[Congressional Record Volume 149, Number 57 (Wednesday, April 9, 2003)]
[Senate]
[Pages S5070-S5071]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ROCKEFELLER:
  S. 836. 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; to the Committee on Veterans' Affairs.
  Mr. ROCKEFELLER. Mr. President, today I rise to reintroduce a bill 
that is enormously important to veterans in my State of West Virginia 
and to all veterans across this great Nation. The bill I am 
reintroducing will extend VA's ability to provide long-term care under 
two specific authorities of the Veterans Millennium Health Care and 
Benefits Act of 1999.
  In November of 1999, Congress passed comprehensive long-term care 
legislation that required VA for the first time to provide extended 
care services to enrolled veterans. Section 101 of Public Law 106-117 
directed 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 respite care, adult day care, home-
based primary care, homemaker/home health aide and skilled home health 
care to all enrolled veterans. Without extension, both authorities will 
expire in December, 2003.
  Long-term care for veterans has been, and remains, a priority for me. 
And the extension of these services is critically important to veterans 
and their families in every State across this country.
  Prior to the passage of the Millennium Health Care Bill, when 
families in West Virginia were told by VA that the long-term care 
services they needed were not available to them, they would turn to me 
in despair. I still frequently hear from families of aging, sick 
veterans who want desperately to keep their husbands, fathers or 
brothers at home, but in order to do that they need help.
  Many of our aging veterans are suffering from debilitating diseases, 
such as Alzheimer's or Parkinson's, or a stroke. A large number of 
these veterans are WW II combat veterans, whose wives are lovingly 
caring for them at home with very limited resources. The 
noninstitutional long-term care services currently available within VA 
provide an array of care that can be a lifesaver for the dedicated care 
givers of critically ill veterans, and allow these veterans to remain 
at home.
  While the purpose of this bill is clear, let me explain the reason it 
is so necessary. Within three years of the enactment of Public Law 106-
117, VA was to evaluate and report to the House and Senate Committees 
on Veterans' Affairs on its experience in providing services under both 
the nursing home care and non-institutional care provisions, and to 
make recommendations on extending or making permanent these provisions. 
These programs were given an expiration date of four years.
  But unfortunately, very little has happened with these long-term care 
programs. It was not until October, 2001, that VA addressed the 
requirements of the law by issuing a directive on such noninstitutional 
long-term care services as respite and adult day care. And even now, we 
find that how these services are being provided, if at all, varies 
widely throughout the VA health care system. The delay in implementing 
these programs will greatly impede our ability to adequately study 
their effects.
  Additionally, in September, 2001, two years after Congress passed the 
Millennium Health Care and Benefits Act of 1999, I asked the General 
Accounting Office to identify the long-term care services that are 
available at each of VA's medical centers, and the standards and 
criteria used by VA to determine which veterans may receive these 
services.
  GAO is expected to release their final report on VA long-term care by 
May 1, but their preliminary report confirms that VA has not made much 
progress in implementing noninstitutional long-term care services for 
veterans.
  Therefore, I believe it is critical that both long-term care 
authorities, due to expire in December of this year, be extended for an 
additional five years, until December 31, 2008, so that we can be 
properly evaluate the services and, if need be, make appropriate 
adjustments.

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