,,ii  #aagth ,,congress  #ast ,session  
,s4 #bheb  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,september #bg1
 #bjba,ms4 ,sinema 7for herself and     
,mrs4 ,blackburn7 introduced the        
following bill2 which was read twice and
 referred to the ,committee on          
,veterans' ,affairs  ,a ,,bill  ,to     
amend title #ch1 ,united ,states ,code1 
to authorize the ,secretary of ,veterans
 ,affairs to enter into contracts and   
agreements for the payment of care in   
non-,department of ,veterans ,affairs   
medical foster homes for certain        
veterans who are unable to live         
independently1 and for other purposes4  
#a4 ,short title ,this ,act may be cited
 as the ,long-,term ,care ,veterans     
,choice ,act4  #b4 ,secretary of        
,veterans ,affairs contract authority   
for payment of care for veterans in     
non-,department of ,veterans ,affairs   
medical foster homes  7a7 ,authority    
7#a7 ,in general ,section #agbj of title
 #ch1 ,united ,states ,code1 is amended 

by adding at the end the following new  
subsection3  7h7 7#a7 ,during the       
five-year period beginning on the date  
of the enactment of the ,long-,term     
,care ,veterans ,choice ,act1 and       
subject to paragraph 7#c7-- 7,a7 at the 
request of a veteran for whom the       
,secretary is required to provide       
nursing home care under section #agaj;,a
 of this title1 the ,secretary may place
 the veteran in a medical foster home   
that meets ,department standards1 at the
 expense of the ,united ,states1        
pursuant to a contract1 agreement1 or   
other arrangement entered into between  
the ,secretary and the medical foster   
home for such purpose2 and  7,b7 the    
,secretary may pay for care of a veteran
 placed in a medical foster home before 
such date of enactment1 if the home     
meets ,department standards1 pursuant to
 a contract1 agreement1 or other        
arrangement entered into between the    
,secretary and the medical foster home  
for such purpose4  7#b7 ,a veteran on   

whose behalf the ,secretary pays for    
care in a medical foster home under     
paragraph 7#a7 shall agree1 as a        
condition of such payment1 to accept    
home health services furnished by the   
,secretary under section #agag of this  
title4  7#c7 ,in any year1 not more than
 a daily average of #ijj veterans       
receiving care in a medical foster home1
 whether placed before1 on1 or after the
 date of the enactment of the           
,long-,term ,care ,veterans ,choice     
,act1 may have their care covered at the
 expense of the ,united ,states under   
paragraph 7#a74  7#d7 ,the prohibition  
under section #agcj7;b77#c7 of this     
title shall not apply to a veteran whose
 care is covered at the expense of the  
,united ,states under paragraph 7#a74   
7#e7 ,in this subsection1 the term      
medical foster home means a home        
designed to provide non-institutional1  
long-term1 supportive care for veterans 
who are unable to live independently and
 prefer a family setting4  4  7#b7      

,effective date ,subsection 7h7 of      
section #agbj of title #ch1 ,united     
,states ,code1 as added by paragraph    
7#a71 shall take effect #ij days after  
the date of the enactment of this ,act4 
7b7 ,ongoing monitoring of medical      
foster home program  7#a7 ,in general   
,the ,secretary of ,veterans ,affairs   
shall create a system to monitor and    
assess the workload for the ,department 
of ,veterans ,affairs in carrying out   
the authority under section #agbj7;h7 of
 title #ch1 ,united ,states ,code1 as   
added by subsection 7a77#a71 including  
by tracking-- 7,a7 requests by veterans 
to be placed in a medical foster home   
under such section2  7,b7 denials of    
such requests1 including the reasons for
 such denials2  7,c7 the total number of
 medical foster homes applying to       
participate under such section1         
disaggregated by those approved and     
those denied approval by the ,department
 to participate2  7,d7 veterans         
receiving care at a medical foster home 

at the expense of the ,united ,states2  
and  7,e7 veterans receiving care at a  
medical foster home at their own        
expense4  7#b7 ,report ,based on the    
monitoring and assessments conducted    
under paragraph 7#a71 the ,secretary    
shall identify and submit to ,congress a
 report on such modifications to        
implementing section #agbj7;h7 of title 
#ch1 ,united ,states ,code1 as added by 
subsection 7a77#a71 as the ,secretary   
considers necessary to ensure the       
authority under such section is         
functioning as intended and care is     
provided to veterans under such section 
as intended4  7#c7 ,medical foster home 
defined ,in this subsection1 the term   
medical foster home has the meaning     
given that term in section #agbj7;h7 of 
title #ch1 ,united ,states ,code1 as    
added by subsection 7a77#a74  7c7       
,comptroller ,general report ,not later 
than each of three years and six years  
after the date of the enactment of this 
,act1 the ,comptroller ,general of the  

,united ,states shall submit to         
,congress a report-- 7#a7 assessing the 
implementation of this section and the  
amendments made by this section2  7#b7  
assessing the impact of the monitoring  
and modifications under subsection 7b7  
on care provided under section #agbj7;h7
 of title #ch1 ,united ,states ,code1 as
 added by subsection 7a77#a72 and  7#c7 
setting forth recommendations for       
improvements to the implementation of   
such section1 as the ,comptroller       
,general considers appropriate4