,i  #aahth ,,congress  #ast ,session    
,h4 ,r4 #ejjb  ,,in ,,the ,,house ,,of  
,,representatives  ,july #bg1 #bjbc,mrs4
 ,harshbarger introduced the following  
bill2 which was referred to the         
,committee on ,veterans' ,affairs  ,a   
,,bill  ,to direct the ,secretary of    
,veterans ,affairs to carry out a pilot 
program for the cognitive care of       
veterans1 and for other purposes4  #a4  
,short title ,this ,act may be cited as 
the ,innovative ,cognitive ,care for    
,veterans ,act of #bjbc4  #b4 ,findings 
,congress finds the following3 7#a7     
,according to a #bjbj study by the      
,office of the ,assistant ,deputy ,under
 ,secretary for ,health for ,policy and 
,planning of the ,department of         
,veterans ,affairs1 it is projected that
 the number of veterans with            
,alzheimer's dementia will increase by  
#bh4i percent between fiscal year #bjba 
and fiscal year #bjcc1 amounting to an  
estimated #dh1jjj new patients with     
cognitive impairments4  7#b7 ,the cost  

of expenditures of the ,department of   
,veterans ,affairs for long-term care is
 growing rapidly1 as demonstrated by a  
#bjbj ,government ,accountability       
,office report that estimates such      
expenditures are projected to double to 
#ad1cjj1jjj1jjj by #bjcg4  7#c7 ,as     
described in the report specified in    
paragraph 7#b71 the ,department of      
,veterans ,affairs also faces both a    
current and incoming workforce shortage1
 in addition to other challenges        
relating to the provision of long-term  
care services to the more than          
#b1hjj1jjj estimated veterans who are   
enrolled in the patient enrollment      
system of the ,department established   
and operated under section #agje7;a7 of 
title #ch1 ,united ,states ,code1 and   
live in rural areas4  7#d7 ,as observed 
by the ,secretary of ,veterans ,affairs1
 veterans can also be prone to unique   
factors that increase the risk for      
future cognitive impairment4 ,for       
example1 it has been found that veterans

 who served during the ,vietnam era and1
 while so serving1 were exposed to      
,agent ,orange are nearly twice as      
likely as those without such exposure to
 receive a diagnosis of dementia4  7#e7 
,according to the ,department of        
,veterans ,affairs1 more than #ahe1jjj  
veterans enrolled in the health care    
system of the ,department of ,veterans  
,affairs have been diagnosed with at    
least one traumatic brain injury4       
,traumatic brain injury often affects   
the cognitive abilities of an individual
 and can disrupt normal brain function4 
,veterans with a traumatic brain injury 
are also #fj percent more likely to     
develop ,alzheimer's ,disease or other  
forms of dementia4  7#f7 ,this data     
compels the ,united ,states ,government 
to do more for veterans and their       
cognitive care4  #c4 ,pilot program of  
,department of ,veterans ,affairs for   
addressing cognitive disorders among    
veterans  7a7 ,pilot program  7#a7      
,pilot program ,not later than #ahj days

 after the date of the enactment of this
 ,act1 the ,secretary of ,veterans      
,affairs shall carry out1 as a part of  
the ,veterans ,community ,care ,program 
under section #agjc of title #ch1 and in
 accordance with the requirements of    
such program1 a pilot program 7in this  
section referred to as the pilot        
program7 under which the ,secretary may 
enter into agreements with eligible     
entities to furnish to participating    
veterans telehealth1 virtual training   
tools for home health aides1 and other  
innovative services1 that slow the      
progression of cognitive disorders4     
7#b7 ,veterans ,care ,agreements ,in    
entering into agreements under paragraph
 7#a71 the ,secretary may enter into a  
,veterans ,care ,agreement under section
 #agjc;,a of title #ch1 ,united ,states 
,code1 consistent with the requirements 
of such section4  7b7 ,selection of     
entities  7#a7 ,eligible entities ,an   
entity is eligible for entry into an    
agreement under the pilot program if the

