).
                    (I) Such other information as may be determined 
                relevant by the Secretary.
    (g) Source of Funds.--Amounts required to carry out this Act shall 
be derived from unobligated amounts appropriated to the Veterans Health 
Administration and determined appropriate by the Secretary.
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