[Congressional Record Volume 164, Number 125 (Wednesday, July 25, 2018)]
[House]
[Pages H7172-H7175]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
LONG-TERM CARE VETERANS CHOICE ACT
Mr. ROE of Tennessee. Mr. Speaker, I move to suspend the rules and
pass the bill (H.R. 5693) 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,
to establish the Veterans Economic Opportunity and Transition
Administration and the Under Secretary for Veterans Economic
Opportunity and Transition of the Department of Veterans Affairs, to
amend the interest rate for certain loans guaranteed under the home
loan program of the Department of Veterans Affairs, and for other
purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 5693
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.--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, 2019, 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, agreement, or other arrangement
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) In any year, not more than a daily average of 900
veterans placed in a medical foster home, whether placed
before or after the date of the enactment of this subsection,
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.''.
(b) Effective Date.--Subsection (h) of title 38, United
States Code, as added by subsection (a), shall take effect on
October 1, 2019.
SEC. 3. ESTABLISHMENT OF VETERANS ECONOMIC OPPORTUNITY AND
TRANSITION ADMINISTRATION.
(a) Veterans Economic Opportunity and Transition
Administration.--
(1) In general.--Part V of title 38, United States Code, is
amended by adding at the end the following new chapter:
``CHAPTER 80--VETERANS ECONOMIC OPPORTUNITY AND TRANSITION
ADMINISTRATION
``8001. Organization of Administration.
``8002. Functions of Administration.
``8003. Annual report to Congress.
``Sec. 8001. Organization of Administration
``(a) Veterans Economic Opportunity and Transition
Administration.--There is in the Department of Veterans
Affairs a Veterans Economic Opportunity and Transition
Administration. The primary function of the Veterans Economic
Opportunity and Transition Administration is the
administration of the programs of the Department that provide
assistance related to economic opportunity to veterans and
their dependents and survivors.
``(b) Under Secretary for Economic Opportunity and
Transition.--The Veterans Economic Opportunity and Transition
Administration is under the Under Secretary for Veterans
Economic Opportunity and Transition, who is directly
responsible to the Secretary for the operations of the
Administration.
``Sec. 8002. Functions of Administration
``The Veterans Economic Opportunity and Transition
Administration is responsible for the administration of the
following programs of the Department:
``(1) Vocational rehabilitation and employment programs.
``(2) Educational assistance programs.
``(3) Veterans' housing loan and related programs.
``(4) The verification of small businesses owned and
controlled by veterans pursuant to subsection (f) of section
8127 of this title, including the administration of the
database of veteran-owned businesses described in such
subsection.
``(5) The Transition Assistance Program under section 1144
of title 10.
``(6) Any other program of the Department that the
Secretary determines appropriate.
``Sec. 8003. Annual report to Congress
``The Secretary shall include in the annual report to the
Congress required by section 529 of this title a report on
the programs administered by the Under Secretary for Veterans
Economic Opportunity and Transition. Each such report shall
include the following with respect to each such program
during the fiscal year covered by that report:
``(1) The number of claims received.
``(2) The number of claims decided.
``(3) The average processing time for a claim.
``(4) The number of successful outcomes (as determined by
the Secretary).
``(5) The number of full-time equivalent employees.
``(6) The amounts expended for information technology.''.
(2) Clerical amendments.--The tables of chapters at the
beginning of title 38, United States Code, and of part V of
title 38, United States Code, are each amended by inserting
after the item relating to chapter 79 the following new item:
``80. Veterans Economic Opportunity and Transition Administ8001''.....
(b) Effective Date.--Chapter 80 of title 38, United States
Code, as added by subsection (a), shall take effect on
October 1, 2019.
(c) Full-Time Employees.--For fiscal years 2019 and 2020,
the total number of full-time equivalent employees authorized
for the Veterans Benefits Administration and the Veterans
Economic Opportunity and Transition Administration, as
established under chapter 80 of title 38, United States Code,
as added by subsection (a), may not exceed 23,692.
