Bill Overview
Title: Expanding Veterans’ Options for Long Term Care Act
Description: This bill requires the Department of Veterans Affairs (VA) to implement a three-year pilot program to assess the effectiveness of providing assisted living services to eligible veterans, including by assessing the satisfaction of veterans participating in the pilot program. Eligible veterans are those who (1) are eligible for assisted living services as determined by the VA; and (2) are already receiving nursing home level care paid for by the VA, are eligible for such care from the VA, or exceed the requirements for domiciliary care paid for by the VA but do not meet the requirements for nursing home level care paid for by the VA. The Inspector General of the VA must report to Congress on the pilot program, and the VA must submit a follow-up plan to address any deficiencies that are identified in the report.
Sponsors: Sen. Tester, Jon [D-MT]
Target Audience
Population: Veterans eligible for long-term care under VA criteria
Estimated Size: 700000
- The bill aims to provide assisted living services to veterans who are eligible for long-term care but are not necessarily in need of full nursing home care.
- The target population includes those veterans who are currently receiving nursing home level care or those eligible for such care.
- According to various data sources, as of recent years, there are approximately 19 million veterans in the United States.
- About 4.1% of veterans (around 780,000 individuals) receive VA disability benefits and may require some form of long-term care.
- The pilot program focuses on veterans needing a level of care between domiciliary and full nursing home care, which is a fraction of those requiring any long-term care.
- Considering the specificity of the eligibility, the actual number of impacted veterans would likely be within the lower end of those statistics.
Reasoning
- The target population for this policy is a subgroup of U.S. veterans who are eligible for specific types of long-term care under VA criteria. These veterans may receive nursing home level care or just fall short of that requirement.
- Given the specific eligibility criteria, not all veterans will be affected. The cost and budget limitations suggest only a fraction of eligible veterans can be included.
- We will simulate interviews from various backgrounds, some directly affected and others observing from a distance to capture a range of perspectives.
- We have identified approximately 700,000 veterans who might be affected, but the actual pilot program's budget limitations mean only a portion will experience changes, mostly in urban areas where VA services are densely located.
Simulated Interviews
retired (California)
Age: 78 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 10/20
Statement of Opinion:
- I've been waiting for something better than a nursing home.
- Assisted living sounds like it could provide more freedom but still help.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 5 | 4 |
| Year 20 | 4 | 4 |
retired nurse (Texas)
Age: 84 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 1.5 years
Commonness: 8/20
Statement of Opinion:
- I might need more help soon, but I'm not ready for a nursing home.
- This policy might cover my needs in a few years.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 4 | 4 |
| Year 20 | 3 | 3 |
unemployed (New Mexico)
Age: 59 | Gender: other
Wellbeing Before Policy: 3
Duration of Impact: 0.5 years
Commonness: 6/20
Statement of Opinion:
- I'm worried about my future as my health declines.
- I hope the pilot could be extended to include younger veterans like me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 3 | 3 |
| Year 2 | 3 | 2 |
| Year 3 | 3 | 2 |
| Year 5 | 3 | 2 |
| Year 10 | 2 | 1 |
| Year 20 | 1 | 1 |
retired, (Florida)
Age: 67 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 2.0 years
Commonness: 7/20
Statement of Opinion:
- I need to understand how this impacts my husband's care.
- Assisted living could mean better quality life for him and peace for me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 4 | 3 |
retired teacher (New York)
Age: 72 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 12/20
Statement of Opinion:
- This is a step in the right direction for vets who can't handle full nursing care.
- Our vets deserve more options that respect their independence.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
retired (Illinois)
Age: 80 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 14/20
Statement of Opinion:
- I think it's a good change for families needing more appropriate care solutions.
- Hope similar options could be available to civilians too.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
retired machinist (Arizona)
Age: 69 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 1.0 years
Commonness: 9/20
Statement of Opinion:
- I'm getting by for now, but may need more later.
- This pilot looks promising for future needs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 4 |
| Year 20 | 4 | 4 |
retired (Ohio)
Age: 74 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 1.5 years
Commonness: 9/20
Statement of Opinion:
- Always good to have more options like assisted living.
- Feels like a bridge between home care and full nursing homes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 4 | 3 |
retired veteran affairs worker (Maryland)
Age: 60 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 1.0 years
Commonness: 8/20
Statement of Opinion:
- We need to allocate the resources effectively to make the pilot work.
- Should reduce bureaucratic barriers so more veterans can benefit.
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 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
retired (Washington)
Age: 93 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 2.5 years
Commonness: 5/20
Statement of Opinion:
- At my age, I just want consistent care.
- If this policy improves care availability, it's a win.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 3 |
| Year 5 | 5 | 3 |
| Year 10 | 4 | 2 |
| Year 20 | 3 | 2 |
Cost Estimates
Year 1: $1500000000 (Low: $1000000000, High: $2000000000)
Year 2: $1500000000 (Low: $1000000000, High: $2000000000)
Year 3: $1500000000 (Low: $1000000000, High: $2000000000)
Year 5: $0 (Low: $0, High: $0)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- The policy is a pilot program and not a permanent change to VA policy.
- Cost impacts will be closely monitored with reports required by the VA Inspector General.
- Actual direct costs to VA could vary significantly depending on the number of participants and program execution efficiency.
- Data collected from this program can influence future policy for long-term care options for veterans.