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115th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 115-868
======================================================================
LONG-TERM CARE VETERANS CHOICE ACT
_______
July 24, 2018.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Roe of Tennessee, from the Committee on Veterans' Affairs,
submitted the following
R E P O R T
[To accompany H.R. 5693]
[Including cost estimate of the Congressional Budget Office]
The Committee on Veterans' Affairs, to whom was referred
the bill (H.R. 5693) to amend title 38, United States Code, to
authorize the Secretary of Veterans Affairs to enter into
contracts and agreements for the placement of veterans in non-
Department medical foster homes for certain veterans who are
unable to live independently, having considered the same,
report favorably thereon with amendments and recommend that the
bill as amended do pass.
CONTENTS
Page
Purpose and Summary.............................................. 5
Background and Need for Legislation.............................. 5
Hearings......................................................... 9
Subcommittee Consideration....................................... 10
Committee Consideration.......................................... 10
Committee Votes.................................................. 10
Committee Oversight Findings..................................... 11
Statement of General Performance Goals and Objectives............ 11
New Budget Authority, Entitlement Authority, and Tax Expenditures 11
Earmarks and Tax and Tariff Benefits............................. 11
Committee Cost Estimate.......................................... 11
Congressional Budget Office Estimate............................. 11
Federal Mandates Statement....................................... 18
Advisory Committee Statement..................................... 18
Constitutional Authority Statement............................... 18
Applicability to Legislative Branch.............................. 18
Statement on Duplication of Federal Programs..................... 18
Disclosure of Directed Rulemaking................................ 18
Section-by-Section Analysis of the Legislation................... 19
Changes in Existing Law Made by the Bill as Reported............. 22
The amendments are as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Long-Term Care Veterans Choice Act''.
SEC. 2. SECRETARY OF VETERANS AFFAIRS CONTRACT AUTHORITY FOR PLACEMENT
OF VETERANS IN NON-DEPARTMENT MEDICAL FOSTER HOMES.
(a) Authority.--Section 1720 of title 38, United States Code, is
amended by adding at the end the following new subsection:
``(h)(1) During the three-year period beginning on October 1, 2019,
and subject to paragraph (2), at the request of a veteran for whom the
Secretary is required to provide nursing home care under section 1710A
of this title, the Secretary may place the veteran in a medical foster
home that meets Department standards, at the expense of the United
States, pursuant to a contract, agreement, or other arrangement entered
into between the Secretary and the medical foster home for such
purpose. A veteran who is placed in a medical foster home under this
subsection shall agree, as a condition of such placement, to accept
home health services furnished by the Secretary under section 1717 of
this title.
``(2) In any year, not more than a daily average of 900 veterans
placed in a medical foster home, whether placed before or after the
date of the enactment of this subsection, may have their care covered
at the expense of the United States under subsection (a).
``(3) In this subsection, the term `medical foster home' means a home
designed to provide non-institutional, long-term, supportive care for
veterans who are unable to live independently and prefer a family
setting.''.
(b) Effective Date.--Subsection (h) of title 38, United States Code,
as added by subsection (a), shall take effect on October 1, 2019.
SEC. 3. ESTABLISHMENT OF VETERANS ECONOMIC OPPORTUNITY AND TRANSITION
ADMINISTRATION.
(a) Veterans Economic Opportunity and Transition Administration.--
(1) In general.--Part V of title 38, United States Code, is
amended by adding at the end the following new chapter:
``CHAPTER 80--VETERANS ECONOMIC OPPORTUNITY AND TRANSITION
ADMINISTRATION
``Sec.
``8001. Organization of Administration.
``8002. Functions of Administration.
``8003. Annual report to Congress.
``Sec. 8001. Organization of Administration
``(a) Veterans Economic Opportunity and Transition Administration.--
There is in the Department of Veterans Affairs a Veterans Economic
Opportunity and Transition Administration. The primary function of the
Veterans Economic Opportunity and Transition Administration is the
administration of the programs of the Department that provide
assistance related to economic opportunity to veterans and their
dependents and survivors.
``(b) Under Secretary for Economic Opportunity and Transition.--The
Veterans Economic Opportunity and Transition Administration is under
the Under Secretary for Veterans Economic Opportunity and Transition,
who is directly responsible to the Secretary for the operations of the
Administration.
``Sec. 8002. Functions of Administration
``The Veterans Economic Opportunity and Transition Administration is
responsible for the administration of the following programs of the
Department:
``(1) Vocational rehabilitation and employment programs.
``(2) Educational assistance programs.
``(3) Veterans' housing loan and related programs.
``(4) The verification of small businesses owned and
controlled by veterans pursuant to subsection (f) of section
8127 of this title, including the administration of the
database of veteran-owned businesses described in such
subsection.
``(5) The Transition Assistance Program under section 1144 of
title 10.
``(6) Any other program of the Department that the Secretary
determines appropriate.
``Sec. 8003. Annual report to Congress
``The Secretary shall include in the annual report to the Congress
required by section 529 of this title a report on the programs
administered by the Under Secretary for Veterans Economic Opportunity
and Transition. Each such report shall include the following with
respect to each such program during the fiscal year covered by that
report:
``(1) The number of claims received.
``(2) The number of claims decided.
``(3) The average processing time for a claim.
``(4) The number of successful outcomes (as determined by the
Secretary).
``(5) The number of full-time equivalent employees.
``(6) The amounts expended for information technology.''.
(2) Clerical amendments.--The tables of chapters at the
beginning of title 38, United States Code, and of part V of
title 38, United States Code, are each amended by inserting
after the item relating to chapter 79 the following new item:
``80. Veterans Economic Opportunity and Transition 8001''.
Administration.
(b) Effective Date.--Chapter 80 of title 38, United States Code, as
added by subsection (a), shall take effect on October 1, 2019.
(c) Full-Time Employees.--For fiscal years 2019 and 2020, the total
number of full-time equivalent employees authorized for the Veterans
Benefits Administration and the Veterans Economic Opportunity and
Transition Administration, as established under chapter 80 of title 38,
United States Code, as added by subsection (a), may not exceed 23,692.
SEC. 4. UNDER SECRETARY FOR VETERANS ECONOMIC OPPORTUNITY AND
TRANSITION.
(a) Under Secretary.--
(1) In general.--Chapter 3 of title 38, United States Code,
is amended by inserting after section 306 the following new
section:
``Sec. 306A. Under Secretary for Veterans Economic Opportunity and
Transition
``(a) Under Secretary.--There is in the Department an Under Secretary
for Veterans Economic Opportunity and Transition, who is appointed by
the President, by and with the advice and consent of the Senate. The
Under Secretary for Veterans Economic Opportunity and Transition shall
be appointed without regard to political affiliation or activity and
solely on the basis of demonstrated ability in--
``(1) information technology; and
``(2) the administration of programs within the Veterans
Economic Opportunity and Transition Administration or programs
of similar content and scope.
``(b) Responsibilities.--The Under Secretary for Veterans Economic
Opportunity and Transition is the head of, and is directly responsible
to the Secretary for the operations of, the Veterans Economic
Opportunity and Transition Administration.
``(c) Vacancies.--(1) Whenever a vacancy in the position of Under
Secretary for Veterans Economic Opportunity and Transition occurs or is
anticipated, the Secretary shall establish a commission to recommend
individuals to the President for appointment to the position.
``(2) A commission established under this subsection shall be
composed of the following members appointed by the Secretary:
``(A) Three persons representing education and training,
vocational rehabilitation, employment, real estate, mortgage
finance and related industries, and survivor benefits
activities affected by the Veterans Economic Opportunity and
Transition Administration.
``(B) Two persons representing veterans served by the
Veterans Economic Opportunity and Transition Administration.
``(C) Two persons who have experience in the management of
private sector benefits programs of similar content and scope
to the economic opportunity and transition programs of the
Department.
``(D) The Deputy Secretary of Veterans Affairs.
``(E) The chairman of the Veterans' Advisory Committee on
Education formed under section 3692 of this title.
``(F) One person who has held the position of Under Secretary
for Veterans Economic Opportunity and Transition, if the
Secretary determines that it is desirable for such person to be
a member of the commission.
``(3) A commission established under this subsection shall recommend
at least three individuals for appointment to the position of Under
Secretary for Veterans Economic Opportunity and Transition. The
commission shall submit all recommendations to the Secretary. The
Secretary shall forward the recommendations to the President and the
Committees on Veterans' Affairs of the Senate and House of
Representatives with any comments the Secretary considers appropriate.
Thereafter, the President may request the commission to recommend
additional individuals for appointment.
``(4) The Assistant Secretary or Deputy Assistant Secretary of
Veterans Affairs who performs personnel management and labor relations
functions shall serve as the executive secretary of a commission
established under this subsection.''.
(2) Clerical amendment.--The table of sections at the
beginning of such chapter is amended by inserting after the
item relating to section 306 the following new item:
``306A. Under Secretary for Veterans Economic Opportunity and
Transition.''.
(b) Conforming Amendments.--Title 38, United States Code, is further
amended--
(1) in section 306(c)(2), by striking subparagraphs (A) and
(E) and redesignating subparagraphs (B), (C), (D), and (F), as
subparagraphs (A) through (D), respectively;
(2) in section 317(d)(2), by inserting after ``Under
Secretary for Benefits,'' the following: ``the Under Secretary
for Veterans Economic Opportunity and Transition,'';
(3) in section 318(d)(2), by inserting after ``Under
Secretary for Benefits,'' the following: ``the Under Secretary
for Veterans Economic Opportunity and Transition,'';
(4) in section 516(e)(2)(C), by striking ``Health and the
Under Secretary for Benefits'' and inserting ``Health, the
Under Secretary for Benefits, and the Under Secretary for
Veterans Economic Opportunity and Transition'';
(5) in section 541(a)(2)(B), by striking ``Health and the
Under Secretary for Benefits'' and inserting ``Health, the
Under Secretary for Benefits, and the Under Secretary for
Veterans Economic Opportunity and Transition'';
(6) in section 542(a)(2)(B)(iii), by striking ``Health and
the Under Secretary for Benefits'' and inserting ``Health, the
Under Secretary for Benefits, and the Under Secretary for
Veterans Economic Opportunity and Transition'';
(7) in section 544(a)(2)(B)(vi), by striking ``Health and the
Under Secretary for Benefits'' and inserting ``Health, the
Under Secretary for Benefits, and the Under Secretary for
Veterans Economic Opportunity and Transition'';
(8) in section 709(c)(2)(A), by inserting after ``Under
Secretary for Benefits,'' the following: ``the Under Secretary
for Veterans Economic Opportunity and Transition,'';
(9) in section 7701(a), by inserting after ``assistance'' the
following: ``, other than assistance related to Economic
Opportunity and Transition,''; and
(10) in section 7703, by striking paragraphs (2) and (3) and
redesignating paragraphs (4) and (5) as paragraphs (2) and (3),
respectively.
(c) Effective Date.--Section 306A of title 38, United States Code, as
added by subsection (a), and the amendments made by this section, shall
take effect on October 1, 2019.
SEC. 5. LOANS GUARANTEED UNDER HOME LOAN PROGRAM OF DEPARTMENT OF
VETERANS AFFAIRS.
The table in section 3729(b)(2) of such title is amended by striking
the item relating to subparagraph (E) and inserting the following new
item:
------------------------------------------------------------------------
------------------------------------------------------------------------
``(E)(i) Interest rate 0.50 0.50 NA
reduction refinancing loan
(closed before January 1,
2019)........................
(E)(ii) Interest rate 0.75 0.75 NA
reduction refinancing loan
(closed on or after January
1, 2019, but before October
1, 2024).....................
(E)(iii) Interest rate 0.50 0.50 NA''.
reduction refinancing loan
(closed on or after October
1, 2024).....................
