{"format":1,"id":"118-hr-542","congress":118,"number":"H.R. 542","kind":"bill","group":"bills","title":"Elizabeth Dole Home Care Act of 2023","title_source":"Short Title(s) as Passed House","official_title":"To amend title 38, United States Code, to improve certain programs of the Department of Veterans Affairs for home and community based services for veterans, and for other purposes.","titles":[{"type":"Official Title as Introduced","title":"To amend title 38, United States Code, to improve certain programs of the Department of Veterans Affairs for home and community based services for veterans, and for other purposes."},{"type":"Display Title","title":"Elizabeth Dole Home Care Act of 2023"},{"type":"Short Title(s) as Introduced","title":"Elizabeth Dole Home- and Community-Based Services for Veterans and Caregivers Act of 2023"},{"type":"Short Title(s) as Introduced","title":"Elizabeth Dole Home Care Act of 2023"},{"type":"Short Title(s) as Reported to House","title":"Elizabeth Dole Home Care Act of 2023"},{"type":"Short Title(s) as Reported to House","title":"Elizabeth Dole Home- and Community-Based Services for Veterans and Caregivers Act of 2023"},{"type":"Short Title(s) as Passed House","title":"Elizabeth Dole Home Care Act of 2023"},{"type":"Short Title(s) as Passed House","title":"Elizabeth Dole Home- and Community-Based Services for Veterans and Caregivers Act of 2023"}],"outcome":"passed_house","law_number":null,"introduced":"2023-01-26","chambers":{"house":{"status":"roll_call","date":"2023-12-05","vote":{"id":"118-2023-h696","question":"On Motion to Suspend the Rules and Pass, as Amended","title":"Elizabeth Dole Home- and Community-Based Services for Veterans and Caregivers Act","result":"Passed","yea":414,"nay":5,"present":0,"not_voting":15,"source":"https://clerk.house.gov/evs/2023/roll696.xml"}},"senate":{"status":"na","date":null,"vote":null}},"president":{"status":"na","date":null},"vice_president_tie_breaker":null,"latest_action":{"text":"Received in the Senate.","date":"2023-12-06"},"nominees":null,"amendments":[],"other_votes":[],"crs_summary":{"date":"2023-12-05","stage":"Passed House","blocks":[{"k":"h","t":"Elizabeth Dole Home- and Community-Based Services for Veterans and Caregivers Act of 2023 or the Elizabeth Dole Home Care Act of 2023"},{"k":"p","t":"This bill addresses home care and caregiver programs provided by the Department of Veterans Affairs (VA)."},{"k":"p","t":"Under the bill, the cost of providing noninstitutional alternatives to nursing home care generally may not exceed 100% of the cost that would have been incurred if a veteran had been furnished VA nursing home care. (Under current law, these expenditures are limited to 65% of the cost.) However, for specified veterans, the VA may exceed 100% of the cost if it determines the higher cost is in the best interest of such veterans (i.e., veterans with amyotrophic lateral sclerosis, a spinal cord injury, or a condition the Secretary determines to be similar to such conditions)."},{"k":"p","t":"Among other requirements, the VA must"},{"k":"li","t":"seek to enter into an agreement with the Program of All-Inclusive Care for the Elderly in certain areas to furnish noninstitutional alternatives to nursing home care;","d":1},{"k":"li","t":"implement various programs (e.g., the Veteran Directed Care program) to expand access to home- and community-based services;","d":1},{"k":"li","t":"provide specified support and benefits to caregivers of certain disabled veterans;","d":1},{"k":"li","t":"implement a pilot program to provide homemaker and home health aide services to veterans who reside in communities with a shortage of home health aides; and","d":1},{"k":"li","t":"ensure the availability of home and community-based services for Native American veterans.","d":1},{"k":"p","t":"For veterans or family caregivers who are discharged from the Program of Comprehensive Assistance for Family Caregivers, a caregiver support coordinator must provide for a personalized transition to an appropriate program."},{"k":"p","t":"The Veterans Health Administration must review programs administered through the Office of Geriatric and Extended Care to ensure consistency in program management, eliminate service gaps at the medical center level, and ensure the availability of and access to home and community-based services."},{"k":"p","t":"The bill also extends certain loan fee rates through February 4, 2032, under the VA's home loan program."