[Congressional Record Volume 169, Number 199 (Monday, December 4, 2023)]
[House]
[Pages H6103-H6106]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  1700
             CAREGIVER OUTREACH AND PROGRAM ENHANCEMENT ACT

  Mr. BERGMAN. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 3581) to amend title 38, United States Code, to modify the 
family caregiver program of the Department of Veterans Affairs to 
include services related to mental health and neurological disorders, 
and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 3581

       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 ``Caregiver Outreach and 
     Program Enhancement Act'' or the ``COPE Act''.

     SEC. 2. AUTHORITY FOR SECRETARY OF VETERANS AFFAIRS TO AWARD 
                   GRANTS TO ENTITIES TO IMPROVE PROVISION OF 
                   MENTAL HEALTH SUPPORT TO FAMILY CAREGIVERS OF 
                   VETERANS.

       (a) In General.--Subchapter II of chapter 17 of title 38, 
     United States Code, is amended by adding at the end the 
     following new section:

     ``Sec. 1720K. Grants to provide mental health support to 
       family caregivers of veterans

       ``(a) Authority.--The Secretary may award grants to carry 
     out, coordinate, improve, or otherwise enhance mental health 
     counseling, treatment, or support to the family caregivers of 
     veterans participating in the family caregiver program.
       ``(b) Application.--(1) To be eligible for a grant under 
     this section, an entity shall submit to the Secretary an 
     application therefor at such time, in such manner, and 
     containing such information as the Secretary may require.
       ``(2) Each application submitted under paragraph (1) shall 
     include the following:
       ``(A) A detailed plan for the use of the grant.
       ``(B) A description of the programs or efforts through 
     which the entity will meet the outcome measures developed by 
     the Secretary under subsection (g).
       ``(C) A description of how the entity will distribute grant 
     amounts equitably among areas with varying levels of 
     urbanization.
       ``(D) A plan for how the grant will be used to meet the 
     unique needs of veterans residing in rural areas, American 
     Indian or Alaska Native veterans, elderly veterans, women 
     veterans, and veterans from other underserved communities.
       ``(c) Distribution.--The Secretary shall seek to ensure 
     that grants awarded under this section are equitably 
     distributed among entities located in States with varying 
     levels of urbanization.
       ``(d) Priority.--The Secretary shall prioritize awarding 
     grants under this section that will serve the following 
     areas:
       ``(1) Areas with high rates of veterans enrolled in the 
     family caregiver program.
       ``(2) Areas with high rates of--
       ``(A) suicide among veterans; or
       ``(B) referrals to the Veterans Crisis Line.
       ``(e) Required Activities.--Any grant awarded under this 
     section shall be used--
       ``(1) to expand existing programs, activities, and 
     services;
       ``(2) to establish new or additional programs, activities, 
     and services; or
       ``(3) for travel and transportation to facilitate carrying 
     out paragraph (1) or (2).
       ``(f) Outcome Measures.--(1) The Secretary shall develop 
     and provide to each entity that receives a grant under this 
     section written guidance on the following:
       ``(A) Outcome measures.
       ``(B) Policies of the Department.
       ``(2) In developing outcome measures under paragraph (1), 
     the Secretary shall consider the following goals:
       ``(A) Increasing the utilization of mental health services 
     among family caregivers of veterans participating in the 
     family caregiver program.
       ``(B) Reducing barriers to mental health services among 
     family caregivers of veterans participating in such program.
       ``(g) Tracking Requirements.--(1) The Secretary shall 
     establish appropriate tracking requirements with respect to 
     the entities receiving a grant under this section.
       ``(2) Not less frequently than annually, the Secretary 
     shall submit to Congress a report on such tracking 
     requirements.
       ``(h) Performance Review.--The Secretary shall--
       ``(1) review the performance of each entity that receives a 
     grant under this section; and
       ``(2) make information regarding such performance publicly 
     available.
       ``(i) Remediation Plan.--(1) In the case of an entity that 
     receives a grant under this section and does not meet the 
     outcome measures developed by the Secretary under subsection 
     (g), the Secretary shall require the entity to submit to the 
     Secretary a remediation plan under which the entity shall 
     describe how and when it plans to meet such outcome measures.
       ``(2) The Secretary may not award a subsequent grant under 
     this section to an entity described in paragraph (1) unless 
     the Secretary approves the remediation plan submitted by the 
     entity under such paragraph.
       ``(j) Maximum Amount.--The amount of a grant awarded under 
     this section may not exceed 10 percent of amounts made 
     available for grants under this section for the fiscal year 
     in which the grant is awarded.
       ``(k) Supplement, Not Supplant.--Any grant awarded under 
     this section shall be used to supplement and not supplant 
     funding that is otherwise available through the Department to 
     provide mental health support among family caregivers of 
     veterans participating in the family caregiver program.
       ``(l) Outreach to Family Caregivers.--The Secretary shall 
     include, in the outreach materials regularly mailed to a 
     family caregiver who participates in the family caregiver 
     program, notice of mental health support provided by 
     recipients of grants under this section that are located in 
     the relevant Veterans Integrated Service Network.
       ``(m) Funding.--(1) Amounts for the activities of the 
     Department under this section shall be budgeted and 
     appropriated through a separate appropriation account.
       ``(2) In the budget justification materials submitted to 
     Congress in support of the budget of the Department for any 
     fiscal year (as submitted with the budget of the President 
     under section 1105(a) of title 31), the Secretary shall 
     include a separate statement of the amount requested to be 
     appropriated for that fiscal year for the account specified 
     in paragraph (1).
       ``(n) Authorization of Appropriations.--There is authorized 
     to be appropriated to the Secretary, for each of fiscal years 
     2024 through 2026, $50,000,000 to carry out this section.
       ``(o) Definitions.--In this section:
       ``(1) The terms `caregiver' and `family caregiver' have the 
     meanings given those terms in section 1720G of this title.
       ``(2) The term `family caregiver program' means the program 
     of comprehensive assistance for family caregivers under 
     section 1720G of this title.
       ``(3) The term `Veterans Crisis Line' means the toll-free 
     hotline for veterans established under section 1720F of this 
     title.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such subchapter is amended by adding at the end 
     the following new item:

