[Congressional Record (Bound Edition), Volume 149 (2003), Part 11]
[Extensions of Remarks]
[Page 14866]
[From the U.S. Government Publishing Office, www.gpo.gov]




                 VETERANS NURSING HOME CARE ACT OF 2003

                                 ______
                                 

                            HON. LANE EVANS

                              of illinois

                    in the house of representatives

                        Thursday, June 12, 2003

  Mr. EVANS. Mr. Speaker, I rise in support of H.R. 2445, the Veterans 
Nursing Home Care Act of 2003. I am introducing this bill in order to 
extend the assurance of a meaningful nursing home benefit for the 
majority of our service-connected veterans. I want to ensure that 
medically necessary nursing care is at least available to those with 
conditions related to their military service.
  This winter, the administration surprised us with a new proposal for 
saving VA about $235 million. Instead of using the guarantee for 
nursing home care as a minimum threshold for veterans to whom VA must 
provide unlimited nursing home care, it proposed to define this group 
as the only veterans who would be eligible for nursing home services. 
This was definitely not Congress's intention and I want to ensure that 
the Department is very clear about that.
  Congress passed the Veterans Millennium Health Care and Benefits Act 
(P.L. 106-117) in 1999. The bill contained a number of measures 
designed to shore up the long-term care mission in VA. Even then, it 
was apparent that VA had begun to abandon its role in traditional long-
term care. VA now acknowledges that the majority of its ``nursing 
home'' beds are dedicated to post-acute care, short-term evaluation, 
and rehabilitative care missions. It continues to turn away from 
custodial care for veterans.
  In response to this shift in mission, Congress was able to agree to a 
small core-group (now known as Priority Group 1A) who would be eligible 
for long-term placement in a VA nursing home. VA would not be able to 
discharge these veterans without the consent of the veteran or his 
representative. In addition, Congress agreed to inclusion of non-
institutional long-term services in the definition of ``medical 
services'' that comprise VA's benefits package. The Millennium Bill 
also established a ``capacity requirement'' that required VA to 
maintain its long-term care services at the FY 1998 level.
  What has occurred in response to this legislation has been 
discouraging to say the least. A letter covering a report VA prepared 
to discuss implementation of the law signed by Secretary of Veterans 
Affairs Anthony J. Principi states: ``. . . there is evidence of only 
small changes in VA's long-term care (LTC) services that were a direct 
result of the Act versus what VA had already planned in providing LTC 
for veterans. In addition, there was only a small increase in numbers 
of veterans 70 percent service-connected or greater who were estimated 
to need nursing home care but who actually received that care from 
VA.''
  In addition there is a long history of correspondence between 
Congress and the Administration about the ``capacity'' requirement. As 
part of its proposal for fiscal year 2004, VA would cut an additional 
5000 nursing home beds from its program projecting an average daily 
census (ADC) of 8500. At the end of FY 2002, it was already 
considerably short (ADC of 11,969) of its FY 1998 required level (an 
average daily census of 13,391).
  The news is not just bad for institutional care. This May, the 
General Accounting Office released a report I requested that looked at 
the availability of non-institutional long-term care. It identified 
major gaps in access and availability of services--including those 
Congress meant to include as part of the ``basic benefits'' package 
available to every enrolled veteran.
  I note that I am not the only one who is apparently concerned about 
VA's vanishing nursing home mission. The Chairman of the Senate 
Veterans Affairs Committee, Arlen Specter has introduced legislation, 
S. 1156, which extends the requirement to provide long-term nursing 
home care to veterans with service-connected conditions rated at least 
50 percent. I look forward to working with him on this legislation. I 
urge all Members of the House to support this measure.

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