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H.R. 2460, a Bill to Amend Title 38, United States Code, to Improve the Provision of Adult Day Health Care Services for Veterans 1 (May 23, 2016)

handle is hein.congrec/cbo2979 and id is 1 raw text is: 





                    CONGRESSIONAL BUDGET OFFICE
                              COST ESTIMATE

                                                                   May  23, 2016


                                 H.R.   2460
 A bill to amend  title 38, United States Code,  to improve   the provision  of
                 adult day  health care  services for veterans

          As ordered reported by the House Committee on Veterans' Affairs
                                on May  18, 2016


H.R. 2460 would require the Department of Veterans Affairs (VA) to enter into provider
agreements or contracts with State Veterans Homes (SVHs) to provide adult day health
care (ADHC)  to veterans with severe service-connected disabilities at rates above VA's
current per-diem rates. SVHs are facilities that offer nursing home care, domiciliary care,
or ADHC  primarily to veterans. Those facilities are operated by state governments, but
do receive some of their funding from the federal government. Under the bill, VA would
pay for ADHC  provided to those veterans at a rate equal to 65 percent of the prevailing
rate for nursing home care in that region.

Under current law, VA is required to comply with the Federal Acquisition Regulation
(FAR) for agreements and contracts with SVHs. The FAR is an extensive and complex
set of rules governing the federal government's purchasing process. VA has been unable
to secure agreements or contracts with any SVH because of the contractual requirements
under the FAR (mostly related to reporting, compensation, and fringe benefits). As a
result, VA would face challenges in entering into agreements or contracts under the bill
and CBO  expects that VA would continue to use grants to pay the SVHs at the current
per-diem rate. Therefore, CBO estimates that implementing the bill would have no
budgetary effects.

Pay-as-you-go procedures do not apply because enacting the legislation would not affect
direct spending or revenues. CBO estimates that enacting H.R. 2460 would not increase
net direct spending or on-budget deficits in any of the four consecutive 10-year periods
beginning in 2027.

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