Elizabeth Dole Home- and Community-Based Services for Veterans and Caregivers Act of 2023
Floor Speech
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Ms. BROWNLEY. Mr. Speaker, I thank Ranking Member Takano for his partnership and his efforts to bring this important bill for our Nation's disabled and aging veterans and their caregivers to the floor.
Mr. Speaker, I rise in support of this bill, Representative Bergman's and my bill, H.R. 542, the Elizabeth Dole Home Care Act.
I am so proud to have authored this legislation, which delivers the largest set of reforms to the VA's long-term care programs in decades. The bill will significantly expand access to the programs disabled and aging veterans need to live their lives at home and with their families.
Specifically, the bill requires the Department of Veterans Affairs to provide access to all home- and community-based services, such as home health aides, home-based primary care, home skilled nursing, and respite care for caregivers to all veterans who need them. Currently, elderly and disabled veterans only have access to these programs if their VA medical centers choose to offer them.
My bill would also require VA to improve care coordination between the Program of Comprehensive Assistance for Family Caregivers and VA's other home-based programs. If a veteran does not meet the enrollment criteria for the comprehensive caregiver program, VA would be required to proactively assist the veteran and their caregiver in enrolling in other home-based programs and ensure there is a warm handoff for those who do not qualify for the comprehensive caregiver program.
Finally, my legislation would require VA to establish a public-facing website that will enable veterans and their loved ones to assess their eligibility for each of the home- and community-based services VA offers and provide information about how to access these services.
I have served on the Veterans' Affairs Committee since my first term in Congress, and over the last 10 years, I have participated in at least five oversight hearings related to improving long-term care for our veterans. I have also spoken with countless veterans and their loved ones, and based on my experience, one thing is very clear: Almost every veteran would prefer to age at home rather than in a facility. However, for many veterans, doing so requires certain clinical support that can be prohibitively expensive if not covered by the VA. This bill would help address just that.
Furthermore, it is important to really underscore this point: Home- and community-based care is far and away higher quality and cheaper to provide than institutional care. VA's veteran-directed care program can serve three veterans for every one who would be in institutionalized care at VA's expense. It is important to note that veterans who participate in this program are less likely to develop complications or to be hospitalized than those who do not.
Yet, this program is currently not made available to all veterans. The Elizabeth Dole Home Care Act changes that.
Passage of this legislation cannot wait any longer. Like so many families across the country, thousands of elderly and catastrophically disabled veterans and their families are having critical and often difficult conversations about their long-term care. They question whether they spend their lifesavings to keep their veterans at home or whether it is safer to go to a VA-funded nursing facility.
H.R. 542 would help relieve this heartache and give families access to programs that will help veterans stay in their homes and receive the care they need, the care that they have earned, and the care that they deserve.
I will repeat one more time that, most importantly, health outcomes prove to be far better at home compared to institutionalized care.
Last week, 45 veterans service organizations, military service organizations, and community-based organizations sent a letter to House and Senate leadership, urging the swift passage of this bill and saying that, as the ranking member said, disabled veterans and their families cannot wait any longer. I could not agree more.
Mr. Speaker, I would like to try to put a face to the experiences that so many disabled or aging veterans often go through and why this bill is so necessary.
This bill is for the 40-year-old veteran who is quadriplegic and who may have to move into institutionalized care because VA won't provide the skilled nursing services that would help him remain at home.
This bill is for the 50-year-old veteran with ALS who has three small children and wants to spend the remaining time he has with them at home. He shouldn't be forced to move into a long-term care facility because the cost of his care has gone over an arbitrary spending cap.
This bill is for the Vietnam-era amputee who needs help getting dressed and preparing food but can otherwise live safely at home. He should not have to wait for Congress to act to get the care and assistance he needs.
Moreover, this bill is for the Korean war veteran whose aging spouse can no longer provide the level of care she once did. They want to stay at home together. It is unconscionable this Congress would make them wait a moment longer. They need these services and support, and they need it now.
I am, therefore, perplexed that when the majority brought H.R. 542 to the House floor, they chose to bring a version of the legislation that did not include the minor revisions that had been negotiated with our Senate counterparts. This means future House action will be warranted, which is truly inexcusable to me and the veterans, their families, and their caregivers who are waiting on passage of this bill. We had the opportunity to get this done before the end of the year, send it to the Senate, and then to the President's desk for enactment.
When Representative Bergman and I first introduced this legislation, we named it after Senator Elizabeth Dole. She has done more for aging and disabled veterans and their caregivers in one lifetime than most of us could hope to do in several.
It was introduced in February 2022, just a few months after the veteran she cared for, Senator Bob Dole, passed away. Tomorrow, we will mark the second anniversary of Senator Bob Dole's passing. It is a shame that we could not honor Senator Elizabeth Dole's example and life's work on this anniversary by sending a hotline-ready bill to the Senate that the President could sign before Christmas. It is shameful, and it is disrespectful, really, to play politics with a bill the veteran community wants so badly and a bill that is more cost- effective, provides better outcomes, and is what our Nation's veterans need and want.
I hope we will soon be voting on the final passage of the bill language that the House and Senate have already agreed to and that veterans and their families so desperately need. All of us will, one day, have conversations about what we want our last years to look like. Our aging and disabled veterans have more than earned the right to have the option of living out these final years at home.
Of all the things we owe these men and women, a peaceful and dignified life after their service to our country is the least we can do. I call on my colleagues to do right by these veterans. Put politics aside, keep families together, and keep veterans healthy and at home.
Mr. Speaker, I urge my colleagues to join me in voting for the Elizabeth Dole Home Care Act, and I thank Ranking Member Takano and Representative Bergman for their work on this bill.
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