------------------------------------------------------------------------
Amend the title so as to read:
A bill to to amend title 38, United States Code, to
authorize the Secretary of Veterans Affairs to enter into
contracts and agreements for the placement of veterans in non-
Department medical foster homes for certain veterans who are
unable to live independently, to establish the Veterans
Economic Opportunity and Transition Administration and the
Under Secretary for Veterans Economic Opportunity and
Transition of the Department of Veterans Affairs, to amend the
interest rate for certain loans guaranteed under the home loan
program of the Department of Veterans Affairs, and for other
purpose.
Purpose and Summary
H.R. 5693, as amended, the Long-Term Care Veterans Choice
Act, would authorize the Department of Veterans Affairs (VA) to
cover the cost of a medical foster home for certain veterans,
create a Veterans Economic Opportunity and Transition
Administration, and authorize a temporary increase in the VA
home loan funding free for interest rate reduction when
refinancing homes. Representative Clay Higgins of Louisiana
introduced H.R. 5693 on May 7, 2018. H.R. 5693, as amended,
which incorporates the text of H.R. 5644, the Veterans'
Education, Transition, and Opportunity Prioritization Plan (or
VET OPP) Act of 2018. H.R. 5644 was introduced by
Representative Brad Wenstrup of Ohio on April 26, 2018.
Background and Need for Legislation
Section 2. Secretary of Veterans Affairs contract authority for
placement of Veterans Affairs in non-department medical foster
homes
Section 101 of the Veterans Millennium Health Care and
Benefits Act (Public Law 106-117; 113 STAT. 1545) established a
requirement for VA to provide nursing home care to enrolled
veterans who are in need of nursing home care due to a service-
connected disability or who are in need of nursing home care
and have a service-connected disability rated at 70 percent or
more.
This requirement is codified in section 1710A of title 38
United States Code (U.S.C.). To fulfill this requirement, VA
provides nursing home care through Community Living Centers
located on VA medical center campuses; through Community
Nursing Homes; and, through State Veterans Homes.\1\ VA
currently provides nursing home care to over 17,000 veterans at
an annual cost of more than $5 billion.\2\ VA's fiscal year
2019 budget submission notes that, ``VA has the responsibility
to reduce its mounting expenditures for nursing home care,
especially where safe and proven home-based alternatives are
available.''\3\ Medical foster homes (MFHs) are one such
alternative.
---------------------------------------------------------------------------
\1\Residential Settings and Nursing Homes. Geriatrics and Extended
Care. https://www.va.gov/GERIATRICS/Guide/LongTermCare/
Nursing_Home_and_Residential_Services.asp. Accessed July 17, 2018.
\2\VA Fiscal Year 2019 Budget Submission, Volume II--Medical
Programs and Information Technology Programs, VHA-340-341.
\3\Ibid.
---------------------------------------------------------------------------
MFHs allow veterans in need of nursing home care to receive
such care in a non-institutional, home-based setting.\4\ MFHs
are private homes in which a trained caregiver provides round-
the-clock care--including room and board, assistance with
activities of daily living, medication management, and
recreational and social support--to a small group on
individuals.\5\ Veterans residing in MFHs also receive care
through VA's Home Based Primary Care program.\6\ MFHs
originated as a VA pilot program in 2000.\7\ Since then, VA has
successfully served over 4,000 veterans in MFHs, including more
than 1,000 veterans who reside in MFHs today.\8\ MFH care costs
approximately $1,500 to $3,000 per month while traditional
nursing home care costs approximately $7,000 per month.\9\
However, VA currently lacks the authority to pay for care in a
MFH, meaning that veterans--even those who VA is required by
law to provide with needed nursing home care--must pay out-of-
pocket to reside in a MFH. As a result, ``VA pays more than
twice as much for the long-term nursing home care for many
veterans than it would if VA was granted . . . authority to pay
for care in a MFH.''\10\
---------------------------------------------------------------------------
\4\Ibid.
\5\Medical Foster Home Care and Elder Veterans. Geriatrics and
Extended Care. https://www.va.gov/geriatrics/guide/longtermcare/
medical_foster_homes.asp. Accessed July 17, 2018.
\6\Ibid.
\7\VA Fiscal Year 2019 Budget Submission, Volume II--Medical
Programs and Information Technology Programs, VHA-340-341.
\8\Ibid.
\9\United States Cong. House Committee on Veterans' Affairs
Subcommittee on Health. ``Legislative Hearing.'' June 13, 2018. 115th
Cong. 2nd sess. Washington: GPO, 2018 (testimony of the Honorable Clay
Higgins, U.S. House of Representatives, 3rd District, Louisiana).
\10\VA Fiscal Year 2019 Budget Submission, Volume II--Medical
Programs and Information Technology Programs, VHA-340-341.
---------------------------------------------------------------------------
The Committee concurs with VA that MFHs can offer safe,
highly veteran-centric care at a lower cost than traditional
nursing home care and can be used to increase access and
promote choice.\11\ The Committee also concurs with VA that,
``many more service-connected veterans referred to or residing
in nursing homes would choose MFH [care] if VA paid the costs
for [the] MFH,'' which would be beneficial because,
``[a]ligning patient choice with optimal locus of care results
in more veterans receiving long-term care in a preferred
setting, with substantial reductions in costs to VA.''\12\
---------------------------------------------------------------------------
\11\United States Cong. House Committee on Veterans' Affairs
Subcommittee on Health. ``Legislative Hearing.'' June 13, 2018. 115th
Cong. 2nd sess. Washington: GPO, 2018 (testimony of Jessica Bonjorni,
the Acting Assistant Deputy Under Secretary for Health for Workforce
Services, Veterans Health Administration, U.S. Department of Veterans
Affairs.)
\12\VA Fiscal Year 2019 Budget Submission, Volume II--Medical
Programs and Information Technology Programs, VHA-340-341.
---------------------------------------------------------------------------
Section 2 of the bill would authorize VA, during the three-
year period beginning on October 1, 2019, to cover the cost of
care in a MFH for a daily average of up to 900 veterans for
whom VA is required to provide nursing home care and who agree
to receive VA home health care. MFH would be defined as a home
designed to provide non-institutional, long-term, supportive
care for veterans who are unable to live independently and
prefer a family setting. According to correspondence the
Committee received from VA, VA estimates that, if the
Department were granted the authority to pay for MFH care
pursuant to section 2 of the bill, cost savings of
approximately $99 million over three years would be achieved.
Section 3. Establishment of Veterans Economic Opportunity and
Transition Administration
Currently, title 38 U.S.C. establishes three separate
administrations within VA. Chapter 73 of title 38 U.S.C.
establishes the Veterans Health Administration (VHA), which is
responsible for the administration of all health care related
facilities and programs. Chapter 77 of title 38 U.S.C.,
establishes the Veterans Benefits Administration (VBA), which
is responsible for the administration of all benefit programs,
including compensation, pension, insurance, educational
assistance and training programs, and loan guaranty programs.
Chapter 24 of title 38 U.S.C. establishes the National Cemetery
Administration (NCA), which is responsible for the
administration of the more than 131 National Cemeteries and
other burial-related facilities and programs.
VA's disability compensation program is a highly complex
program designed to provide monthly payments for disabilities
incurred or aggravated in military service. With the wars in
the Middle East and the aging of the veteran population in
general, the number of compensation claims that have been
received by VA has continued to increase. As of July 16, 2018,
there were 347,404 pending disability claims at VA and 77,215
(22%) of those were pending more than 125 days. Moreover, as of
June 1, 2018, there were 441,133 appeals pending at both VBA
and the Board of Veterans' Appeals, with many veterans waiting
more than five years for a final decision on their claims. As
the backlog continues to rise and fall over time, it continues
to draw considerable criticism from the veterans' community as
well as Congress and the media. Understandably, senior VBA
leaders spend considerable time and resources focusing on
decreasing the inventory of disability compensation claims at
the expense of time and focus needed for other benefit
programs.
Over time, this has led to less leadership attention to the
non-compensation programs administered by VBA. As an example,
the Administration's FY 2019 budget request includes funds to
support 21,543 direct labor full time equivalent employees
(FTEE) for VBA. Of this number, 15,851 direct labor FTEE were
requested to administer disability compensation, pension,
burial, dependency indemnity compensation, which leaves 5,692
employees to work on other benefits. The Committee believes the
focus on disability compensation and pension results in a lack
of attention being given to the lengthy waits for benefits from
the education, vocational rehabilitation, and loan guaranty
programs and only undermines the potential for veterans to
improve their lives through programs that increase economic
opportunities.
Therefore, to ensure more effective oversight of those
programs, the Committee believes that separating the
compensation and pension programs from programs which lead to
increased employability and economic success would be
appropriate. Section 3 of the bill would create Chapter 80 in
title 38 U.S.C. to establish the Veterans Economic Opportunity
and Transition Administration (VEOTA), which would manage the
G.I. Bill, Home Loan Guaranty, and Vocational Rehabilitation
and Employment (VR&E;) programs along with VA's portion of the
Transition Assistance Program that help servicemembers
transition to civilian life.
Additionally, Section 8127 of title 38 U.S.C. established a
program to assist VA in meeting the statutory goals for
procurement of goods and services from service disabled
veteran-owned small businesses. Because small business
ownership can be a significant contributor to economic success
and due to VA's continued difficulty in administering the
service disabled veteran-owned small business program, section
3 of the bill would place the program authorized by Section
8127 under the auspices of VEOTA.
The Committee also believes that with the significant
growth in VA employees it would be appropriate to staff the new
VEOTA using existing personnel resources so section 3 of the
bill would also cap the amount of combined FTEE at both VBA and
VEOTA to no more than 23,692 FTEE for fiscal year 2019 and
fiscal year 2020. In order for the organization of the VEOTA to
take place in an orderly and efficient manner, the amendments
made by this section would not go into effect until October 1,
2019. The Committee believes this gives VA enough time to allow
for a smooth transition in the realignment these programs
within VEOTA.
Finally, section 3 of the bill would also require that VA
include data in the annual benefits report on claims received,
claims decided, and processing times for claims administered by
VEOTA as well as long term outcomes of participants in VEOTA's
programs. The Committee believes this reporting requirement
would be critical to analyze and track the performance of
VEOTA's programs and benefits especially how these programs
lead to positive economic outcomes for veterans.
Section 4. Under Secretary for Veterans Economic Opportunity and
Transition
Section 4 of the bill would amend title 38 U.S.C. by adding
a new section 306A to create the position of Under Secretary
for Veterans Economic Opportunity and Transition to oversee all
VEOTA programs and operations. This section would complement
section 3 of the bill by creating this Under Secretary position
to put the new VEOTA on par with other administrations within
VA.
Under this section, the new Under Secretary would be
appointed by the President with the advice and consent of the
Senate. The section would also require that the Under Secretary
have demonstrated ability in the use of information technology
(IT) and administration of programs similar to those in the new
VEOTA. The section would also require that, when there is a
vacancy for this position, the Secretary would be required to
convene a commission to recommend individuals to the President
for appointment, and that the commission consists of
individuals who represent a cross section of the programs
administered by the VEOTA. While the President is not bound to
appoint any individuals recommended by the commission, the
Committee would expect that the commission's recommendations
would be seriously considered during the appointment process.
Finally, the Committee would also expect the commission to
recommend individuals who have private sector experience in
running programs similar to those under VEOTA.
Section 5. Loans guaranteed under home loan program of Department of
Veterans Affairs
First authorized by the Servicemember's Readjustment Act of
1944, the VA Home Loan Guaranty program helps hundreds of
thousands of servicemembers and veterans, each year, purchase
their part of the American dream. In fiscal year 2017, the VA
Loan Guaranty Service guaranteed 740,389 loans totaling over
$188 billion.\13\ Section 3729 of title 38 U.S.C. requires
certain users of VA's loan guaranty benefit to pay a funding
fee. The amount of the funding fee varies based on an
individual's active duty or reserve status, the amount of down
payment brought forward, and the date of loan origination. The
costs of the funding fee can be rolled into the loan and can be
waived if the servicemember has a service-connected disability.
These fees reduce the subsidy cost associated with VA's
guaranty of mortgage loans and have typically been viewed as a
reasonable cost to the benefit gained by having VA guarantee a
mortgage loan.
