[Congressional Record Volume 148, Number 34 (Thursday, March 21, 2002)]
[Senate]
[Page S2265]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ROCKEFELLER:
  S. 2043. A bill to amend title 38, United States Code, to extend by 
five years the period for the provision by the Secretary of Veterans 
Affairs of noninstitutional extended care services and required nursing 
home care, and for other purposes; to the Committee on Veterans' 
Affairs.
  Mr. ROCKEFELLER. Mr. President, today I introduce legislation to 
improve VA's response to meeting the long-term care needs of an aging 
veteran population. Specifically, the bill would extend two long-term 
care authorities of the Veterans Millennium Health Care and Benefits 
Act of 1999.
  In November of 1999, Congress passed comprehensive long-term care 
legislation for veterans. For the first time, VA was required to 
provide extended care services to enrolled veterans. Section 101 of 
Public Law 106-117, directed the VA to provide nursing home care to any 
veteran who is in need of such care for a service-connected condition, 
or who is 70 percent or more service-connected disabled. In addition, 
VA was to have provided non-institutional care, such as home-based 
care, respite, and adult day health care, to all enrolled veterans. 
Within 3 years of the bill's enactment, VA was to evaluate and report 
to the House and Senate Committees on Veterans' Affairs on its 
experience in providing services under both of these provisions and to 
make recommendations on extending or making permanent these provisions. 
These programs were given an expiration date of 4 years so that we 
could adequately study its effects and, if need be, make appropriate 
adjustments.
  Unfortunately, it's been more than two years and very little has 
happened with these long-term care programs. With both provisions due 
to expire next year, there is hardly enough time to sufficiently study 
them. The legislation I introduce today will extend the expiration 
dates of both long-term care authorities for an additional 5 years, 
until December 31, 2008.
  I am extremely disappointed that the VA has taken so long to bring 
these new extended care authorities into the lives of veterans. 
Although there is a sense of urgency about meeting the long-term care 
needs of veterans, the VA seems frozen to respond.
  In addition to mandating that VA provide nursing home care to any 
veteran who is in need of such care for a service-connected condition, 
or who is 70 percent or more service-connected disabled, the Veterans 
Millennium Health Care and Benefits Act required the VA to maintain the 
staffing and level of extended care during any fiscal year at the same 
level that was provided in fiscal year 1998. Unfortunately, both the 
staffing level for nursing home care and the average daily census has 
dropped since 1998, and VA readily admits that they are not in 
compliance with this mandate, citing a lack of resources.
  In addition to providing nursing home care, a key element of the 
Millennium bill required VA to furnish non-institutional long-term care 
as part of the standard benefits package. While the bill was signed 
into law at the end of 1999, it was just last October that VA finally 
issued interim guidance on the new benefit. The policy was essentially 
meaningless, in that it required facilities to either have these non-
institutional long-term care services available or to develop a plan 
for providing such services. As a result, I suspect that many 
facilities have not yet made non-institutional services universally 
available. In order to confirm this, I have asked that the General 
Accounting Office provide me with information as to what inventory of 
noninstitutional long-term care programs exists within VA. The GAO's 
report should be completed shortly.
  We know that there is an expanding need for long-term care in our 
country, and in the VA that demand is even more pressing. About 37 
percent of the veteran population is 65 years or older, and that number 
will grow dramatically in the next few years. By extending the existing 
long-term care authorities, we signal to VA that they cannot shirk this 
responsibility.
  There is no doubt that long-term care is expensive. It is our 
responsibility, however, to make sure that the necessary resources are 
provided to VA to implement existing long-term care programs. For my 
part, I will continue to push VA to move forward, and in the near 
future, I will be chairing a Committee hearing to learn more about VA's 
inaction.
  Long-term care should be seen as a part of the continuum of quality 
health care we have promised our veterans. The point of this 
legislation is to extend two important VA long-term care authorities, 
and I urge all of my Senate colleagues to support it.
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