SEC. 4. UNDER SECRETARY FOR VETERANS ECONOMIC OPPORTUNITY AND
TRANSITION.
(a) Under Secretary.--
(1) In general.--Chapter 3 of title 38, United States Code,
is amended by inserting after section 306 the following new
section:
``Sec. 306A. Under Secretary for Veterans Economic
Opportunity and Transition
``(a) Under Secretary.--There is in the Department an Under
Secretary for Veterans Economic Opportunity and Transition,
who is appointed by the President, by and with the advice and
consent of the Senate. The Under Secretary for Veterans
Economic Opportunity and Transition shall be appointed
without regard to political affiliation or activity and
solely on the basis of demonstrated ability in--
[[Page H7173]]
``(1) information technology; and
``(2) the administration of programs within the Veterans
Economic Opportunity and Transition Administration or
programs of similar content and scope.
``(b) Responsibilities.--The Under Secretary for Veterans
Economic Opportunity and Transition is the head of, and is
directly responsible to the Secretary for the operations of,
the Veterans Economic Opportunity and Transition
Administration.
``(c) Vacancies.--(1) Whenever a vacancy in the position of
Under Secretary for Veterans Economic Opportunity and
Transition occurs or is anticipated, the Secretary shall
establish a commission to recommend individuals to the
President for appointment to the position.
``(2) A commission established under this subsection shall
be composed of the following members appointed by the
Secretary:
``(A) Three persons representing education and training,
vocational rehabilitation, employment, real estate, mortgage
finance and related industries, and survivor benefits
activities affected by the Veterans Economic Opportunity and
Transition Administration.
``(B) Two persons representing veterans served by the
Veterans Economic Opportunity and Transition Administration.
``(C) Two persons who have experience in the management of
private sector benefits programs of similar content and scope
to the economic opportunity and transition programs of the
Department.
``(D) The Deputy Secretary of Veterans Affairs.
``(E) The chairman of the Veterans' Advisory Committee on
Education formed under section 3692 of this title.
``(F) One person who has held the position of Under
Secretary for Veterans Economic Opportunity and Transition,
if the Secretary determines that it is desirable for such
person to be a member of the commission.
``(3) A commission established under this subsection shall
recommend at least three individuals for appointment to the
position of Under Secretary for Veterans Economic Opportunity
and Transition. The commission shall submit all
recommendations to the Secretary. The Secretary shall forward
the recommendations to the President and the Committees on
Veterans' Affairs of the Senate and House of Representatives
with any comments the Secretary considers appropriate.
Thereafter, the President may request the commission to
recommend additional individuals for appointment.
``(4) The Assistant Secretary or Deputy Assistant Secretary
of Veterans Affairs who performs personnel management and
labor relations functions shall serve as the executive
secretary of a commission established under this
subsection.''.
(2) Clerical amendment.--The table of sections at the
beginning of such chapter is amended by inserting after the
item relating to section 306 the following new item:
``306A. Under Secretary for Veterans Economic Opportunity and
Transition.''.
