[Congressional Record Volume 161, Number 35 (Monday, March 2, 2015)]
[House]
[Pages H1509-H1510]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  1715
                   LONG-TERM CARE VETERANS CHOICE ACT

  Mr. MILLER of Florida. Mr. Speaker, I move to suspend the rules and 
pass the bill (H.R. 294) to amend title 38, United States Code, to 
authorize the Secretary of Veterans Affairs to enter into contracts and 
agreements for the transfer of veterans to non-Department medical 
foster homes for certain veterans who are unable to live independently, 
as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 294

       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 ``Long-Term Care Veterans 
     Choice Act''.

     SEC. 2. SECRETARY OF VETERANS AFFAIRS CONTRACT AUTHORITY FOR 
                   PLACEMENT OF VETERANS IN NON-DEPARTMENT MEDICAL 
                   FOSTER HOMES.

       (a) Authority.--
       (1) In general.--Section 1720 of title 38, United States 
     Code, is amended by adding at the end the following new 
     subsection:
       ``(h)(1) During the three-year period beginning on October 
     1, 2015, and subject to paragraph (2), at the request of a 
     veteran for whom the Secretary is required to provide nursing 
     home care under section 1710A of this title, the Secretary 
     may place the veteran in a medical foster home that meets 
     Department standards, at the expense of the United States, 
     pursuant to a contract or agreement entered into between the 
     Secretary and the medical foster home for such purpose. A 
     veteran who is placed in a medical foster home under this 
     subsection shall agree, as a condition of such placement, to 
     accept home health services furnished by the Secretary under 
     section 1717 of this title.
       ``(2) Not more than 900 veterans placed in a medical foster 
     home, whether placed before or after the enactment of the 
     Long-Term Care Veterans Choice Act, may have their care 
     covered at the expense of the United States under subsection 
     (a).
       ``(3) In this subsection, the term `medical foster home' 
     means a home designed to provide non-institutional, long-
     term, supportive care for veterans who are unable to live 
     independently and prefer a family setting.''.
       (2) Effective date.--Subsection (h) of title 38, United 
     States Code, as added by subsection (a), shall take effect on 
     October 1, 2015.
       (b) Limitations on Awards and Bonuses.--Section 705 of the 
     Veterans Access, Choice, and Accountability Act of 2014 
     (Public Law 113-146; 38 U.S.C. 703 note) is amended to read 
     as follows:

     ``SEC. 705. LIMITATION ON AWARDS AND BONUSES PAID TO 
                   EMPLOYEES OF DEPARTMENT OF VETERANS AFFAIRS.

       ``The Secretary of Veterans Affairs shall ensure that the 
     aggregate amount of awards and bonuses paid by the Secretary 
     in a fiscal year under chapter 45 or 53 of title 5, United 
     States Code, or any other awards or bonuses authorized under 
     such title or title 38, United States Code, does not exceed 
     the following amounts:
       ``(1) With respect to each of fiscal years 2015 through 
     2018, $300,000,000.
       ``(2) With respect to each of fiscal years 2019 through 
     2024, $360,000,000.''.
       Amend the title so as to read: ``A bill to amend title 38, 
     United States Code, to authorize the Secretary of Veterans 
     Affairs to enter into contracts and agreements for the 
     placement of veterans in non-Department medical foster homes 
     for certain veterans who are unable to live independently.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Florida (Mr. Miller) and the gentlewoman from Florida (Ms. Brown) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Florida.
  Mr. MILLER of Florida. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, H.R. 294, as amended, the Long-Term Care Veterans Choice 
Act, would authorize the Department of Veterans Affairs for 3 years, 
beginning October 1 of 2015, to enter into a contract or agreement with 
a certified medical foster home to pay for long-term care for not more 
than 900 eligible veterans.
  An eligible veteran is defined as one who is eligible for VA-paid 
nursing home care and would agree to receive VA home health services. 
The bill would also limit the amount of awards and bonuses paid to VA 
employees at $300 million for each of fiscal years 2015 through 2018.
  Medical foster home care is a noninstitutional, long-term care 
alternative for those who prefer a smaller, more homelike, and familial 
care setting than many traditional nursing homes are able to provide.
  VA has been helping to place veterans in medical foster homes for 
over a decade and providing the oversight and the safeguards needed to 
ensure that veterans receive safe, high-quality care.
  According to VA, over 900 veterans currently receive medical foster 
home care. However, VA does not currently have the authority to pay for 
the cost of medical foster home care, regardless of whether or not the 
veteran who chooses medical foster home care is eligible for more 
costly VA-paid nursing home care.
  This creates a situation, Mr. Speaker, where many service-connected 
veterans are limited with their financial resources and are unable to 
access the medical foster home care that they desire because of limited 
financial resources; instead, these veterans often move into nursing 
homes at a much greater expense to VA.
  With the creation of the choice program last August, Congress, on an 
overwhelmingly bipartisan basis, agreed that our veterans deserve the 
right to choose for themselves where and how they receive health care 
that they have earned.
  With today's passage of H.R. 294, as amended, we will reaffirm that 
right to choose for the growing population of veterans in need of long-
term care services.
  Mr. Speaker, I reserve the balance of my time.
  Ms. BROWN of Florida. Mr. Speaker, I rise in support of H.R. 294, as 
amended.
  Providing high-quality health care to our Nation's veterans has 
always been a number one priority for this committee. Ensuring that the 
VA is a leader in the provision of long-term care to our veterans has 
also been a priority.
  We must work to make sure that VA provides a full range of long-term 
care programs, and H.R. 294, as amended, is a valuable improvement in 
providing veterans the choice of obtaining long-term care in a medical 
foster home.
  H.R. 294 gives VA the authority to pay for veterans' long-term care 
in VA-approved medical foster homes. These homes provide care in a 
private home at much lower cost than nursing home care. Medical foster 
homes are safe, and we know through experience that many veterans 
prefer them to the traditional nursing home.
  Older veterans also indicated that they prefer to receive care closer 
to home. The Long-Term Care Veterans Choice Act would provide the 
opportunity for more veterans to take advantage of this home care 
setting.
  I fully support this legislation and thank the chairman for 
introducing it.
  Mr. Speaker, I reserve the balance of my time.
  Mr. MILLER of Florida. Mr. Speaker, I have no further speakers at 
this time, so I reserve the balance of my time.
  Ms. BROWN of Florida. Mr. Speaker, I urge my colleagues to support 
H.R. 294, as amended.
  I yield back the balance of my time.
  Mr. MILLER of Florida. Once again, Mr. Speaker, I encourage all 
Members to support H.R. 294, as amended.


