[Congressional Record Volume 164, Number 44 (Tuesday, March 13, 2018)]
[House]
[Pages H1513-H1515]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATE VETERANS HOME ADULT DAY HEALTH CARE IMPROVEMENT ACT OF 2017
Mr. ROE of Tennessee. Mr. Speaker, I move to suspend the rules and
pass the bill (S. 324) to amend title 38, United States Code, to
improve the provision of adult day health care services for veterans.
The Clerk read the title of the bill.
The text of the bill is as follows
S. 324
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``State Veterans Home Adult
Day Health Care Improvement Act of 2017''.
SEC. 2. PROVISION OF CERTAIN ADULT DAY HEALTH CARE SERVICES
FOR VETERANS.
(a) In General.--Section 1745 of title 38, United States
Code, is amended--
(1) by adding at the end the following new subsection:
``(d)(1) The Secretary shall enter into an agreement with
each State home for payment by the Secretary for medical
supervision model adult day health care provided to a veteran
described in subsection (a)(1) on whose behalf the State home
is not in receipt of payment for nursing home care from the
Secretary.
``(2)(A) Payment under each agreement between the Secretary
and a State home under paragraph (1) for each veteran who
receives medical supervision model adult day health care
under such agreement shall be made at a rate established
through regulations prescribed by the Secretary to adequately
reimburse the State home for the care provided by the State
home, including necessary transportation expenses.
``(B) The Secretary shall consult with the State homes in
prescribing regulations under subparagraph (A).
``(C) The rate established through regulations under
subparagraph (A) shall not take effect until the date that is
30 days after the date on which those regulations are
published in the Federal Register.
``(3) Payment by the Secretary under paragraph (1) to a
State home for medical supervision model adult day health
care provided to a veteran described in that paragraph
constitutes payment in full to the State home for such care
furnished to that veteran.
``(4) In this subsection, the term `medical supervision
model adult day health care' means adult day health care that
includes the coordination of physician services, dental
services, nursing services, the administration of drugs, and
such other requirements as determined appropriate by the
Secretary.''; and
(2) in the section heading, by inserting ``, adult day
health care,'' after ``home care''.
(b) Initial Rate.--Before the Secretary of Veterans Affairs
establishes a payment rate under subsection (d)(2)(A) of
section 1745 of such title, as added by subsection (a), the
Secretary shall pay to a State home that has entered into an
agreement with the Secretary for medical supervision model
adult day health care (as defined in subsection (d)(4) of
such section) an amount equal to 65 percent of the rate the
Secretary would pay under subsection (a)(2) of such section
to the State home for nursing home care provided to the
veteran.
(c) Clerical Amendment.--The table of sections at the
beginning of chapter 17 of such title is amended by striking
the item relating to section 1745 and inserting the following
new item:
``1745. Nursing home care, adult day health care, and medications for
veterans with service-connected disabilities.''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Tennessee (Mr. Roe) and the gentleman from Minnesota (Mr. Walz) each
will control 20 minutes.
The Chair recognizes the gentleman from Tennessee.
General Leave
Mr. ROE of Tennessee. Mr. Speaker, I ask unanimous consent that all
Members have 5 legislative days to revise and extend their remarks and
include extraneous material.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Tennessee?
There was no objection.
Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, before I begin today, I would like to take a moment to
express my deepest sympathies to those affected by last week's tragedy
in Yountville, California. I closely followed the situation. I am truly
saddened by what has occurred.
All three employees who lost their lives--Christine Loeber and
Jennifer Golick from the Pathway Home and Jennifer Gonzales from the
Department of Veterans Affairs--were committed to helping veterans
struggling with difficulties like post-traumatic stress disorder and
other mental problems.
As Secretary Shulkin said: ``Caring for veterans and our employees
serving them is always important. It is even more critical that we
reach out to one another and provide support during painful times like
these.''
I think I can speak for myself and the rest of the members on the
House Committee on Veterans' Affairs when I offer prayers and support
during this incredibly difficult and challenging time for these
families.
Mr. Speaker, I rise today in support of S. 324, the State Veterans
Home Adult Day Health Care Improvement Act of 2017. It is imperative
that we ensure that VA is equipped with a variety of geriatric and
long-term care programs to best meet the individual needs and goals of
the increasing number of veterans who are reaching retirement age.
Current law requires VA to cover the cost of nursing home care in a
State Veterans Home for any veteran in need of such care due to a
service-connected disability or with a service-connected disability
rating of 70 percent or more. However, veterans are increasingly
seeking opportunities to get additional care they need as they age
while remaining at home rather than in a nursing care facility or other
institutional setting. S. 324 would help those veterans by requiring VA
to enter into an agreement or a contract with the State Veterans Home
to pay for adult day healthcare for veterans who are eligible but not
receiving nursing home care.