---------------------------------------------------------------------------
\13\Fiscal Year 2019 Budget Submission, U.S. Department of Veterans
Affairs, Volume 3, ``Benefits and Burial Programs and Departmental
Administration, page 234.
---------------------------------------------------------------------------
Section 5 of the bill would make adjustments to the home
loan fee for refinanced loans that lead to an interest rate
reduction and would be made on or after January 1, 2019 but
before September 30, 2024. The funding fee rate would be
changed from 0.50 from 0.75. After September 20, 2026, the rate
will revert back to current rate. The Committee believes that
these modest increases would have minimal impact on the home
loan market and would not seriously limit a veteran's or a
servicemember's ability to use their home loan benefit. It
should also be noted that, according to VA data, out of the
589,533 VA loans expected to close this year, approximately 42
percent, or 247,603, will not require any loan fee due to the
veteran borrower's disability rating.
Hearings
On June 13, 2018, the Subcommittee on Health conducted a
legislative hearing on a number of bills including H.R. 5693.
The following witnesses testified:
The Honorable Vicky Hartzler, U.S. House of
Representatives, 4th District, Missouri; The Honorable
Marcy Kaptur, U.S. House of Representatives, 9th
District, Ohio; The Honorable Matt Cartwright, U.S.
House of Representatives, 17th District, Pennsylvania;
The Honorable Clay Higgins, U.S. House of
Representatives, 3rd District, Louisiana; The Honorable
Mike Bost, U.S. House of Representatives, 12th
District, Illinois; The Honorable Jeff Denham, U.S.
House of Representatives, 10th District, California;
The Honorable Jenniffer Gonzalez-Colon, U.S. House of
Representatives, Puerto Rico; The Honorable Brad
Wenstrup, U.S. House of Representatives, 2nd District,
Ohio; Roscoe Butler, Deputy Director for Health Care,
Veterans Affairs and Rehabilitation, The American
Legion; Jeremy Villanueva, Associate National
Legislative Director, Disabled American Veterans; Kayda
Keleher, Associate Director, National Legislative
Service, Veterans of Foreign Wars of the United States;
and Jessica Bonjorni MBA, PMP, SPHR, Acting Assistant
Deputy Under Secretary for Health for Workforce
Services, Veterans Health Administration, U.S.
Department of Veterans Affairs, who was accompanied by
Dayna Cooper MSN, RN, Director, Home and Community-
Based Programs, Veterans Health Administration, U.S.
Department of Veterans Affairs.
Statements for the record were submitted by:
American Orthotic and Prosthetic Association,
Paralyzed Veterans of America, and Military Officers
Association of America.
On May 23, 2018, the Subcommittee on Economic Opportunity
held a legislative hearing on a number of bills including H.R.
5644 which was incorporated in sections three and four of H.R.
5693, as amended.
The following witnesses testified:
The Honorable Julia Brownley, U.S. House of
Representatives, 26th District, California; The
Honorable Scott Peters, U.S. House of Representatives,
52nd District, California; The Honorable Brad Wenstrup,
U.S. House of Representatives, 2nd District, Ohio; The
Honorable Cheri Bustos, U.S. House of
Representatives,17th District, Illinois; The Honorable
Ryan Costello, U.S. House of Representatives, 6th
District, Pennsylvania; Ms. Margarita Devlin, Principal
Deputy Under Secretary for Benefits, Veterans Benefits
Administration, U.S. Department of Veterans Affairs;
Mr. John Kamin, Assistant Director, Veterans Employment
and Education Division, The American Legion; Ms. Lauren
Augustine, Vice President of Government Affairs,
Student Veterans of America; and Ms. Rebecca Burgess,
Program Manager, Program on American Citizenship,
American Enterprise Institute.
Statements for the record were submitted by:
U.S. Department of Defense; U.S. Department of
Justice; Tragedy Assistance Program for Survivors; and
Paralyzed Veterans of America
Subcommittee Consideration
On June 27, 2018, the Subcommittee on Health met in open
markup session, a quorum being present and favorably forwarded
H.R. 5693, as amended, to the Full Committee. During
consideration of the bills, the following amendment was
considered and agreed to by voice vote:
An amendment in the nature of a substitute offered by
Representative Clay Higgins of Louisiana, which would
clarify that the pilot program would authorize VA to
cover the costs of medical foster home care for a daily
average of up to 900 veteran patients for whom VA would
otherwise be required to provide nursing home care.
Committee Consideration
On July 12, 2018, the full Committee met in open markup
session, a quorum being present, and ordered H.R. 5693, as
amended, to be reported favorably to the House of
Representatives by voice vote. During consideration of the
bill, the following amendment was considered and agreed to by
voice vote:
An amendment in the nature of a substitute offered by
Representative David P. Roe of Tennessee--the Chairman
of the Committee on Veterans' Affairs--which would
combine the contents of H.R. 5693, as amended, H.R.
5644, and a provision that would authorize a temporary
nominal increase in the funding fee for refinanced VA
guaranteed loans.
Committee Votes
In compliance with clause 3(b) of rule XIII of the Rules of
the House of Representatives, there were no recorded votes
taken on amendments or in connection with ordering H.R. 5693,
as amended, reported to the House. A motion by Representative
Tim Walz of Minnesota--the Ranking Member of the Committee on
Veterans' Affairs--to report H.R. 5693, as amended, favorably
to the House of Representatives was adopted by voice vote.
Committee Oversight Findings
In compliance with clause 3(c)(1) of rule XIII and clause
(2)(b)(1) of rule X of the Rules of the House of
Representatives, the Committee's oversight findings and
recommendations are reflected in the descriptive portions of
this report.
Statement Of General Performance Goals and Objectives
In accordance with clause 3(c)(4) of rule XIII of the Rules
of the House of Representatives, the Committee's performance
goals and objectives are to authorize VA to cover the cost of
care in a medical foster home for certain veterans, create a
new fourth administration at VA, and make nominal changes to
home loan funding fees.
New Budget Authority, Entitlement Authority, and Tax Expenditures
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee adopts as its
own the estimate of new budget authority, entitlement
authority, or tax expenditures or revenues contained in the
cost estimate prepared by the Director of the Congressional
Budget Office pursuant to section 402 of the Congressional
Budget Act of 1974.
Earmarks and Tax and Tariff Benefits
H.R. 5693, as amended, does not contain any Congressional
earmarks, limited tax benefits, or limited tariff benefits as
defined in clause 9 of rule XXI of the Rules of the House of
Representatives.
Committee Cost Estimate
The Committee adopts as its own the cost estimate on H.R.
5693, as amended, prepared by the Director of the Congressional
Budget Office pursuant to section 402 of the Congressional
Budget Act of 1974.
Congressional Budget Office Cost Estimate
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate
for H.R. 5693, as amended, provided by the Director of the
Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, July 19, 2018.
Hon. Phil Roe, M.D.,
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 5693, the Long-
Term Care Veterans Choice Act.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Ann E.
Futrell.
Sincerely,
Mark P. Hadley
(For Keith Hall, Director).
Enclosure.
H.R. 5693--Long-Term Care Veterans Choice Act
Summary: H.R. 5693 would expand the authority of the
Department of Veterans Affairs (VA) to provide long-term care
for certain veterans and would reorganize the administration of
several veterans benefit programs. CBO estimates that
implementing the bill would cost $200 million over the 2019-
2023 period, assuming appropriation of the necessary amounts.
In addition, the bill would modify the program that
provides mortgage loan guarantees for veterans. CBO estimates
that enacting H.R. 5693 would decrease direct spending by $202
million over the 2019-2028 period.
Pay-as-you-go procedures apply because enacting the
legislation would affect direct spending. Enacting the bill
would not affect revenues.
CBO estimates that enacting H.R. 5693 would not increase
net direct spending or on-budget deficits in any of the four
consecutive 10-year periods beginning in 2029.
H.R. 5693 contains no intergovernmental or private-sector
mandates as defined in the Unfounded Mandates Reform Act
(UMRA).
Estimated cost to the Federal Government: The estimated
budgetary effects of H.R. 5693 are shown in Table 1. The costs
of the legislation fall within budget function 700 (veterans
benefits and services).
TABLE 1.--ESTIMATED BUDGETARY EFFECTS OF H.R. 5693, THE LONG-TERM CARE VETERANS CHOICE ACT
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
-----------------------------------------------------------------------------------------------------------------------------------
2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2019-2023 2019-2028
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
INCREASES IN SPENDING SUBJECT TO APPROPRIATION
Estimated Authorization Level............................... 0 1 47 48 57 56 n.a. n.a. n.a. n.a. n.a. 209 n.a.
Estimated Outlays........................................... 0 1 42 47 55 55 n.a. n.a. n.a. n.a. n.a. 200 n.a.
DECREASES IN DIRECT SPENDING
Estimated Budget Authority.................................. 0 -35 -42 -37 -34 -29 -25 0 0 0 0 -177 -202
Estimated Outlays........................................... 0 -35 -42 -37 -34 -29 -25 0 0 0 0 -177 -202
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
n.a. = not applicable.
Basis of Estimate: For this estimate, CBO assumes that H.R.
5693 will be enacted near the beginning of fiscal year 2019 and
that the estimated amounts will be appropriated each year.
Estimated outlays are based on historical spending patterns for
the affected programs.
Spending subject to appropriation
H.R. 5693 would authorize VA to provide long-term care to
veterans in medical foster homes (MFHs) and establish a new
organization in VA to administer readjustment benefits,
transition assistance, and several other benefit programs that
are currently part of the Veterans Benefits Administration. In
total, CBO estimates that implementing the bill would cost $200
million over the 2019-2023 period, assuming appropriation of
the necessary amounts (see Table 2).
Medical Foster Homes. For the three-year period beginning
on October 1, 2019, section 2 would authorize VA to place up to
900 veterans (on an average daily basis) with severe service-
connected disabilities in MFHs and to pay the full cost of
their stay in those establishments. A MFH is a private home in
which a trained caregiver provides services to a few
individuals. VA has an existing program to inspect and approve
MFHs for veterans. Veterans currently living in such homes are
eligible to receive VA's Home Based Primary Care services,
which include case management and health care provided in the
home. This bill would authorize VA to also pay for the cost of
living (room and board) in MFHs. CBO expects that once veterans
are placed in medical foster care under this new program, VA
would continue to pay for their stays in those facilities
indefinitely so that the costs for the program would continue
after 2022.
TABLE 2.--ESTIMATE OF THE EFFECTS ON SPENDING SUBJECT TO APPROPRIATION OF H.R. 5693, THE LONG-TERM CARE VETERANS
CHOICE ACT
----------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
----------------------------------------------------------------------
2018 2019 2020 2021 2022 2023 2019-2023
----------------------------------------------------------------------------------------------------------------
Medical Foster Homes:
Estimated Authorization Level........ 0 0 34 41 50 49 174
Estimated Outlays.................... 0 0 30 39 48 48 165
Veterans Economic Opportunity and
Transition Administration:
Estimated Authorization Level........ 0 1 13 7 7 7 35
Estimated Outlays.................... 0 1 12 8 7 7 35
Total Changes in Spending Subject to
Appropriation:
Estimated Authorization Level.... 0 1 47 48 57 56 209
Estimated Outlays................ 0 1 42 47 55 55 200
----------------------------------------------------------------------------------------------------------------
Of the 900 veterans eligible for this program, CBO
estimates that 600 would become residents of MFHs as a result
of the bill's enactment. For those veterans, VA would pay for
their living expenses, as well as the costs for Home Based
Primary Care services. We estimate that those veterans would
receive health care that would cost $16,000 per year more than
they would receive under current law because providing care in
individual homes is costlier than providing health care at VA
medical facilities. Including the costs for living expenses at
the MFHs of $42,000 per year, on average, we estimate total
costs per new resident of $58,000 per year, on average. On that
basis, CBO estimates that total costs for new MFH residents
would be about $35 million a year.
