US SB3647

Secretary of Veterans Affairs must establish a bowel and bladder care program for veterans with spinal cord injuries who are enrolled in VA healthcare and depend on others for this care in non-institutional settings

Veterans may receive care through qualified family members, individually employed caregivers, or contracted home health agencies, with individualized assessments determining hours of care needed

Family members and individually employed caregivers receive monthly stipends capped at GS-5 nursing assistant hourly rates at the nearest VA facility; home health agencies are paid at standard VA payment rates

VA must provide medical training to family and individually employed caregivers; these caregivers are not classified as vendors or contractors and should not be subject to self-employment taxes

Veterans requiring care continuously for 3+ years are deemed to need it for life unless their medical provider determines otherwise; any denial of care requires review and concurrence from a designated VA Spinal Cord Injuries and Disorders Center