Congress Debates HCBS Expansion, Improvement for Veterans

The Elizabeth Dole HCBS for Veterans and Caregivers ActH.R. 6823 introduced in the U.S. House of Representatives earlier this month and would work to improve home and community-based services (HCBS) services for patients, their families, and their caregivers.

NAHC previously reported on it here.

Specifically, this legislation would:

  • Expand access to HCBS services for veterans living in US territories and to Native veterans enrolled in IHS or tribal health program.
  • Raise the cap on how much the VA can pay for the cost of home care from 65% of the cost of nursing home care to 100%.
  • Coordinate expanded VA home care programs with other VA programs.
  • Establish a pilot project to address home health aide shortages.
  • Providing respite care to caregivers of veterans enrolled in home care programs.
  • Establish a “one stop shop” webpage to centralize information for families and veterans on programs available.
  • Require the VA to provide a coordinated handoff for veterans and caregivers denied or discharged from the Program of Comprehensive Assistance for Family Caregivers into any other home care program they may be eligible for.

Following the introduction of the Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act, the House Committee on Veterans’ Affairs held a hearing on the bill, and several other pieces of legislation designed to improve the Veterans Administration (VA) and health care delivery for veterans.

In written testimony, Dr. Julianne Flynn, Acting Assistant Under Secretary for Health Care within the Veterans Health Administration offered support for numerous provisions included in H.R. 6823, in particular the increase of to 100% of what the VA can pay for home based on the cost of nursing home care. Likewise, the legislation received favorable comments from other members of the panel as well as testifying witnesses from the Elizabeth Dole Foundation and the Paralyzed Veterans of America.

NAHC supports this legislation as it will make much needed improvements for veterans receiving home care through increased accessibility, improved coordination, and caregiver support.

Congress Debates HCBS Expansion, Improvement for Veterans

The Elizabeth Dole HCBS for Veterans and Caregivers Act, H.R. 6823 introduced in the U.S. House of Representatives earlier this month and would work to improve home and community-based services (HCBS) services for patients, their families, and their caregivers. NAHC previously reported on it here. Specifically, this legislation would: Expand access to HCBS services for veterans…

Bill to Expand HCBS for Veterans Introduced in Congress

Bipartisan legislation to ensure that veterans are able to receive care in their home for as long as possible has been introduced in the House of Representatives. The Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act of 2022 (H.R. 6823) would expand and improve expand the home and community-based services (HCBS) programs within the Department of Veterans Affairs (VA), and align public policy with improved outcomes and patient choice, which is to stay in their own home.

NAHC supports this bill, as it will make much needed improvements to the delivery of HCBS for veterans, enabling options in how and where they receive care, while also working to address workforce shortages and support family caregivers.

Specifically, this legislation would:

  • Expand access to HCBS services for veterans living in US territories and to Native veterans enrolled in IHS or tribal health program.
  • Raise the cap on how much the VA can pay for the cost of home care from 65% of the cost of nursing home care to 100%.
  • Coordinate expanded VA home care programs with other VA programs.
  • Establish a pilot project to address home health aide shortages.
  • Providing respite care to caregivers of veterans enrolled in home care programs.
  • Establish a “one stop shop” webpage to centralize information for families and veterans on programs available.
  • Require the VA to provide a coordinated handoff for veterans and caregivers denied or discharged from the Program of Comprehensive Assistance for Family Caregivers into any other home care program they may be eligible for.

The legislation is led by Representatives Julia Brownley (D-CA) and Jack Bergman (R-MI) and NAHC thanks them for their leadership on this important issue.

At introduction, Rep. Brownley stated, “Over half of all veterans that use VA are over the age of 65, age, combined with their unique health needs, makes many elderly veterans especially vulnerable to going into nursing homes and institutional care. Our nation’s veterans deserve the right to age comfortably and with dignity in their homes.

“I introduced the Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act to ensure that every veteran has access to the care they need, when and where they need it. The focus of my legislation is to keep veterans in their homes for as long as possible, if they want, bringing them the care they need to the place they feel most comfortable, and ensure that every VA medical center has these necessary support programs.

“By expanding home and community-based services, veterans will have the assistance needed to remain members of their communities, to be present in their family lives, to support their caregivers, and to age with dignity.”

Rep. Bergman added, “As the studies show and as many of the older Veterans throughout our Nation will attest, care in home settings is often preferable to care in a clinical facility. This is especially true for those disabled and elderly Veterans living in the rural and remote communities of Michigan’s First Congressional District. The Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act recognizes this reality.”

A hearing on the bill is scheduled for March 16. NAHC will update this issue.

Bill to Expand HCBS for Veterans Introduced in Congress

Bipartisan legislation to ensure that veterans are able to receive care in their home for as long as possible has been introduced in the House of Representatives. The Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act of 2022 (H.R. 6823) would expand and improve expand the home and community-based services (HCBS) programs within the…

VA to Expand Home and Community Based Services by 2026

The Department of Veterans Affairs’ Office of Geriatrics and Extended Care is expanding its Home-Based Primary CareMedical Foster Home and Veteran-Directed Care programs to make them available at all VA medical centers (VAMC) by the end of fiscal year 2026.

VA will add 58 medical foster homes and 70 Veteran-directed care programs to VAMCs  across the nation and add 75 home-based primary care teams to areas with the highest unmet need.

“These evidence-based programs allow Veterans to age-in-place, avoid or delay nursing home placement and choose the care environment that aligns most with their care needs, preferences and goals,” said Executive Director of VA Office of Geriatrics and Extended Care Scotte Hartronft, M.D. “Veterans using these programs have experienced fewer hospitalizations and emergency department visits, reduced hospital and nursing home days and fewer nursing home readmissions and inpatient complications.”

According to VA’s Policy Analysis and Forecasting Office, the number of Veterans of all ages who are eligible for nursing home care is estimated to expand from approximately 2 million Veterans in 2019 to more than 4 million by 2039. As this population grows, VA remains steadfast in providing the highest levels of care to Veterans in the least-restrictive settings.

These programs provide an in-home or smaller care setting than traditional institutionalized long-term care. This smaller setting of care supports less risk of transmission of COVID and other infectious diseases. Many Veterans have chosen these programs instead of institutionalized care during the pandemic for more flexibility in care preferences and less risk of COVID transmission.

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Home Care and Hospice Providers Report Problems Working with VA

The National Association for Home Care and Hospice (NAHC) has recently received reports of home care and hospice providers facing challenges in working with the Veterans Health Administration (VA) following their transition of third-party administrator (TPA) from TriWest to Optum. As background, following the passage of the VA Mission Act, Optum was named the TPA…

Disabled Veteran Wins Home Care from VA, Highlights Caregiver Crisis

The United States Department of Veterans Affairs settled a lawsuit on June 15 with Michael Williamson, a disabled veteran from Springfield, Oregon, who sued the federal agency earlier this year after he was told his home health care would soon end due to a lack of caregivers. According to the January 23 lawsuit in U.S.…