article: SECTION 1. SHORT TITLE. This Act may be cited as the ``Caregiver Assistance and Resource Enhancement Act''. SEC. 2. SUPPORT SERVICES FOR CAREGIVERS. (a) Definitions.--Section 1701 of title 38, United States Code, is amended by adding at the end the following new paragraphs: ``(10) The term `caregiver services' means noninstitutional extended care (as used in paragraph (6)). ``(11) The term `caregiver' means an individual who-- ``(A) with respect to a disabled veteran who is enrolled in the health care system established under section 1705(a) of this title, provides caregiver services to such veteran for such disability; and ``(B) is not a member of the family (including parents, spouses, children, siblings, step-family members, and extended family members) of such veteran. ``(12) The term `family caregiver' means an individual who-- ``(A) with respect to a disabled veteran who is enrolled in the health care system established under section 1705(a) of this title, provides caregiver services to such veteran for such disability; ``(B) is a member of the family (including parents, spouses, children, siblings, step-family members, and extended family members) of such veteran; and ``(C) may or may not reside with such veteran.''. (b) Support Services.-- (1) 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. 1720G. Support services for caregivers and family caregivers ``(a) Establishment of Program.--The Secretary shall develop and carry out a program for caregivers and family caregivers that includes the following: ``(1) The educational sessions, stipends, and access to support services provided under this section. ``(2) Counseling and other services provided under section 1782 of this title. ``(3) Respite care provided under section 1720B of this title. ``(4) With respect to family caregivers, medical care provided under section 1781(e) of this title. ``(5) Travel expenses provided under section 111(e) of this title. ``(b) Educational Sessions.--(1) The Secretary shall make available educational sessions for caregivers, family caregivers, and individuals described in paragraph (2). Such educational sessions shall-- ``(A) be made available both in person and on an Internet website; ``(B) incorporate available technology, including telehealth technology to the extent practicable; and ``(C) teach techniques, strategies, and skills for caring for a disabled veteran, including, at a minimum, a veteran who-- ``(i) was deployed in support of Operation Enduring Freedom or Operation Iraqi Freedom; and ``(ii) has post-traumatic stress disorder, a traumatic brain injury, or other severe injury or illness. ``(2) Individuals described in this paragraph are individuals who provide caregivers and family caregivers with support under this chapter or through an aging network (as defined in section 102(5) of the Older Americans Act of 1965 (42 U.S.C. 3002(5)), including-- ``(A) respite care providers; ``(B) nursing care providers; and ``(C) counselors. ``(c) Stipends.--(1) The Secretary shall provide monthly stipends to eligible family caregivers described in paragraph (2). ``(2) An eligible family caregiver described in this paragraph is a family caregiver who-- ``(A) provides caregiver services to a veteran who-- ``(i) was deployed in support of Operation Enduring Freedom or Operation Iraqi Freedom; and ``(ii) for purposes of this subsection, is determined by the Secretary-- ``(I) to have a service-connected disability or illness that is severe; ``(II) to be in need of caregiver services, such that without such services, the veteran would require hospitalization, nursing home care, or other residential institutional care; and ``(III) based on an examination by a physician employed by the Department (or, in areas where no such physician is available, by a physician carrying out such function under a contract or fee arrangement), to be unable to carry out the activities (including instrumental activities) of daily living; ``(B) with respect to such veteran, meets the definition of the term `family caregiver' under section 1701(12) of this title; ``(C) is designated by such veteran as the primary family caregiver for such veteran; and ``(D) is not-- ``(i) employed by a home health care agency to provide such caregiver services; or ``(ii) otherwise receiving payment for such services. ``(3) The authority of the Secretary to provide a stipend to an eligible family caregiver under this subsection shall expire on October 1, 2012. ``(d) Access to Support Services.--The Secretary shall provide caregivers and family caregivers with information concerning public, private, and non-profit agencies that offer support to caregivers. In providing such information, the Secretary shall-- ``(1) collaborate with the Assistant Secretary for Aging of the Department of Health and Human Services in order to provide caregivers and family caregivers access to aging and disability resource centers under the Administration on Aging of the Department of Health and Human Services; and ``(2) include on an Internet website that is dedicated to caregivers and family caregivers-- ``(A) a directory of services available for caregivers and family caregivers at the county level; and ``(B) tools that provide caregivers and family caregivers with the ability to interact with each other for the purpose of fostering peer support and creating support networks. ``(e) Information and Outreach.--(1) The Secretary shall conduct outreach to inform disabled veterans and the families of such veterans of the following: ``(A) Medical care, educational sessions, stipends, and other services available for caregivers and family caregivers under this chapter. ``(B) The ability of a family caregiver to be trained and certified by a home health care agency in order to be paid by such agency for providing caregiver services. ``(2) Outreach under this subsection shall include, at a minimum, the following: ``(A) Public service announcements. ``(B) Brochures and pamphlets. ``(C) Full use of Internet-based outreach methods, including such methods designed specifically for veterans and the families of such veterans who reside in rural areas. ``(3) With respect to a Department employee providing case management services (as defined in section 1720C(b)(2) of this title) to a disabled veteran, the Secretary shall ensure that such employee provides a caregiver or family caregiver of such veteran with information on the services described in subparagraphs (A) and (B) of paragraph (1).''