Adult day healthcare programs provide companionship, peer support,
recreation, certain healthcare services, case management assistance
with activities of daily living, and more to veterans, and needed
respite and relief to caregivers. What is more, adult day healthcare
programs are a much less costly alternative to nursing home care,
meaning that, with the enactment of this bill, we could grant veterans
who desire to age at home the opportunity to do so without sacrificing
the care and support services they may need and save taxpayer dollars.
S. 324, which is sponsored by Senator Orrin Hatch of Utah, is
companion legislation to H.R. 1005, which is sponsored by the gentleman
from New York (Mr. Zeldin) and passed the House with unanimous support
earlier this year. I am grateful to both of them for their leadership
on this issue, and I urge all of my colleagues to join me in supporting
S. 324.
Mr. Speaker, I reserve the balance of my time.
Mr. WALZ. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I would like to thank the gentleman from Tennessee for
his compassionate words on the tragic loss of three dedicated, selfless
servants in care of our veterans. I very much appreciate that, and it
is a challenging time.
Mr. Speaker, I rise today in support of S. 324, the State Veterans
Home Adult Day Health Care Improvement Act. I want to thank Senator
Hatch for introducing this innovative and bipartisan bill.
S. 324 directs the VA to enter into an agreement with each State home
to pay for medical supervision model adult healthcare for a veteran for
whom the home is not receiving VA nursing home payments.
Ensuring that veterans have access to appropriate affordable
geriatric and long-term care is becoming increasingly important. In
2017, approximately 9.8 million veterans, or 46 percent, were 65 years
or older.
In addition, VA's own Enrollee Health Care Projection Model indicates
a further demand on long-term care and support services is coming as
the Vietnam-era cohort ages, with most having gone beyond age 75 by
2026.
At present, VA is required to cover the cost of nursing home care in
the
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State Veterans Home for any veteran in need of such care due to a
service-connected disability or with a service-connected disability
rated 70 percent or more. However, there is increasing demand for VA to
offer geriatric and long-term programs for veterans in noninstitutional
settings that would allow them to receive the services and support they
need to remain in their homes--their preferred venue.
Adult day healthcare programs provide veterans in need of supportive
services with companionship, peer support, recreation, and certain
healthcare services, while allowing them to stay and maintain their
independence.
In testimony before the Subcommittee on Health last year, the
National Association of State Veterans Homes claimed that there are a
number of State homes across the country interested in providing
medical model ADHC services; however, the current basic ADHC per diem
paid to the State Veterans Home by the VA is not sufficient for most
homes to cover the cost of this program. As a result, only 3 State
Veterans Homes out of 153, nationwide, provide this program.
This legislation would correct that imbalance, allowing veterans who
would otherwise qualify for more costly VA nursing home care the
ability to stay in their home longer, at a reduced cost.
Mr. Speaker, I reserve the balance of my time.
Mr. ROE of Tennessee. Mr. Speaker, I yield 3 minutes to the gentleman
from Michigan (Mr. Bergman), from the Upper Peninsula, chairman of the
Subcommittee on Oversight and Investigations.
Mr. BERGMAN. Mr. Speaker, I rise today in support of S. 324, the
State Veterans Home Adult Day Health Care Improvement Act of 2017.
This is very personal to me. My cousin, a fellow Vietnam vet who
served on the DMZ with the Army, is currently in need of and receiving
some of that care for some serious health issues he has right now as a
result of exposure to Agent Orange.
The bill we are talking about here strikes a responsible balance by
promoting access to necessary medical services for veterans, while also
improving quality of life by allowing them to return home to their
families each night. Adult day healthcare does more than just provide
veterans with the medical care that they need; it also offers much-
needed relief to their caregivers. Oftentimes, friends and family come
together to help with the daily care that these veterans and their
families require.
By giving veterans the opportunity to access medical care for up to 8
hours a day through a State veterans home, caregivers will have the
opportunity to fulfill their personal responsibilities for themselves
and their families. They can get on and get their life in order while
still serving their veteran family member.
These folks work day in and day out to provide unparalleled care,
loving care to our most vulnerable veterans. S. 324 recognizes their
selfless commitment and works to enhance their work-life balance so
they can continue to serve veterans.
In my district, folks deal with the circumstances of rural living
every day. This often means limited access to resources and fewer
options for receiving the services they need.
The D.J. Jacobetti Home for Veterans in Marquette is a perfect
example of what can be achieved when Federal resources are narrowly
focused and responsibly applied. Jacobetti Home's ability to create a
family environment where veterans can receive the care they need while
maintaining quality in their daily lives is a testament to what is
possible when the Federal Government helps local institutions provide
services for the people they know best.
Mr. Speaker, I urge support of S. 324.
Mr. WALZ. Mr. Speaker, I continue to reserve the balance of my time.