                             General Leave

  Mr. MILLER of Florida. Mr. Speaker, I ask unanimous consent that all 
Members may have 5 legislative days within which to revise and extend 
their remarks and include extraneous material on both H.R. 280, as 
amended, and H.R. 294, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  There was no objection.
  Mr. MILLER of Florida. Mr. Speaker, I yield back the balance of my 
time.
  Ms. JACKSON LEE. Mr. Speaker, I rise in support of H.R. 203, the 
``Long-Term Care Veteran Choice Act'', which will help expand access to 
healthcare for our nation's veterans.

[[Page H1510]]

  In 2014, it was found that some VA Department employees were 
responsible for deliberately falsifying wait-time records for veteran's 
medical appointments in order to create the appearance of reaching 
wait-time targets.
  This falsification of records even resulted in the unfortunate death 
of several veterans who were forced to wait unreasonably long periods 
of time before receiving the healthcare they unquestionably earned.
  H.R. 294 is intended to prevent another unacceptable incident and to 
ensure our veterans receive the healthcare they deserve.
  H.R. 294 allows veterans to obtain health care at non-VA health care 
facilities if they live more than 40 miles from a VA clinic or cannot 
be scheduled for an appointment at a VA clinic within 30 days.
  Further, the bill increases the VA's capacity to provide health care 
services by providing expedited authority to hire more doctors and 
nurses and by providing for leases for the opening of 27 additional VA 
health facilities across the nation.
  This bill will also propose a three year pilot program which will 
transfer certain veterans to non-department medical foster homes if 
they are unable to live independently at the cost of the VA.
  It is our duty to make available only the best health care to our 
veterans, and I cite as an example the Michael E. DeBakey VA Medical 
Center in Houston.
  The DeBakey VA Medical Center provides world-class services to almost 
130,000 veterans in southeast Texas and employs over 4,000 health care 
professionals.
  The DeBakey VA Medical Center has earned prestigious awards and 
accreditations for the quality of care provided, including:
  Accreditation from Joint Commission for hospital, long-term care, 
behavioral health care, home care, and substance abuse;
  Re-designation for Magnet Recognition for Excellence in Nursing 
Services by the American Nurses Credentialing Center;
  Gold Seal of Approval in 2011 from the Joint Commission as an 
Advanced Primary Stroke Center; and
  Specialty accreditation by the American Psychological Association 
Commission on Accreditation for its Clinical Neuropsychology 
Postdoctoral Program.
  Mr. Speaker, our veterans have given this country so much and we owe 
it to them and to ourselves-that they have the best and most accessible 
health care services.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Florida (Mr. Miller) that the House suspend the rules 
and pass the bill, H.R. 294, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. MILLER of Florida. Mr. Speaker, on that I demand the yeas and 
nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this motion will be postponed.

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