Nursing Home Care Necessary Now

By Dyhouse, Tim | VFW Magazine, December 1998 | Go to article overview

Nursing Home Care Necessary Now


Dyhouse, Tim, VFW Magazine


It should come as a surprise to no one that America's veterans population is aging. But what many people don't realize is that unless the status quo is changed, many of these older warriors will not have a place to live when they get to the age where they cannot take care of themselves. Making that change is an objective VFW intends to meet.

"Whether members of Congress like it or not, they will have to face a reality soon;' said Bill Bradshaw, deputy director for National Veterans Service. "VA must provide nursing home care in the future."

VFW Resolution 613-Entitlement to Nursing Home Care-was approved at the organization's last convention to rectify what members see as a gaping hole in VA care for elderly veterans. It seeks to amend Public Law 104-262-the Veterans Health Care Reform Act of 1996-which excludes mandatory nursing home care. As the law now stands, nursing home care "may be provided" as discretionary care.

Another problem, as a recent VFW survey of VA facilities showed, is that many VA nursing home beds have been closed in the past two years.

"Simply closing nursing home beds to save dollars is unacceptable and unconscionable," said VFW Commander-inChief Tom Pouliot. "At a time when the number of older veterans continues to increase, the system should be looking for ways to help them, not shut them out."

WORKING WITHIN THE SYSTEM

When the 106th Congress convenes next month, VFW officials plan to work with legislators to address the issue of longterm care for veterans. Additionally, the objectives outlined in Res. 613 have been expanded.

"An amendment to P.L. 104-262 will not do it," Bradshaw said. "A new law is required. This will be a very costly undertaking, but the need is great."

According to VA, 32%, or 8.5 million, of the nation's 26 million veterans are "older veterans," meaning they are 65 or older.

By 2010, that figure will rise to 42%. The percentage of those over the age of 75 will double to 53%, and those over the age of 85 will rise to 15%.

VA officials anticipate that the overall number of veterans who use VA services will increase 17% by 2010. However, they also predict that use by vets over 85 will increase nearly 400%.

CONTINUING CARE FOR VETERANS

Currently, nursing home care is provided at VA facilities for veterans whose serviceconnected injuries require it. It also may be provided when space and resources are available to both service-connected and non-service connected veterans. Some non-service connected and 0% serviceconnected veterans with higher income levels are required to make copayments for their care.

VA also can contract to provide community nursing home care for non-service connected veterans for up to six months. The reality is, however, that VA now rarely pays for more than 30 days, after which, vets must pay their own way or apply for Medicaid.

In addition, the State Home Per Diem Program allows VA to pay states an established per diem rate that covers a portion of the cost of care for eligible veterans in VA-recognized state nursing homes. States also may set additional eligibility standards, such as residency requirements.

Latest figures show 88 state veterans nursing homes operate in 41 states with an "average daily census" of 14,039 residents. The cost is $202.1 million in VA per diem payments.

CONVENING EXPERTS

In March 1997, Kenneth W. Kizer, VA's undersecretary for health, convened a group of experts to evaluate VA's longterm care programs.

"The committee's mandate was to advise me on current and anticipated needs for long-term care in an era of no-growth budgets in VA medical care and on the adequacy of VA's present and planned programs for addressing these needs," Kizer said. "The committee used 2010 as the planning horizon."

Called the Federal Advisory Committee on the Future of VA Long-Term Care, the panel evaluated four major areas: access and equity; service delivery; VA longterm care in the context of the overall VA health care system; and long-term investments. …

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