 entity-- 7,a7 furnishes telehealth1    
virtual training tools for home health  
aides1 or other innovative services1    
that slow the progression of cognitive  
disorders2 and  7,b7 meets such other   
requirements as the ,secretary may      
prescribe4  7#b7 ,priority ,in selecting
 eligible entities for entry into an    
agreement under the pilot program1 the  
,secretary shall give priority to       
eligible entities with-- 7,a7           
demonstrated experience in-- 7i7        
providing assistance to individuals with
 cognitive disorders2  7ii7 addressing  
behavioral and temperament issues1      
including through interactive engagement
 and stimulation solutions2  7iii7      
caregiver or home health aid training2  
and  7iv7 working in the field of       
cognitive disorders1 including through  
the treatment of1 or rehabilitation for1
 traumatic brain injury or              
neurodegenerative conditions2 and  7,b7 
the ability to provide services under   
the pilot program to veterans at        

locations other than a hospital1 nursing
 home1 or other medical facility1 in    
accordance with subsection 7d77#b74     
7#c7 ,list of selected entities ,the    
,secretary shall-- 7,a7 publish on an   
internet website of the ,department a   
list identifying each eligible entity   
with which the ,secretary has entered   
into an agreement under the pilot       
program2 and  7,b7 ensure such list is  
accessible to veterans selected for     
participation in the pilot program4  7c7
 ,selection of veterans ,in selecting   
veterans for participation in the pilot 
program1 the ,secretary-- 7#a7 shall    
ensure that not more than #ejj veterans 
participate in the pilot program at any 
given time2 and  7#b7 may not take into 
consideration age or risk factors for   
cognitive disorders4  7d7 ,services3    
self-,directed and in-,home nature ,each
 veteran selected by the ,secretary for 
participation in the pilot program--    
7#a7 may select1 from among the entities
 listed under subsection 7b77#c7 that   

are accessible to the veteran1 the      
entity from which services shall be     
received by the veteran under the pilot 
program2 and  7#b7 may elect to receive 
services under the pilot program at a   
location that is not a traditional      
medical setting1 such as at the         
residence of the veteran1 in lieu of    
receiving such services at a hospital1  
nursing home1 or other medical facility4
  7e7 ,termination ,the pilot program   
shall terminate on the date that is five
 years after the date on which the pilot
 program commences4  7f7 ,report ,not   
later than #ahj days after the date of  
termination under subsection 7e71 the   
,secretary shall submit to the          
,committees on ,veterans' ,affairs of   
the ,house of ,representatives and the  
,senate a report on the pilot program4  
,such report shall include the          
following3 7#a7 ,a detailed overview of 
each entity with which the ,secretary   
entered into an agreement under the     
pilot program1 and the services that    

entity provided to participating        
veterans pursuant to such agreement4    
7#b7 ,an identification of the types of 
technology that eligible entities with  
which the ,secretary entered into an    
agreement under the pilot program used  
to provide services to participating    
veterans pursuant to such agreement4    
7#c7 ,an identification of the          
following3 7,a7 ,the number of veterans 
that participated in the pilot program4 
7,b7 ,the number of veterans that       
applied to participate in the pilot     
program but were not selected for       
participation as a result of the        
limitation under subsection 7c77#b74    
7,c7 ,of the veterans who participated  
in the pilot program1 the number who1   
for the duration of such participation1 
received services under the pilot       
program4  7,d7 ,of the veterans who     
participated in the pilot program1 the  
number who suffered traumatic brain     
injury while serving in the ,armed      
,forces1 including1 for each such       

veteran-- 7i7 a classification of the   
traumatic brain injury so suffered as   
mild1 moderate1 or severe 7as the case  
may be72 and  7ii7 an identification of 
the mechanism of injury4  7,e7 ,the     
percentage of veterans who participated 
in the pilot program 7disaggregated by  
type of outcome specified in clauses 7i7
 through 7iii77 who reported that such  
participation resulted in the following 
outcomes1 with respect to the individual
 veteran3 7i7 ,quality of life improved4
  7ii7 ,quality of life was unaffected4 
7iii7 ,quality of life worsened4  7,f7  
,a socioeconomic and demographic        
breakdown of veterans who participated  
in the pilot program4  7,g7 ,the type of
 housing in which the veterans who      
participated in the pilot program       
reside4  7,h7 ,whether the veterans who 
participated in the pilot program have  
access to personal care services from a 
caregiver1 and if so1 whether such      
services were furnished by the          
,secretary 7including through a         

non-,department of ,veterans ,affairs   
health care provider providing such     
services under the laws administered by 
the ,secretary74  7,i7 ,such other      
information as may be determined        
relevant by the ,secretary4  7g7 ,source
 of funds ,amounts required to carry out
 this ,act shall be derived from        
unobligated amounts appropriated to the 
,veterans ,health ,administration and   
determined appropriate by the           
,secretary4