CBO estimates that the remaining 300 veterans would be
those who are already living in MFHs. Because VA currently
provides those veterans with in-home health care services, the
estimated incremental cost would be $42,000 a year per veteran
to cover the expense of living in the MFHs. Those costs would
total about $10 million a year for those 300 veterans, CBO
estimates.
After accounting for inflation, the appropriate mortality
rates, and a gradual implementation period to reflect the
necessary time for VA to transition additional veterans into
the MFH program, CBO estimates that implementing this bill
would cost an additional $165 million over the 2019-2023
period, assuming appropriation of the necessary amounts.
Veterans Economic Opportunity and Transition
Administration. Sections 3 and 4 would create a new
administration at VA to manage programs for readjustment
benefits, home-loan guarantees, and small-business assistance.
Beginning in fiscal year 2020, the bill would establish the
Veterans Economic Opportunity and Transition Administration
(VEOTA). The Veterans Benefits Administration (VBA) currently
manages the following benefit programs for veterans and other
eligible individuals:
Disability compensation;
Pension, dependency and indemnity
compensation, burial, and fiduciary programs;
Readjustment benefits (including education
and vocational rehabilitation benefits);
Home-loan guarantees;
Small business programs; and
Insurance.
This bill would transfer some programs that are currently
administered by VBA to VEOTA. Under this new organizational
structure, all readjustment benefit programs (including
employment programs), the home-loan guarantee program,
veterans' small business programs, and VA's responsibilities
under the transition assistance program would be managed by
VEOTA. VBA and VEOTA each would be led by an Undersecretary.
Section 3 would limit the total number of full-time equivalent
(FTE) positions serving in both administrations to 23,692 in
fiscal years 2019 and 2020.
VA reports that about 4,400 VA employees currently oversee
and carry out the benefits programs that would transfer to
VEOTA under this provision. CBO estimates that those personnel,
and the records, property, and budgetary resources currently
used by VBA to manage those programs also would be transferred.
Using the current operating costs for VBA of $115 million, we
estimate a 10 percent increase in 2020 to capture moving
expenses, IT costs and other reorganization expenses, and about
a 3 percent increase thereafter for ongoing operating expenses.
Those estimated additional operating costs would total about
$22 million over the 2019-2023 period. In addition, CBO
estimates that VEOTA would require an additional 20 FTE
positions at an average annual cost of $200,000 to manage the
daily operations of the new administration. CBO estimates costs
of $13 million for those additional staff.
In total, CBO estimates that establishing VEOTA would cost
$35 million over the 2019-2023 period.
Direct spending
Section 5 would change the fee that VA charges veterans for
providing loan guarantees under its home loan program. Under
that program, VA provides lenders a payment of up to 25 percent
of the outstanding mortgage balances (subject to some
limitations on the original loan amounts) in the event that
veterans default on guaranteed loans. The guarantees enable
veterans to get better loan terms, such as lower interest rates
or smaller down payments. The fee varies by several factors
such as the type of the loan and the amount of the down
payment. Increasing the fee would lower the subsidy cost of the
guarantees by partially offsetting the costs of subsequent
defaults.\1\ (Reducing the fee would have the opposite effect.)
The subsidy cost of VA loan guarantees are paid from mandatory
appropriations. Hence, changing the subsidy cost would affect
direct spending.
---------------------------------------------------------------------------
\1\Under the Federal Credit Reform Act of 1990, the subsidy cost of
a loan guarantee is the net present value of estimated payments by the
government to cover defaults and delinquencies, interest subsidies, or
other expenses, offset by any payments to the government, including
origination fees, other fees, penalties, and recoveries on defaulted
loans. Such subsidy costs are calculated by discounting those expected
cash flows using the rate on Treasury securities of comparable
maturity. The resulting estimated subsidy costs are recorded in the
budget when the loans are disbursed.
---------------------------------------------------------------------------
Veterans can refinance VA-guaranteed loans with another
loan that also would be guaranteed by VA. Those borrowers pay a
fee of 0.50 percent of the new principal if the amount of the
new loan is the same as the outstanding principal balance of
the prior loan and the interest rate on the new loan is lower.
Section 5 would increase that fee to 0.75 percent of the
principal amount for loans that are refinanced after December
31, 2018, and before October 1, 2024. After that latter date,
the fee would revert to 0.50 percent.
Using information from VA on the number and size of
refinancing loans guaranteed in recent years, the default rate
for those loans, and the amount of fees collected, CBO
estimates that increasing the fees would decrease direct
spending by $202 million over the 2019-2028 period.
Pay-As-You-Go considerations: The Statutory Pay-As-You-Go
Act of 2010 establishes budget-reporting and enforcement
procedures for legislation affecting direct spending or
revenues. The net changes in outlays that are subject to those
pay-as-you-go procedures are shown in Table 3.
TABLE 3.--CBO ESTIMATE OF PAY-AS-YOU-GO EFFECTS OF H.R. 5693, THE LONG-TERM CARE VETERANS CHOICE ACT, AS ORDERED REPORTED BY THE HOUSE COMMITTEE ON VETERANS' AFFAIRS ON JULY 12, 2018
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
-----------------------------------------------------------------------------------------------------------------------------------
2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2019-2023 2019-2028
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
DECREASES IN THE ON-BUDGET DEFICIT
Statutory Pay-As-You-Go Impact.............................. 0 -35 -42 -37 -34 -29 -25 0 0 0 0 -177 -202
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Increase in long-term direct spending and deficits: CBO
estimates that enacting H.R. 5693 would not increase net direct
spending or on-budget deficits in any of the four consecutive
10-year periods beginning in 2029.
Mandates: H.R. 5693 contains no intergovernmental or
private-sector mandates as defined in UMRA.
Estimate prepared by: Federal Costs: Ann E. Futrell, David
Newman, and Logan Smith; Mandates: Andrew Laughlin.
Estimate reviewed by: Sarah Jennings Chief, Defense,
International Affairs, and Veterans' Affairs Cost Estimates
Unit; Leo Lex, Deputy Assistant Director for Budget Analysis.
Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates regarding H.R. 5693, as amended, prepared by the
Director of the Congressional Budget Office pursuant to section
423 of the Unfunded Mandates Reform Act.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act would be created by H.R.
5693, as amended.
Statement of Constitutional Authority
Pursuant to Article I, section 8 of the United States
Constitution, H.R. 5693, as amended, is authorized by Congress'
power to ``provide for the common Defense and general Welfare
of the United States.''
Applicability to Legislative Branch
The Committee finds that H.R. 5693, as amended, does not
relate to the terms and conditions of employment or access to
public services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
Statement on Duplication of Federal Programs
Pursuant to clause 3(c)(5) of rule XIII of the Rules of the
House of Representatives, the Committee finds that no provision
of H.R. 5693, as amended, establishes or reauthorizes a program
of the Federal Government known to be duplicative of another
Federal program, a program that was included in any report from
the Government Accountability Office to Congress pursuant to
section 21 of Public Law 111-139, or a program related to a
program identified in the most recent Catalog of Federal
Domestic Assistance.
Disclosure of Directed Rulemaking
Pursuant to section 3(i) of H. Res. 5, 115th Cong. (2017),
the Committee estimates that H.R. 5693, as amended, contains no
directed rulemaking that would require the Secretary to
prescribe regulations.
Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 of the bill would provide a short title of the
bill as the ``Long-Term Care Veterans Choice Act.''
Section 2. Secretary of Veterans Affairs contract authority for
placement of Veterans Affairs in non-department medical foster
homes
Section 2(a) of the bill would amend section 1720 of title
38 U.S.C. by adding at the new the following new subsection:
``(h)(1) During the three year period beginning on October 1,
2019, and subject to paragraph (2), at the request of a veteran
for whom the Secretary is required to provide nursing home care
under section 1710A of this title, the Secretary may place the
veteran in a medical foster home that meets Department
standards, at the expense of the United States, pursuant to a
contract, agreement, or other arrangement entered into between
the Secretary and the medical foster home for such purpose. A
veteran who is placed in a medical foster home under this
subsection shall agree, as a condition of such placement, to
accept home health services furnished by the Secretary under
section 1717 of this tile. (2) In any year, not more than a
daily average of 900 veterans placed in a medical foster home,
whether placed before or after the date of enactment of this
subsection, may have their care covered at the expense of the
United States under subsection (a). (3) In this subsection, the
term medical foster home' means a home designed to provide non-
institutional, long-term, supportive care for veterans who are
unable to live independently and prefer a family setting.''.
Section 2(b) of the bill would provide an effective date
for subsection (h) of title 38 U.S.C. as October 1, 2019.
Section 3. Establishment of Veterans Economic Opportunity and
Transition Administration
Section 3(a) of the bill would amend Part V of title 38
U.S.C. by adding at the end the following new chapter:
``Chapter 80--Veterans Economic Opportunity and Transition
Administration.''
The new section 8001 would establish within VA the VEOTA
with a primary function of administering VA programs that
provide assistance related to economic opportunity to veterans
and their dependents and survivors. The new section 8001 would
also establish within VA the Under Secretary for Veterans
Economic Opportunity and Transition to be directly responsible
to the VA Secretary for the operations of the VEOTA.
The new section 8002 would establish that the VEOTA is
responsible for the administration of the following VA
programs: vocational rehabilitation and employment programs;
educational programs; veterans' housing loan and related
programs; the verification of small businesses owned and
controlled by veterans pursuant to subsection (f) of section
8127 of title 38 U.S.C., including the administration of the
database of veteran-owned businesses described in such
subsection; VA's portion of TAP under section 1144 of title 10
U.S.C.; and any other VA program that the VA Secretary
determines appropriate.
The new section 8003 would require VA to include in the
annual report to Congress required by section 529 of title 38
U.S.C. a report on the programs administered by the Under
Secretary for Veterans Economic Opportunity and Transition and
require each such report to include the following with respect
to each such program during the fiscal year covered by that
report: the number of claims received; the number of claims
decided; the average processing time for a claim; the number of
successful outcomes (as described by VA); the number of full-
time equivalent employees; and the amounts expended for
information technology.
Section 3(a) of the bill would also amend the table of
chapters at the beginning of title 38 U.S.C. and of part V of
title 38 U.S.C. by inserting after the item relating to chapter
79 a new item relating to the Veterans Economic Opportunity and
Transition Administration.
Section 3(b) of the bill would require an effective date
for the new chapter 80 of title 38 U.S.C. as added by
subsection (a) of October 1, 2019.
Section 3(c) of the bill would require that, for fiscal
years 2019 and 2020, the title number of the full-time
equivalent employees authorized for the Veterans Benefits
Administration and the Veterans Economic Opportunity and
Transition Administration, as established under the new chapter
80 of title 38 U.S.C. as added by subsection (a) of the bill,
may not exceed 23,692.
Section 4. Under Secretary for Veterans Economic Opportunity and
Transition
Section 4(a) of the bill would amend chapter 3 of title 38
U.S.C. by inserting after section 306 the following new
section: ``306A. Under Secretary for Veterans Economic
Opportunity and Transition''.
The new subsection 306A(a) would establish within VA an
Under Secretary for Veterans Economic Opportunity and
Transition, who is appointed by the President by and with the
advice and consent of the Senate. The new subsection 306A(a)
would also require that the Under Secretary for Veterans
Economic Opportunity and Transition be appointed without regard
to political affiliation or activity and solely on the basis of
demonstrated ability in information technology and the
administration of programs within the VEOTA or programs of
similar content and scope.
The new subsection 306A(b) would require that the Under
Secretary for Veterans Economic Opportunity and Transition is
the head of, and directly responsible to the VA Secretary for
the operations of, the VEOTA.
The new subsection 306A(c) would require that, whenever a
vacancy in the position of Under Secretary for Veterans
Economic Opportunity and Transition occurs or is anticipated,
the VA Secretary shall establish a commission to recommend
individuals to the President for appointment to the position.