(b) Conforming Amendments.--Title 38, United States Code,
is further amended--
(1) in section 306(c)(2), by striking subparagraphs (A) and
(E) and redesignating subparagraphs (B), (C), (D), and (F),
as subparagraphs (A) through (D), respectively;
(2) in section 317(d)(2), by inserting after ``Under
Secretary for Benefits,'' the following: ``the Under
Secretary for Veterans Economic Opportunity and
Transition,'';
(3) in section 318(d)(2), by inserting after ``Under
Secretary for Benefits,'' the following: ``the Under
Secretary for Veterans Economic Opportunity and
Transition,'';
(4) in section 516(e)(2)(C), by striking ``Health and the
Under Secretary for Benefits'' and inserting ``Health, the
Under Secretary for Benefits, and the Under Secretary for
Veterans Economic Opportunity and Transition'';
(5) in section 541(a)(2)(B), by striking ``Health and the
Under Secretary for Benefits'' and inserting ``Health, the
Under Secretary for Benefits, and the Under Secretary for
Veterans Economic Opportunity and Transition'';
(6) in section 542(a)(2)(B)(iii), by striking ``Health and
the Under Secretary for Benefits'' and inserting ``Health,
the Under Secretary for Benefits, and the Under Secretary for
Veterans Economic Opportunity and Transition'';
(7) in section 544(a)(2)(B)(vi), by striking ``Health and
the Under Secretary for Benefits'' and inserting ``Health,
the Under Secretary for Benefits, and the Under Secretary for
Veterans Economic Opportunity and Transition'';
(8) in section 709(c)(2)(A), by inserting after ``Under
Secretary for Benefits,'' the following: ``the Under
Secretary for Veterans Economic Opportunity and
Transition,'';
(9) in section 7701(a), by inserting after ``assistance''
the following: ``, other than assistance related to Economic
Opportunity and Transition,''; and
(10) in section 7703, by striking paragraphs (2) and (3)
and redesignating paragraphs (4) and (5) as paragraphs (2)
and (3), respectively.
(c) Effective Date.--Section 306A of title 38, United
States Code, as added by subsection (a), and the amendments
made by this section, shall take effect on October 1, 2019.
SEC. 5. LOANS GUARANTEED UNDER HOME LOAN PROGRAM OF
DEPARTMENT OF VETERANS AFFAIRS.
Section 3729(b)(2)(E) of such title is amended to read as
follows:
------------------------------------------------------------------------
Active duty Other
``Type of loan veteran Reservist obligor
------------------------------------------------------------------------
(E)(i) Interest rate reduction 0.50 0.50 NA
refinancing loan (closed
before January 1, 2019)......
(E)(ii) Interest rate 0.75 0.75 NA
reduction refinancing loan
(closed on or after January
1, 2019, but before March 1,
2025)........................
(E)(iii) Interest rate 0.50 0.50 NA''.
reduction refinancing loan
(closed on or after March 1,
2025)........................
------------------------------------------------------------------------
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Tennessee (Mr. Roe) and the gentleman from California (Mr. Takano) each
will control 20 minutes.
The Chair recognizes the gentleman from Tennessee.
General Leave
Mr. ROE of Tennessee. Mr. Speaker, I ask unanimous consent that all
Members have 5 legislative days to revise and extend their remarks and
insert extraneous material.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Tennessee?
There was no objection.
Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I rise today in support of my bill, H.R. 5693, as
amended, the Long-Term Care Veterans Choice Act. This bill would expand
long-term care opportunities for veterans by allowing the Department of
Veterans Affairs, VA, to cover the cost of a medical foster home for
certain veterans.
Medical foster homes are private homes in which a trained caregiver
provides round-the-clock care to a small group of individuals. Medical
foster homes have proven to be a popular, safe, and cost-effective
alternative to traditional nursing homes, particularly for veterans who
prefer a more familial, less institutional care setting.
However, VA is unable to cover the cost of care for a veteran
residing in a medical foster home. That is true even for veterans who
VA would otherwise be required to pay for in a more expensive nursing
home.
As a result, VA estimates the department pays more than twice as much
for nursing home care than it otherwise would. The Long-Term Care
Veterans Choice Act would help address that issue, and, in doing so,
ensure that veterans have the flexibility to choose the long-term care
setting that feels most comfortable for them.
The bill would also create a Veterans Economic Opportunity and
Transition Administration to be led by an under secretary for Veterans
Economic Opportunity and Transition. Investing in education and
employment opportunities for our Nation's veterans is one of VA's most
important but least recognized missions.
Today, programs concerning education and employment are embedded
within the Veterans Benefit Administration, which, understandably,
devotes most of its time, attention, and resources on disability
compensation-related issues and backlogs that rise and fall with time.
Creating a new administration within VA to house education and
employment programs will ensure that those programs receive the focused
leadership, time and attention that they deserve.
