Notice of Tribal Consultation on the Department of Veterans Affairs' State Home Programs

Published date19 May 2021
Citation86 FR 27145
Record Number2021-10556
SectionNotices
CourtVeterans Affairs Department
Federal Register, Volume 86 Issue 95 (Wednesday, May 19, 2021)
[Federal Register Volume 86, Number 95 (Wednesday, May 19, 2021)]
                [Notices]
                [Pages 27145-27146]
                From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
                [FR Doc No: 2021-10556]
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                DEPARTMENT OF VETERANS AFFAIRS
                Notice of Tribal Consultation on the Department of Veterans
                Affairs' State Home Programs
                AGENCY: Department of Veterans Affairs.
                ACTION: Notice of tribal consultation.
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                SUMMARY: The Department of Veterans Affairs (VA) is seeking Tribal
                consultation to assist VA in implementing the requirements of section
                3004 of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care
                and Benefits Improvement Act of 2020 (the Act), The Act amended the
                statutory authorities of two VA programs (the State Veterans Home
                Construction Grant Program and the State Home Per Diem Program) so that
                Indian tribes were included in definitions for ``state'' and ``state
                home.'' VA is required to consult with Indian tribes to determine if
                any legislative or administrative action is necessary to modify these
                state home programs to function efficiently in support of state
                Veterans homes operated by Indian tribes pursuant to the amendments
                made by section 3004 of the Act. VA seeks input on the legislative,
                regulatory and administrative modifications that may be necessary to
                support State Veterans Homes operated by American Indian and Alaska
                Native tribes in response to these amendments.
                DATES: Comments must be received by VA on or before July 3, 2021.
                ADDRESSES: Written comments may be submitted by any of the following
                methods:
                 Federal Rulemaking Portal at http://www.regulations.gov.
                Follow the online instructions for submitting comments.
                 Email to [email protected].
                 By mail to U.S. Department of Veterans Affairs, Office of
                Geriatrics and Extended Care (12GEC), 810 Vermont Avenue NW,
                Washington, DC 20420. Comments should indicate that the submission is
                in response to ``Notice of Tribal Consultation State Veterans Homes.''
                FOR FURTHER INFORMATION CONTACT: Scotte Hartronft, M.D., Executive
                Director, Office of Geriatrics and Extended Care (12GEC), U.S.
                Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC
                20420, 202-461-6750. (This is not a toll-free number.)
                SUPPLEMENTARY INFORMATION:
                Background
                 On January 5, 2021, the Act, Public Law 116-315, was passed into
                law. Among other things, this legislation (per section 3004(a)-(c))
                changed or added statutory definitions for ``state home'' and ``state''
                with regard to VA's State Veterans Home Construction Grant and State
                Home Per Diem Programs (hereinafter combinedly referred to as ``State
                Veterans Home Programs'') to include Indian tribes (as defined in 25
                U.S.C. 5304). Per section 3004(d)(1) of the Act, not later than 180
                days after the date of enactment of the Act, VA must consult with
                Indian tribes to determine if any legislative or administrative action
                is necessary to modify the State Veterans Home Programs to function
                efficiently in support of state homes operated by Indian tribes
                pursuant to the amendments made by section 3004. Per section 3004(d)(2)
                of the Act, not later than 90 days after completing these
                consultations, VA must also submit to the appropriate committees of
                Congress a report recommending legislative action that VA considers
                appropriate to modify the State Veterans Home Programs in light of
                those consultations. Per section 3004(d)(3), not later than 180 days
                after completing these consultations, VA must also make any
                modifications to regulations implementing the State Veterans Home
                Programs, for which legislative action is not necessary, as VA
                considers appropriate in light of those consultations. Therefore, in
                accordance with section 3004(d)(1), and prior to submitting a report to
                Congress and making any modifications to regulations, VA seeks
                consultation with American Indian and Alaska Native tribes.
                 Pursuant to section 1741 through 1745 of title 38, United States
                Code, VA provides per diem payments to states for eligible Veterans
                receiving domiciliary or nursing care in a state home. This is referred
                to as the State Home Per Diem Program, and VA has implemented this
                program through regulations in Part 51 of title 38, Code of Federal
                Regulations (CFR). Pursuant to 38 U.S.C. 8131 through 8138, VA provides
                funding to assist states to construct state home facilities (or to
                acquire facilities that are to be used as state homes facilities) for
                furnishing domiciliary or nursing home care to Veterans, and to expand,
                remodel or alter existing buildings for furnishing domiciliary, nursing
                home or adult day health care to Veterans in state homes. This program
                is referred to as the State Veterans Home Construction Grant Program
                and was implemented by VA through 38 CFR part 59.
                 While, historically, these two programs have been available only to
                states, section 3004 of the Act amended this by revising the
                definitions of state home in 38 U.S.C. 101(19) and state in 38 U.S.C.
