[Congressional Record Volume 160, Number 59 (Thursday, April 10, 2014)]
[Senate]
[Pages S2382-S2386]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. MURRAY:
  S. 2243. A bill to expand eligibility for the program of 
comprehensive assistance for family caregivers of the Department of 
Veterans Affairs, to expand benefits available to participants under 
such program, to enhance special compensation for members of the 
uniformed services who require assistance in everyday life, and for 
other purposes; to the Committee on Veterans' Affairs.
  Mrs. MURRAY. Mr. President, I come to the floor today to introduce 
the Military and Veteran Caregiver Services Improvement Act. This is a 
bill that will make critical improvements to how we support our ill and 
injured veterans and their caregivers.
  I am especially pleased to be joined this morning by our former 
colleague Senator Elizabeth Dole, who has come to the floor today and 
who has been such a tremendous and invaluable person in working to 
bring these caregiver issues to national attention. I really appreciate 
her being here and being such a champion on this, and a leader. She has 
brought people from all over the country together to make a difference 
for our caregivers and for our veterans.
  We also have many of the very caregivers this bill is designed to 
help--representing, by the way, almost every State--in the gallery 
today to see this legislation introduced. I am very proud they are 
here. It is incredibly important that they are here today and on 
Capitol Hill because, as the Presiding Officer knows, our caregivers 
work extremely hard without any recognition, and they rarely ask for 
anything for themselves. In fact, most of the caregivers I have met 
sound much like the veterans and servicemembers they care for when they 
say: Oh, this isn't about me; I am just doing my part.
  So last week, when RAND released their comprehensive, groundbreaking 
study on military caregivers, they chose a very appropriate title: 
``Hidden Heroes.'' That is why it is so important to have all of those 
caregivers here today and working constantly to make sure we all 
understand what they do.
  I am very proud to be introducing this bill not only as a Senator and 
a senior member of the Veterans' Affairs Committee and someone who has 
fought so hard for the implementation of the VA caregivers program, 
but, as many of my colleagues know, for me, this is really a deeply 
personal issue.
  Growing up, I saw firsthand the many ways military service can affect 
both veterans and their families. My father served in World War II. He 
was among the first soldiers to land in Okinawa. He came home as a 
disabled veteran and was awarded the Purple Heart.
  Later in life he was diagnosed with multiple sclerosis. Eventually he 
became too sick to work at the little five-and-dime store he managed, 
and my mom became his caregiver. This was no small burden for my mom, 
who had to raise seven children, care for my dad, and was now all of a 
sudden the primary source of income for our family.
  Today, after more than a decade of two wars, men and women in 
uniform, as did my father, have done everything that has been asked of 
them and so much more. But now, as our role in this conflict winds 
down, the support we provide cannot end when the war no longer leads 
the nightly news broadcasts and disappears from the front pages of our 
newspapers. It is an enduring commitment for those who will first need 
help now or those who will need help later in their lives. It is a 
lifetime of care for so many.
  In so many cases, the responsibility for providing that care often 
falls on the loved ones of severely injured veterans. Their courage and 
their devotion in taking on these responsibilities is inspiring for all 
of us. They are the reason we created the VA caregivers program, which 
now provides these family members with health care and counseling and 
training and respite and a living stipend.
  I was proud to lead congressional efforts to push the VA to stop 
delaying the implementation of the caregivers program and restore the 
eligibility criteria to the intent of the law. Thankfully, as we know, 
in the end the White House and the VA announced they would allow more 
caregivers of more veterans to be eligible for benefits and finally got 
the program implemented. But there is a lot more we can do because, as 
the RAND study clearly shows us, caregivers are still struggling. 
Military caregivers have significantly worse health than noncaregivers, 
and they are at higher risk for depression. The stress they live under 
jeopardizes their relationships and puts them at greater risk of 
divorce, and they have trouble with employment and keeping health 
insurance. There is no way we will sit by and let caregivers and 
veterans face this on their own--not when we can make it a little bit 
easier.
  The bill we are introducing this morning, the Military and Veterans 
Caregivers and Services Improvement Act, makes some broad changes to 
help give caregivers and veterans the tools they need to help tackle 
what they face. I wish to take a moment on the floor today to highlight 
just a few of the important provisions contained in this bill.
  First and foremost, this bill will make veterans of all eras eligible 
for the full range of caregiver support services. We took an important 
first step in creating the post-9/11 veterans caregivers program. Now 
that the VA has had some time to get this program