. (2) Clerical amendment.--The table of sections at the beginning of chapter 17 of title 38, United States Code, is amended by inserting after the item related to section 1720F the following new item: ``1720G. Support services for caregivers and family caregivers.''. (c) Plan.--Not later than 180 days after the date of the enactment of this Act, the Secretary shall submit to the Committee on Veterans' Affairs of the House of Representatives and the Committee on Veterans' Affairs of the Senate a plan for carrying out section 1720G of title 38, United States Code, as added by subsection (b) of this section. (d) Reports.--Not later than 180 days after the date on which the plan is submitted under subsection (c), and annually thereafter for the following five years, the Secretary shall submit to the Committee on Veterans' Affairs of the House of Representatives and the Committee on Veterans' Affairs of the Senate a report describing the implementation of the plan. SEC. 3. COUNSELING AND MENTAL HEALTH SERVICES FOR CAREGIVERS AND FAMILY CAREGIVERS. (a) In General.--Section 1782 of title 38, United States Code, is amended-- (1) in the section heading, by adding at the end the following: ``, caregivers, and family caregivers''; and (2) in subsection (c)-- (A) in paragraph (1), by striking ``; or'' and inserting a semicolon; (B) by redesignating paragraph (2) as paragraph (3); and (C) by inserting after paragraph (1) the following new paragraph (2): ``(2) a caregiver or family caregiver of a veteran; or''. (b) Clerical Amendment.--The table of sections at the beginning of chapter 17 of title 38, United States Code, is amended by striking the item relating to section 1782 and inserting the following new item: ``1782. Counseling, training, and mental health services for immediate family members, caregivers, and family caregivers.''. SEC. 4. RESPITE CARE TO ASSIST FAMILY CAREGIVERS. Section 1720B of title 38, United States Code, is amended-- (1) in subsection (a), by striking ``title.'' and inserting ``title or who receives care from a family caregiver.''; and (2) by adding at the end the following new subsection: ``(d) In furnishing respite care services under this section, the Secretary shall ensure that such services-- ``(1) fulfill the needs of the veteran receiving care (including 24-hour in-home respite care); and ``(2) are appropriate for the veteran with respect to the age of the veteran.''. SEC. 5. MEDICAL CARE FOR FAMILY CAREGIVERS. Section 1781 of title 38, United States Code, is amended-- (1) in subsection (a)-- (A) in paragraph (2), by striking ``and'' at the end; (B) in paragraph (3), by inserting ``and'' at the end; and (C) by inserting after paragraph (3) the following new paragraph: ``(4) in accordance with subsection (e), a family caregiver,''; (2) in the third sentence of subsection (b), by striking ``dependent or survivor'' and inserting ``dependent, survivor, or family caregiver''; and (3) by adding at the end the following new subsection: ``(e)(1) The Secretary shall provide medical care to a family caregiver under this section if the Secretary determines that the family caregiver is not entitled to care or services under a health- plan contract as defined under section 1725(f)(2) of this title (determined, in the case of a health-plan contract as defined in subsection (f)(2)(B) or (f)(2)(C) of such section, without regard to any requirement or limitation relating to eligibility for care or services from any department or agency of the United States). ``(2) In this subsection, a family caregiver is an individual who-- ``(A) provides caregiver services to a veteran who-- ``(i) was deployed in support of Operation Enduring Freedom or Operation Iraqi Freedom; and ``(ii) for purposes of this subsection, is determined by the Secretary-- ``(I) to have a service-connected disability or illness that is severe; ``(II) to be in need of caregiver services, such that without such services, the veteran would require hospitalization, nursing home care, or other residential institutional care; and ``(III) based on an examination by a physician employed by the Department (or, in areas where no such physician is available, by a physician carrying out such function under a contract or fee arrangement), to be unable to carry out the activities (including instrumental activities) of daily living; ``(B) with respect to such veteran, meets the definition of the term `family caregiver' under section 1701(12) of this title; and ``(C) is designated by such veteran as the primary family caregiver for such veteran. ``(3) The authority of the Secretary to provide medical care to a family caregiver under this section shall expire on October 1, 2012.''. SEC. 6. LODGING AND SUBSISTENCE FOR FAMILY CAREGIVERS. Section 111(e) of title 38, United States Code, is amended-- (1) by striking ``When'' and inserting the following: ``(1) Except as provided in paragraph (2), when''; and (2) by adding at the end the following new paragraphs: ``(2) Without regard to whether a covered veteran entitled to mileage under this section requires an attendant in order to perform such travel, an attendant of such covered veteran may be allowed expenses of travel (including lodging and subsistence) upon the same basis as such veteran during-- ``(A) the period of time in which such veteran is traveling to and from a treatment facility; and ``(B) the duration of the treatment episode for such veteran. ``(3) The Secretary may prescribe regulations to carry out this subsection. Such regulations may include provisions-- ``(A) to limit the number of attendants that may receive expenses of travel under paragraph (2) for a single treatment episode of a covered veteran; and ``(B) to require such attendants to use certain travel services. ``(4) In this subsection, the term `covered veteran' means a veteran who-- ``(A) was deployed in support of Operation Enduring Freedom or Operation Iraqi Freedom; and ``(B) for purposes of this subsection, is determined by the Secretary-- ``(i) to have a service-connected disability or illness that is severe; ``(ii) to be in need of caregiver services, such that without such services, the veteran would require hospitalization, nursing home care, or other residential institutional care; and ``(iii) based on an examination by a physician employed by the Department (or, in areas where no such physician is available, by a physician carrying out such function under a contract or fee arrangement), to be unable to carry out the activities (including instrumental activities) of daily living.''