Home- and community-based services: programs

38 U.S.C. § 1720L
in effect
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(a) In General.—In furnishing noninstitutional alternatives to nursing home care pursuant to the authority of section 1720C of this title (or any other authority under this chapter or other provision of law administered by the Secretary of Veterans Affairs), the Secretary shall carry out each of the programs specified in this section in accordance with such relevant authorities except as otherwise provided in this section. (b) Veteran-Directed Care Program.—(1) The Secretary of Veterans Affairs, in collaboration with the Secretary of Health and Human Services, shall carry out a program to be known as the “Veteran-Directed Care program”. Under such program, the Secretary of Veterans Affairs may enter into agreements with the providers described in paragraph (2) to provide to eligible veterans funds, to the extent practicable, to obtain such in-home care services and related items that support clinical need and improve quality of life, as may be determined appropriate by the Secretary of Veterans Affairs and selected by the veteran, including through the veteran hiring individuals to provide such services and items or directly purchasing such services and items. (2) The providers described in this paragraph are the following:(A) An Aging and Disability Resource Center, an area agency on aging, or a State agency. (B) A center for independent living. (C) An Indian tribe or tribal organization receiving assistance under title VI of the Older Americans Act of 1965 (42 U.S.C. 3057 et seq.). (D) Any other entity that the Secretary, in consultation with the Secretary of Health and Human Services, determines appropriate. (3) In carrying out the Veteran-Directed Care program, the Secretary of Veterans Affairs shall—(A) administer such program through each medical center of the Department of Veterans Affairs; (B) seek to ensure the availability of such program in American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the Commonwealth of Puerto Rico, the Virgin Islands of the United States, and any other territory or possession of the United States, to the extent practicable; and (C) seek to ensure the availability of such program for eligible veterans who are Native American veterans receiving care and services furnished by the Indian Health Service, a tribal health program, an Urban Indian organization, or (in the case of a Native Hawaiian veteran) a Native Hawaiian health care system, to the extent practicable. (4) If a veteran participating in the Veteran-Directed Care program is hospitalized, the veteran may continue to use funds under the program during a period of hospitalization in the same manner that the veteran would be authorized to use such funds under the program if the veteran were not hospitalized. (c) Homemaker and Home Health Aide Program.—(1) The Secretary shall carry out a program to be known as the “Homemaker and Home Health Aide program” under which the Secretary may enter into agreements with home health agencies to provide to eligible veterans such home health aide services as may be determined appropriate by the Secretary. (2) In carrying out the Homemaker and Home Health Aide program, the Secretary shall—(A) administer such program in the locations specified in subparagraph (A) of subsection (b)(3); (B) seek to ensure the availability of such program in the locations specified in subparagraph (B) of subsection (b)(3); and (C) seek to ensure the availability of such program for the veteran populations specified in subparagraph (C) of subsection (b)(3). (d) Home-Based Primary Care Program.—The Secretary shall carry out a program to be known as the “Home-Based Primary Care program” under which the Secretary may furnish to eligible veterans in-home health care, the provision of which is overseen by a provider of the Department. (e) Purchased Skilled Home Care Program.—The Secretary shall carry out a program to be known as the “Purchased Skilled Home Care program” under which the Secretary may furnish to eligible veterans such in-home care services as may be determined appropriate and selected by the Secretary for the veteran. (f) Caregiver Support.—(1) With respect to a resident eligible caregiver of a veteran participating in a program under this section, the Secretary shall—(A) if the veteran meets the requirements of a covered veteran under section 1720G(b) of this title, provide to such caregiver the option of enrolling in the program of general caregiver support services under such section; (B) provide to such caregiver covered respite care of not less than 30 days annually; and (C) conduct on an annual basis (and, to the extent practicable, in connection with in-person services provided under the program in which the veteran is participating), a wellness contact of such caregiver. (2) Covered respite care provided to a resident eligible caregiver of a veteran under paragraph (1) may exceed 30 days annually if such extension is requested by the resident eligible caregiver or veteran and determined medically appropriate by the Secretary. (g) Rule of Construction.—Nothing in this section shall be construed to limit the authority of the Secretary to carry out programs providing home- and community-based services under any other provision of law. (h) Definitions.—In this section:(1) The terms “Aging and Disability Resource Center”, “area agency on aging”, and “State agency” have the meanings given those terms in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002). (2) The terms “caregiver” and “family caregiver”, with respect to a veteran, have the meanings given those terms, respectively, under subsection (e) 11 So in original. Probably should be “subsection (d)”. of section 1720G of this title with respect to an eligible veteran under subsection (a) of such section or a covered veteran under subsection (b) of such section, as the case may be. (3) The term “center for independent living” has the meaning given that term in section 702 of the Rehabilitation Act of 1973 (29 U.S.C. 796a). (4) The term “covered respite care” has the meaning given such term in section 1720G(d) of this title. (5) The term “eligible veteran” means any veteran—(A) for whom the Secretary determines participation in a specific program under this section is medically necessary to promote, preserve, or restore the health of the veteran; and (B) who absent such participation would be at increased risk for hospitalization, placement in a nursing home, or emergency room care. (6) The term “home health aide” means an individual employed by a home health agency to provide in-home care services. (7) The term “in-home care service” means any service, including a personal care service, provided to enable the recipient of such service to live at home. (8) The terms “Indian tribe” and “tribal organization” have the meanings given those terms in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304). (9) The terms “Native American” and “Native American veteran” have the meanings given those terms in section 3765 of this title. (10) The terms “Native Hawaiian” and “Native Hawaiian health care system” have the meanings given those terms in section 12 of the Native Hawaiian Health Care Improvement Act (42 U.S.C. 11711). (11) The terms “tribal health programs” and “Urban Indian organizations” have the meanings given those terms in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603). (12) The term “resident eligible caregiver” means an individual who—(A) is a caregiver, or a family caregiver, of a veteran and resides with that veteran; and (B) has not entered into a contract, agreement, or other arrangement for such individual to act as a caregiver for that veteran unless such individual is a family member of the veteran or is furnishing caregiver services through a medical foster home.

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