[[Page S2383]]

working, it is time for us to get services to our older veterans who 
are also in great need.
  The bill also expands eligibility for the VA caregivers program by 
recognizing a wider array of needs which may require caregiving, 
placing greater emphasis on mental health injuries and removing 
restrictions on who is eligible to become a caregiver.
  Under the bill, caregiver services will also be expanded to include 
childcare, financial advice, and legal counseling. Those are some of 
the top and currently unmet needs of family caregivers.
  The bill will also require the Federal Government to meet the unique 
needs of employees who are caregivers with flexible work arrangements 
so they can stay employed while caring for their veteran. I, of course, 
want to see all employers make these kinds of accommodations for 
caregivers, but I want the Federal Government to lead by example.
  When it comes to the Department of Defense, the bill makes several 
improvements to the special compensation for assistance with activities 
of daily living--first, by making those benefits tax exempt, and 
second, eligibility for special compensation would also be set at a 
more appropriate level of disability and would be more inclusive of 
mental health injuries and TBI.
  The Military and Veteran Caregiver Services Improvement Act also 
addresses a key theme identified by RAND. There are many services 
inside the government and outside to assist caregivers, but these 
programs are not coordinated. Eligibility criteria are different for 
each one of them, and there is not enough oversight to ensure the 
quality of those services. So what our bill does is create a national 
interagency working group on caregiver services. It will coordinate 
caregiver policy among all the different departments and create 
standards of care and oversight tools to make sure our veterans and 
their caregivers receive high-quality services.
  The last provision I wish to highlight is intended to help a military 
spouse who may be required to become the primary source of income for 
the family after the servicemember has been injured, just as my mom 
was. In order to help that spouse get the job they need to support the 
family, this bill will allow the injured servicemember or veteran to 
transfer their post-9/11 GI bill benefits to their dependents by 
exempting them from the length of service requirements that would 
currently prevent them from transferring those benefits. Injured 
veterans should not be penalized because their injury occurred early in 
their service.
  This provision is extremely important because for 2013 the 
unemployment rate for people with bachelor's degrees was only 4 
percent--about one-third lower than the national average--and their 
median weekly earnings were 34 percent higher than the national 
average. Meanwhile, the RAND study found that 62 percent of post-9/11 
caregivers reported financial strain because of their caregiving.
  I know this is important because I saw it in my family. For my 
family, the additional education my mom obtained got her a better job 
so she could support her family while she was caring for my dad. It is 
what made the difference.

  I want to again thank some key people who have been true leaders to 
get this to this point.
  I again want to thank Senator Dole and her great staff at the 
Elizabeth Dole Foundation for keeping our country focused on the needs 
of our military and veteran caregivers and for bringing such national 
momentum to make the changes we need.
  I also want to thank the Wounded Warrior Project, which was a driving 
force in creating the very first VA caregivers program. They have 
provided invaluable advice in developing the bill I am introducing 
today.
  Finally, I really want to thank the outstanding folks at the RAND 
Corporation. They have put together a truly groundbreaking study that 
takes stock of where care and benefits have fallen short, where new 
needs are emerging, and how we can make it easier for veterans to get 
the care and benefits they deserve.
  There are many ways for the whole country--government, nonprofits, 
businesses, community leaders, faith leaders--to do more to help. For 
all of us in Congress, that starts with passing this legislation to 
help our hidden heroes--our military and veteran caregivers.
  I again want to thank all of our tremendous caregivers in this 
country for their service, for not asking for help, as they should. We 
are the ones who need to ask for help for them and to be there to 
provide it.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 2243

       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 ``Military and Veteran 
     Caregiver Services Improvement Act of 2014''.

     SEC. 2. EXPANSION OF ELIGIBILITY FOR PARTICIPATION IN AND 
                   SERVICES PROVIDED UNDER FAMILY CAREGIVER 
                   PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS.

