June 22, 2023

VA supports assisted living pilot program for veterans — with conditions

McKnights Senior Living

The US Department of Veterans Affairs supports legislation that would create a pilot program enabling some veterans to have their care needs met in an assisted living community rather than in a VA home, Erica Scavella, MD, of the VA testified Wednesday at a hearing of the House Committee on Veterans’ Affairs Subcommittee on Health. But that support comes with conditions, she said.

H.R. 1815, the Expanding Veterans’ Options for Long Term Care Act, which would establish a three-year test that could be extended for an additional three years, was one of several bills discussed by the subcommittee.

Scavella, assistant under secretary for health for clinical services at the Veterans Service Administration of the VA, testified that having the authority to provide assisted living services would help the VA place veterans who need such services and don’t qualify for nursing home care.

“Moreover, due to shifts in the industry to an assisted living model of care, particularly for patients with dementia, Alzheimer’s, or other memory deficits, VA’s lack of authority to furnish assisted living services means they have no appropriate option.” she said in written testimony published on the committee’s website. “The pilot authority would allow VA to determine how best to develop a program to support these Veterans’ needs. VA supports the protections this bill would include to ensure that Veterans are protected and receiving safe and appropriate care.”

The VA’s support of the bill is conditional, however. Scavella enumerated several suggested amendments, one of which would give the agency more time to implement the program if the legislation is signed into law. The proposal currently gives the VA one year from enactment to implement the program, but Scavella said the timeline is “untenable.”

“VA would need to issue regulations, hire staff, draft and enter into new agreements, and likely develop new systems or processes to support successful implementation,” she testified. “VA recommends providing two years from enactment and will require timely and sufficient resources to support the program.”

Other changes sought by the VA are meant to clarify language in the bill regarding various requirements.

Scavella also said that the VA’s support would be subject to the availability of appropriations to cover costs associated with the program.

The department estimates that the pilot program would cost approximately $60.3 million in fiscal year 2024 and $62.6 million in FY 2025. The VA also calculated the anticipated cost over five years, which Scavella said was estimated at $188.2 million.

“We welcome the VA’s support of this important legislation,” Maggie Elehwany, senior vice president of public affairs at Argentum, said after the hearing. Forty-two percent of assisted living residents are veterans or their spouses, she said.

Elehwany pointed to a 2021 report to Congress in which the VA said that approximately 5% of veterans residing in federally funded community nursing homes could be appropriately housed in assisted living. “By utilizing assisted living for individuals who meet the relevant criteria at the time of admission, the VA would realize a potential cost of avoidance of $69,101 per placement per year,” she said.

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