To offset the medical foster home and Veterans Economic Opportunity
and Transition Administration provisions of the bill, it would also
authorize a temporary increase in the VA home loan funding fee for
interest reduction loans when refinancing homes. This bill is sponsored
by Congressman Clay Higgins from Louisiana. As an engaged member of the
Subcommittee on Health, Clay is a champion for his
[[Page H7174]]
fellow veterans, and I thank him for his leadership on this
legislation.
I am also grateful to my good friend and former senior committee
member, Dr. Brad Wenstrup from Ohio, who has sponsored the Veterans
Economic Opportunity and Transition Administration provisions of this
bill. As a veteran and physician, Brad has championed veteran
employment and education issues because he knows better than most how
important it is that veterans transitioning from combat zones come home
to meaningful education and employment opportunities.
I thank him for his efforts and urge all of my colleagues to join me
in supporting this bill today.
Mr. Speaker, I reserve the balance of my time.
Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, to begin, I thank Representative Higgins for his hard
work on this legislation, and I support H.R. 5693, as amended.
This bipartisan legislation is a forward-thinking first step toward
better aligning VA's long-term care options with veteran preferences.
Medical foster homes are a solution for veterans that may not be
comfortable in a traditional institutional setting, such as a nursing
home, yet still need some form of daily assistance and care. These
homes provide caregiving services in a group setting for veterans that
lack access to caregiving services at home.
By allowing VA to cover the cost of medical foster homes, VA will be
able to ensure veterans are achieving the most appropriate level of
care in the most appropriate setting.
The care delivered at medical foster homes is less intensive;
therefore, less expensive. Additionally, the sense of community and the
familiar home-like setting can promote a veteran's physical and mental
health.
Again, I appreciate my colleague's hard work on this legislation and
look forward to voting in favor of the bill. I congratulate the
gentleman from Louisiana's hard work.
Mr. Speaker, I reserve the balance of my time.
Mr. ROE of Tennessee. Mr. Speaker, I yield 5 minutes to the gentleman
from Louisiana (Mr. Higgins), an active member of the VA committee and
one of the primary sponsors of this, an Army veteran, and reserve
police officer.
Mr. HIGGINS of Louisiana. Mr. Speaker, I rise today in support of
H.R. 5693, the Long-Term Care Veterans Choice Act. My bill would
authorize the Department of Veterans Affairs for 3 years to cover the
cost of long-term care at medical foster homes for up to 900 veterans
at a time who are otherwise eligible for nursing home care through the
VA.
Medical foster homes are private homes in which a caregiver provides
services to a smaller group of individuals who are unable to live
without day-to-day assistance. Medical foster homes are an alternative
to nursing homes for those who require care but prefer a
noninstitutional setting with fewer residents.
For many younger veterans in need of round-the-clock care, medical
foster homes can provide a more age-appropriate independent setting
than traditional nursing homes. The VA has operated its medical foster
home initiative for nearly 20 years, and currently oversees more than
700 licensed caregivers assisting nearly 1,000 veterans across 42
States.
Unfortunately, Mr. Speaker, while the VA will cover the cost of home-
based primary care for eligible veterans living in medical foster
homes, the VA does not cover the cost of medical foster home living
arrangements for veterans eligible for nursing home care through the
VA. The reforms in my bill increase access to medical foster homes and
represent a significant cost savings for the Department of Veterans
Affairs.
There should be no one-size-fits-all standard of care for veterans.
Veterans should be afforded flexibility to use the benefits they
righteously earned in a manner that best suits their individual needs,
which is why the VA, American Legion, and many other veteran service
organizations have offered their support for this language.
Further, the bill refocuses the administrative bodies of the VA to
better prioritize programs like the GI bill, vocational rehabilitation,
home loan benefits, and transition assistance programs that create
economic opportunities for veterans.
This allows existing veterans' health benefits and National Cemetery
Administration to better focus on providing healthcare and cemetery
services. This critical refocus will improve oversight and veterans
access to important services like the medical foster home program that
give much needed choice and personal dignity back to the brave men and
women who have sacrificed so much for our Nation.
