[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 3647 Introduced in Senate (IS)]

<DOC>






119th CONGRESS
  2d Session
                                S. 3647

To require the Secretary of Veterans Affairs to establish a program to 
  address bowel and bladder care needs for veterans with spinal cord 
            injuries and disorders, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            January 15, 2026

   Mr. Moran introduced the following bill; which was read twice and 
             referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
To require the Secretary of Veterans Affairs to establish a program to 
  address bowel and bladder care needs for veterans with spinal cord 
            injuries and disorders, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Disabled Veterans Dignity Act of 
2026''.

SEC. 2. FINDINGS; SENSE OF CONGRESS.

    (a) Findings.--Congress finds the following:
            (1) Bowel care and bladder care are supportive and 
        necessary medical services for veterans with spinal cord 
        injuries and disorders when they are unable to manage their 
        bowel and bladder functions independently.
            (2) Inadequate care will lead to complications and problems 
        such as autonomic dysreflexia that can be potentially life-
        threatening and result in illness and hospitalization.
            (3) Bowel care and bladder care are essential to support 
        veterans with spinal cord injuries and disorders in non-
        institutional settings, improve quality of life, optimize 
        health, and prevent complications from neurogenic bowel and 
        bladder.
            (4) Family caregivers and individually employed caregivers 
        provide life-sustaining care for the bowel and bladder care 
        needs of veterans that allow them to live in their communities.
    (b) Sense of Congress.--It is the sense of Congress that--
            (1) family caregivers and individually employed caregivers 
        should not be subjected to self-employment taxes and treated as 
        vendors or contractors for the veterans to whom they provide 
        care;
            (2) veterans should not be forced to finish their bowel and 
        bladder care needs in a set period of time that does not 
        consider their individual needs; and
            (3) veterans should not be subjected to ongoing clinical 
        determinations regarding their bowel and bladder care needs 
        absent a decision by their medical care provider that such care 
        is no longer needed.

SEC. 3. BOWEL AND BLADDER CARE PROGRAM OF DEPARTMENT OF VETERANS 
              AFFAIRS.

    (a) In General.--The Secretary of Veterans Affairs shall establish 
a program to address the bowel and bladder care needs of covered 
veterans (in this section referred to as the ``program'').
    (b) Provision of Care.--
            (1) Clinical need.--The Secretary shall provide bowel and 
        bladder care under the program to covered veterans based on 
        clinical need, which may include covered veterans receiving aid 
        and attendance benefits from the Department of Veterans 
        Affairs.
            (2) Caregiver or agency.--A covered veteran may receive 
        bowel and bladder care under the program through a qualified 
        family member, an individually employed caregiver, or a 
        contracted home health agency.
            (3) Individualized assessment.--The Secretary shall conduct 
        an individualized assessment with respect to a covered veteran 
        to determine the number of hours of bowel and bladder care 
        needed by such veteran under the program.
            (4) Denial of care.--Before denying bowel and bladder care 
        for any covered veteran under the program, the Secretary shall 
        first obtain review of and concurrence with respect to such 
        denial from a designated Spinal Cord Injuries and Disorders 
        Center of the Department.
    (c) Coordination of Care and Benefits.--The Secretary shall ensure 
the program is coordinated with other programs and benefits of the 
Department for which the covered veteran is eligible to ensure that 
covered veterans and caregivers receive appropriate support without 
duplicating benefits or services.
    (d) Supportive Medical Training and Qualifications.--
            (1) In general.--The Secretary shall provide to each family 
        member or individually employed caregiver providing care to a 
        covered veteran under the program necessary supportive medical 
        training to participate in and receive payment by the Secretary 
        for the provision of such care.
            (2) Qualifications.--The Secretary shall establish such 
        requirements, conditions, and qualifications for providers of 
        care under the program as necessary to provide clinically 
        appropriate bowel and bladder care to covered veterans and to 
        ensure the financial and administrative integrity of the 
        program.
    (e) Payment.--
            (1) In general.--The Secretary shall provide a monthly 
        stipend to family members and individually employed caregivers 
        and payment to contracted home health agencies for care 
        provided to covered veterans under the program.
            (2) Limitation.--
                    (A) Family members and individually employed 
                caregivers.--The stipend for a family member or 
                individually employed caregiver for care provided to a 
                covered veteran under the program--
                            (i) shall be determined by the Secretary;
                            (ii) shall be based on the amount and 
                        degree of assistance provided; and
                            (iii) may not exceed the fifth step of the 
                        applicable grade of the General Schedule hourly 
                        rate paid to nursing assistants who provide 
                        such care at the medical facility of the 
                        Department that is nearest to the residence of 
                        such veteran.
                    (B) Home health agencies.--Payment to a home health 
                agency for care provided to a covered veteran under the 
                program may not exceed the payment rates of the 
                Department under section 17.4035 of title 38, Code of 
                Federal Regulations (relating to payment rates and 
                methodologies), or successor regulations.
    (f) Submission of Documentation.--Family members and individually 
employed caregivers providing care to covered veterans under the 
program shall provide such documentation and information in such format 
and under such terms as the Secretary may require as a condition of 
receiving payment under the program.
    (g) Continued Participation in Program.--If a covered veteran has 
been medically determined to require care under the program for a 
continuous period of three years or more, the veteran is deemed to 
require such care for life or until such time as the medical provider 
for such veteran determines the service is no longer needed.
    (h) Not Vendors or Contractors.--Family members and individually 
employed caregivers providing care to covered veterans under the 
program shall not be considered vendors or contractors for purposes of 
the program.
    (i) Limitation.--Care may not be provided under the program to a 
veteran who can perform the bowel and bladder functions of the veteran 
without assistance.
    (j) Covered Veteran Defined.--In this section, the term ``covered 
veteran'' means a veteran who--
            (1) is enrolled in the system of annual patient enrollment 
        of the Department of Veterans Affairs established and operated 
        under section 1705(a) of title 38, United States Code;
            (2) has a spinal cord injury or disorder; and
            (3) is dependent upon others for bowel and bladder care 
        while residing in non-institutional settings.
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