,i #aahth ,,congress #ast ,session ,h4 ,r4 #ahae ,,in ,,the ,,house ,,of ,,representatives ,march #bg1 #bjbc,ms4 ,slotkin 7for herself1 ,mr4 ,steil1 ,mr4 ,trone1 and ,ms4 ,kuster7 introduced the following bill2 which was referred to the ,committee on ,veterans' ,affairs ,a ,,bill ,to require the ,secretary of ,veterans ,affairs to carry out a pilot program to provide assisted living services to eligible veterans1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,expanding ,veterans' ,options for ,long ,term ,care ,act4 #b4 ,pilot program on assisted living services for veterans 7a7 ,program 7#a7 ,in general ,beginning not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall carry out a three-year pilot program to assess-- 7,a7 the effectiveness of providing assisted living services to eligible veterans1 at the election of such veterans2 and 7,b7 the satisfaction with the pilot program of veterans participating in the pilot program4 7#b7 ,extension ,the ,secretary may extend the duration of the pilot program under paragraph 7#a7 for an additional three-year period if the ,secretary1 based on the results of the reports submitted under subsection 7f71 determines that it is appropriate to do so4 7b7 ,program locations 7#a7 ,veterans ,integrated ,service ,networks 7,a7 ,in general ,the ,secretary shall select not fewer than six ,veterans ,integrated ,service ,networks of the ,department of ,veterans ,affairs at which to carry out the pilot program under subsection 7a77#a74 7,b7 ,veterans receiving nursing home care ,the ,secretary shall ensure that not fewer than three ,veterans ,integrated ,service ,networks selected under subparagraph 7,a7 serve regions with the top three highest percentage of veterans who are currently receiving nursing home care through the ,department and would be eligible to receive assisted living services under the pilot program4 7#b7 ,facilities 7,a7 ,in general ,within the ,veterans ,integrated ,service ,networks selected under paragraph 7#a71 the ,secretary shall select facilities at which to carry out the pilot program under subsection 7a77#a74 7,b7 ,selection criteria ,in selecting facilities under subparagraph 7,a71 the ,secretary shall ensure that-- 7i7 the locations of such facilities are in geographically diverse areas2 7ii7 not fewer than two such facilities serve veterans in rural or highly rural areas 7as determined through the use of the ,rural-,urban ,commuting ,areas coding system of the ,department of ,agriculture72 7iii7 not fewer than one such facility is located in each ,veterans ,integrated ,service ,network selected under paragraph 7#a72 and 7iv7 not fewer than two such facilities are ,state homes4 7c7 ,provision of assisted living services 7#a7 ,agreements ,in carrying out the pilot program under subsection 7a77#a71 the ,secretary may enter into agreements for the provision of assisted living services on behalf of eligible veterans with-- 7,a7 a provider participating under a ,state plan or waiver under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq472 or 7,b7 a ,state home recognized and certified under subpart ,b of part #ea of title #ch1 ,code of ,federal ,regulations1 or successor regulations4 7#b7 ,standards ,the ,secretary may not place1 transfer1 or admit a veteran to any facility for assisted living services under the pilot program under subsection 7a77#a7 unless the ,secretary determines that-- 7,a7 the facility meets the standards for community residential care established under sections #ag4fa through #ag4gb of title #ch1 ,code of ,federal ,regulations1 or successor regulations1 and any additional standards of care as the ,secretary may specify2 or 7,b7 in the case of a facility that is a ,state home1 the ,state home meets such standards of care as the ,secretary may specify4 7#c7 ,inspection ,the ,secretary shall inspect facilities at which veterans are placed under the pilot program under subsection 7a77#a7-- 7,a7 with respect to a facility that is a ,state home1 not less frequently than annually and in the same manner as the ,secretary conducts inspection of ,state homes under section #agdb of title #ch1 ,united ,states ,code2 and 7,b7 with respect to any other facility1 not less frequently than annually and in the same manner as the ,secretary conducts inspection of facilities under section #agcj of such title4 7#d7 ,payment to certain facilities 7,a7 ,state homes ,in the case of a facility participating in the pilot program under subsection 7a77#a7 that is a ,state home1 the ,secretary shall pay to the ,state home a per diem for each veteran participating in the pilot program at a rate agreed to by the ,secretary and the ,state home4 7,b7 ,community assisted living facilities ,in the case of a facility participating in the pilot program under subsection 7a77#a7 that is a community assisted living facility1 the ,secretary shall-- 7i7 pay to the facility an amount that is less than the average rate paid by the ,department for placement in a community nursing home in the same ,veterans ,integrated ,service ,network2 and 7ii7 re-evaluate payment rates annually to account for current