                8131(2) to include Indian tribes (as defined in 25 U.S.C. 5304), and
                adding a definition for state in 38 U.S.C. 1741 to include Indian
                tribes (as defined in 25 U.S.C. 5304). These changes allow American
                Indian and Alaska Native tribes to apply for the State Veterans Home
                Programs. As previously mentioned, section 3004 of the Act requires VA
                to consult with American Indian and Alaska Native tribes to determine
                if any legislative or administrative action is necessary to modify the
                State Veterans Home Programs to function efficiently in support of
                state homes operated by American Indian and Alaska Native tribes
                pursuant to the amendments made by section 3004. Per section 3004 of
                the Act, after completion of such consultations, VA will submit a
                report to Congress recommending legislative action to modify the State
                Veterans Home Programs and will make modifications to regulations
                implementing the State Veterans Home programs as necessary.
                 Through this tribal consultation, VA will ensure that the needs of
                the American Indian and Alaska Native Veterans and the priorities of
                tribal governments are taken into consideration as part of any changes
                VA makes to the State Veterans Home Programs, now and in the future.
                Such changes have the potential to increase American Indian and Alaska
                Native Veterans' access to health care (specifically, nursing home,
                domiciliary and adult day health care). The Veterans
                [[Page 27146]]
                Health Administration (VHA) will use input received from tribal leaders
                to inform Congress of any recommended legislative action appropriate to
                modify the State Veterans Home Programs and related implementation
                regulations.
                Tribal Consultation
                 Pursuant to changes made by section 3004 of the Act, VA is seeking
                written comments from tribal leaders and representatives on what
                legislative, regulatory and administrative modifications may be
                necessary to support State Veterans Homes operated by American Indian
                and Alaska Native tribes. Through this tribal consultation, the
                Secretary seeks information on the questions listed below. Comments do
                not need to address every question and should focus on those that
                relate to their expertise or perspectives. To the extent possible,
                please clearly indicate which questions you address in your response
                and include any rationale and information to support your response.
                 1. Are changes to 38 U.S.C. 1741 through 1745 needed so that the
                State Home Per Diem Program functions efficiently in support of state
                homes operated by American Indian and Alaska Native tribes (as defined
                in 25 U.S.C. 5304)? If so, what changes do you recommend be made to
                these authorities and why?
                 2. Are changes to 38 U.S.C. 8131 through 8138 needed so that the
                State Home Construction Grant Program functions efficiently in support
                of state homes operated by American Indian and Alaska Native tribes (as
                defined in 25 U.S.C. 5304)? If so, what changes do you recommend be
                made to these authorities and why?
                 3. Are changes to 38 CFR part 51 needed so that the State Home Per
                Diem Program functions efficiently in support of state homes operated
                by American Indian and Alaska Native tribes (as defined in 25 U.S.C.
                 4. 5304)? If so, what changes do you recommend be made to the
                regulations and why? These regulations are located at: https://www.ecfr.gov/cgi-bin/text-idx?SID=7e1be46cc62e7f0ecde2ac13524459d5&mc=true&node=pt38.2.51&rgn=div5
                .
                 5. Are changes to 38 CFR part 59 needed so that the State Home
                Construction Grant Program functions efficiently in support of state
                homes operated by American Indian and Alaska Native tribes (as defined
                in 25 U.S.C. 5304)? If so, what changes do you recommend be made to the
                regulations and why? These regulations are located at: https://www.ecfr.gov/cgi-bin/text-idx?SID=7e1be46cc62e7f0ecde2ac13524459d5&mc=true&node=pt38.2.59&rgn=div5
                .
                 6. What administrative actions, if any, do you recommend are needed
                to modify the State Veterans Home Programs to function efficiently in
                support of state Veterans homes operated by American Indian and Alaska
                Native tribes (as defined in 25 U.S.C. 5304)?
                Webinar
                 As part of this tribal consultation, and so tribes can provide
                thoughtful and thorough responses to the questions above, VA is
                providing tribes with a virtual webinar that will provide detailed
                information about the State Veterans Home Programs. On May 25, 2021,
                VHA will provide an educational virtual webinar session that will
                include describing the requirements for receiving a State Veterans Home
                Construction Program grant; how to seek recognition and certification
                of a state Veterans home; how per diem payments are calculated; and the
                requirements to receive per diem payments. The webinar is an additional
                opportunity for participants to get questions answered, and to engage
                in an open discussion with leaders of the VA Office of Geriatrics and
                Extended Care about how VHA can better serve the long term and
                geriatric care needs of American Indian and Alaska Native Veterans. The
                webinar is voluntary. Registration for this event is located at https://veteransaffairs.webex.com/veteransaffairs/onstage/g.php?MTID=e45a91c0eb17719cd7b724f96d810cf83.
                Signing Authority
                 Denis McDonough, Secretary of Veterans Affairs, approved this
                document on May 13, 2021, and authorized the undersigned to sign and
                submit the document to the Office of the Federal Register for
                publication electronically as an official document of the Department of
                Veterans Affairs.
                Luvenia Potts,
                Regulation Development Coordinator, Office of Regulation Policy &
                Management, Office of General Counsel, Department of Veterans Affairs.
                [FR Doc. 2021-10556 Filed 5-18-21; 8:45 am]
                BILLING CODE 8320-01-P
                

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