Notice of Tribal Consultation on the Department of Veterans Affairs' State Home Programs, 27145-27146 [2021-10556]

Agencies

• DEPARTMENT OF VETERANS AFFAIRS

[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 https://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