Home care providers are lobbying a Senate committee to reverse its recent decision to remove a central provision from the Elizabeth Dole Home Care Act. The provision would allow the Department of Veterans Affairs to fund nursing home-level home care at 100% of the cost of nursing home care. Currently, the VA can only fund home care at 65% of the cost of institutional care.
“We urge you to keep section 3 in the Elizabeth Dole HCBS Act, which will provide veterans a choice as to where they receive care by raising the 65% cap on non-institutional care,” Vicki Hoak, CEO of the Home Care Association of America, wrote in a Feb. 14 letter to the chair and ranking member of the U.S. Senate Committee on Veterans Affairs.
HCAOA, many of whose members provide VA-funded home care, learned earlier this month that the Senate committee intended to eliminate Section 3 of the bill. In the letter to the committee, Hoak referred to a General Accounting Office (GAO) report that found the average cost of institutional care per veteran in nursing homes was $268 per day, or nearly $98,000 per year. That compares to VA data showing the average cost per veteran receiving non-institutional care was only $5,500 a year.
She also mentioned that allowing the VA to offer home care alleviates the strain on nursing homes. Most nursing homes have limited capacity to serve veterans with special needs, especially those needing dementia, ventilator or behavioral care, she wrote.
“Removing the 65% cap on nursing level care in the home setting would provide relief to the capacity issues of institutional care while providing access and choice for veterans,” Hoak wrote.
She told McKnight’s Home Care Daily Pulse that if a veteran hits the 65% cap and still needs services, they need to go to a nursing home. It doesn’t negate the obligation of the VA. And it’s not just home care that contributes to the cap; respite and adult day care services also add to the cost, she said.
Removing the provision in the bill hurts those veterans who want to stay in their homes as long as possible, she said.
“Everyone wants to age in place, but when they need the care we put a cap on the care,” she said.