``1720K. Grants to provide mental health support to family caregivers 
              of veterans.''.

     SEC. 3. CONTRIBUTIONS TO LOCAL AUTHORITIES TO MITIGATE THE 
                   RISK OF FLOODING ON LOCAL PROPERTY ADJACENT TO 
                   MEDICAL FACILITIES OF THE DEPARTMENT OF 
                   VETERANS AFFAIRS.

       (a) In General.--Section 8108 of title 38, United States 
     Code, is amended by inserting ``, or to mitigate the risk of 
     flooding, including the risk of flooding associated with 
     rising sea levels'' before the period at the end.
       (b) Report.--Not later than two years after the date of the 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall submit to the Committees on Veterans' Affairs of the 
     House of Representatives and the Senate a report that 
     includes an assessment of--
       (1) the extent to which each medical facility (as such term 
     is defined in section 8101(3) of title 38, United States 
     Code) is at risk of flooding, including the risk of flooding 
     associated with rising sea levels; and
       (2) whether additional resources are necessary to address 
     the risk of flooding at each such facility.
       (c) Authorization of Appropriations.--There is authorized 
     to be appropriated for the Department of Veterans Affairs for 
     each of fiscals year 2024 through 2028 $25,000,000 to carry 
     out the amendment made by subsection (a).

     SEC. 4. GAO REPORT ON MENTAL HEALTH SUPPORT FOR CAREGIVERS.

       (a) Report Required.--Not later than one year after the 
     date of the enactment of this Act, the Comptroller General of 
     the United States

[[Page H6104]]

     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 provision of mental health 
     support to caregivers of veterans.
       (b) Contents.--The report submitted under subsection (a) 
     shall include the following:
       (1) An assessment of the need for mental health support 
     among caregivers participating in the caregiver programs.
       (2) An assessment of options for mental health support in 
     facilities of the Department of Veterans Affairs and in the 
     community for caregivers participating in the caregiver 
     programs.
       (3) An assessment of the availability and accessibility of 
     mental health support in facilities of the Department and in 
     the community for caregivers participating in the caregiver 
     programs.
       (4) An assessment of the awareness among caregivers of the 
     availability of mental health support in facilities of the 
     Department and in the community for caregivers participating 
     in the caregiver programs.
       (5) An assessment of barriers to mental health support in 
     facilities of the Department and in the community for 
     caregivers participating in the caregiver programs.
       (c) Definitions.--In this section:
       (1) The term ``caregiver'' has the meaning given that term 
     in section 1720G of title 38, United States Code.
       (2) The term ``caregiver programs'' means--
       (A) the program of comprehensive assistance for family 
     caregivers under subsection (a) of section 1720G of title 38, 
     United States Code; and
       (B) the program of support services for caregivers under 
     subsection (b) of such section.

