PILOT PROGRAM ON PROVISION OF NONINSTITUTIONAL ALTER-NATIVES TO NURSING HOME CARE.

SEC. 201. PILOT PROGRAM ON PROVISION OF NONINSTITUTIONAL ALTER-NATIVES TO NURSING HOME CARE. (a) Authority To Provide for Noninstitutional Care.— (1) Subchapter II of chapter 17 of title 38, United States Code, is amended by adding at the end the following new section: “§ 620C. Noninstitutional alternatives to nursing home care: pilot program “(a) During the four-year period beginning on October 1, 1990, the Secretary may conduct a pilot program for the furnishing of medical, rehabilitative, and health-related services in noninstitutional settings for veterans who are eligible under this chapter for, and are in need of, nursing home care and who— “(1) are in receipt of, or are in need of, nursing home care primarily for the treatment of a service-connected disability; or “(2) have a service-connected disability rated at 50 percent or more. “(b) (1) Under the pilot program conducted pursuant to subsection (a), the Secretary shall (A) furnish appropriate health-related services solely through contracts with appropriate public and private agencies that provide such services, and (B) designate Department health-care employees to furnish case management services to veteran furnished services under the program. “(2) For the purposes of paragraph (1), the term ‘case management services’ includes the coordination and facilitation of all services furnished to a veteran by the Department of Veterans Affairs, either directly or through contract, including assessment of needs, planning, referral (including referral for services to be furnished by the Department, either directly or through a contract, or by an entity other than the Department), monitoring, reassessment, and followup. 104 STAT. 438 “(c) The Secretary may provide in-kind assistance (through the services of Department of Veterans Affairs employees and the sharing of other Department resources) to a facility furnishing services to veterans under subsection (b)(1)(A). Any such in-kind assistance shall be provided under a contract between the Department and the facility concerned. The Secretary may provide such assistance only for use solely in the furnishing of appropriate services under this section and only if, under such contract, 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. “(d) The total cost of providing services or in-kind assistance in the case of any veteran for any fiscal year under the pilot program may not exceed 65 percent of the cost that would have been incurred by the Department during that fiscal year if the veteran had been furnished, instead, nursing home care under section 610 of this title during that fiscal year. “(e) The authority of the Secretary to enter into contracts under this section shall be effective for any fiscal year only to the extent that appropriations are available.”. (2) The table of sections at the beginning of chapter 17 of such title is amended by inserting after the item relating to section 620B the following new item: “620C. Noninstitutional alternatives to nursing home care: pilot program.”. (b) Report.— Not later than February 1, 1994, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report setting forth the Secretary’s evaluation, findings, and conclusions regarding the conduct, through September 30, 1993, of the pilot program required by section 620C of title 38, United States Code (as added by subsection (a)), and the results of the furnishing of care under such pilot program for the participating veterans. The report shall include a description of the conduct of the pilot program (including a description of the veterans furnished services and of the services furnished under the pilot program), and any plans for administrative action, and any recommendations for legislation, that the Secretary considers appropriate to include in the report.