#aaeth ,,congress  #ast ,session  ,s4   
#cbd  ,,an ,,act  ,to amend title #ch1  
,united ,states ,code1 to improve the   
provision of adult day health care      
services for veterans4  #a4 ,short title
 ,this ,act may be cited as the ,state  
,veterans ,home ,adult ,day ,health     
,care ,improvement ,act of #bjag4  #b4  
,provision of certain adult day health  
care services for veterans  7a7 ,in     
general ,section #agde of title #ch1    
,united ,states ,code1 is amended-- 7#a7
 by adding at the end the following new 
subsection3  7d7 7#a7 ,the ,secretary   
shall enter into an agreement with each 
,state home for payment by the          
,secretary for medical supervision model
 adult day health care provided to a    
veteran described in subsection 7a77#a7 
on whose behalf the ,state home is not  
in receipt of payment for nursing home  
care from the ,secretary4  7#b7 7,a7    
,payment under each agreement between   
the ,secretary and a ,state home under  
paragraph 7#a7 for each veteran who     

receives medical supervision model adult
 day health care under such agreement   
shall be made at a rate established     
through regulations prescribed by the   
,secretary to adequately reimburse the  
,state home for the care provided by the
 ,state home1 including necessary       
transportation expenses4  7,b7 ,the     
,secretary shall consult with the ,state
 homes in prescribing regulations under 
subparagraph 7,a74  7,c7 ,the rate      
established through regulations under   
subparagraph 7,a7 shall not take effect 
until the date that is #cj days after   
the date on which those regulations are 
published in the ,federal ,register4    
7#c7 ,payment by the ,secretary under   
paragraph 7#a7 to a ,state home for     
medical supervision model adult day     
health care provided to a veteran       
described in that paragraph constitutes 
payment in full to the ,state home for  
such care furnished to that veteran4    
7#d7 ,in this subsection1 the term      
medical supervision model adult day     

health care means adult day health care 
that includes the coordination of       
physician services1 dental services1    
nursing services1 the administration of 
drugs1 and such other requirements as   
determined appropriate by the           
,secretary4  2 and  7#b7 in the section 
heading1 by inserting 1 adult day health
 care1 after home care4  7b7 ,initial   
rate ,before the ,secretary of ,veterans
 ,affairs establishes a payment rate    
under subsection 7d77#b77;,a7 of section
 #agde of such title1 as added by       
subsection 7a71 the ,secretary shall pay
 to a ,state home that has entered into 
an agreement with the ,secretary for    
medical supervision model adult day     
health care 7as defined in subsection   
7d77#d7 of such section7 an amount equal
 to #fe percent of the rate the         
,secretary would pay under subsection   
7a77#b7 of such section to the ,state   
home for nursing home care provided to  
the veteran4  7c7 ,clerical amendment   
,the table of sections at the beginning 

of chapter #ag of such title is amended 
by striking the item relating to section
 #agde and inserting the following new  
item3  #agde4 ,nursing home care1 adult 
day health care1 and medications for    
veterans with service-connected         
disabilities4  4  ,passed the ,senate   
,november #i1 #bjag4,secretary