       (a) Family Caregiver Program.--
       (1) Expansion of eligibility.--Subsection (a)(2)(B) of 
     section 1720G of title 38, United States Code, is amended by 
     striking ``on or after September 11, 2001''.
       (2) Clarification of eligibility for illness.--Such 
     subsection is further amended by inserting ``or illness'' 
     after ``serious injury''.
       (3) Expansion of needed services in eligibility criteria.--
     Subsection (a)(2)(C) of such section is amended--
       (A) in clause (ii), by striking ``; or'' and inserting a 
     semicolon;
       (B) by redesignating clause (iii) as clause (iv); and
       (C) by inserting after clause (ii) the following new clause 
     (iii):
       ``(iii) a need for regular or extensive instruction or 
     supervision in completing two or more instrumental activities 
     of daily living; or''.
       (4) Expansion of services provided.--Subsection 
     (a)(3)(A)(ii) of such section is amended--
       (A) in subclause (IV), by striking ``; and'' and inserting 
     a semicolon;
       (B) in subclause (V), by striking the period at the end and 
     inserting a semicolon; and
       (C) by adding at the end the following new subclauses:
       ``(VI) child care services or a monthly stipend for such 
     services if such services are not readily available from the 
     Department;
       ``(VII) financial planning services relating to the needs 
     of injured and ill veterans and their caregivers; and
       ``(VIII) legal services, including legal advice and 
     consultation, relating to the needs of injured and ill 
     veterans and their caregivers.''.
       (5) Expansion of respite care provided.--Subsection 
     (a)(3)(B) of such section is amended by striking ``shall be'' 
     and all that follows through the period at the end and 
     inserting ``shall--
       ``(i) be medically and age-appropriate;
       ``(ii) include in-home care; and
       ``(iii) include peer-oriented group activities.''.
       (6) Modification of stipend calculation.--Subsection 
     (a)(3)(C) of such section is amended--
       (A) by redesignating clause (iii) as clause (iv); and
       (B) by inserting after clause (ii) the following new clause 
     (iii):
       ``(iii) In determining the amount and degree of personal 
     services provided under clause (i) with respect to an 
     eligible veteran whose need for personal care services is 
     based in whole or in part on a need for supervision or 
     protection under paragraph (2)(C)(ii) or regular instruction 
     or supervision in completing tasks under paragraph 
     (2)(C)(iii), the Secretary shall take into account the 
     following:
       ``(I) The assessment by the family caregiver of the needs 
     and limitations of the veteran.
       ``(II) The extent to which the veteran can function safely 
     and independently in the absence of such supervision, 
     protection, or instruction.
       ``(III) The amount of time required for the family 
     caregiver to provide such supervision, protection, or 
     instruction to the veteran.''.
       (7) Periodic evaluation of need for certain services.--
     Subsection (a)(3) of such section is amended by adding at the 
     end the following new subparagraph:
       ``(D) In providing instruction, preparation, and training 
     under subparagraph (A)(i)(I) and technical support under 
     subparagraph (A)(i)(II) to each family caregiver who is 
     approved as a provider of personal care services for an 
     eligible veteran under paragraph (6), the Secretary shall 
     periodically evaluate the needs of the eligible veteran and 
     the skills of the family caregiver of such veteran to 
     determine if additional instruction, preparation, training, 
     or technical support under those subparagraphs is 
     necessary.''.
       (b) Repeal of General Caregiver Support Program.--Such 
     section is amended by striking subsection (b).
       (c) Provision of Assistance to Caregivers of Certain 
     Veterans.--Such section is further amended by inserting after 
     subsection (a) the following new subsection (b):

[[Page S2384]]