The new subsection 306A(c) would also require that such
commission be composed of the following members appointed by
the VA Secretary: three persons representing education and
training, vocational rehabilitation, employment, real estate,
mortgage finance and related industries, and survivor benefits
activities affected by the VEOTA; two persons representing
veterans served by the VEOTA; two persons who have experience
in the management of private sector benefits programs of
similar content and scope to the VA economic opportunity and
transition programs; the VA Deputy Secretary; the chairman of
the Veterans' Advisory Committee on Education formed under
section 3692 of title 38 U.S.C.; one person who has held the
position of Under Secretary for Veterans Economic Opportunity
and Transition if the VA Secretary determines that it is
desirable for such person to be a member of the commission. The
new subsection 306A(c) would further require that the
commission established under this subsection recommend at least
three individuals for appointment to the position of Under
Secretary for Veterans Economic Opportunity and Transition and
to submit all recommendations to the VA Secretary and the VA
Secretary to forward the recommendations to the President and
the Committees on Veterans' Affairs of the Senate and U.S.
House of Representatives with any comments as the VA Secretary
considers appropriate. It would also authorize the President to
request the commission to recommend additional individuals for
appointment. The new subsection 306A(c) would finally require
the VA Assistant Secretary or Deputy Secretary who performs
personnel management and labor relations functions to serve as
the executive secretary of a commission established under this
subsection and amend the table of sections at the beginning of
chapter 3 of title 38 U.S.C. by inserting after the item
relating to section 306 the following new item: ``306A. Under
Secretary for Veterans Economic Opportunity and Transition.''.
Section 4(b) of the bill would amend section 306(c)(2) of
title 38 U.S.C.: by striking subparagraphs (A) and (E) and
redesignating subparagraphs (B), (C), (D), and (F), as
subparagraphs (A) through (D), respectively; in section
317(d)(2) by inserting after ``Under Secretary for Benefits,''
the following: ``Under Secretary for Veterans Economic
Opportunity and Transition,''; in section 318(d)(2), by
inserting after ``Under Secretary for Benefits, the following:
``Under Secretary for Veterans Economic Opportunity and
Transition,''; in section 516(e)(2)(C), by striking ``Health
and the Under Secretary for Benefits'' and inserting ``Health,
the Under Secretary for Benefits, and the Under Secretary for
Veterans Economic Opportunity and Transition''; in section
541(a)(2)(B) by striking ``Health and the Under Secretary for
Benefits'' and inserting ``Health, the Under Secretary for
Benefits, and the Under Secretary for Veterans Economic
Opportunity and Transition''; in section 542(a)(2)(B)(iii), by
striking ``Health and the Under Secretary for Benefits'' and
inserting ``Health, the Under Secretary for Benefits, and the
Under Secretary for Veterans Economic Opportunity and
Transition; in section 544(a)(2)(B)(vi), by striking ``Health
and Under Secretary for Benefits'' and inserting ``Health, the
Under Secretary for Benefits, and the Under Secretary for
Veterans Economic Opportunity and Transition''; in section
709(c)(2)(A), by inserting after ``Under Secretary for
Benefits,'' the following: ``the Under Secretary for Veterans
Economic Opportunity and Transition,''; in section 7701(a), by
inserting after ``assistance'' the following: ``, other than
assistance related to Economic Opportunity and Transition,'';
and in section 7703, by striking paragraphs (2) and (3) and
redesignating paragraphs (4) and (5) as paragraphs (2) and (3),
respectively.
Section 4(c) of the bill would provide an effective date of
October 1, 2019, for section 306A of title 38 U.S.C. as added
by subsection (a) and the amendments made by this section.
Section 5. Loans guaranteed under home loan program of Department of
Veterans Affairs
Section 5 of the bill would amend section 3729(b)(2)(E) of
title 38 U.S.C. to increase the funding fees for interest rate
reduction refinanced loans from 0.50 to 0.75 for loans made on
or after January 1, 2019, but before October 1, 2024.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italic, and existing law in which no
change is proposed is shown in roman):
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italic, and existing law in which no
change is proposed is shown in roman):
TITLE 38, UNITED STATES CODE
* * * * * * *
PART I. GENERAL PROVISIONS
Chapter Sec.
General........................................................101
* * * * * * *
PART V. BOARDS, ADMINISTRATIONS, AND SERVICES
* * * * * * *
8001Veterans Economic Opportunity and Transition Administration.......
* * * * * * *
PART I--GENERAL PROVISIONS
* * * * * * *
CHAPTER 3--DEPARTMENT OF VETERANS AFFAIRS
Sec.
301. Department.
* * * * * * *
306A. Under Secretary for Veterans Economic Opportunity and Transition.
* * * * * * *
Sec. 306. Under Secretary for Benefits
(a) There is in the Department an Under Secretary for
Benefits, who is appointed by the President, by and with the
advice and consent of the Senate. The Under Secretary for
Benefits shall be appointed without regard to political
affiliation or activity and solely on the basis of demonstrated
ability in--
(1) fiscal management; and
(2) the administration of programs within the
Veterans Benefits Administration or programs of similar
content and scope.
(b) The Under Secretary for Benefits is the head of, and is
directly responsible to the Secretary for the operations of,
the Veterans Benefits Administration.
(c)(1) Whenever a vacancy in the position of Under Secretary
for Benefits occurs or is anticipated, the Secretary shall
establish a commission to recommend individuals to the
President for appointment to the position.
(2) A commission established under this subsection shall be
composed of the following members appointed by the Secretary:
[(A) Three persons representing education and
training, real estate, mortgage finance, and related
industries, and survivor benefits activities affected
by the Veterans Benefits Administration.
[(B)] (A) Two persons representing veterans served by
the Veterans Benefits Administration.
[(C)] (B) Two persons who have experience in the
management of veterans benefits programs or programs of
similar content and scope.
[(D)] (C) The Deputy Secretary of Veterans Affairs.
[(E) The chairman of the Veterans' Advisory Committee
on Education formed under section 3692 of this title.
[(F)] (D) One person who has held the position of
Under Secretary for Benefits (including service as
Chief Benefits Director of the Veterans'
Administration), if the Secretary determines that it is
desirable for such person to be a member of the
commission.
(3) A commission established under this subsection shall
recommend at least three individuals for appointment to the
position of Under Secretary for Benefits. The commission shall
submit all recommendations to the Secretary. The Secretary
shall forward the recommendations to the President with any
comments the Secretary considers appropriate. Thereafter, the
President may request the commission to recommend additional
individuals for appointment.
(4) The Assistant Secretary or Deputy Assistant Secretary of
Veterans Affairs who performs personnel management and labor
relations functions shall serve as the executive secretary of a
commission established under this subsection.
Sec. 306A. Under Secretary for Veterans Economic Opportunity and
Transition
(a) Under Secretary.--There is in the Department an Under
Secretary for Veterans Economic Opportunity and Transition, who
is appointed by the President, by and with the advice and
consent of the Senate. The Under Secretary for Veterans
Economic Opportunity and Transition shall be appointed without
regard to political affiliation or activity and solely on the
basis of demonstrated ability in--
(1) information technology; and
(2) the administration of programs within the
Veterans Economic Opportunity and Transition
Administration or programs of similar content and
scope.
(b) Responsibilities.--The Under Secretary for Veterans
Economic Opportunity and Transition is the head of, and is
directly responsible to the Secretary for the operations of,
the Veterans Economic Opportunity and Transition
Administration.
(c) Vacancies.--(1) Whenever a vacancy in the position of
Under Secretary for Veterans Economic Opportunity and
Transition occurs or is anticipated, the Secretary shall
establish a commission to recommend individuals to the
President for appointment to the position.
(2) A commission established under this subsection shall be
composed of the following members appointed by the Secretary:
(A) Three persons representing education and
training, vocational rehabilitation, employment, real
estate, mortgage finance and related industries, and
survivor benefits activities affected by the Veterans
Economic Opportunity and Transition Administration.
(B) Two persons representing veterans served by the
Veterans Economic Opportunity and Transition
Administration.
(C) Two persons who have experience in the management
of private sector benefits programs of similar content
and scope to the economic opportunity and transition
programs of the Department.
(D) The Deputy Secretary of Veterans Affairs.
(E) The chairman of the Veterans' Advisory Committee
on Education formed under section 3692 of this title.
(F) One person who has held the position of Under
Secretary for Veterans Economic Opportunity and
Transition, if the Secretary determines that it is
desirable for such person to be a member of the
commission.
(3) A commission established under this subsection shall
recommend at least three individuals for appointment to the
position of Under Secretary for Veterans Economic Opportunity
and Transition. The commission shall submit all recommendations
to the Secretary. The Secretary shall forward the
recommendations to the President and the Committees on
Veterans' Affairs of the Senate and House of Representatives
with any comments the Secretary considers appropriate.
Thereafter, the President may request the commission to
recommend additional individuals for appointment.
(4) The Assistant Secretary or Deputy Assistant Secretary of
Veterans Affairs who performs personnel management and labor
relations functions shall serve as the executive secretary of a
commission established under this subsection.
* * * * * * *
Sec. 317. Center for Minority Veterans
(a) There is in the Department a Center for Minority
Veterans. There is at the head of the Center a Director.
(b) The Director shall be a career or noncareer appointee in
the Senior Executive Service. The Director shall be appointed
for a term of six years.
(c) The Director reports directly to the Secretary or the
Deputy Secretary concerning the activities of the Center.
(d) The Director shall perform the following functions with
respect to veterans who are minorities:
(1) Serve as principal adviser to the Secretary on
the adoption and implementation of policies and
programs affecting veterans who are minorities.
(2) Make recommendations to the Secretary, the Under
Secretary for Health, the Under Secretary for Benefits,
the Under Secretary for Veterans Economic Opportunity
and Transition, and other Department officials for the
establishment or improvement of programs in the
Department for which veterans who are minorities are
eligible.
(3) Promote the use of benefits authorized by this
title by veterans who are minorities and the conduct of
outreach activities to veterans who are minorities, in
conjunction with outreach activities carried out under
chapter 77 of this title.
(4) Disseminate information and serve as a resource
center for the exchange of information regarding
innovative and successful programs which improve the
services available to veterans who are minorities.
(5) Conduct and sponsor appropriate social and
demographic research on the needs of veterans who are
minorities and the extent to which programs authorized
under this title meet the needs of those veterans,
without regard to any law concerning the collection of
information from the public.
(6) Analyze and evaluate complaints made by or on
behalf of veterans who are minorities about the
adequacy and timeliness of services provided by the
Department and advise the appropriate official of the
Department of the results of such analysis or
evaluation.
(7) Consult with, and provide assistance and
information to, officials responsible for administering
Federal, State, local, and private programs that assist
veterans, to encourage those officials to adopt
policies which promote the use of those programs by
veterans who are minorities.
(8) Advise the Secretary when laws or policies have
the effect of discouraging the use of benefits by
veterans who are minorities.
(9) Publicize the results of medical research which
are of particular significance to veterans who are
minorities.
(10) Advise the Secretary and other appropriate
officials on the effectiveness of the Department's
efforts to accomplish the goals of section 492B of the
Public Health Service Act (42 U.S.C. 289a-2) with
respect to the inclusion of minorities in clinical
research and on particular health conditions affecting
the health of members of minority groups which should
be studied as part of the Department's medical research
program and promote cooperation between the Department
and other sponsors of medical research of potential
benefit to veterans who are minorities.
(11) Provide support and administrative services to
the Advisory Committee on Minority Veterans provided
for under section 544 of this title.
(12) Perform such other duties consistent with this
section as the Secretary shall prescribe.
(e) The Secretary shall ensure that the Director is furnished
sufficient resources to enable the Director to carry out the
functions of the Center in a timely manner.
(f) The Secretary shall include in documents submitted to
Congress by the Secretary in support of the President's budget
for each fiscal year--
(1) detailed information on the budget for the
Center;
(2) the Secretary's opinion as to whether the
resources (including the number of employees) proposed
in the budget for that fiscal year are adequate to
enable the Center to comply with its statutory and
regulatory duties; and
(3) a report on the activities and significant
accomplishments of the Center during the preceding
fiscal year.
