S. 3647 — Disabled Veterans Dignity Act of 2026

This section states congressional findings recognizing bowel and bladder care as essential supportive medical services for veterans with spinal cord injuries and disorders who cannot independently manage these functions, noting that inadequate care risks life-threatening complications such as autonomic dysreflexia and that family caregivers and individually employed caregivers enable community living. It expresses the sense of Congress that (1) such caregivers should not be subject to self-employment taxes or treated as vendors or contractors; (2) veterans should not be required to complete bowel and bladder care within inflexible time limits; and (3) veterans should not face ongoing clinical reviews of their care needs absent a provider's determination that such care is unnecessary.

This section establishes a bowel and bladder care program in the Department of Veterans Affairs (VA) for covered veterans, defined as VA-enrolled veterans with a spinal cord injury or disorder who require assistance with such care while residing in non-institutional settings. (As background, spinal cord injuries and disorders often necessitate regular bowel and bladder management to prevent complications such as infections or autonomic dysreflexia.) The program provides care based on clinical need—including for veterans receiving VA aid and attendance benefits—through qualified family members, individually employed caregivers, or contracted home health agencies, following an individualized assessment of required hours. Denials require concurrence from a VA Spinal Cord Injuries and Disorders Center; care coordinates with other VA programs and benefits to avoid duplication; and family members or individual caregivers receive supportive medical training and must meet VA-established qualifications. Payments include monthly stipends to family members and individual caregivers—based on assistance level and capped at the fifth step of the General Schedule hourly rate for nursing assistants at the nearest VA medical facility—and payments to home health agencies not exceeding VA rates under 38 C.F.R. § 17.4035. Caregivers must submit required documentation, are not considered vendors or contractors, and if a veteran's need persists for three continuous years, it is deemed lifelong unless a medical provider determines otherwise; the program excludes veterans able to perform these functions independently.