       ``(b) Provision of Assistance to Caregivers of Certain 
     Veterans.--(1) In providing assistance under subsection (a) 
     to family caregivers of eligible veterans who were discharged 
     from the Armed Forces before September 11, 2001, the 
     Secretary may enter into memoranda of understanding with 
     agencies, States, and other entities to provide such 
     assistance to such veterans.
       ``(2) The Secretary may provide assistance under this 
     subsection only if such assistance is reasonably accessible 
     to the veteran and is substantially equivalent or better in 
     quality to similar services provided by the Department.
       ``(3) The Secretary may provide fair compensation to 
     entities that provide assistance under this subsection 
     pursuant to memoranda of understanding entered into under 
     paragraph (1).
       ``(4) In carrying out this subsection, the Secretary shall 
     work with the interagency working group on policies relating 
     to caregivers of veterans and members of the Armed Forces 
     established under section 7 of the Military and Veteran 
     Caregiver Services Improvement Act of 2014.''.
       (d) Modification of Definition of Family Member.--
     Subparagraph (B) of subsection (d)(3) of such section is 
     amended to read as follows:
       ``(B) is not a member of the family of the veteran and does 
     not provide care to the veteran on a professional basis.''.
       (e) Modification of Definition of Personal Care Services.--
     Subsection (d)(4) of such section is amended--
       (1) in subparagraph (A), by striking ``independent'';
       (2) by redesignating subparagraph (B) as subparagraph (D); 
     and
       (3) by inserting after subparagraph (A) the following new 
     subparagraphs:
       ``(B) Supervision or protection based on symptoms or 
     residuals of neurological or other impairment or injury.
       ``(C) Regular or extensive instruction or supervision in 
     completing two or more instrumental activities of daily 
     living.''.
       (f) Annual Evaluation Report.--
       (1) In general.--Paragraph (2) of section 101(c) of the 
     Caregivers and Veterans Omnibus Health Services Act of 2010 
     (Public Law 111-163; 38 U.S.C. 1720G note) is amended to read 
     as follows:
       ``(2) Contents.--Each report required by paragraph (1) 
     after the date of the enactment of the Military and Veteran 
     Caregiver Services Improvement Act of 2014 shall include the 
     following with respect to the program of comprehensive 
     assistance for family caregivers required by subsection 
     (a)(1) of such section 1720G:
       ``(A) The number of family caregivers that received 
     assistance under such program.
       ``(B) The cost to the Department of providing assistance 
     under such program.
       ``(C) A description of the outcomes achieved by, and any 
     measurable benefits of, carrying out such program.
       ``(D) An assessment of the effectiveness and the efficiency 
     of the implementation of such program, including a 
     description of any barriers to accessing and receiving care 
     and services under such program.
       ``(E) A description of the outreach activities carried out 
     by the Secretary under such program.
       ``(F) An assessment of the manner in which resources are 
     expended by the Secretary under such program, particularly 
     with respect to the provision of monthly personal caregiver 
     stipends under subsection (a)(3)(A)(ii)(V) of such section 
     1720G.
       ``(G) An evaluation of the sufficiency and consistency of 
     the training provided to family caregivers under such program 
     in preparing family caregivers to provide care to veterans 
     under such program.
       ``(H) Such recommendations, including recommendations for 
     legislative or administrative action, as the Secretary 
     considers appropriate in light of carrying out such 
     program.''.
       (g) Conforming Amendments.--
       (1) Eligible veteran.--Subsection (a)(2) of such section is 
     amended, in the matter preceding subparagraph (A), by 
     striking ``subsection'' and inserting ``section''.
       (2) Definitions.--Subsection (d) of such section is 
     amended--
       (A) in paragraph (1), by striking ``under subsection (a) or 
     a covered veteran under subsection (b)'';
       (B) in paragraph (2), by striking ``under subsection (a)'';
       (C) in paragraph (3), by striking ``under subsection (a)''; 
     and
       (D) in paragraph (4), in the matter preceding subparagraph 
     (A), by striking ``under subsection (a) or a covered veteran 
     under subsection (b)''; and
       (3) Counseling, training, and mental health services.--
     Section 1782(c)(2) of title 38, United States Code, is 
     amended by striking ``or a caregiver of a covered veteran''.

     SEC. 3. AUTHORITY TO TRANSFER ENTITLEMENT TO POST-9/11 
                   EDUCATION ASSISTANCE TO FAMILY MEMBERS BY 
                   SERIOUSLY INJURED VETERANS IN NEED OF PERSONAL 
                   CARE SERVICES.

       (a) In General.--Subchapter II of chapter 33 of title 38, 
     United States Code, is amended by adding at the end the 
     following new section:

     ``Sec. 3319A. Authority to transfer unused education benefits 
       to family members by seriously injured veterans

