[Congressional Record Volume 149, Number 118 (Tuesday, September 2, 2003)]
[Senate]
[Pages S10972-S10973]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. REID (for Mr. Graham of Florida):
  S. 1572. A bill to authorize the expansion of the pilot program of 
the Department of Veterans Affairs on assisted living for veterans to 
include three additional health care regions of the Department of 
Veterans Affairs; to the Committee on Veterans' Affairs.
  (At the request of Mr. Reid, the following statement was ordered to 
be printed in the Record.)
 Mr. GRAHAM of Florida. Mr. President, I rise today to urge my 
colleagues to support an expansion of an existing Department of 
Veterans Affairs assisted living pilot program.
  Currently, 35 percent of veterans are 65 or older, which translates 
into 8.75 million people. Of that, about 640,000 are 85 and older--
those most in need of long-term care. VA estimates that the numbers 
will more than double to about 1.3 million in 2012.
  The assisted living pilot program is designed to help this massive 
group of men and women who either need long-term care now or 
potentially will need it in the future. The pilot program was first 
established through The Veterans Millennium Health Care and Benefits 
Act, which gave VA clear authority to furnish an assisted living 
service, including to the spouses of veterans.
  For my colleagues who do not know--and I doubt there can be many--
assisted living is a form of institutional care for those who need help 
caring for themselves but who do not need to be in a nursing home. By 
giving them the option of assisted living in an assistive facility, we 
allow our elderly veterans to retain their independence. The existing 
pilot has also provided VA a way to offer long-term care without having 
to house the program within its hospitals, reducing some of the burden 
to increase its number of beds.
  The Veterans Millennium Health Care and Benefits Act allowed for only 
one pilot program. After an extensive application process, on January 
9, 2001, the Northwest Veterans Integrated Service Network (VISN 20) 
was selected as the pilot site. Though the panel which selected the 
winner felt that other applicants, including the second place proposal 
from Florida's VISN 8, warranted funding, they were tied by the law's 
limit of one program.
  Since its inception, the VA assisted living pilot program in VISN 20 
has placed a total of 181 veterans in assisted living facilities. The 
average veteran selected for the pilot is a 69-year-old unmarried male 
who was referred from an inpatient hospital setting. The average 
veteran enrolled in the pilot also typically shows significant 
functional impairment and a wide variety of physical and mental health 
conditions.
  Initial findings show the average cost of the program is comparable 
to that of private assisted living--even costing less than some offered 
in Boise and Portland, two cities that are hosting the program. The 
average contract facility used for the pilot has 25 rooms.
  Another valuable facet of the program is its use of a computerized 
database that makes it extremely efficient for components such as 
recruitment, processing of payments, high quality data collection, and 
data analysis for ongoing management feedback and evaluation.

[[Page S10973]]

  Clearly, VA needs to do more in the area of long-term care. On May 22 
of this year, at the request of the Senate and House Committees on 
Veterans Affairs, the General Accounting Office (GAO) issued the report 
VA Long-Term Care: Service Gaps and Facility Restrictions Limit 
Veterans' Access to Noninstitutional Care. GAO found that ``VA's lack 
of emphasis on increasing access to noninstitutional long-term care 
services has contributed to service gaps and individual facility 
restrictions that limit access to care.'' The report made several 
recommendations to VA, including that they ``refine current performance 
measures to help ensure that all VA facilities provide veterans with 
access to required noninstitutional services.''
  In fiscal year 2002, VA served about 36 percent of its long-term care 
workload in non-institutional settings, yet, that same year, non-
institutional care accounted for just 9 percent of VA's long-term care 
expenditures. Clearly a move from traditional institutional care is 
wise. The assisted living pilot program goes far in helping VA address 
these problems and meet the goals set out for them by GAO.
  While the assisted living pilot in VISN 20 does not expire until 
October 2004, I am convinced that veterans in that part of the country 
are benefitting from the approach. The legislation I introduce today 
would expand the pilot program to three additional networks, for three 
additional years. Why should the rest of the Nation be prevented from 
reaping the benefits of such a practical, cost-effective program?
  Both veterans and VA employees affiliated with the program have 
praised what it has to offer. They believe that it fills an important 
gap for those who require care but do not need nor want to go to a 
nursing home. We must expand this program that provides such deserved 
care to our Nation's veterans, allowing them to maintain both their 
health and their self-respect.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1572

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. EXPANSION OF PILOT PROGRAM OF DEPARTMENT OF 
                   VETERANS AFFAIRS ON ASSISTED LIVING FOR 
                   VETERANS.

       Section 103(b) of the Veterans Millennium Health Care and 
     Benefits Act (Public Law 106-117; 113 Stat. 1552; 38 U.S.C. 
     1710B note) is amended--
       (1) by striking ``Location of Pilot Program.--'' and 
     inserting ``Locations of Pilot Program.--(1)''; and
       (2) by adding at the end the following new paragraph:
       ``(2)(A) In the addition to the health care region of the 
     Department selected for the pilot program under paragraph 
     (1), the Secretary may also carry out the pilot program in 
     not more than three additional designated health care regions 
     of the Department selected by the Secretary for purposes of 
     this section.
       ``(B) Notwithstanding subsection (f), the authority of the 
     Secretary to provide services under the pilot program in a 
     health care region of the Department selected under 
     subparagraph (A) shall cease on the date that is three years 
     after the commencement of the provision of services under the 
     pilot program in the health care region.''.

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