     SEC. 5. ANNUAL REVIEW OF SECURITY AT COVERED FACILITIES OF 
                   THE DEPARTMENT OF VETERANS AFFAIRS.

       (a) Annual Survey.--Not later than one year after the date 
     of the enactment of this Act, and annually thereafter for 
     each of the following five years, the Secretary of Veterans 
     Affairs, in coordination with the Director of the Office of 
     Security and Law Enforcement of the Department of Veterans 
     Affairs, shall conduct an annual survey of covered employees 
     to collect information regarding security at each covered 
     facility. Each annual survey shall include questions about--
       (1) the type and frequency of criminal activity experienced 
     at the covered facility during the 12 months prior to the 
     date the covered employee completes the survey;
       (2) the number of vacant positions for Department police 
     officers at the covered facility and the number of days each 
     vacant position has been vacant;
       (3) the availability and adequacy of covered equipment;
       (4) the availability and adequacy of resources, classes, or 
     other time set aside for training Department police officers 
     who work at each covered facility about any skill or tactic 
     related to law enforcement, including the proper use of 
     force, firearms qualifications and training, procedures for 
     responding to an active threat, and any other training 
     required for Department police officers;
       (5) any security weakness;
       (6) an analysis of the relationship between the covered 
     facility (including the Department police officers who work 
     at the covered facility) and local law enforcement agencies;
       (7) efforts by the personnel of the covered facility to 
     address and reduce criminal activity at, or in close 
     proximity to, the covered facility; and
       (8) recommendations for the Secretary to better address and 
     reduce criminal activity at, or in close proximity to, 
     covered facilities.
       (b) Report.--Not later than one year after the date of the 
     enactment of this Act, and annually thereafter for each of 
     the following five years, the Secretary shall submit to each 
     of the Committees on Veterans' Affairs of the Senate and the 
     House of Representatives an annual report regarding security 
     at covered facilities that includes--
       (1) the results of the annual survey described under 
     subsection (a) for the year covered by the report;
       (2) an analysis, made in coordination with the Director of 
     the Office of Security and Law Enforcement of such Department 
     and each director and police chief of a Veterans Integrated 
     Service Network, of the results of the annual survey 
     described under subsection (a) for the year covered by the 
     report;
       (3) a plan of action that describes how the Secretary plans 
     to address any security weakness identified in the results of 
     the annual survey and includes clearly-stated goals with 
     measurable benchmarks for each goal and deadlines for each 
     benchmark; and
       (4) a list of each vacant position for police chief or 
     deputy police chief at each covered facility, and the number 
     of days the position has been vacant.
       (c) Definitions.--In this section:
       (1) The term ``covered equipment'' means any item issued by 
     the Secretary of Veterans Affairs to a Department police 
     officer (including batons, firearms, pepper spray, ballistic 
     vests, body-worn cameras, and radios) for use in the 
     provision of services under section 902 of title 38, United 
     States Code.
       (2) The term ``covered employee'' means any employee of the 
     Department of Veterans Affairs who is employed at a covered 
     facility as a police chief, a facility emergency management 
     leader, a facility director, or a person carrying out the 
     responsibilities of one of these positions in an acting 
     capacity.
       (3) The term ``covered facility'' means any facility of the 
     Department of Veterans Affairs where Department police 
     officers have jurisdiction.
       (4) The term ``Department police officer'' has the meaning 
     given to such term as used in section 902 of title 38, United 
     States Code.
       (5) The term ``security weakness'' means a deficiency in 
     the facilities, staffing, or covered equipment at a covered 
     facility that a covered employee of the covered facility 
     determines presents a risk to the safety of visitors or 
     staff, including an unsecured door, inoperable security 
     camera, unsecured police operations room, a lack of security 
     presence at an entrance to the covered facility, and a lack 
     of security presence in an area of the covered facility or 
     the grounds of the covered facility that the director of the 
     covered facility determines requires an increased security 
     presence.

     SEC. 6. DEPARTMENT OF VETERANS AFFAIRS HOUSING LOAN FEES.

       The loan fee table in section 3729(b)(2) of title 38, 
     United States Code, is amended by striking ``November 14, 
     2031'' each place it appears and inserting ``March 12, 
     2032''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Michigan (Mr. Bergman) and the gentleman from California (Mr. Takano) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Michigan.