}],"words":323},"summary":{"main_subject":{"text":"Amends title 38, United States Code, to change Department of Veterans Affairs programs that provide home- and community-based services and caregiver support to veterans, and requires related reviews, reports and a pilot program.","cites":[{"label":"Sec. 2","href":"https://www.congress.gov/bill/118th-congress/house-bill/542/text/eh#toc-H5EF8932A577D42E59D203353191944A3"},{"label":"Sec. 4","href":"https://www.congress.gov/bill/118th-congress/house-bill/542/text/eh#toc-HF7343D3869F1498CB1AF8659825DFAF1"},{"label":"Sec. 5","href":"https://www.congress.gov/bill/118th-congress/house-bill/542/text/eh#toc-H948DE8D2CD374AB28114679AB5348208"},{"label":"Sec. 7","href":"https://www.congress.gov/bill/118th-congress/house-bill/542/text/eh#toc-H69296066C5D44378AEA914E0D035C89D"},{"label":"Sec. 8","href":"https://www.congress.gov/bill/118th-congress/house-bill/542/text/eh#toc-H36DB56F1F4EC4877BC118553BF60E227"}]},"core_areas":["Expenditure cap for noninstitutional alternatives to VA nursing home care","VA home- and community-based services programs","Caregiver support and respite care","Homemaker and Home Health Aide program and pilot program","VA reviews, reports and goals for geriatric and extended care"],"what_it_does":[{"text":"Changes the cap on the total cost of noninstitutional alternatives to nursing home care from 65 percent to 100 percent of the cost that would otherwise have been incurred, and lets the Secretary exceed 100 percent for a veteran with amyotrophic lateral sclerosis, a spinal cord injury, or a similar condition when the Secretary finds it in the veteran's best interest.","cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/118th-congress/house-bill/542/text/eh#toc-H5EF8932A577D42E59D203353191944A3"}},{"text":"Adds section 1720K to title 38, requiring the Secretary to carry out the Veteran-Directed Care, Homemaker and Home Health Aide, Home-Based Primary Care, and Purchased Skilled Home Care programs, and to give caregivers of participating veterans respite care of not less than 30 days annually.","cite":{"label":"Sec. 4","href":"https://www.congress.gov/bill/118th-congress/house-bill/542/text/eh#toc-HF7343D3869F1498CB1AF8659825DFAF1"}},{"text":"Requires the Secretary to offer general caregiver support enrollment, assess for other home- and community-based programs, and provide written information to a veteran or caregiver who is denied or discharged from the Program of Comprehensive Assistance for Family Caregivers, with a caregiver support coordinator providing a personalized transition.","cite":{"label":"Sec. 5","href":"https://www.congress.gov/bill/118th-congress/house-bill/542/text/eh#toc-H948DE8D2CD374AB28114679AB5348208"}},{"text":"Requires a three-year pilot program, beginning not later than 18 months after enactment, providing homemaker and home health aide services to veterans in at least five locations with a shortage of home health aides, and allows the Secretary to hire or reassign nursing assistants for it.","cite":{"label":"Sec. 7","href":"https://www.congress.gov/bill/118th-congress/house-bill/542/text/eh#toc-H69296066C5D44378AEA914E0D035C89D"}},{"text":"Requires the Secretary to develop and maintain a centralized, publicly accessible website with a description of each covered program, an informational eligibility assessment tool, and a list of procedures for medical facility directors to follow in determining veterans' eligibility and suitability.","cite":{"label":"Sec. 6","href":"https://www.congress.gov/bill/118th-congress/house-bill/542/text/eh#toc-H3B8C1F4FF4F94FD2BF4EE81CB99A0E10"}},{"text":"Requires the Under Secretary for Health to review each program administered through the Office of Geriatric and Extended Care to ensure consistent management, eliminate service gaps at the medical center level, and ensure availability of home- and community-based services.","cite":{"label":"Sec. 8","href":"https://www.congress.gov/bill/118th-congress/house-bill/542/text/eh#toc-H36DB56F1F4EC4877BC118553BF60E227"}}],"unexpected":[{"category":"selective_carve_out","items":[{"cite":{"label":"Sec. 2","href":"https://www.congress.gov/bill/118th-congress/house-bill/542/text/eh#toc-H5EF8932A577D42E59D203353191944A3"},"heading":"Increase of expenditure cap for noninstitutional care alternatives to nursing home care","effect":"Raises the cost cap for noninstitutional alternatives to nursing home care from 65 percent to 100 percent. It also lets costs exceed 100 percent for veterans with ALS, a spinal cord injury, or a similar condition the Secretary determines.","amount":null,"quote":"A veteran described in this subparagraph is a veteran with amyotrophic lateral sclerosis, a spinal cord injury, or a condition the Secretary determines to be similar to such conditions."}]},{"category":"political_name","items":[{"cite":{"label":"Sec. 1","href":"https://www.congress.gov/bill/118th-congress/house-bill/542/text/eh#toc-HCE8E0B831D9F43B58493A89370F0DE27"},"heading":"Short title; table of contents","effect":"Gives the Act the short titles \"Elizabeth Dole Home- and Community-Based Services for Veterans and Caregivers Act of 2023\" and \"Elizabeth Dole Home Care Act of 2023\", which use a person's name.","amount":null,"quote":"“Elizabeth Dole Home- and Community-Based Services for Veterans and Caregivers Act of 2023” or the “Elizabeth Dole Home Care Act of 2023”"}]}],"version":{"type":"Engrossed in House","date":"2023-12-05","rule":"passed","href":"https://www.congress.gov/bill/118th-congress/house-bill/542/text/eh"},"current":true,"model":"claude-sonnet-5-5","approved":"2026-10-02","approved_by":"checks"},"sources":{"congress_gov":"https://www.congress.gov/bill/118th-congress/house-bill/542","text":"https://www.congress.gov/bill/118th-congress/house-bill/542/text"},"card":{"image":"card/item/118-hr-542.png","v":"1132c1300f40","alt":"Votes on Record. H.R. 542, 118th Congress: Elizabeth Dole Home Care Act of 2023. House: 414 Yea, 5 Nay. Outcome: Passed House, 5 Dec 2023."}}