       ``(a) In General.--Subject to the provisions of this 
     section, the Secretary may permit an individual described in 
     subsection (b) who is entitled to educational assistance 
     under this chapter to elect to transfer to one or more of the 
     dependents specified in subsection (c) a portion of such 
     individual's entitlement to such assistance, subject to the 
     limitation under subsection (d).
       ``(b) Eligible Individuals.--An individual referred to in 
     subsection (a) is any individual who--
       ``(1) retired for physical disability under chapter 61 of 
     title 10; or
       ``(2) is described in paragraph (2) of section 1720G(a) of 
     this title and who is participating in the program 
     established under paragraph (1) of such section.
       ``(c) Eligible Dependents.--An individual approved to 
     transfer an entitlement to educational assistance under this 
     section may transfer the individual's entitlement as follows:
       ``(1) To the individual's spouse.
       ``(2) To one or more of the individual's children.
       ``(3) To a combination of the individuals referred to in 
     paragraphs (1) and (2).
       ``(d) Limitation on Months of Transfer.--(1) The total 
     number of months of entitlement transferred by a individual 
     under this section may not exceed 36 months.
       ``(2) The Secretary may prescribe regulations that would 
     limit the months of entitlement that may be transferred under 
     this section to no less than 18 months.
       ``(e) Designation of Transferee.--An individual 
     transferring an entitlement to educational assistance under 
     this section shall--
       ``(1) designate the dependent or dependents to whom such 
     entitlement is being transferred;
       ``(2) designate the number of months of such entitlement to 
     be transferred to each such dependent; and
       ``(3) specify the period for which the transfer shall be 
     effective for each dependent designated under paragraph (1).
       ``(f) Time for Transfer; Revocation and Modification.--(1) 
     Transfer of entitlement to educational assistance under this 
     section shall be subject to the time limitation for use of 
     entitlement under section 3321 of this title.
       ``(2)(A) An individual transferring entitlement under this 
     section may modify or revoke at any time the transfer of any 
     unused portion of the entitlement so transferred.
       ``(B) The modification or revocation of the transfer of 
     entitlement under this paragraph shall be made by the 
     submittal of written notice of the action to the Secretary.
       ``(3) Entitlement transferred under this section may not be 
     treated as marital property, or the asset of a marital 
     estate, subject to division in a divorce or other civil 
     proceeding.
       ``(g) Commencement of Use.--A dependent child to whom 
     entitlement to educational assistance is transferred under 
     this section may not commence the use of the transferred 
     entitlement until either--
       ``(1) the completion by the child of the requirements of a 
     secondary school diploma (or equivalency certificate); or
       ``(2) the attainment by the child of 18 years of age.
       ``(h) Additional Administrative Matters.--(1) The use of 
     any entitlement to educational assistance transferred under 
     this section shall be charged against the entitlement of the 
     individual making the transfer at the rate of one month for 
     each month of transferred entitlement that is used.
       ``(2) Except as provided under subsection (e)(2) and 
     subject to paragraphs (5) and (6), a dependent to whom 
     entitlement is transferred under this section is entitled to 
     educational assistance under this chapter in the same manner 
     as the individual from whom the entitlement was transferred.
       ``(3) The monthly rate of educational assistance payable to 
     a dependent to whom entitlement referred to in paragraph (2) 
     is transferred under this section shall be payable at the 
     same rate as such entitlement would otherwise be payable 
     under this chapter to the individual making the transfer.
       ``(4) The death of an individual transferring an 
     entitlement under this section shall not affect the use of 
     the entitlement by the dependent to whom the entitlement is 
     transferred.
       ``(5)(A) A child to whom entitlement is transferred under 
     this section may use the benefits transferred without regard 
     to the 15-year delimiting date specified in section 3321 of 
     this title, but may not, except as provided in subparagraph 
     (B), use any benefits so transferred after attaining the age 
     of 26 years.
       ``(B)(i) Subject to clause (ii), in the case of a child 
     who, before attaining the age of 26 years, is prevented from 
     pursuing a chosen program of education by reason of acting as 
     the primary provider of personal care services for a veteran 
     or member of the Armed Forces under section 1720G(a) of this 
     title, the child may use the benefits beginning on the date 
     specified in clause (iii) for a period whose length is 
     specified in clause (iv).
       ``(ii) Clause (i) shall not apply with respect to the 
     period of an individual as a primary provider of personal 
     care services if the period concludes with the revocation of 
     the individual's designation as such a primary provider under 
     section 1720G(a)(7)(D) of this title.
       ``(iii) The date specified in this clause for the beginning 
     of the use of benefits by a child under clause (i) is the 
     later of--
       ``(I) the date on which the child ceases acting as the 
     primary provider of personal care services for the veteran or 
     member concerned as described in clause (i);

[[Page S2385]]

       ``(II) the date on which it is reasonably feasible, as 
     determined under regulations prescribed by the Secretary, for 
     the child to initiate or resume the use of benefits; or
       ``(III) the date on which the child attains the age of 26 
     years.
       ``(iv) The length of the period specified in this clause 
     for the use of benefits by a child under clause (i) is the 
     length equal to the length of the period that--
       ``(I) begins on the date on which the child begins acting 
     as the primary provider of personal care services for the 
     veteran or member concerned as described in clause (i); and
       ``(II) ends on the later of--
       ``(aa) the date on which the child ceases acting as the 
     primary provider of personal care services for the veteran or 
     member as described in clause (i); or
       ``(bb) the date on which it is reasonably feasible, as so 
     determined, for the child to initiate or resume the use of 
     benefits.
       ``(6) The purposes for which a dependent to whom 
     entitlement is transferred under this section may use such 
     entitlement shall include the pursuit and completion of the 
     requirements of a secondary school diploma (or equivalency 
     certificate).
       ``(7) The administrative provisions of this chapter shall 
     apply to the use of entitlement transferred under this 
     section, except that the dependent to whom the entitlement is 
     transferred shall be treated as the eligible individual for 
     purposes of such provisions.
       ``(i) Overpayment.--(1) In the event of an overpayment of 
     educational assistance with respect to a dependent to whom 
     entitlement is transferred under this section, the dependent 
     and the individual making the transfer shall be jointly and 
     severally liable to the United States for the amount of the 
     overpayment for purposes of section 3685 of this title.
       ``(2)(A) Except as provided in subparagraph (B), if an 
     individual transferring entitlement under this section fails 
     to complete the service agreed to by the individual under 
     subsection (b)(1) in accordance with the terms of the 
     agreement of the individual under that subsection, the amount 
     of any transferred entitlement under this section that is 
     used by a dependent of the individual as of the date of such 
     failure shall be treated as an overpayment of educational 
     assistance under paragraph (1).
       ``(B) Subparagraph (A) shall not apply in the case of an 
     individual who fails to complete service agreed to by the 
     individual--
       ``(i) by reason of the death of the individual; or
       ``(ii) for a reason referred to in section 3311(c)(4) of 
     this title.
       ``(j) Regulations.--(1) The Secretary shall prescribe 
     regulations to carry out this section.
       ``(2) Such regulations shall specify--
       ``(A) the manner of authorizing the transfer of 
     entitlements under this section;
       ``(B) the eligibility criteria in accordance with 
     subsection (b); and
       ``(C) the manner and effect of an election to modify or 
     revoke a transfer of entitlement under subsection (f)(2).''.
       (b) Conforming Amendments.--
       (1) Transfers by members of armed forces.--The heading of 
     section 3319 of such title is amended by inserting ``by 
     members of the Armed Forces'' after ``family members''.
       (2) Bar to duplication of educational assistance 
     benefits.--Section 3322(e) of such title is amended by 
     inserting ``or 3319A'' after ``and 3319''.
       (c) Clerical Amendment.--The table of sections at the 
     beginning of chapter 33 of such title is amended by striking 
     the item relating to section 3319 and inserting the following 
     new items:

``3319. Authority to transfer unused education benefits to family 
              members by members of the Armed Forces.
``3319A. Authority to transfer unused education benefits to family 
              members by seriously injured veterans.''.

     SEC. 4. ENHANCEMENT OF SPECIAL COMPENSATION FOR MEMBERS OF 
                   THE UNIFORMED SERVICES WITH INJURIES OR 
                   ILLNESSES REQUIRING ASSISTANCE IN EVERYDAY 
                   LIVING.

       (a) Expansion of Covered Members.--Subsection (b) of 
     section 439 of title 37, United States Code, is amended--
       (1) by striking paragraphs (1) through (3) and inserting 
     the following new paragraphs:
       ``(1) has a serious injury or illness that was incurred or 
     aggravated in the line of duty;
       ``(2) is in need of personal care services (including 
     supervision or protection or regular instruction or 
     supervision) as a result of such injury or illness; and''; 
     and
       (2) by redesignating paragraph (4) as paragraph (3).
       (b) Nontaxability of Special Compensation.--Such section is 
     further amended--
       (1) by redesignating subsections (e), (f), (g), and (h) as 
     subsections (g), (h), (i) and (j), respectively; and
       (2) by inserting after subsection (d) the following new 
     subsection (e):
       ``(e) Nontaxability of Compensation.--Monthly special 
     compensation paid under subsection (a) shall not be included 
     in income for purposes of the Internal Revenue Code of 
     1986.''.
       (c) Provision of Assistance to Family Caregivers.--Such 
     section is further amended by inserting after subsection (e), 
     as amended by subsection (b) of this section, the following 
     new subsection (f):
       ``(f) Assistance for Family Caregivers.--(1) The Secretary 
     of Veterans Affairs shall provide family caregivers of a 
     member in receipt of monthly special compensation under 
     subsection (a) the assistance required to be provided to 
     family caregivers of eligible veterans under section 
     1720G(a)(3)(A) of title 38 (other than the monthly personal 
     caregiver stipend provided for in clause (ii)(V) of such 
     section). For purposes of the provision of such assistance 
     under this subsection, the definitions in section 1720G(d) of 
     title 38 shall apply, except that any reference in such 
     definitions to a veteran or eligible veteran shall be deemed 
     to be a reference to the member concerned.
       ``(2) The Secretary of Veterans Affairs shall provide 
     assistance under this subsection--
       ``(A) in accordance with a memorandum of understanding 
     entered into by the Secretary of Veterans Affairs and the 
     Secretary of Defense; and
       ``(B) in accordance with a memorandum of understanding 
     entered into by the Secretary of Veterans Affairs and the 
     Secretary of Homeland Security (with respect to members of 
     the Coast Guard).''.
       (d) Expansion of Covered Injuries and Illnesses.--
     Subsection (i) of such section, as redesignated by subsection 
     (b)(1) of this section, is amended to read as follows:
       ``(i) Serious Injury or Illness Defined.--In this section, 
     the term `serious injury or illness' means an injury, 
     disorder, or illness (including traumatic brain injury, 
     psychological trauma, or other mental disorder) that--
       ``(1) renders the afflicted person unable to carry out one 
     or more activities of daily living;
       ``(2) renders the afflicted person in need of supervision 
     or protection due to the manifestation by such person of 
     symptoms or residuals of neurological or other impairment or 
     injury;
       ``(3) renders the afflicted person in need of regular or 
     extensive instruction or supervision in completing two or 
     more instrumental activities of daily living; or
       ``(4) otherwise impairs the afflicted person in such manner 
     as the Secretary of Defense (or the Secretary of Homeland 
     Security, with respect to the Coast Guard) prescribes for 
     purposes of this section.''.
       (e) Clerical Amendments.--
       (1) Heading amendment.--The heading for such section is 
     amended to read as follows:

     ``Sec. 439. Special compensation: members of the uniformed 
       services with serious injuries or illnesses requiring 
       assistance in everyday living''.