                             General Leave

  Mr. BERGMAN. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
on H.R. 3581, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Michigan?
  There was no objection.
  Mr. BERGMAN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 3581, as amended, the 
Caregiver Outreach and Program Enhancement Act, or COPE Act.
  Representative Kiggans' COPE Act would allow for grant awards 
expanding access to mental health counseling, treatment, or support to 
caregivers of veterans participating in the Program of Comprehensive 
Assistance for Family Caregivers.
  VA's caregiver program provides caregivers of seriously ill or 
injured veterans with resources and services to help them with the 
important role they play in their veterans' lives.
  Becoming a veteran caregiver is a noble undertaking and caregivers 
often put their entire lives aside in pursuit of caring for their loved 
ones. Mental health support is an important component of the caregiver 
program, but too often caregivers are reluctant to seek care at VA.
  Whether it is because of stigma, not wanting to take provider 
resources away from veteran care, or the fear that seeking mental 
health care may in some way jeopardize their standing as a caregiver, 
caregivers should have access to every option without barriers.
  The 3-year pilot program the COPE Act would create would expand 
caregiver mental health access to outside of VA. Ensuring caregiver 
wellness is critical to ensuring the highest quality of care for the 
veterans caregivers serve.
  This new pilot program is an important next step in continuing to 
meet caregiver needs. Representative Kiggans' bill would also allow VA 
to assist local and State authorities with funding help for the 
mitigation of flood risk on non-VA property that may be adjacent to VA 
facilities. Many VA medical facilities are at least 60 years old. Some 
of these facilities have, over the years and due to locations in low-
lying areas, been subject to flooding that impact veteran and staff 
access or even threatens building function.
  Flood preparedness is a prudent focus for all VA facilities that are 
historically at risk of flooding from storms or from water 
encroachment. It is important that VA has the means to work with local 
authorities on issues that impact the operation of its facilities.
  Finally, this bill would require a review and report to Congress on 
the security environment at VA facilities. We know that crime has been 
increasing at VA campuses, and while VA claims it has reworked its 
policing structure and hired a record number of officers, our committee 
lacks the data needed for proper oversight.
  Veterans and the staff that support them need to be confident that 
the facilities they use are safe places to receive care and seek 
benefits.
  This review will go a long way toward identifying ways to enhance 
safety and improve security within the Veterans Administration 
buildings and campuses.
  I thank Representatives Kiggans and Mace, both members of the 
committee,

[[Page H6105]]

for their work on the various elements of this bill and for their 
unwavering commitment to the veterans we serve.
  Additionally, to maintain our commitment to fiscal responsibility, we 
have identified an offset and fully funded this bill to ensure the best 
possible outcome for our veterans.
  Mr. Speaker, I urge all my colleagues to support H.R. 3581, as 
amended, and I reserve the balance of my time.
  Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H.R. 3581, as amended, the 
Caregiver Outreach and Program Enhancement Act, or COPE Act.
  This legislation, as amended, incorporates three Republican-sponsored 
bills, which were marked up at the subcommittee and full committee 
level over the summer.
  First, H.R. 3581 would create a 3-year, $50 million per year grant 
program to award grants to entities that will provide mental health 
counseling, treatment, or support to caregivers participating in VA's 
family caregiver program.
  The VA would also be required to provide outreach to caregivers to 
inform them of available mental health support offered by grantees. The 
legislation also requires the Government Accountability Office to 
conduct a study to assess the availability and accessibility of mental 
health support for veterans' caregivers.
  Additionally, H.R. 3581, as amended, will authorize VA to contribute 
to local authorities to mitigate the risk of flooding on local property 
adjacent to VA medical facilities. It would also authorize up to $125 
million over 5 years for VA to carry out flood mitigation improvements.
  Currently, the statute only allows VA to contribute to local 
authorities for improvements needed for safe ingress or egress; 
however, veterans' access to healthcare is frequently disrupted in 
areas that experience frequent flooding, and VA's ability to partner 
with local authorities on flood mitigation projects has been limited.
  This legislation would also require VA to submit to Congress a report 
assessing the extent to which each of its medical facilities is at risk 
of flooding, including flooding associated with rising sea levels.
  Finally, H.R. 3581, as amended, will establish a 5-year survey 
program to examine security and criminal activity at VA facilities, 
staffing of VA's police departments, and the availability and adequacy 
of VA police equipment and training.