. SEC. 7. SURVEY ON CAREGIVERS AND FAMILY CAREGIVERS. (a) In General.--Not later than 270 days after the date of the enactment of this Act, and not less than once in each three-year period thereafter, the Secretary of Veterans Affairs shall design and conduct a survey of caregivers and family caregivers. In carrying out the survey, the Secretary shall collect the following information: (1) The number of caregivers. (2) The number of family caregivers. (3) The number of veterans receiving caregiver services from caregivers and family caregivers, including the era in which each veteran served in the Armed Forces. (4) The range of caregiver services provided by caregivers and family caregivers, including-- (A) the average schedule of such services; and (B) the average amount of time a caregiver and family caregiver has spent providing such services. (5) The average age of a caregiver and family caregiver. (6) The health care coverage of caregivers and family caregivers, including the sources of such coverage. (7) The employment status of caregivers and family caregivers. (8) Incidents of significant life changes related to being a caregiver or family caregiver, including unemployment and disenrollment from a course of education. (9) The number of family caregivers trained and certified through a home health care agency. (10) Other information the Secretary considers appropriate. (b) Survey Sample.--In carrying out the survey required by subsection (a), the Secretary shall ensure that-- (1) a statistically representative sample of caregivers and family caregivers is included in the survey; and (2) such sample covers veterans in each Veterans Integrated Service Network. (c) Findings.--The Secretary shall consider the findings of the survey when carrying out programs related to caregivers and family caregivers. (d) Reports.--Not later than 180 days after the date on which each survey is completed, the Secretary shall submit to the Committee on Veterans' Affairs of the House of Representatives and the Committee on Veterans' Affairs of the Senate a report on caregivers and family caregivers. Each such report shall include-- (1) the findings of the survey required by subsection (a); (2) a summary of the services made available to caregivers and family caregivers by the Secretary; (3) the number of caregivers and family caregivers who receive such services; (4) the cost to the Department of Veterans Affairs of providing each such service; and (5) other information the Secretary considers appropriate. (e) Definitions.--In this section: (1) The term ``caregiver'' has the meaning given such term in section 1701(11) of title 38, United States Code, as added by section 2(a) of this Act. (2) The term ``family caregiver'' has the meaning given such term in section 1701(12) of title 38, United States Code, as added by section 2(a) of this Act. Passed the House of Representatives July 27, 2009. Attest: LORRAINE C. MILLER, Clerk.
summary: Caregiver Assistance and Resource Enhancement Act - (Sec. 2) Directs the Secretary of Veterans Affairs (VA) to develop and carry out a program of support services for family and non-family caregivers providing noninstitutional extended care to disabled veterans enrolled in the VA health care system. Requires such support services to include: (1) educational sessions, stipends, and access to support services; (2) counseling and related services; (3) respite care; (4) medical care for family caregivers; and (5) travel expenses in connection with the outpatient care of such veterans. Requires the Secretary to: (1) conduct outreach to inform disabled veterans and their families of services available for caregivers, as well as the ability of a caregiver to be trained and certified by a home health care agency in order to be paid for providing such services; (2) submit to the congressional veterans' committees a plan for implementation of such program; and (3) report annually thereafter for five years on plan implementation. (Sec. 3) Makes counseling and mental health services available to family and non-family caregivers of enrolled veterans. (Sec. 4) Directs the Secretary to ensure that respite care meets the needs of the veteran receiving such care, including 24-hour home respite care, and is appropriate with respect to the veteran's age. (Sec. 5) Authorizes the provision of medical care through the VA for family caregivers of eligible veterans, if the caregiver is without health insurance and ineligible for other public health insurance. Defines a "family caregiver" as an individual who provides care to a veteran who was deployed in support of Operations Iraqi Freedom or Enduring Freedom and are determined by the Secretary to: (1) have a severe service-connected disability or illness; (2) be in need of caregiver services since, without such services, the veteran would require hospitalization, nursing home care, or other residential institutional care; and (3) be unable to carry out the activities of daily living. (Sec. 6) Authorizes a lodging and subsistence allowance for family caregivers of eligible veterans described above, to cover the time in which the veteran is traveling to and from a treatment facility as well as the duration of the treatment period. (Sec. 7) Requires the Secretary to: (1) at least once every three years, design and conduct a survey of family and non-family caregivers; (2) consider survey findings when carrying out programs related to caregivers; and (3) report to the veterans' committees on survey results and services made available to caregivers.