Vern Evans
House lawmakers on Monday advanced plans to overhaul veterans’ medical options outside the department’s health care system, including expanded in-home care for aging veterans and providing mental health care for their caregivers.
The overwhelming bipartisan vote — 389-9 — comes after months of behind-the-scenes wrangling surrounding the legislation, expected to cost as much as $2 billion over the next decade. The Senate is expected to take up the issue in the next few weeks, potentially putting in place a series of sweeping veterans policy changes at the start of the new year.
Veterans advocates praised the House action and called on the Senate to move quickly on the issue.
“This bill includes a number of critical provisions that will expand the quality of care that veterans receive, increase support for caregivers, improve the functioning of the VA, and much more,” American Legion National Commander James LaCoursiere Jr. said. “We are excited to see this package make it to the finish line in the House.”
Rye Barcott, CEO and Co-Founder of With Honor Action — another vocal backer of the legislation — hailed lawmakers for “leading the way in Congress to make changes to the VA and provide life-saving support to veterans, caregivers, and survivors across the country.”
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Caregiver support
Titled the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, the legislation features significant improvements to current caregiver support programs within the Department of Veterans Affairs.
It would expand access to home-based and community-based services at every VA medical center. Supporters have said that will allow tens of thousands more veterans to receive medical care at home rather than in nursing home institutions, if they choose to do so.
The bill would increase the cap for in-home care programs from 65% of nursing home costs to 100%, potentially providing thousands of dollars more a month to eligible families. In some cases, that figure could go even higher, if VA officials decide that at-home care is “in the best interest of the veterans.”
The legislation would also require an overhaul of the programs and processes surrounding those at-home care options, and clear up criteria for enrollment in VA’s Program of Comprehensive Assistance for Family Caregivers.
It would create a mental health care grant program for family caregivers in the VA’s current program. And the bill closes a loophole to stop veterans from losing their burial benefits if they choose to pass in hospice care rather than a VA facility
“For nearly two years we have been listening to the veteran community to find the gaps within VA’s services to build a VA that meets the needs of today’s community and puts veterans — not government bureaucracy — at the center of the system,” House Veterans’ Affairs Committee Chairman Mike Bost, R-Ill., said in a statement following the bill’s passage. “[This bill] will help to meet that mission head-on.”
Rep. Julia Brownley, D-Calif., authored several provisions featured in the bill and called long-term care “one of the biggest challenges facing our aging population and their families.” She praised the House vote as setting the stage for “the single largest expansion of long-term care services at VA in decades.”
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Other provisions
The package also includes several provisions related to community care, the program through which veterans can use taxpayer funding to schedule medical appointments at private-sector clinics. About 40% of all VA medical appointments are currently handled through the community care program.
The legislation would prohibit VA officials from overriding medical decisions made by those outside physicians, giving more autonomy to non-VA doctors in veterans’ overall health care planning.
It would also require new outreach by VA to veterans about their community care options, and require department officials to look into potential reimbursement rate increases for those types of appointments.
Community care is poised to be a major point of attention next year, with President-elect Donald Trump promising on the campaign trail to provide more outside medical options for veterans as part of his administration’s reforms.
But VA officials have pushed back on that idea in recent months, offering arguments to investing more resources into department hospitals and staffing instead.
The Dole Act also includes provisions to boost supportive housing grants, in an effort to provide more funding to charities providing shelter for homeless veterans. And it mandates a closer look at VA dental care options, with a pilot program to gauge the feasibility of expanding dental coverage to more veterans.
To pay for the package, lawmakers would extend the VA home loan funding fees for three years, at a cost of about $5 per loan. That extra expense would not apply to veterans with a service-connected disability.
Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.
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