  After surveying all facilities, VA will be required to submit annual 
reports to Congress summarizing the survey results and providing action 
plans for addressing any identified weaknesses.
  While I support the policy ideas in H.R. 3581, as amended, I know our 
colleagues in the Senate would like to make some changes to this 
legislation before it can be enacted. Just last Friday, House committee 
staff met with their Senate counterparts to discuss changes to the VA 
security reporting provisions.
  Senate staff also have proposed broadening the report on VA medical 
facility flooding risks such that VA would be required to assess all of 
its mission-critical assets, including medical facilities, cemeteries, 
and regional offices, and their vulnerabilities to flooding, wildfire, 
tornadoes, hurricanes, and other disasters.
  Therefore, similar to the other veterans bills we are considering on 
the floor today, we already know this legislation simply cannot be 
taken up and passed in the Senate, and future House action will be 
needed.
  It would have been preferable if the majority had resolved these 
differences before bringing this bill to the floor. Nevertheless, I 
will support H.R. 3581, as amended, and encourage my colleagues to join 
me in passing it.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BERGMAN. Mr. Speaker, I yield 3 minutes to the gentlewoman from 
Virginia (Mrs. Kiggans), an esteemed colleague, distinguished naval 
officer, and nurse practitioner.
  Mrs. KIGGANS of Virginia. Mr. Speaker, I rise today in strong support 
of my Caregiver Outreach and Program Enhancement Act. Known as the COPE 
Act, this bill takes an important step toward providing mental health 
resources to those who care for our Nation's veterans. Specifically, 
this legislation would authorize the VA to provide grants to 
organizations that support family caregivers' mental health.
  Caregivers play a critical role in the lives of older Americans, 
especially our veterans. As the only geriatric nurse practitioner in 
Congress, I have seen firsthand the positive impact caregivers have in 
the lives of the people they care for.
  When I was practicing in clinic settings, I had countless 
conversations with the people who cared for my patients. I know that 
this genuinely rewarding role comes with immense emotional challenges, 
as well. These dedicated individuals frequently put aside their own 
needs to care for their loved ones and desperately need to have the 
resources at their disposal to effectively handle the stress of taking 
on such a role.
  By ensuring veteran caregivers can properly take care of their mental 
health, the COPE Act will improve the lives of our Nation's heroes and 
solidify the support system they need to age with dignity. The VA 
offers so many great benefits and programs, unfortunately navigating 
the wide range of these benefits and programs is so complicated that 
many are unaware that they might qualify for them or that these 
services even exist at all.
  My legislation also seeks to fix this problem by requiring the VA to 
reach out to eligible veteran caregivers and make them aware of the 
mental health benefits available to them.
  I am very proud that another bipartisan bill of mine, the VA Medical 
Center Security Reporting Act, is included in this version of the COPE 
Act that is being considered today.
  From 2018 to 2021, violent crimes at VA medical center campuses more 
than doubled from 3,141 to 6,505.
  There is a significant lack of important statistics and information 
relevant to crime and safety on VA campuses, including the vacancy rate 
for VA police departments, availability of issued equipment, and 
recommendations to address and reduce criminal activity at medical 
centers.
  By ensuring these statistics are properly reported, my legislation 
will equip us with the information we need to address the increasing 
crime at VA medical centers, support our law enforcement officers, and 
provide veterans with a safe environment to receive the quality 
healthcare they have earned and deserve.
  Mr. Speaker, I am the granddaughter of a veteran, the daughter of a 
veteran, the wife of a veteran, and the mother of future veterans, and 
I served 10 years myself in the Navy as a helicopter pilot. I am also 
blessed to represent one of the largest veteran populations in the 
country in Hampton Roads, Virginia.
  Improving the lives of our Nation's heroes is and always will be one 
of my top priorities in Congress, and this bill helps to do just that.
  In closing, I thank Chairman Bost for moving this legislation through 
the Veterans' Affairs Committee as well as my colleagues on the other 
side of the aisle, Representative Chrissy Houlahan and Chris Pappas, 
who joined me in introducing these important bills.
  I am confident that with the passage of this legislation, we as a 
country will move closer to fulfilling our promise to provide for 
America's veteran population and those who care for them.
  Mr. Speaker, I urge my colleagues to support the COPE Act.
  Mr. TAKANO. Mr. Speaker, again, I ask all my colleagues to join me in 
passing H.R. 3581, as amended, and I yield back the balance of my time.
  Mr. BERGMAN. Mr. Speaker, once again, I encourage all Members to 
support this legislation, and I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Michigan (Mr. Bergman) that the House suspend the rules 
and pass the bill, H.R. 3581, 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.

[[Page H6106]]

  

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