       (2) Table of sections amendment.--The table of sections at 
     the beginning of chapter 7 of such title is amended by 
     striking the item relating to section 439 and inserting the 
     following new item:

``439. Special compensation: members of the uniformed services with 
              serious injuries or illnesses requiring assistance in 
              everyday living.''.

     SEC. 5. FLEXIBLE WORK ARRANGEMENTS FOR CERTAIN FEDERAL 
                   EMPLOYEES.

       (a) Definition of Covered Employee.--In this section, the 
     term ``covered employee'' means an employee (as defined in 
     section 2105 of title 5, United States Code) who--
       (1) is a caregiver, as defined in section 1720G of title 
     38, United States Code; or
       (2) is a caregiver of an individual who receives 
     compensation under section 439 of title 37, United States 
     Code.
       (b) Authority to Allow Flexible Work Arrangements.--The 
     Director of the Office of Personnel Management may promulgate 
     regulations under which a covered employee may--
       (1) use a flexible schedule or compressed schedule in 
     accordance with subchapter II of chapter 61 of title 5, 
     United States Code; or
       (2) telework in accordance with chapter 65 of title 5, 
     United States Code.

     SEC. 6. LIFESPAN RESPITE CARE.

       (a) Definitions.--Section 2901 of the Public Health Service 
     Act (42 U.S.C. 300ii) is amended--
       (1) in paragraph (1)--
       (A) by redesignating subparagraphs (A) through (C) as 
     clauses (i) through (iii), respectively, and realigning the 
     margins accordingly;
       (B) by striking ``who requires care or supervision to--'' 
     and inserting ``who--
       ``(A) requires care or supervision to--'';
       (C) by striking the period and inserting ``; or''; and
       (D) by adding at the end the following:
       ``(B) is a veteran participating in the program of 
     comprehensive assistance for family caregivers under section 
     1720G of title 38, United States Code.''; and
       (2) in paragraph (5), by striking ``or another unpaid 
     adult,'' and inserting ``another unpaid adult, or a family 
     caregiver as defined in section 1720G of title 38, United 
     States Code, who receives compensation under such section,''.
       (b) Grants and Cooperative Agreements.--Section 2902(c) of 
     the Public Health Service Act (42 U.S.C. 300ii-1(c)) is 
     amended by inserting ``and the interagency working group on 
     policies relating to caregivers of veterans established under 
     section 7 of the Military and Veteran Caregiver Services 
     Improvement Act of 2014'' after ``Human Services''.
       (c) Authorization of Appropriations.--Section 2905 of the 
     Public Health Service Act (42 U.S.C. 300ii-4) is amended--
       (1) in paragraph (4), by striking ``and'' at the end;
       (2) in paragraph (5), by striking the period and inserting 
     ``; and''; and

[[Page S2386]]

       (3) by adding at the end the following:
       ``(6) $15,000,000 for each of fiscal years 2015 through 
     2019.''.

     SEC. 7. INTERAGENCY WORKING GROUP ON CAREGIVER POLICY.