(g) In this section--
(1) The term ``veterans who are minorities'' means
veterans who are minority group members.
(2) The term ``minority group member'' has the
meaning given such term in section 544(d) of this
title.
Sec. 318. Center for Women Veterans
(a) There is in the Department a Center for Women Veterans.
There is at the head of the Center a Director.
(b) The Director shall be a career or noncareer appointee in
the Senior Executive Service. The Director shall be appointed
for a term of six years.
(c) The Director reports directly to the Secretary or the
Deputy Secretary concerning the activities of the Center.
(d) The Director shall perform the following functions with
respect to veterans who are women:
(1) Serve as principal adviser to the Secretary on
the adoption and implementation of policies and
programs affecting veterans who are women.
(2) Make recommendations to the Secretary, the Under
Secretary for Health, the Under Secretary for Benefits,
the Under Secretary for Veterans Economic Opportunity
and Transition, and other Department officials for the
establishment or improvement of programs in the
Department for which veterans who are women are
eligible.
(3) Promote the use of benefits authorized by this
title by veterans who are women and the conduct of
outreach activities to veterans who are women, in
conjunction with outreach activities carried out under
chapter 77 of this title.
(4) Disseminate information and serve as a resource
center for the exchange of information regarding
innovative and successful programs which improve the
services available to veterans who are women.
(5) Conduct and sponsor appropriate social and
demographic research on the needs of veterans who are
women and the extent to which programs authorized under
this title meet the needs of those veterans, without
regard to any law concerning the collection of
information from the public.
(6) Analyze and evaluate complaints made by or on
behalf of veterans who are women about the adequacy and
timeliness of services provided by the Department and
advise the appropriate official of the Department of
the results of such analysis or evaluation.
(7) Consult with, and provide assistance and
information to, officials responsible for administering
Federal, State, local, and private programs that assist
veterans, to encourage those officials to adopt
policies which promote the use of those programs by
veterans who are women.
(8) Advise the Secretary when laws or policies have
the effect of discouraging the use of benefits by
veterans who are women.
(9) Publicize the results of medical research which
are of particular significance to veterans who are
women.
(10) Advise the Secretary and other appropriate
officials on the effectiveness of the Department's
efforts to accomplish the goals of section 492B of the
Public Health Service Act (42 U.S.C. 289a-2) with
respect to the inclusion of women in clinical research
and on particular health conditions affecting women's
health which should be studied as part of the
Department's medical research program and promote
cooperation between the Department and other sponsors
of medical research of potential benefit to veterans
who are women.
(11) Provide support and administrative services to
the Advisory Committee on Women Veterans established
under section 542 of this title.
(12) Perform such other duties consistent with this
section as the Secretary shall prescribe.
(e) The Secretary shall ensure that the Director is furnished
sufficient resources to enable the Director to carry out the
functions of the Center in a timely manner.
(f) The Secretary shall include in documents submitted to
Congress by the Secretary in support of the President's budget
for each fiscal year--
(1) detailed information on the budget for the
Center;
(2) the Secretary's opinion as to whether the
resources (including the number of employees) proposed
in the budget for that fiscal year are adequate to
enable the Center to comply with its statutory and
regulatory duties; and
(3) a report on the activities and significant
accomplishments of the Center during the preceding
fiscal year.
* * * * * * *
CHAPTER 5--AUTHORITY AND DUTIES OF THE SECRETARY
* * * * * * *
SUBCHAPTER I--GENERAL AUTHORITIES
* * * * * * *
Sec. 516. Equal employment responsibilities
(a) The Secretary shall provide that the employment
discrimination complaint resolution system within the
Department be established and administered so as to encourage
timely and fair resolution of concerns and complaints. The
Secretary shall take steps to ensure that the system is
administered in an objective, fair, and effective manner and in
a manner that is perceived by employees and other interested
parties as being objective, fair, and effective.
(b) The Secretary shall provide--
(1) that employees responsible for counseling
functions associated with employment discrimination and
for receiving, investigating, and processing complaints
of employment discrimination shall be supervised in
those functions by, and report to, an Assistant
Secretary or a Deputy Assistant Secretary for complaint
resolution management; and
(2) that employees performing employment
discrimination complaint resolution functions at a
facility of the Department shall not be subject to the
authority, direction, and control of the Director of
the facility with respect to those functions.
(c) The Secretary shall ensure that all employees of the
Department receive adequate education and training for the
purposes of this section and section 319 of this title.
(d) The Secretary shall, when appropriate, impose
disciplinary measures, as authorized by law, in the case of
employees of the Department who engage in unlawful employment
discrimination, including retaliation against an employee
asserting rights under an equal employment opportunity law.
(e)(1)(A) Not later than 45 days after the end of each
calendar quarter, the Assistant Secretary for Human Resources
and Administration shall submit to the Committees on Veterans'
Affairs of the Senate and House of Representatives a report
summarizing the employment discrimination complaints filed
against the individuals referred to in paragraph (2) during
such quarter.
(B) Subparagraph (A) shall apply in the case of complaints
filed against individuals on the basis of such individuals'
personal conduct and shall not apply in the case of complaints
filed solely on the basis of such individuals' positions as
officials of the Department.
(2) Paragraph (1) applies to the following officers and
employees of the Department:
(A) The Secretary.
(B) The Deputy Secretary of Veterans Affairs.
(C) The Under Secretary for [Health and the Under
Secretary for Benefits] Health, the Under Secretary for
Benefits, and the Under Secretary for Veterans Economic
Opportunity and Transition.
(D) Each Assistant Secretary of Veterans Affairs and
each Deputy Assistant Secretary of Veterans Affairs.
(E) The Under Secretary of Veterans Affairs for
Memorial Affairs.
(F) The General Counsel of the Department.
(G) The Chairman of the Board of Veterans' Appeals.
(H) The Chairman of the Board of Contract Appeals of
the Department.
(I) The director and the chief of staff of each
medical center of the Department.
(J) The director of each Veterans Integrated Services
Network.
(K) The director of each regional office of the
Department.
(L) Each program director of the Central Office of
the Department.
(3) Each report under this subsection--
(A) may not disclose information which identifies the
individuals filing, or the individuals who are the
subject of, the complaints concerned or the facilities
at which the discrimination identified in such
complaints is alleged to have occurred;
(B) shall summarize such complaints by type and by
equal employment opportunity field office area in which
filed; and
(C) shall include copies of such complaints, with the
information described in subparagraph (A) redacted.
(4) Not later than April 1 each year, the Assistant Secretary
shall submit to the committees referred to in paragraph (1)(A)
a report on the complaints covered by paragraph (1) during the
preceding year, including the number of such complaints filed
during that year and the status and resolution of the
investigation of such complaints.
(f) The Secretary shall ensure that an employee of the
Department who seeks counseling relating to employment
discrimination may elect to receive such counseling from an
employee of the Department who carries out equal employment
opportunity counseling functions on a full-time basis rather
than from an employee of the Department who carries out such
functions on a part-time basis.
(g) The number of employees of the Department whose duties
include equal employment opportunity counseling functions as
well as other, unrelated functions may not exceed 40 full-time
equivalent employees. Any such employee may be assigned equal
employment opportunity counseling functions only at Department
facilities in remote geographic locations (as determined by the
Secretary). The Secretary may waive the limitation in the
preceding sentence in specific cases.
(h) The provisions of this section shall be implemented in a
manner consistent with procedures applicable under regulations
prescribed by the Equal Employment Opportunity Commission.
* * * * * * *
SUBCHAPTER III--ADVISORY COMMITTEES
Sec. 541. Advisory Committee on Former Prisoners of War
(a)(1) The Secretary shall establish an advisory committee to
be known as the Advisory Committee on Former Prisoners of War
(hereinafter in this section referred to as the ``Committee'').
(2)(A) The members of the Committee shall be appointed by the
Secretary from the general public and shall include--
(i) appropriate representatives of veterans who are
former prisoners of war;
(ii) individuals who are recognized authorities in
fields pertinent to disabilities prevalent among former
prisoners of war, including authorities in
epidemiology, mental health, nutrition, geriatrics, and
internal medicine; and
(iii) appropriate representatives of disabled
veterans.
(B) The Committee shall also include, as ex officio members,
the Under Secretary for [Health and the Under Secretary for
Benefits] Health, the Under Secretary for Benefits, and the
Under Secretary for Veterans Economic Opportunity and
Transition, or their designees.
(3) The Secretary shall determine the number, terms of
service, and pay and allowances of members of the Committee
appointed by the Secretary, except that the term of service of
any such member may not exceed three years.
(b) The Secretary shall, on a regular basis, consult with and
seek the advice of the Committee with respect to the
administration of benefits under this title for veterans who
are former prisoners of war and the needs of such veterans with
respect to compensation, health care, and rehabilitation.
(c)(1) Not later than July 1 of each odd-numbered year
through 2009, the Committee shall submit to the Secretary a
report on the programs and activities of the Department that
pertain to veterans who are former prisoners of war. Each such
report shall include--
(A) an assessment of the needs of such veterans with
respect to compensation, health care, and
rehabilitation;
(B) a review of the programs and activities of the
Department designed to meet such needs; and
(C) such recommendations (including recommendations
for administrative and legislative action) as the
Committee considers to be appropriate.
(2) The Secretary shall, within 60 days after receiving each
report under paragraph (1), submit to the Congress a copy of
the report, together with any comments concerning the report
that the Secretary considers appropriate.
(3) The Committee may also submit to the Secretary such other
reports and recommendations as the Committee considers
appropriate.
(4) The Secretary shall submit with each annual report
submitted to the Congress pursuant to section 529 of this title
a summary of all reports and recommendations of the Committee
submitted to the Secretary since the previous annual report of
the Secretary submitted to the Congress pursuant to that
section.
Sec. 542. Advisory Committee on Women Veterans
(a)(1) The Secretary shall establish an advisory committee to
be known as the Advisory Committee on Women Veterans
(hereinafter in this section referred to as ``the Committee'').
(2)(A) The Committee shall consist of members appointed by
the Secretary from the general public, including--
(i) representatives of women veterans;
(ii) individuals who are recognized authorities in
fields pertinent to the needs of women veterans,
including the gender-specific health-care needs of
women;
(iii) representatives of both female and male
veterans with service-connected disabilities, including
at least one female veteran with a service-connected
disability and at least one male veteran with a
service-connected disability; and
(iv) women veterans who are recently separated from
service in the Armed Forces.
(B) The Committee shall include, as ex officio members--
(i) the Secretary of Labor (or a representative of
the Secretary of Labor designated by the Secretary
after consultation with the Assistant Secretary of
Labor for Veterans' Employment);
(ii) the Secretary of Defense (or a representative of
the Secretary of Defense designated by the Secretary of
Defense after consultation with the Defense Advisory
Committee on Women in the Services); and
(iii) the Under Secretary for [Health and the Under
Secretary for Benefits] Health, the Under Secretary for
Benefits, and the Under Secretary for Veterans Economic
Opportunity and Transition, or their designees.
(C) The Secretary may invite representatives of other
departments and agencies of the United States to participate in
the meetings and other activities of the Committee.
(3) The Secretary shall determine the number, terms of
service, and pay and allowances of members of the Committee
appointed by the Secretary, except that a term of service of
any such member may not exceed three years. The Secretary may
reappoint any such member for additional terms of service.
(b) The Secretary shall, on a regular basis, consult with and
seek the advice of the Committee with respect to the
administration of benefits by the Department for women
veterans, reports and studies pertaining to women veterans and
the needs of women veterans with respect to compensation,
health care, rehabilitation, outreach, and other benefits and
programs administered by the Department, including the Center
for Women Veterans.
(c)(1) Not later than July 1 of each even-numbered year, the
Committee shall submit to the Secretary a report on the
programs and activities of the Department that pertain to women
veterans. Each such report shall include--
(A) an assessment of the needs of women veterans with
respect to compensation, health care, rehabilitation,
outreach, and other benefits and programs administered
by the Department;
(B) a review of the programs and activities of the
Department designed to meet such needs; and
(C) such recommendations (including recommendations
for administrative and legislative action) as the
Committee considers appropriate.
