CARE Act of 2023

II 118TH CONGRESS 1ST SESSION S. 1792 To amend title 38, United States Code, to modify the program of comprehen- sive assistance for family caregivers of veterans, and for other purposes. IN THE SENATE OF THE UNITED STATES JUNE 1, 2023 Mr. TESTER (for himself, Mr. BRAUN, Mr. CORNYN, Ms. BALDWIN, Ms. ROSEN, Mr. PETERS, and Mr. HOEVEN) introduced the following bill; which was read twice and referred to the Committee on Veterans’ Affairs A BILL To amend title 38, United States Code, to modify the pro- gram of comprehensive assistance for family caregivers of veterans, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Veteran Caregiver Ap- 4 plication and Appeals Reform Act of 2023’’ or the ‘‘CARE 5 Act of 2023’’. 6 VerDate Sep 11 2014 00:59 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1792.IS S1792 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1792 IS SEC. 2. MODIFICATION OF PROGRAM OF COMPREHENSIVE 1 ASSISTANCE FOR FAMILY CAREGIVERS OF 2 VETERANS. 3 (a) IN GENERAL.—Subsection (a) of section 1720G 4 of title 38, United States Code, is amended— 5 (1) in paragraph (5), in the matter preceding 6 subparagraph (A), by inserting ‘‘and relevant med- 7 ical specialists’’ after ‘‘primary care team’’; 8 (2) in paragraph (12)— 9 (A) in subparagraph (A), by inserting ‘‘, 10 which shall include all criteria used to deter- 11 mine eligibility for such assistance and, in the 12 case of a completed evaluation, how those cri- 13 teria were used to evaluate information pro- 14 vided in assessments to determine such eligi- 15 bility’’ before the period at the end; and 16 (B) in subparagraph (C)(i), by inserting 17 ‘‘or who is being reassessed for eligibility to 18 continue in such program’’ after ‘‘paragraph 19 (1)’’; and 20 (3) by adding at the end the following new 21 paragraph: 22 ‘‘(14)(A) Not less frequently than annually, the Sec- 23 retary shall submit to the Committee on Veterans’ Affairs 24 of the Senate and the Committee on Veterans’ Affairs of 25 the House of Representatives a comprehensive report on 26 VerDate Sep 11 2014 00:59 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1792.IS S1792 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1792 IS the program required by paragraph (1) that includes the 1 following: 2 ‘‘(i) The number of applications received for 3 such program during the one-year period preceding 4 the report. 5 ‘‘(ii) The number of approvals of such applica- 6 tions during such period, disaggregated by race, gen- 7 der, era of service, and branch of service. 8 ‘‘(iii) The number of denials of such applica- 9 tions during such period, disaggregated by race, gen- 10 der, era of service, and branch of service. 11 ‘‘(iv) The number of reassessments conducted 12 for such program during such period. 13 ‘‘(v) An identification of each decision made 14 with respect to a reassessment conducted for such 15 program during such period, disaggregated by deci- 16 sions resulting in— 17 ‘‘(I) disenrollment, including removal, dis- 18 charge, or voluntary withdrawal; 19 ‘‘(II) tier reduction; and 20 ‘‘(III) continuation at current tier. 21 ‘‘(vi) The number of appeals of decisions made 22 with respect to such program during such period, 23 disaggregated by type of appeal. 24 VerDate Sep 11 2014 00:59 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1792.IS S1792 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1792 IS ‘‘(vii) With respect to each appeal identified 1 under clause (vi), the decision rendered, if any. 2 ‘‘(viii) A description of all tools used in assess- 3 ments conducted for such program, including an ex- 4 planation of how and by whom those tools are ad- 5 ministered. 6 ‘‘(ix) A description of procedures used under 7 such program for reviewing and integrating clinical 8 records from health care providers and an expla- 9 nation of how those records are used in eligibility de- 10 terminations for such program. 11 ‘‘(x) A description of procedures available under 12 such program for health care providers, including 13 providers in the private sector and providers under 14 the Veterans Community Care Program under sec- 15 tion 1703 of this title, to communicate medical opin- 16 ions to the assessment teams determining eligibility 17 for such program. 18 ‘‘(xi) A description of information technology 19 systems and processes used under such program to 20 upload and integrate all clinical records from all 21 non-Department providers, including providers in 22 the private sector and providers under the Veterans 23 Community Care Program. 24 VerDate Sep 11 2014 00:59 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1792.IS S1792 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1792 IS ‘‘(B) Each report required by subparagraph (A) 1 shall— 2 ‘‘(i) ensure that all data included in the re- 3 port— 4 ‘‘(I) relating to a decision made under the 5 program required by paragraph (1), are 6 disaggregated by the specific reason for the de- 7 cision; and 8 ‘‘(II) with respect to a veteran, include 9 comprehensive demographic information of the 10 veteran, including the time period of the inju- 11 ries, if any, of the veteran and the Veterans In- 12 tegrated Service Network in which the veteran 13 is located; and 14 ‘‘(ii) with respect to eligibility determinations 15 made during the period covered by the report relat- 16 ing to a serious injury of a veteran, specify— 17 ‘‘(I) how many such determinations relate 18 to the ability of the veteran to perform activi- 19 ties of daily living; and 20 ‘‘(II) how many such determinations relate 21 to the need of a veteran for supervision and 22 protection.’’. 23 (b) RULE OF CONSTRUCTION.—Subsection (c) of 24 such section is amended— 25 VerDate Sep 11 2014 00:59 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1792.IS S1792 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1792 IS (1) by striking ‘‘(1) A decision’’ and all that 1 follows through ‘‘(2) Nothing in this section’’ and in- 2 serting ‘‘Nothing in this section’’; and 3 (2) by redesignating subparagraphs (A) and 4 (B) as paragraphs (1) and (2), respectively. 5 SEC. 3. RECOGNITION OF ORGANIZATIONS AND INDIVID- 6 UALS TO ASSIST VETERANS, FAMILY MEM- 7 BERS, AND CAREGIVERS NAVIGATING PRO- 8 GRAMS AND SERVICES OF VETERANS 9 HEALTH ADMINISTRATION. 10 (a) IN GENERAL.—Not later than one year after the 11 date of the enactment of this Act, the Secretary of Vet- 12 erans Affairs shall establish a process through which the 13 Department of Veterans Affairs may recognize organiza- 14 tions and individuals to assist a veteran, a family member 15 of a veteran, or a caregiver of a veteran (as defined in 16 section 1720G(d) of title 38, United States Code) in navi- 17 gating the programs and services of the Veterans Health 18 Administration. 19 (b) SOLICITATION OF FEEDBACK.—The Secretary 20 shall solicit feedback and recommendations in the creation 21 of the process under subsection (a) from such organiza- 22 tions as the Secretary may consider relevant. 23 (c) LIMITATION.—The Secretary may not recognize 24 an organization or individual pursuant to the process es- 25 VerDate Sep 11 2014 00:59 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1792.IS S1792 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1792 IS tablished under subsection (a) unless the organization or 1 individual has certified to the Secretary that no fee or 2 compensation of any nature will be charged to any indi- 3 vidual for services rendered in providing assistance pursu- 4 ant to such subsection. 5 Æ VerDate Sep 11 2014 00:59 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\S1792.IS S1792 kjohnson on DSK79L0C42PROD with BILLS