Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act
What changed between versions
The bill's scope expanded dramatically from a 9-section act focused on home and community-based services to a multi-title omnibus with over 50 sections covering Veterans Community Care Program operations, quality of care standards, educational assistance, employment, home loans, disability benefits, homelessness, and oversight.
New Title II (Economic Opportunity Matters) adds provisions for temporary expansion of the Marine Gunnery Sergeant John David Fry Scholarship, removal of expiration on surviving spouse entitlement, full monthly housing stipend for veterans in their final semester under Post-9/11 GI Bill, and improvements to Native American direct housing loans.
New Title IV (Homelessness Matters) adds per diem payments for services furnished to homeless veterans and authorization for improved flexibility in assistance to homeless veterans, including access to telehealth services.
The expenditure cap for noninstitutional care alternatives to nursing home care was increased from 65 percent to 100 percent of the cost that would otherwise have been incurred in a nursing home setting.
New authority (Section 122) allows the Secretary of Veterans Affairs to award grants or contracts to entities to provide mental health counseling, treatment, or support to family caregivers of veterans, with priorities for areas with high suicide rates and high crisis line referrals.
A new exception allows total costs to exceed 100 percent of the nursing home benchmark for veterans with amyotrophic lateral sclerosis, spinal cord injury, or conditions the Secretary determines to be similar, based on clinical need and geographic market factors.
The PACE coordination requirement was weakened from 'shall establish a partnership' to 'shall seek to enter into an agreement' with PACE programs in areas where services are available.
New Section 101 requires that during a two-year pilot period, the determination of eligibility for care under the Veterans Community Care Program be made by the veteran and the veteran's referring clinician, making such determinations final.
New Section 104 requires the Secretary to contract with a non-Department entity to audit the quality of care from the Department, including through non-Department providers, with findings reported to Congress within 60 days of completion.
New Section 107 establishes a working group on value-based care that must develop a strategic plan within one year of enactment, followed by a three-year pilot program in four geographically dispersed Veterans Integrated Service Networks.
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