(2) The Secretary shall, within 60 days after receiving each
report under paragraph (1), submit to the Congress a copy of
the report, together with any comments concerning the report
that the Secretary considers appropriate.
(3) The Committee may also submit to the Secretary such other
reports and recommendations as the Committee considers
appropriate.
(4) The Secretary shall submit with each annual report
submitted to the Congress pursuant to section 529 of this title
a summary of all reports and recommendations of the Committee
submitted to the Secretary since the previous annual report of
the Secretary submitted pursuant to such section.
* * * * * * *
Sec. 544. Advisory Committee on Minority Veterans
(a)(1) The Secretary shall establish an advisory committee to
be known as the Advisory Committee on Minority Veterans
(hereinafter in this section referred to as ``the Committee'').
(2)(A) The Committee shall consist of members appointed by
the Secretary from the general public, including--
(i) representatives of veterans who are minority
group members;
(ii) individuals who are recognized authorities in
fields pertinent to the needs of veterans who are
minority group members;
(iii) veterans who are minority group members and who
have experience in a military theater of operations;
(iv) veterans who are minority group members and who
do not have such experience; and
(v) women veterans who are minority group members and
are recently separated from service in the Armed
Forces.
(B) The Committee shall include, as ex officio members, the
following:
(i) The Secretary of Labor (or a representative of
the Secretary of Labor designated by the Secretary
after consultation with the Assistant Secretary of
Labor for Veterans' Employment).
(ii) The Secretary of Defense (or a representative of
the Secretary of Defense designated by the Secretary of
Defense).
(iii) The Secretary of the Interior (or a
representative of the Secretary of the Interior
designated by the Secretary of the Interior).
(iv) The Secretary of Commerce (or a representative
of the Secretary of Commerce designated by the
Secretary of Commerce).
(v) The Secretary of Health and Human Services (or a
representative of the Secretary of Health and Human
Services designated by the Secretary of Health and
Human Services).
(vi) The Under Secretary for [Health and the Under
Secretary for Benefits] Health, the Under Secretary for
Benefits, and the Under Secretary for Veterans Economic
Opportunity and Transition, or their designees.
(C) The Secretary may invite representatives of other
departments and agencies of the United States to participate in
the meetings and other activities of the Committee.
(3) The Secretary shall determine the number, terms of
service, and pay and allowances of members of the Committee
appointed by the Secretary, except that a term of service of
any such member may not exceed three years. The Secretary may
reappoint any such member for additional terms of service.
(4) The Committee shall meet as often as the Secretary
considers necessary or appropriate, but not less often than
twice each fiscal year.
(b) The Secretary shall, on a regular basis, consult with and
seek the advice of the Committee with respect to the
administration of benefits by the Department for veterans who
are minority group members, reports and studies pertaining to
such veterans and the needs of such veterans with respect to
compensation, health care, rehabilitation, outreach, and other
benefits and programs administered by the Department, including
the Center for Minority Veterans.
(c)(1) Not later than July 1 of each year, the Committee
shall submit to the Secretary a report on the programs and
activities of the Department that pertain to veterans who are
minority group members. Each such report shall include--
(A) an assessment of the needs of veterans who are
minority group members with respect to compensation,
health care, rehabilitation, outreach, and other
benefits and programs administered by the Department;
(B) a review of the programs and activities of the
Department designed to meet such needs; and
(C) such recommendations (including recommendations
for administrative and legislative action) as the
Committee considers appropriate.
(2) The Secretary shall, within 60 days after receiving each
report under paragraph (1), submit to Congress a copy of the
report, together with any comments concerning the report that
the Secretary considers appropriate.
(3) The Committee may also submit to the Secretary such other
reports and recommendations as the Committee considers
appropriate.
(4) The Secretary shall submit with each annual report
submitted to the Congress pursuant to section 529 of this title
a summary of all reports and recommendations of the Committee
submitted to the Secretary since the previous annual report of
the Secretary submitted pursuant to such section.
(d) In this section, the term ``minority group member'' means
an individual who is--
(1) Asian American;
(2) Black;
(3) Hispanic;
(4) Native American (including American Indian,
Alaskan Native, and Native Hawaiian); or
(5) Pacific-Islander American.
(e) The Committee shall cease to exist September 30, 2018.
* * * * * * *
CHAPTER 7--EMPLOYEES
* * * * * * *
SUBCHAPTER I--GENERAL EMPLOYEE MATTERS
* * * * * * *
Sec. 709. Employment restrictions
(a)(1) Notwithstanding section 3134(d) of title 5, the number
of Senior Executive Service positions in the Department which
are filled by noncareer appointees in any fiscal year may not
at any time exceed 5 percent of the average number of senior
executives employed in Senior Executive Service positions in
the Department during the preceding fiscal year.
(2) For purposes of this subsection, the average number of
senior executives employed in Senior Executive Service
positions in the Department during a fiscal year shall be equal
to 25 percent of the sum of the total number of senior
executives employed in Senior Executive Service positions in
the Department on the last day of each quarter of such fiscal
year.
(b) The number of positions in the Department which may be
excepted from the competitive service, on a temporary or
permanent basis, because of their confidential or policy-
determining character may not at any time exceed the equivalent
of 15 positions.
(c)(1) Political affiliation or activity may not be taken
into account in connection with the appointment of any person
to any position in or to perform any service for the Department
or in the assignment or advancement of any employee in the
Department.
(2) Paragraph (1) shall not apply--
(A) to the appointment of any person by the President
under this title, other than the appointment of the
Under Secretary for Health, the Under Secretary for
Benefits, the Under Secretary for Veterans Economic
Opportunity and Transition, and the Inspector General;
or
(B) to the appointment of any person to (i) a Senior
Executive Service position as a noncareer appointee, or
(ii) a position that is excepted from the competitive
service, on a temporary or permanent basis, because of
the confidential or policy-determining character of the
position.
* * * * * * *
PART II--GENERAL BENEFITS
* * * * * * *
CHAPTER 17--HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE
* * * * * * *
SUBCHAPTER II--HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL
TREATMENT
* * * * * * *
Sec. 1720. Transfers for nursing home care; adult day health care
(a)(1) Subject to subsection (b) of this section, the
Secretary may transfer to a non-Department nursing home, for
care at the expense of the United States--
(A) a veteran--
(i) who has been furnished care by the
Secretary in a facility under the direct
jurisdiction of the Secretary; and
(ii) who the Secretary determines--
(I) requires a protracted period of
nursing home care which can be
furnished in the non-Department nursing
home; and
(II) in the case of a veteran who has
been furnished hospital care in a
facility under the direct jurisdiction
of the Secretary, has received maximum
benefits from such care; and
(B) a member of the Armed Forces--
(i) who has been furnished care in a hospital
of the Armed Forces;
(ii) who the Secretary concerned determines
has received maximum benefits from such care
but requires a protracted period of nursing
home care; and
(iii) who upon discharge from the Armed
Forces will become a veteran.
(2) The Secretary may transfer a person to a nursing home
under this subsection only if the Secretary determines that the
cost to the United States of the care of such person in the
nursing home will not exceed--
(A) the amount equal to 45 percent of the cost of
care furnished by the Department in a general hospital
under the direct jurisdiction of the Secretary (as such
cost may be determined annually by the Secretary); or
(B) the amount equal to 50 percent of such cost, if
such higher amount is determined to be necessary by the
Secretary (upon the recommendation of the Under
Secretary for Health) to provide adequate care.
(3) Nursing home care may not be furnished under this
subsection at the expense of the United States for more than
six months in the aggregate in connection with any one transfer
except--
(A) in the case of a veteran--
(i) who is transferred to a non-Department
nursing home from a hospital under the direct
jurisdiction of the Secretary; and
(ii) whose hospitalization was primarily for
a service-connected disability;
(B) in a case in which the nursing home care is
required for a service-connected disability; or
(C) in a case in which, in the judgment of the
Secretary, a longer period of nursing home care is
warranted.
(4) A veteran who is furnished care by the Secretary in a
hospital or domiciliary facility in Alaska or Hawaii may be
furnished nursing home care at the expense of the United States
under this subsection even if such hospital or domiciliary
facility is not under the direct jurisdiction of the Secretary.
(b) No veteran may be transferred or admitted to any
institution for nursing home care under this section, unless
such institution is determined by the Secretary to meet such
standards as the Secretary may prescribe. The standards
prescribed and any report of inspection of institutions
furnishing care to veterans under this section made by or for
the Secretary shall, to the extent possible, be made available
to all Federal, State, and local agencies charged with the
responsibility of licensing or otherwise regulating or
inspecting such institutions.
(c)(1)(A) In furnishing nursing home care, adult day health
care, or other extended care services under this section, the
Secretary may enter into agreements for furnishing such care or
services with--
(i) in the case of the medicare program, a provider
of services that has entered into a provider agreement
under section 1866(a) of the Social Security Act (42
U.S.C. 1395cc(a));
(ii) in the case of the medicaid program, a provider
participating under a State plan under title XIX of
such Act (42 U.S.C. 1396 et seq.); and
(iii) a provider of services eligible to enter into a
contract pursuant to section 1745(a) of this title that
is not otherwise described in clause (i) or (ii).
(B) In entering into an agreement under subparagraph (A) with
a provider of services described in clause (i) of that
subparagraph or a provider described in clause (ii) of that
subparagraph, the Secretary may use the procedures available
for entering into provider agreements under section 1866(a) of
the Social Security Act.
(2) In applying the provisions of section 6704(a) of title 41
with respect to any contract entered into under this section to
provide nursing home care of veterans, the payment of wages not
less than those specified in section 6(b) of the Fair Labor
Standards Act of 1938 (29 U.S.C. 206(b)) shall be deemed to
constitute compliance with such provisions.
(d)(1) Subject to subsection (b) of this section, the
Secretary may authorize for any veteran requiring nursing home
care for a service-connected disability direct admission for
such care at the expense of the United States to any non-
Department nursing home. The Secretary may also authorize a
direct admission to such a nursing home for nursing home care
for any veteran who has been discharged from a hospital under
the direct jurisdiction of the Secretary and who is currently
receiving medical services as part of home health services from
the Department.
(2) Direct admission authorized by paragraph (1) of this
subsection may be authorized upon determination of need
therefor--
(A) by a physician employed by the Department; or
(B) in areas where no such physician is available, by
a physician carrying out such function under contract
or fee arrangement,
based on an examination by such physician.
(3) The amount which may be paid for such care and the length
of care available under this subsection shall be the same as
authorized under subsection (a) of this section.
(e)(1) The cost of intermediate care for purposes of payment
by the United States pursuant to subsection (a)(2)(B) of this
section shall be determined by the Secretary except that the
rate of reimbursement shall be commensurately less than that
provided for nursing home care.
(2) For the purposes of this section, the term ``non-
Department nursing home'' means a public or private institution
not under the direct jurisdiction of the Secretary which
furnishes nursing home care.
(f)(1)(A) The Secretary may furnish adult day health care
services to a veteran enrolled under section 1705(a) of this
title who would otherwise require nursing home care.
(B) The Secretary may provide in-kind assistance (through the
services of Department employees and the sharing of other
Department resources) to a facility furnishing care to veterans
under subparagraph (A) of this paragraph. Any such in-kind
assistance shall be provided under a contract or agreement
between the Secretary and the facility concerned. The Secretary
may provide such assistance only for use solely in the
furnishing of adult day health care and only if, under such
contract or agreement, the Department receives reimbursement
for the full cost of such assistance, including the cost of
services and supplies and normal depreciation and amortization
of equipment. Such reimbursement may be made by reduction in
the charges to the United States or by payment to the United
States. Any funds received through such reimbursement shall be
credited to funds allotted to the Department facility that
provided the assistance.