Mr. Speaker, this bill reflects the compassion of the American
citizenry in our dedication to serve the veterans who have served us.
Please join me in supporting our servicemen and women by voting in
support of H.R. 5693, the Long-Term Care Veterans Choice Act.
Mr. TAKANO. Mr. Speaker, I yield 3 minutes to the gentleman from
California (Mr. Correa), a member of the House Committee on Veterans'
Affairs, and let it also be known that prior to his coming to Congress,
he chaired a veterans committee in the California State Legislature.
Mr. CORREA. Mr. Speaker, I rise in strong support of H.R. 5693, the
Long-Term Care Veterans Choice Act. This bipartisan legislation will
expand veterans' access to medical foster homes, an alternative to
nursing home care, by allowing the Department of Veterans Affairs to
cover such care for up to 900 veterans every year.
{time} 1230
The Medical Foster Homes program allows eligible veterans who require
day-to-day assistance to live in private homes with trained caregivers
who provide around-the-clock care and the services needed to help these
veterans with their daily tasks, such as getting dressed. The program
requires that caregivers be licensed and involved in frequent
inspections by the VA.
Most importantly, the Medical Foster Homes program provides aging
veterans the option to live in a private setting that may feel more
like a home than a nursing institution.
Additionally, the amended bill creates a fourth administration within
the VA, headed by a new Under Secretary, to administer the educational
and employment benefits currently managed by the Veterans Benefits
Administration.
Mr. Speaker, I urge passage of H.R. 5693.
Mr. ROE of Tennessee. Mr. Speaker, I yield 2 minutes to the gentleman
from Ohio (Mr. Wenstrup), my good friend, who has been an active member
of the Veterans' Affairs Committee and chairs the Subcommittee on
Health. I appreciate his leadership on this bill.
Mr. WENSTRUP. Mr. Speaker, I rise to support the Long-Term Care
Veterans Choice Act, legislation that contains the text of my bill, the
VET OPP Act. The VET OPP Act continues our effort to invest in our
troops from the day they take their oath of service to when they begin
their civilian careers.
Part of our commitment to our men and women in uniform is helping
them reintegrate back into civilian life. We can ease this transition
by prioritizing programs that help them find meaningful employment or
educational opportunities when they return home.
For too long, the outdated structure of the VA has allowed economic
opportunity and transition programs for our veterans to fall by the
wayside. H.R. 5693 will change that. With the inclusion of the VET OPP
Act, it prioritizes veteran employment and education programs at the VA
by utilizing existing resources to place educational, employment, and
transition programs together in a fourth administration within the VA.
This will promote transparency and oversight, while placing greater
priority on opportunity-based programs within the VA.
Mr. Speaker, I urge my colleagues to support H.R. 5693.
Mr. TAKANO. Mr. Speaker, I ask my colleagues to join me in passing
H.R. 5693, as amended, and I yield back the balance of my time.
Mr. ROE of Tennessee. Mr. Speaker, this is commonsense legislation
that will allow veterans in certain circumstances to stay in a less
intense nursing home facility. We hear this all the time: ``I don't
want to go to a nursing home.'' This will allow veterans who have
earned these benefits to reside outside there. It is much less
expensive for the VA, and it is also much
[[Page H7175]]
better for the veteran if they can do this.
A second part of this bill, which is to create the fourth
administration, is not more bureaucracy, but to focus on the education
benefits and transition as Active-Duty military leave and enter
civilian life again. I think it is one of the most critical things we
do. A seamless transition from Active Duty to an active job, I think,
will help reduce veteran depression, suicide, dependence, and other
things. That is why we wanted to do this.
Mr. Speaker, I urge my colleagues to support H.R. 5693, as amended,
and I yield back the balance of my time.
The SPEAKER pro tempore (Mr. Emmer). The question is on the motion
offered by the gentleman from Tennessee (Mr. Roe) that the House
suspend the rules and pass the bill, H.R. 5693, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
A motion to reconsider was laid on the table.
____________________