Mr. ROE of Tennessee. Mr. Speaker, I yield 3 minutes to the gentleman
from New York (Mr. Zeldin), the author of the bill on the House side
and also an Iraq war veteran.
Mr. ZELDIN. Mr. Speaker, I am very excited to be here because I know
just how many disabled veterans in our country are on wait lists for
adult day healthcare and now will be getting a service that is just so
important and overdue.
I certainly want to thank Chairman Roe and his great staff, the House
Veterans' Affairs Committee, the ranking member and his team as well,
everybody coming together working hard on behalf of our disabled
veterans who need it most.
I rise in support of S. 324. It is the Senate companion to my bill,
H.R. 1005, which is a bill to provide adult day healthcare and save
State Veterans Homes for veterans who are 70 percent or more service-
connected disabled. This bill is an extension to the Veterans Benefits,
Health Care, and Information Technology Act of 2006, which currently
provides no-cost nursing home care at any State Veterans Home to
veterans who are 70 percent or more service-connected disabled.
Medical model adult day healthcare provides comprehensive medical
nursing and personal care services combined with engaging social
activities for physically or cognitively impaired adults. Medical model
adult day healthcare offers a complete array of rehabilitative
therapies, including physical, occupational, and speech therapies,
hospice and palliative care, social work, spiritual, nutritional
counseling, and therapeutic recreation.
The program is designed to promote socialization and stimulation and
maximize the participant's independence, while enhancing their quality
of life. The program is staffed by a great team of multidisciplinary
healthcare professionals who evaluate each participant and customize an
individualized plan of care specific to their health and social needs.
Adult day healthcare is an alternative care setting that can allow
some veterans who require long-term care services to remain in their
homes as opposed to being institutionalized in a nursing home. Such
veterans typically require support from some, but not all, activities
of assisted daily living--ADLs--such as bathing, dressing, or feeding.
In many cases, the spouse or their family member may provide the
veteran with much of their care, but they require additional support
for some of the veteran's ADLs. By filling these gaps, adult day
healthcare can allow these veterans to remain in their homes and
communities for additional months, or even years, and thereby lower the
financial cost of caring for these heroes.
Adult day healthcare also provides family caregivers support and
relief to meet their other professional and family obligations and
provides a well-deserved respite while their loved ones are
participating in the program.
In addition to thanking Chairman Roe for his leadership and support
on this important issue, I also want to thank Senator Hatch for
carrying this effort in the Senate, as well as Fred Sganga and the Long
Island State Veterans Home in Stony Brook for their great efforts. That
is a State Veterans Home located in the First Congressional District of
New York, one of three places currently offering adult day healthcare.
The SPEAKER pro tempore. The time of the gentleman has expired.
Mr. ROE of Tennessee. Mr. Speaker, I yield an additional 1 minute to
the gentleman from New York.
Mr. ZELDIN. Mr. Speaker, this is a piece of legislation that will
provide a valuable and necessary service to our Nation's veterans, and
I am urging my colleagues to support this commonsense, bipartisan
legislation.
What goes on too often unnoticed in this House is the great staff
that we have to help make these efforts possible. So, from the
leadership team, I want to thank staff John Leganski and Kelly Dixon,
and in my office, as legislative director, Kevin Dowling, and Matthew
Scott.
Thank you again to the great House Veterans' Affairs Committee, and
we will all greatly miss Chairman Roe as he departs. Hopefully, maybe
we will get him to change his mind, but in the meantime, I will just
say we enjoyed serving with him, and I hope that he won't go anywhere
for a very long time. He is a great leader for our veterans as well as
being our ranking member.
Mr. WALZ. Mr. Speaker, if the gentleman has no further speakers, I am
prepared to close.
Mr. Speaker, I would like to thank the gentleman from Long Island--he
clearly understands this issue--for his
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passionate work on this, and we are grateful for it.
I, too, would like to add my voice to this, to the chairman for once
again proving to America that this Congress can work, that there are
bipartisan solutions to issues that we care about in serving our
constituents and our veterans and others. It is something that we are
very proud of here. It doesn't always come easy, but his leadership
somehow finds a way to bring us to the table. We get it done, and I am
grateful for that.
I urge my colleagues to join us in passing S. 324, and I yield back
the balance of my time.
Mr. ROE of Tennessee. Mr. Speaker, unless Mr. Zeldin has talked to my
doctor and knows something I don't know, I hope to be here next year.
That is my plan.
I appreciate the opportunity to work on this bill with him. He has
been a great advocate, as the ranking member has been. This is a bill
that is long overdue, much needed, and I give my strong support along
with--I think I can speak for them--the entire Veterans' Affairs
Committee. We voiced this. I encourage Members to support this
legislation.
Mr. Speaker, I yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Tennessee (Mr. Roe) that the House suspend the rules and
pass the bill, S. 324.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill was passed.
A motion to reconsider was laid on the table.
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