,,ii #aai? ,,congress #b;d ,session ,s4 #cfdg ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,janu>y #ae1 #bjbf,mr4 ,moran introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,vet]ans' ,affairs ,a ,,bill ,to require ! ,secret>y ( ,vet]ans ,affairs to e/abli% a program to address b[el & bladd] c>e ne$s = vet]ans ) sp9al cord injuries & disord]s1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,disabl$ ,vet]ans ,dignity ,act ( #bjbf4 #b4 ,f9d+s2 s5se ( ,congress 7a7 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,b[el c>e & bladd] c>e are supportive & necess>y m$ical s]vices = vet]ans ) sp9al cord injuries & disord]s :5 !y are unable to manage _! b[el & bladd] functions indep5d5tly4 7#b7 ,inadequate c>e w lead to complications & problems su* z autonomic dysreflexia t c be pot5tially life-?reat5+ & result 9 illness & hospitalization4 7#c7 ,b[el c>e & bladd] c>e are ess5tial to support vet]ans ) sp9al cord injuries & disord]s 9 non-in/itutional sett+s1 improve quality ( life1 optimize heal?1 & prev5t complications f neurog5ic b[el & bladd]4 7#d7 ,family c>egiv]s & individually employ$ c>egiv]s provide life-su/a9+ c>e = ! b[el & bladd] c>e ne$s ( vet]ans t all[ !m to live 9 _! communities4 7b7 ,s5se ( ,congress ,x is ! s5se ( ,congress t-- 7#a7 family c>egiv]s & individually employ$ c>egiv]s %\ld n be subject$ to self-employm5t taxes & treat$ z v5dors or contractors = ! vet]ans to :om !y provide c>e2 7#b7 vet]ans %\ld n be =c$ to f9i% _! b[el & bladd] c>e ne$s 9 a set p]iod ( "t t does n consid] _! individual ne$s2 & 7#c7 vet]ans %\ld n be subject$ to ongo+ cl9ical det]m9ations reg>d+ _! b[el & bladd] c>e ne$s abs5t a decision by _! m$ical c>e provid] t su* c>e is no long] ne$$4 #c4 ,b[el & bladd] c>e program ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all e/abli% a program to address ! b[el & bladd] c>e ne$s ( cov]$ vet]ans 79 ?is section ref]r$ to z ! program74 7b7 ,provision ( c>e 7#a7 ,cl9ical ne$ ,! ,secret>y %all provide b[el & bladd] c>e "u ! program to cov]$ vet]ans bas$ on cl9ical ne$1 :i* may include cov]$ vet]ans receiv+ aid & att5dance b5efits f ! ,dep>tm5t ( ,vet]ans ,affairs4 7#b7 ,c>egiv] or ag5cy ,a cov]$ vet]an may receive b[el & bladd] c>e "u ! program ?r\gh a qualifi$ family memb]1 an individually employ$ c>egiv]1 or a contract$ home heal? ag5cy4 7#c7 ,individualiz$ assessm5t ,! ,secret>y %all conduct an individualiz$ assessm5t ) respect to a cov]$ vet]an to det]m9e ! numb] ( h\rs ( b[el & bladd] c>e ne$$ by su* vet]an "u ! program4 7#d7 ,d5ial ( c>e ,be=e d5y+ b[el & bladd] c>e = any cov]$ vet]an "u ! program1 ! ,secret>y %all fir/ obta9 review ( & concurr5ce ) respect to su* d5ial f a designat$ ,sp9al ,cord ,injuries & ,disord]s ,c5t] ( ! ,dep>tm5t4 7c7 ,coord9ation ( c>e & b5efits ,! ,secret>y %all ensure ! program is coord9at$ ) o!r programs & b5efits ( ! ,dep>tm5t = :i* ! cov]$ vet]an is eligible to ensure t cov]$ vet]ans & c>egiv]s receive appropriate support )\t duplicat+ b5efits or s]vices4 7d7 ,supportive m$ical tra9+ & qualifications 7#a7 ,9 g5]al ,! ,secret>y %all provide to ea* family memb] or individually employ$ c>egiv] provid+ c>e to a cov]$ vet]an "u ! program necess>y supportive m$ical tra9+ to p>ticipate 9 & receive paym5t by ! ,secret>y = ! provision ( su* c>e4 7#b7 ,qualifications ,! ,secret>y %all e/abli% su* requirem5ts1 conditions1 & qualifications = provid]s ( c>e "u ! program z necess>y to provide cl9ically appropriate b[el & bladd] c>e to cov]$ vet]ans & to ensure ! f9ancial & adm9i/rative integrity ( ! program4 7e7 ,paym5t 7#a7 ,9 g5]al ,! ,secret>y %all provide a mon?ly /ip5d to family memb]s & individually employ$ c>egiv]s & paym5t to contract$ home heal? ag5cies = c>e provid$ to cov]$ vet]ans "u ! program4 7#b7 ,limitation 7,a7 ,family memb]s & individually employ$ c>egiv]s ,! /ip5d = a family memb] or individually employ$ c>egiv] = c>e provid$ to a cov]$ vet]an "u ! program-- 7i7 %all be det]m9$ by ! ,secret>y2 7ii7 %all be bas$ on ! am\nt & degree ( assi/ance provid$2 & 7iii7 may n exce$ ! fif? /ep ( ! applicable grade ( ! ,g5]al ,s*$ule h\rly rate paid to nurs+ assi/ants :o provide su* c>e at ! m$ical facility ( ! ,dep>tm5t t is ne>e/ to ! resid5ce ( su* vet]an4 7,b7 ,home heal? ag5cies ,paym5t to a home heal? ag5cy = c>e provid$ to a cov]$ vet]an "u ! program may n exce$ ! paym5t rates ( ! ,dep>tm5t "u section #ag4djce ( title #ch1 ,code ( ,f$]al ,regulations 7relat+ to paym5t rates & me?odologies71 or successor regulations4 7f7 ,submission ( docum5tation ,family memb]s & individually employ$ c>egiv]s provid+ c>e to cov]$ vet]ans "u ! program %all provide su* docum5tation & in=mation 9 su* =mat & "u su* t]ms z ! ,secret>y may require z a condition ( receiv+ paym5t "u ! program4 7g7 ,cont9u$ p>ticipation 9 program ,if a cov]$ vet]an has be5 m$ically det]m9$ to require c>e "u ! program = a cont9u\s p]iod ( ?ree ye>s or m1 ! vet]an is deem$ to require su* c>e = life or until su* "t z ! m$ical provid] = su* vet]an det]m9es ! s]vice is no long] ne$$4 7h7 ,n v5dors or contractors ,family memb]s & individually employ$ c>egiv]s provid+ c>e to cov]$ vet]ans "u ! program %all n be consid]$ v5dors or contractors = purposes ( ! program4 7i7 ,limitation ,c>e may n be provid$ "u ! program to a vet]an :o c p]=m ! b[el & bladd] functions ( ! vet]an )\t assi/ance4 7j7 ,cov]$ vet]an def9$ ,9 ?is section1 ! t]m cov]$ vet]an means a vet]an :o-- 7#a7 is enroll$ 9 ! sy/em ( annual pati5t enrollm5t ( ! ,dep>tm5t ( ,vet]ans ,affairs e/abli%$ & op]at$ "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code2 7#b7 has a sp9al cord injury or disord]2 & 7#c7 is dep5d5t ^u o!rs = b[el & bladd] c>e :ile resid+ 9 non-in/itutional sett+s4