       (a) Establishment.--There shall be established in the 
     executive branch an interagency working group on policies 
     relating to caregivers of veterans and members of the Armed 
     Forces (in this section referred to as the ``working 
     group'').
       (b) Composition.--
       (1) In general.--The working group shall be composed of the 
     following:
       (A) A chair selected by the President.
       (B) A representative from each of the following agencies or 
     organizations selected by the head of such agency or 
     organization:
       (i) The Department of Veterans Affairs.
       (ii) The Department of Defense.
       (iii) The Department of Health and Human Services.
       (iv) The Department of Labor.
       (v) The Centers for Medicare and Medicaid Services.
       (2) Advisors.--The chair may select any of the following 
     individuals that the chair considers appropriate to advise 
     the working group in carrying out the duties of the working 
     group:
       (A) Academic experts in fields relating to caregivers.
       (B) Clinicians.
       (C) Caregivers.
       (D) Individuals in receipt of caregiver services.
       (c) Duties.--The duties of the working group are as 
     follows:
       (1) To regularly review policies relating to caregivers of 
     veterans and members of the Armed Forces.
       (2) To coordinate and oversee the implementation of 
     policies relating to caregivers of veterans and members of 
     the Armed Forces.
       (3) To evaluate the effectiveness of policies relating to 
     caregivers of veterans and members of the Armed Forces, 
     including programs in each relevant agency, by developing and 
     applying specific goals and performance measures.
       (4) To develop standards of care for caregiver services and 
     respite care services provided to a caregiver, veteran, or 
     member of the Armed Forces by a non-profit or private sector 
     entity.
       (5) To ensure the availability of mechanisms for agencies, 
     and entities affiliated with or providing services on behalf 
     of agencies, to enforce the standards described in paragraph 
     (4) and conduct oversight on the implementation of such 
     standards.
       (6) To develop recommendations for legislative or 
     administrative action to enhance the provision of services to 
     caregivers, veterans, and members of the Armed Forces, 
     including eliminating gaps in such services and eliminating 
     disparities in eligibility for such services.
       (7) To coordinate with State and local agencies and 
     relevant non-profit organizations on maximizing the use and 
     effectiveness of resources for caregivers of veterans and 
     members of the Armed Forces.
       (d) Reports.--
       (1) In general.--Not later than December 31, 2014, and 
     annually thereafter, the chair of the working group shall 
     submit to Congress a report on policies and services relating 
     to caregivers of veterans and members of the Armed Forces.
       (2) Elements.--Each report required by paragraph (1) shall 
     include the following:
       (A) An assessment of the policies relating to caregivers of 
     veterans and members of the Armed Forces and services 
     provided pursuant to such policies as of the date of 
     submittal of such report.
       (B) A description of any steps taken by the working group 
     to improve the coordination of services for caregivers of 
     veterans and members of the Armed Forces among the entities 
     specified in subsection (b)(1)(B) and eliminate barriers to 
     effective use of such services, including aligning 
     eligibility criteria.
       (C) An evaluation of the performance of the entities 
     specified in subsection (b)(1)(B) in providing services for 
     caregivers of veterans and members of the Armed Forces.
       (D) An evaluation of the quality and sufficiency of 
     services for caregivers of veterans and members of the Armed 
     Forces available from non-governmental organizations.
       (E) A description of any gaps in care or services provided 
     by caregivers to veterans or members of the Armed Forces 
     identified by the working group, and steps taken by the 
     entities specified in subsection (b)(1)(B) to eliminate such 
     gaps or recommendations for legislative or administrative 
     action to address such gaps.
       (F) Such other matters or recommendations as the chair 
     considers appropriate.

     SEC. 8. STUDIES ON POST-SEPTEMBER 11, 2001, VETERANS AND 
                   SERIOUSLY INJURED VETERANS.

       (a) Longitudinal Study on Post-9/11 Veterans.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     provide for the conduct of a longitudinal study on members of 
     the Armed Forces who commenced service in the Armed Forces 
     after September 11, 2001.
       (2) Grant or contract.--The Secretary shall award a grant 
     to, or enter into a contract with, an appropriate entity 
     unaffiliated with the Department of Veterans Affairs to 
     conduct the study required by paragraph (1).
       (3) Plan.--Not later than one year after the date of the 
     enactment of this Act, 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 plan for the conduct of the study required 
     by paragraph (1).
       (4) Reports.--Not later than October 1, 2019, and every 
     four years thereafter, 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 report on the results of the study required 
     by paragraph (1) as of the date of such report.
       (b) Comprehensive Study on Seriously Injured Veterans and 
     Their Caregivers.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     provide for the conduct of a comprehensive study on the 
     following:
       (A) Veterans who have incurred a serious injury or illness, 
     including a mental health injury.
       (B) Individuals who are acting as caregivers for veterans.
       (2) Elements.--The comprehensive study required by 
     paragraph (1) shall include the following with respect to 
     each veteran included in such study:
       (A) The health of the veteran and, if applicable, the 
     impact of the caregiver of such veteran on the health of such 
     veteran.
       (B) The employment status of the veteran and, if 
     applicable, the impact of the caregiver of such veteran on 
     the employment status of such veteran.
       (C) The financial status and needs of the veteran.
       (D) The use by the veteran of benefits available to such 
     veteran from the Department of Veterans Affairs.
       (E) Any other information that the Secretary considers 
     appropriate.
       (3) Grant or contract.--The Secretary shall award a grant 
     to, or enter into a contract with, an appropriate entity 
     unaffiliated with the Department of Veterans Affairs to 
     conduct the study required by paragraph (1).
       (4) Report.--Not later than two years after the date of the 
     enactment of this Act, 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 report on the results of the study required 
     by paragraph (1).

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