economic conditions and current costs of assisted living services4 7d7 ,continuity of care ,upon the termination of the pilot program under subsection 7a77#a71 the ,secretary shall-- 7#a7 provide to all veterans participating in the pilot program at the time of such termination the option to continue to receive assisted living services at the site they were assigned to under the pilot program1 at the expense of the ,department2 and 7#b7 for such veterans who do not opt to continue to receive such services-- 7,a7 ensure such veterans do not experience lapses in care2 and 7,b7 provide such veterans with information on1 and enroll such veterans in1 other extended care services based on their preferences and best medical interest4 7e7 ,determination of quality ,the ,secretary shall determine a method for assessment of quality of care provided to veterans participating in the pilot program under subsection 7a77#a7 and shall communicate that method to providers of services under the pilot program4 7f7 ,annual report ,not later than one year after the initiation of the pilot program under subsection 7a77#a71 and annually thereafter for each year in which the pilot program is carried out1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the pilot program1 including-- 7#a7 an identification of ,veterans ,integrated ,services ,networks and facilities of the ,department participating in the pilot program and assisted living facilities and ,state homes at which veterans are placed under the pilot program2 7#b7 the number of participants in the pilot program1 disaggregated by facility2 7#c7 general demographic information of participants in the pilot program1 including average age1 gender1 and race or ethnicity2 7#d7 disability status of participants in the pilot program2 7#e7 an identification of any barriers or challenges to enrolling veterans in the pilot program1 conducting oversight of the pilot program1 or any other barriers or challenges2 7#f7 the cost of care at each assisted living facility and ,state home participating in the pilot program1 including an analysis of any cost savings by the ,department when comparing that cost to the cost of nursing home care2 7#g7 aggregated feedback from participants in the pilot program1 including from veteran resident surveys and interviews2 and 7#h7 such other matters the ,secretary considers appropriate4 7g7 ,final report ,not later than four years after the initiation of the pilot program under subsection 7a77#a71 or not later than seven years after the initiation of the pilot program if the pilot program is extended under subsection 7a77#b71 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the pilot program that-- 7#a7 includes the matters required under paragraphs 7#a7 through 7#h7 of subsection 7f72 7#b7 includes recommendations on whether the model studied in the pilot program should be continued or adopted throughout the ,department2 and 7#c7 indicates whether the ,secretary requests action by ,congress to make the pilot program permanent4 7h7 ,report by ,inspector ,general 7#a7 ,in general ,not later than three years after the initiation of the pilot program under subsection 7a77#a71 the ,inspector ,general of the ,department of ,veterans ,affairs shall submit to the ,secretary and the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report on the pilot program4 7#b7 ,elements ,the report required by paragraph 7#a7 shall include an assessment of-- 7,a7 the quality of care provided to veterans at facilities participating in the pilot program1 measured pursuant to the method determined under subsection 7e72 7,b7 the oversight of such facilities1 as conducted by the ,department1 the ,centers for ,medicare ,medicaid ,services1 ,state agencies1 and other relevant entities2 and 7,c7 such other matters as the ,inspector ,general considers appropriate4 7#c7 ,follow-up ,not later than #ij days after the submission of the report required by paragraph 7#a71 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a plan to address the deficiencies identified in the report1 if any4 7i7 ,definitions ,in this section3 7#a7 ,the term assisted living services means services of a facility in providing room1 board1 and personal care for and supervision of residents for their health1 safety1 and welfare4 7#b7 ,the term eligible veteran means a veteran who-- 7,a7 7i7 is already receiving nursing home level care paid for by the ,department2 7ii7 is eligible to receive nursing home level care paid for by the ,department pursuant to section #agaj;,a of title #ch1 ,united ,states ,code2 or 7iii7 requires a higher level of care than the domiciliary care provided by the ,department but does not meet the requirements for nursing home level care provided by the ,department pursuant to such section2 and 7,b7 7i7 is eligible for assisted living services1 as determined by the ,secretary2 or 7ii7 meets such additional criteria for eligibility for the pilot program under subsection 7a77#a7 as the ,secretary may establish4 7#c7 ,the term ,state home has the meaning given that term in section #aja of title #ch1 ,united ,states ,code4