Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act

What S. 141 does, in plain terms

Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act This act addresses various programs, benefits, and services provided by the Department of Veterans Affairs (VA), including those related to health care, educational assistance, home loans, homelessness, and disability and memorial affairs. TITLE I--HEALTH CARE MATTERS Subtitle A--Veterans Community Care Program Matters (Sec. 101) This section requires that for a two-year period the VA must provide care under the Veterans Community Care Program (VCCP) when the veteran and the referring clinician determine it is in the best medical interest of the veteran. The veteran and the clinician may correct any errors made with respect to a determination of eligibility for VCCP care. (Sec. 102) This section requires the VA to conduct outreach to inform veterans about care and services available under the VCCP. The Government Accountability Office (GAO) must report to Congress on the efforts of the VA to ensure that veterans are informed about eligibility for VCCP care and services. (Sec. 103) This section requires the VA to annually review and report to Congress on waivers of payment rates for Third Party Administrators (i.e., entities that manage provider networks and perform administrative services related to such networks) to identify whether the waivers help alleviate community-specific challenges. (Sec. 104) This section requires the VA to periodically update standards of quality of care utilizing the most up-to-date practices and all relevant data. (Sec. 105) This section requires the VA to implement a pilot program to seek to develop and implement a plan for the improvement of the administration of care under the VCCP. (Sec. 106) This section requires the VA to implement a pilot program to hire (1) general dentists at VA medical facilities to manage approval of treatment plans requested by dental providers in providing care under the VCCP, and (2) dental specialists at Veterans Integrated Service Networks (VISNs) to manage approval of treatment plans for specialty dental care requested by dental providers in providing dental care under the VCCP. (Sec. 107) This section requires the VA to (1) establish a working group on value-based care, and (2) submit a strategic plan developed by the group to Congress. Following the submission of the plan, the VA must commence a three-year pilot program to implement the plan relating to the delivery, by the Veterans Health Administration (VHA), of primary care, inpatient and outpatient mental health treatment, inpatient and outpatient substance abuse treatment, spinal cord injury disorder care, and polytrauma care. (Sec. 108) This section requires the VA to create and implement a plan to adopt national health information interoperability standards for the VA and VCCP providers with respect to the coordination of care and benefits, patient identity matching, measurement and reporting of quality, population health, and public health. Additionally, the VA must submit to Congress a plan to provide a capability to facilitate the electronic direct exchange of veterans’ health records and related documents to VCCP providers at no cost. (Sec. 109) This section requires the VA to report on efforts to incorporate value-based reimbursement models under the VCCP and related recommendations for legislative or administrative action. (Sec. 110) The Office of Inspector General (OIG) of the VA must periodically assess the VA’s performance in (1) appropriately identifying veterans eligible for care and services under the VCCP, (2) informing veterans of their eligibility for such care and services, and (3) delivering such care and services in a timely manner. The OIG must brief Congress on such assessments. (Sec. 111) The GAO must report to Congress on the dental care furnished by the VA under the VCCP, including the impact of reimbursement rates and dental provider satisfaction. Subtitle B--Matters Relating to Nursing Home and Other Long Term Care and Family Caregivers (Sec. 120) Under this section, the cost of providing noninstitutional alternatives to nursing home care generally may not exceed 100% of the cost that would have been incurred if a veteran had been furnished VA nursing home care. (Under existing law, these expenditures are limited to 65% of the cost.) However, for certain veterans, the VA may exceed 100% of the cost if it determines the higher cost is in the best interest of such veterans (i.e., veterans with amyotrophic lateral sclerosis, a spinal cord injury, or a condition the Secretary determines to be similar to such conditions). (Sec. 121) The VA must seek to enter into an agreement with the Program of All-Inclusive Care for the Elderly (PACE) in certain areas to furnish noninstitutional alternatives to nursing home care. (Sec. 122) This section authorizes the VA to award grants or contracts to carry out, coordinate, improve, or otherwise enhance mental health counseling, treatment, or support to the family caregivers of veterans who are participating in the Program of Comprehensive Assistance for Family Caregivers (PCAFC). (Sec. 123) This section provides statutory authority for various VA programs (e.g., the Veteran Directed Care program) to expand access to home- and community-based services. (Sec. 124) For veterans or family caregivers who are denied support or discharged from the PCAFC, the VA must assess the veteran or caregiver for support from another program. This section requires that a caregiver support coordinator provide for a personalized transition to an appropriate program for individuals discharged from the PCAFC. (Sec. 125) Under existing law, the VA must provide notifications regarding decisions affecting the furnishing of assistance to individuals who submit applications for the PCAFC and their family caregivers. This section requires the VA to provide such notifications to individuals who are being reassessed for eligibility to continue