(2) The Secretary may conduct, at facilities over which the
Secretary has direct jurisdiction, programs for the furnishing
of adult day health care to veterans who are eligible for such
care under paragraph (1) of this subsection, except that
necessary travel and incidental expenses (or transportation in
lieu thereof) may be furnished under such a program only under
the terms and conditions set forth in section 111 of this
title. The furnishing of care under any such program shall be
subject to the limitations that are applicable to the duration
of adult day health care furnished under paragraph (1) of this
subsection.
(g) The Secretary may contract with appropriate entities to
provide specialized residential care and rehabilitation
services to a veteran of Operation Enduring Freedom or
Operation Iraqi Freedom who the Secretary determines suffers
from a traumatic brain injury, has an accumulation of deficits
in activities of daily living and instrumental activities of
daily living, and because of these deficits, would otherwise
require admission to a nursing home even though such care would
generally exceed the veteran's nursing needs.
(h)(1) During the three-year period beginning on October 1,
2019, and subject to paragraph (2), at the request of a veteran
for whom the Secretary is required to provide nursing home care
under section 1710A of this title, the Secretary may place the
veteran in a medical foster home that meets Department
standards, at the expense of the United States, pursuant to a
contract, agreement, or other arrangement entered into between
the Secretary and the medical foster home for such purpose. A
veteran who is placed in a medical foster home under this
subsection shall agree, as a condition of such placement, to
accept home health services furnished by the Secretary under
section 1717 of this title.
(2) In any year, not more than a daily average of 900
veterans placed in a medical foster home, whether placed before
or after the date of the enactment of this subsection, may have
their care covered at the expense of the United States under
subsection (a).
(3) In this subsection, the term ``medical foster home''
means a home designed to provide non-institutional, long-term,
supportive care for veterans who are unable to live
independently and prefer a family setting.
* * * * * * *
PART III--READJUSTMENT AND RELATED BENEFITS
* * * * * * *
CHAPTER 37--HOUSING AND SMALL BUSINESS LOANS
SUBCHAPTER III--ADMINISTRATIVE PROVISIONS
* * * * * * *
Sec. 3729. Loan fee
(a) Requirement of Fee.--(1) Except as provided in subsection
(c), a fee shall be collected from each person obtaining a
housing loan guaranteed, insured, or made under this chapter,
and each person assuming a loan to which section 3714 of this
title applies. No such loan may be guaranteed, insured, made,
or assumed until the fee payable under this section has been
remitted to the Secretary.
(2) The fee may be included in the loan and paid from the
proceeds thereof.
(b) Determination of Fee.--(1) The amount of the fee shall be
determined from the loan fee table in paragraph (2). The fee is
expressed as a percentage of the total amount of the loan
guaranteed, insured, or made, or, in the case of a loan
assumption, the unpaid principal balance of the loan on the
date of the transfer of the property.
(2) The loan fee table referred to in paragraph (1) is as
follows:
LOAN FEE TABLE
------------------------------------------------------------------------
Active duty
Type of loan veteran Reservist Other obligor
------------------------------------------------------------------------
(A)(i) Initial 2.00 2.75 NA
loan
described in
section 3710
(a) to
purchase or
construct a
dwelling with
0-down, or
any other
initial loan
described in
section 3710
(a) other
than with 5-
down or 10-
down (closed
before
January 1,
2004)
(A)(ii) 2.20 2.40 NA
Initial loan
described in
section 3710
(a) to
purchase or
construct a
dwelling with
0-down, or
any other
initial loan
described in
section 3710
(a) other
than with 5-
down or 10-
down (closed
on or after
January 1,
2004, and
before
October 1,
2004)
(A)(iii) 2.15 2.40 NA
Initial loan
described in
section 3710
(a) to
purchase or
construct a
dwelling with
0-down, or
any other
initial loan
described in
section 3710
(a) other
than with 5-
down or 10-
down (closed
on or after
October 1,
2004, and
before
September 30,
2027)
(A)(iv) 1.40 1.65 NA
Initial loan
described in
section 3710
(a) to
purchase or
construct a
dwelling with
0-down, or
any other
initial loan
described in
section 3710
(a) other
than with 5-
down or 10-
down (closed
on or after
September 30,
2027)
(B)(i) 3.30 3.30 NA
Subsequent
loan
described in
section 3710
(a) to
purchase or
construct a
dwelling with
0-down, or
any other
subsequent
loan
described in
section 3710
(a) (closed
before
September 30,
2027)
(B)(ii) 1.25 1.25 NA
Subsequent
loan
described in
section 3710
(a) to
purchase or
construct a
dwelling with
0-down, or
any other
subsequent
loan
described in
section 3710
(a) (closed
on or after
September 30,
2027)
(C)(i) Loan 1.50 1.75 NA
described in
section 3710
(a) to
purchase or
construct a
dwelling with
5-down
(closed
before
September 30,
2027)
(C)(ii) Loan 0.75 1.00 NA
described in
section 3710
(a) to
purchase or
construct a
dwelling with
5-down
(closed on or
after
September 30,
2027)
(D)(i) Initial 1.25 1.50 NA
loan
described in
section 3710
(a) to
purchase or
construct a
dwelling with
10-down
(closed
before
September 30,
2027)
(D)(ii) 0.50 0.75 NA
Initial loan
described in
section 3710
(a) to
purchase or
construct a
dwelling with
10-down
(closed on or
after
September 30,
2027)
[(E) Interest 0.50 0.50 NA]
rate
reduction
refinancing
loan
(E)(i) 0.50 0.50 NA
Interest rate
reduction
refinancing
loan (closed
before
January 1,
2019)
(E)(ii) 0.75 0.75 NA
Interest rate
reduction
refinancing
loan (closed
on or after
January 1,
2019, but
before
October 1,
2024)
(E)(iii) 0.50 0.50 NA
Interest rate
reduction
refinancing
loan (closed
on or after
October 1,
2024)
(F) Direct 1.00 1.00 NA
loan under
section 3711
(G) 1.00 1.00 NA
Manufactured
home loan
under section
3712 (other
than an
interest rate
reduction
refinancing
loan)
(H) Loan to 1.25 1.25 NA
Native
American
veteran under
section 3762
(other than
an interest
rate
reduction
refinancing
loan)
(I) Loan 0.50 0.50 0.50
assumption
under section
3714
(J) Loan under 2.25 2.25 2.25
section 3733
(a)
------------------------------------------------------------------------
(3) Any reference to a section in the ``Type of loan'' column
in the loan fee table in paragraph (2) refers to a section of
this title.
(4) For the purposes of paragraph (2):
(A) The term ``active duty veteran'' means any
veteran eligible for the benefits of this chapter other
than a Reservist.
(B) The term ``Reservist'' means a veteran described
in section 3701 (b)(5)(A) of this title who is eligible
under section 3702(a)(2)(E) of this title.
(C) The term ``other obligor'' means a person who is
not a veteran, as defined in section 101 of this title
or other provision of this chapter.
(D) The term ``initial loan'' means a loan to a
veteran guaranteed under section 3710 or made under
section 3711 of this title if the veteran has never
obtained a loan guaranteed under section 3710 or made
under section 3711 of this title.
(E) The term ``subsequent loan'' means a loan to a
veteran, other than an interest rate reduction
refinancing loan, guaranteed under section 3710 or made
under section 3711 of this title if the veteran has
previously obtained a loan guaranteed under section
3710 or made under section 3711 of this title.
(F) The term ``interest rate reduction refinancing
loan'' means a loan described in section 3710(a)(8),
3710(a)(9)(B)(i), 3710(a)(11), 3712(a)(1)(F), or
3762(h) of this title.
(G) The term ``0-down'' means a downpayment, if any,
of less than 5 percent of the total purchase price or
construction cost of the dwelling.
(H) The term ``5-down'' means a downpayment of at
least 5 percent or more, but less than 10 percent, of
the total purchase price or construction cost of the
dwelling.
(I) The term ``10-down'' means a downpayment of 10
percent or more of the total purchase price or
construction cost of the dwelling.
(c) Waiver of Fee.--(1) A fee may not be collected under this
section from a veteran who is receiving compensation (or who,
but for the receipt of retirement pay or active service pay,
would be entitled to receive compensation) or from a surviving
spouse of any veteran (including a person who died in the
active military, naval, or air service) who died from a
service-connected disability.
(2)(A) A veteran described in subparagraph (B) shall be
treated as receiving compensation for purposes of this
subsection as of the date of the rating described in such
subparagraph without regard to whether an effective date of the
award of compensation is established as of that date.
(B) A veteran described in this subparagraph is a veteran who
is rated eligible to receive compensation--
(i) as the result of a pre-discharge disability
examination and rating; or
(ii) based on a pre-discharge review of existing
medical evidence (including service medical and
treatment records) that results in the issuance of a
memorandum rating.
* * * * * * *
PART V--BOARDS, ADMINISTRATIONS, AND SERVICES
Chap. Sec.
Board of Veterans' Appeals....................................7101
* * * * * * *
8001Veterans Economic Opportunity and Transition Administration.......
* * * * * * *
CHAPTER 77--VETERANS BENEFITS ADMINISTRATION
* * * * * * *
SUBCHAPTER I--ORGANIZATION; GENERAL
Sec. 7701. Organization of the Administration
(a) There is in the Department of Veterans Affairs a Veterans
Benefits Administration. The primary function of the Veterans
Benefits Administration is the administration of nonmedical
benefits programs of the Department which provide assistance,
other than assistance related to Economic Opportunity and
Transition, to veterans and their dependents and survivors.
(b) The Veterans Benefits Administration is under the Under
Secretary for Benefits, who is directly responsible to the
Secretary for the operations of the Administration. The Under
Secretary for Benefits may be referred to as the Chief Benefits
Director.
Sec. 7703. Functions of the Administration
The Veterans Benefits Administration is responsible for the
administration of the following programs of the Department:
(1) Compensation and pension programs.
[(2) Vocational rehabilitation and educational
assistance programs.
[(3) Veterans' housing loan programs.
[(4)] (2) Veterans' and servicemembers' life
insurance programs.
[(5)] (3) Outreach programs and other veterans'
services programs.
* * * * * * *
CHAPTER 80--VETERANS ECONOMIC OPPORTUNITY AND TRANSITION ADMINISTRATION
Sec.
8001. Organization of Administration.
8002. Functions of Administration.
8003. Annual report to Congress.
Sec. 8001. Organization of Administration
(a) Veterans Economic Opportunity and Transition
Administration.--There is in the Department of Veterans Affairs
a Veterans Economic Opportunity and Transition Administration.
The primary function of the Veterans Economic Opportunity and
Transition Administration is the administration of the programs
of the Department that provide assistance related to economic
opportunity to veterans and their dependents and survivors.
(b) Under Secretary for Economic Opportunity and
Transition.--The Veterans Economic Opportunity and Transition
Administration is under the Under Secretary for Veterans
Economic Opportunity and Transition, who is directly
responsible to the Secretary for the operations of the
Administration.
Sec. 8002. Functions of Administration
The Veterans Economic Opportunity and Transition
Administration is responsible for the administration of the
following programs of the Department:
(1) Vocational rehabilitation and employment
programs.
(2) Educational assistance programs.
(3) Veterans' housing loan and related programs.
(4) The verification of small businesses owned and
controlled by veterans pursuant to subsection (f) of
section 8127 of this title, including the
administration of the database of veteran-owned
businesses described in such subsection.
(5) The Transition Assistance Program under section
1144 of title 10.
(6) Any other program of the Department that the
Secretary determines appropriate.
Sec. 8003. Annual report to Congress
The Secretary shall include in the annual report to the
Congress required by section 529 of this title a report on the
programs administered by the Under Secretary for Veterans
Economic Opportunity and Transition. Each such report shall
include the following with respect to each such program during
the fiscal year covered by that report:
(1) The number of claims received.
(2) The number of claims decided.
(3) The average processing time for a claim.
(4) The number of successful outcomes (as determined
by the Secretary).
(5) The number of full-time equivalent employees.
(6) The amounts expended for information technology.
* * * * * * *
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