Bill Overview
Title: Long-Term Care Veterans Choice Act
Description: This bill authorizes the Department of Veterans Affairs (VA) to enter into contracts to pay for specified veterans (i.e., certain veterans who have service-connected disabilities and require nursing home care) to be placed in medical foster homes at their request. A medical foster home is a home designed to provide non-institutional, long-term, supportive care for veterans who are unable to live independently and prefer a family setting. Veterans receiving such care must agree, as a condition of payment for their care, to accept home health services furnished by the VA. Under the bill, no more than a daily average of 900 veterans may have their care in a medical foster home covered by the VA. The VA must create a monitoring system to assess its workload in carrying out the medical foster home payments. Additionally, the Government Accountability Office must submit to Congress reports that assess the implementation of this program and provide recommendations for improvements. The bill also extends certain loan fee rates through February 15, 2031, under the VA's home loan program.
Sponsors: Rep. Higgins, Clay [R-LA-3]
Target Audience
Population: Veterans needing nursing home care due to service-connected disabilities
Estimated Size: 900
- The bill addresses veterans with service-connected disabilities who require nursing home care.
- It specifies a non-institutional care setting by authorizing placement in medical foster homes at the request of the veteran.
- Medical foster homes provide long-term supportive care in a quasi-family setting, beneficial for veterans who prefer not to be in traditional nursing homes.
- The number of veterans impacted is capped at a daily average of 900, indicating a significant but focused target group.
Reasoning
- The policy is designed to address veterans with service-connected disabilities requiring nursing home care by providing them an option to reside in medical foster homes, offering a more family-like setting than traditional nursing homes.
- The policy targets a very specific group: up to 900 veterans at any time, representing a high-impact change for those individuals but not affecting the broader veteran community.
- It is essential to include perspectives from both directly affected veterans and other stakeholders, such as those who do not qualify or choose not to participate, caregivers, and family members.
- The limited budget implies a need for prudent allocation, potentially focusing on veterans with the highest need or lack of other viable care options.
- Perspectives from different demographic and geographic areas within the U.S. will provide a full spectrum of insights into the impact and reception of the policy.
Simulated Interviews
Retired (Phoenix, AZ)
Age: 71 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- The thought of moving to a foster home is a relief as I've been struggling with daily tasks.
- I'm concerned about losing my independence but the family setting is appealing.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 2 |
N/A (Veteran) (Boston, MA)
Age: 82 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 7.0 years
Commonness: 10/20
Statement of Opinion:
- Being amongst fellow veterans in a family-like setting sounds ideal.
- I'm glad there's an option away from traditional care homes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 2 |
Disabled Veteran Advocate (Houston, TX)
Age: 58 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- The program is a great alternative for those struggling with institutional settings.
- I fear the cap of 900 might leave some deserving veterans without this option.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 6 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 3 |
Veteran Care Facility Coordinator (Fayetteville, NC)
Age: 65 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 15.0 years
Commonness: 6/20
Statement of Opinion:
- It's an important step in diversifying veteran care options.
- The wellbeing impact on veterans may need more study and refinement.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 7 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 3 |
Retired mechanic (Detroit, MI)
Age: 74 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 0.0 years
Commonness: 15/20
Statement of Opinion:
- I prefer living with my wife rather than move to any care facility.
- Although it won't affect me directly, more options for others is always good.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 3 |
| Year 20 | 4 | 3 |
VA Social Worker (Los Angeles, CA)
Age: 47 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 20.0 years
Commonness: 4/20
Statement of Opinion:
- This initiative will help address some housing and personal care barriers.
- The cap might create competition for these spaces, which could be a concern.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 6 | 3 |
Retired teacher (Des Moines, IA)
Age: 69 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 0.0 years
Commonness: 12/20
Statement of Opinion:
- The policy could make great improvements for some, but I'm content where I am.
- I hope those who need it can access these homes easily.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 4 | 4 |
| Year 3 | 4 | 3 |
| Year 5 | 3 | 3 |
| Year 10 | 3 | 2 |
| Year 20 | 2 | 2 |
Retired nurse (Chicago, IL)
Age: 79 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 11/20
Statement of Opinion:
- It'd be nice to have a homier environment than hospitals or nursing homes.
- I'm curious how well-integrated these services will become.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 4 |
| Year 5 | 5 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 4 | 2 |
Software Engineer (Seattle, WA)
Age: 55 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 10.0 years
Commonness: 9/20
Statement of Opinion:
- The policy wouldn't directly affect me, but gives peace of mind knowing my father could choose this option.
- Concerns remain regarding the number of available spots.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 4 |
Retired Architect (Miami, FL)
Age: 83 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 8.0 years
Commonness: 7/20
Statement of Opinion:
- The idea of joining a foster home doesn't appeal much to me now, but it's nice knowing it's an option.
- I think many would benefit from the program.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 3 |
| Year 20 | 4 | 2 |
Cost Estimates
Year 1: $45000000 (Low: $40000000, High: $50000000)
Year 2: $46000000 (Low: $41000000, High: $51000000)
Year 3: $47000000 (Low: $42000000, High: $52000000)
Year 5: $49000000 (Low: $44000000, High: $54000000)
Year 10: $54000000 (Low: $48000000, High: $60000000)
Year 100: $99000000 (Low: $88000000, High: $110000000)
Key Considerations
- The program aims to support a maximum of 900 veterans simultaneously, keeping the target population contained and costs predictable.
- Monitoring and reporting requirements by VA and GAO may incur additional costs not accounted for explicitly in foster home care expenses.
- Program success may lead to adjustments in legislative or funding approaches based on efficacy and veteran satisfaction.