in the program. (Sec. 126) The VA must implement a three-year pilot program to provide homemaker and home health aide services to veterans who reside in communities with a shortage of home health aides. Additionally, the VA must issue updated guidance for the Homemaker and Home Health Aide program that includes specified elements, including a process for transitioning veterans from the Homemaker and Home Health Aide program to other programs. (Sec. 127) This section requires the VA to implement a pilot program to assess the effectiveness of providing assisted living services to veterans who meet certain requirements and elect to participate. The VA OIG must report on the program. (Sec. 128) This section authorizes the VA to provide state homes with medicine, personal protective equipment, medical supplies, and other assistance available to the VA. A state home is a home established by a state or tribe for veterans who are disabled by age, disease, or otherwise and are incapable of earning a living because of such disability. The term also includes a home that furnishes nursing home care for veterans. (Sec. 129) This section requires the VA to establish a process though which it may recognize organizations and individuals to assist a veteran, a veteran’s family member, or a veteran’s caregiver in navigating the programs and services of the VHA. (Sec. 130) The VHA must review programs administered through the Office of Geriatric and Extended Care and the Caregiver Support Program Office to ensure, among other elements, consistency in program management. This section also requires the VA to review incentives and efforts relating to the provision of home- and community-based services. Further, the VA must also review the use, availability, cost, and effectiveness of its respite care services. (Sec. 131) The GAO must report to Congress on the provision of mental health support to caregivers of veterans. (Sec. 132) This section requires the VA to develop and maintain a centralized and publicly accessible website for information and resources relating to VA programs for home- and community-based services. Subtitle C--Medical Treatment and Other Matters (Sec. 140) This section requires the VA to provide Congress with a quarterly report on the amount of time between steps in the referral process for referrals for non-VA health care for each medical facility that originates such a referral. (Sec. 141) This section removes certain requirements for appointing Assistant Under Secretaries for Health within the Office of the Under Secretary for Health of the VA (e.g., the requirement that at least one appointee must be a qualified doctor of dental surgery or dental medicine). (Sec. 142) This section generally aligns the position of optometrists with that of physicians for pay and grade purposes within the VHA. Further, the section provides that the VHA may authorize awards or incentives to physicians, podiatrists, optometrists, and dentists and may waive any pay limitation it determines necessary for the recruitment or retention of critical health care personnel. The section also authorizes retroactive compensation in certain situations where compensation was deferred due to a cap on the employee’s annual compensation. (Sec. 143) This section requires the VA to pay or reimburse certain veterans that have service-connected disabilities for the cost of an ambulance from certain rural areas to a VA provider, non-VA provider, or hospital that can meet the needs of the veteran for care. Specifically, the location must be in a state that is 100 miles or more from the nearest VA medical center and be in an area rated as a 10 or higher under the rural-urban commuting areas coding system of the Department of Agriculture. (Sec. 144) This section requires the VA to implement a two-year pilot program to provide VA dental care to veterans who are (1) enrolled in the VA health care system but are not currently eligible for VA dental services and treatment, and (2) have been diagnosed with ischemic heart disease. (Sec. 145) This section requires the VA to develop a mechanism to solicit the preference of veterans enrolled in the VA health care system regarding how appointments are scheduled, including through non-VA providers. (Sec. 146) This section requires the VA to develop, validate, and implement a staffing model for the Office of Integrated Veteran Care, VISNs, and VA medical centers that includes appropriate target staffing levels nationally, regionally, and locally to ensure timely access to care and effectively oversee the provision of care by VA and non-VA providers. The GAO must assess the performance of the Office of Integrated Veteran Care in improving access to care for veterans in VA facilities and provide recommendations for improving access to care. (Sec. 147) This section requires the VA to establish a health education portal with interactive modules to ensure that veterans who are enrolled in the VA health care system understand their basic health care eligibilities and entitlements. (Sec. 148) This section requires the VA to comply with certain notification and staffing requirements when a VA medical center director is on detail. Specifically, within 90 days, the VA must notify Congress with specified information about the detail (e.g., the location of the detail). Additionally, the VA must appoint an individual as acting director not later than 120 days after detailing a director to a different position. (Sec. 149) This section requires the VA to publish reports, including an annual report, on veteran suicide prevention. Additionally, the section requires the VA to enter into one or more contracts with a private entity or entities to assess the annual report. Further, the VA must collaborate with the Centers for Disease Control and Prevention to develop a toolkit for state and local coroners and medical examiners on best practices for identifying and reporting on suicide

Official summary by the Congressional Research Service, via Congress.gov.