H.R. 3155: Caregiver Assistance and Resource Enhancement Act

H.R. 3155

Caregiver Assistance and Resource Enhancement Act

Sponsor
Rep. Michael H. Michaud

Date
July 28, 2009 (111th Congress, 1st Session)

Staff Contact
Sarah Makin

Floor Situation

H.R. 3155 is being considered under suspension of the rules, requiring a two-thirds vote for passage. The legislation was introduced by Rep. Michael Michaud (D-ME) on July 9, 2009.

Bill Summary

H.R. 3155 would require VA to provide support services to family and non-family caregivers of veterans.  Such services should include educational sessions on how to be a better caregiver; one-stop access to support services via a dedicated caregiver support website; information and outreach regarding available services.  The bill also:

  • Defines (1) caregiver services as non-institutional extended care services; (2) a caregiver as an individual who provides caregiver services to a disabled veteran enrolled in VA health care for such disability, and is not a member of the family of that veteran; and (3) a family caregiver as a family member (parent, spouse, child, sibling, step- and extended family member) who provides caregiver services to a disabled veteran enrolled in VA health care for such disability, and is a family member of the family who may or may not live with that veteran.
  • Requires VA to provide a monthly stipend to a primary family caregiver of an eligible veteran (defined as a veteran who has a severe service-connected disability or illness, is in need of caregiver services and without such services would require institutional care, and is medically determined to be unable to carryout the activities of daily living and instrumental activities of daily living). Prohibit a family caregiver who is certified and paid through a home health agency from receiving the stipend. Authority for stipend expires on October 1, 2012.
  • Requires the VA to submit a plan to Congress on how the Department intends to implement the supportive services provisions in the section no later than 6 months after enactment and submit a subsequent report to Congress on implementation no later than 6 months following the submission of the plan.
  • Authorizes VA to provide counseling and mental health services to caregivers and family caregivers of veterans in connection with the veteran's treatment.
  • Requires the VA to ensure that respite care meets the needs of a veteran receiving services and include 24-hour in-home and age appropriate respite care.
  • Expands CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs) eligibility to a primary family caregiver of an eligible veteran that is without health insurance and not eligible for any other public health insurance.
  • Allows the VA to provide travel expenses, including lodging and subsistence, to an attendant of an eligible veteran.
  • Requires VA to conduct a survey on caregivers and family caregivers of disabled veterans enrolled in VA health care and submit a report to Congress no later than six months after completion of the survey. Thereafter, VA must conduct a survey every three years.

Background

According to the Committee Report, today, more servicemembers are surviving the wounds of war than those injured in previous conflicts. For example, the ratio of wounded to killed averaged approximately 1.7 wounded for every fatality for the first two World Wars. In Korea and Vietnam, the ratio improved to three wounded per fatality, largely due to air medical evacuation. In Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF), improved body armor and superior battlefield medicine techniques have resulted in seven wounded per fatality. The increasing number of wounded OEF/OIF servicemembers surviving the war brings to the forefront the question of who will provide continuing care for these injured men and women once they transition to veteran status.

It is estimated that for any given year there are more than 50 million people who provide informal caregiving for a chronically ill, disabled, or aged family member or friend. These caregivers serve as the foundation of the country's long-term care system. It is estimated that about 80 percent of adults living in the community and in need of long-term care depend on a family member or a friend, thereby avoiding costly institutional nursing home care. The majority of these caregivers are women. Caregiving exacts both a financial and physical toll on these individuals. For example, women caregivers are more than twice as likely to live in poverty and are five times more likely to receive Supplemental Security Income (SSI) than their non-caregiver counterparts. Also, individuals serving as caregivers for a family or friend report having a chronic health condition at twice the rate of non-caregivers and those who provide 36 or more hours of weekly care are more likely to experience symptoms of depression and anxiety than non-caregivers.

Because the VA does not collect data on this population, the number of family members and friends who provide care for veterans is unknown. However, the July 2007 report of the President's Commission on Care for America's Returning Wounded Warriors (Dole-Shalala Commission) found that of the 1,730 injured OEF/OIF veterans surveyed, about 21 percent of active duty, 15 percent of the reserve, and 24 percent of retired or separated servicemembers had friends or family who gave up a job to be a caregiver. In order to better understand the caregiver population providing care to veterans, H.R. 3155 would require the VA to conduct a caregivers survey at least once every three years to individuals caring for veterans enrolled in the VA health care system. It would also require a report to Congress providing the findings of the survey no later than 180 days after the date on which the survey is completed.

Cost

According to CBO, implementing the bill would cost $193 million over the 2010-2014 period, assuming appropriation of the estimated amounts.  Enacting the bill would not affect direct spending or revenues.  For a more detailed outline of the costs per each section of the bill, see CBO's analysis here