Giving Vets With Severe Service-Related Disabilities Access To Longterm Care Outside Of The VA (H.R. 294)

What is H.R. 294?

(Updated September 21, 2018)

This bill would allow the Dept. of Veterans Affairs (VA) to offer long-term care in medical foster homes (MFH) to certain veterans with severe service-related disabilities. 

The VA would be authorized to put up to 900 veterans in these medical facilities, and would have to foot the bill. MFH's are private homes where trained caregivers attend to a small number of individuals. As the CBO explains in it's cost estimate of this bill: 

"VA has an existing program under which it inspects and approves MFHs for veterans. Veterans currently living in such homes are eligible to receive VA’s Home Based Primary Care services, which include case management and health care provided in the home. VA is not currently authorized to pay for the cost of living in MFHs, but under this bill, VA could pay that cost."  

This bill would also cap the number of bonuses awarded to VA employees through 2018 at $300 million. From 2019 - 2024, the cap would be $360 million. For context, the CBO found that between 2010 and 2013, the VA averaged $395 million in bonuses and awards to employees. 

Argument in favor

After the service that they’ve given our country, veterans deserve the best care. If the government can’t provide it, the private sector will.

Argument opposed

After the service they’ve given our country, we’re going to schlep our veterans off to some cut-rate facility because the government can’t manage its budget?

Impact

Veterans in need of medical foster care, their families and caretakers, public and private healthcare providers, medical foster care owners and operators, the Department of Veterans’ Affairs, and the U.S. military.

Cost of H.R. 294

A CBO cost estimate found that implementing this bill would reduce discretionary costs by $253 million over the 2016-2020 period, subject to appropriation action consistent with the bill.

Additional Info

In Depth:

Sponsoring Rep. Jeff Miller (R-FL) introduced an earlier version of this bill to the House in the summer of 2013. It did not see a vote.

If passed, this law would go into effect in October of 2015 and expire three years later.

Of Note: 

This bill comes at a time when the Department of Veterans’ Affairs is facing something of a crisis. In 2014, it drew heavy criticism for excessive wait times, preventable deaths, and inaccurate data eventually forcing the resignation of its Secretary, Eric Shinseki. Since then, it’s had a budget expansion and the introduction of a new Secretary — Robert McDonald — who has promised to hire thousands of new personnel.

Near the end of February, a group called Concerned Veterans for America proposed a number of changes to the VA. These include subsidizing veteran care to private providers and turning the VA into a non-profit corporation that competes with other medical providers. This bill’s sponsor, Rep. Jeff Miller (R-FL) supports them. Secretary McDonald opposes them.

Media:

Washington Post

The Arizona Republic