Elderly veteran wearing World War Two cap thinking about what’s next while approaching the end of life.
(Credit: Johnrob / Getty Images)

After going nowhere in the last Congress, a bill expanding veterans’ access to assisted living has been reintroduced in this Congress, with backing from all four main trade associations representing senior living providers.

Senate Bill 495, the Expanding Veterans’ Options for Long Term Care Act, would create a small pilot program to offer eligible veterans who participate the option to have their care needs met in an assisted living community rather than at a Department of Veterans Affairs state home. The bill was introduced by Senate Veterans Affairs Committee Chair Jon Tester (D-MT), along with Sens. Patty Murray (D-WA), Jerry Moran (R-KS) and Mike Rounds (R-SD).

The sponsors made a few tweaks to the latest version of the bill, including changing the timeline for an inspector general’s report on the program from two years to three years after the pilot, changing how assisted living is defined and adding language meant to allow program rates to keep pace with inflation to ensure that veterans receive quality care throughout the pilot.

The legislation is an update of Senate Bill 4169, spurred by a 2020 Department of Veterans Affairs report to Congress on the critical need for increasing veterans’ access to different long-term care settings. The VA cannot pay for room and board fees for veterans living at assisted living communities, preventing many veterans from using the option.

Specifically, the VA found that veteran placement in a skilled nursing facility was considerably more expensive, at $120,701 annually, compared with the $51,600 price tag of assisted living. That study noted the VA would save $69,101 annually per assisted living placement. 

Outpouring of support

In a combined Feb. 16 letter of support from the American Seniors Housing Association, Argentum, the National Center for Assisted Living and LeadingAge to the bill’s sponsors, the aging services leaders called the bill a “commonsense approach” for veterans.

“This is an economically sound and sensible approach to demonstrate the benefits of assisted living to not only the resident veterans, but to their families and friends,” the letter reads.

“This pilot program makes sense for a number of reasons. It offers a new option in long-term care for veterans, creates significant savings for the Department of Veterans Affairs, and will demonstrate the numerous benefits of assisted living,” a statement from the four associations reads. “The VA’s daunting cost estimate for long-term care — both current and in the future — illustrate the need for policies that mitigate the significant financial burden.”

The trade associations also noted that the demand for long-term care services is not limited to veterans. The number of older adults needing care is expected to increase from 6.3 million in 2015 to 15 million by 2050. And 10,000 Americans are turning 70 every day.

Indeed, Maggie Elehwany, Argentum senior vice president of public affairs, said the bill would expand access to assisted living at a time when the nation faces a “seismic demographic shift” that will bring a growing demand by older Americans and veterans for long-term care options.

“Veterans who have mandatory eligibility for nursing home care are expected to increase by approximately 535% over the next 20 years,” she said. “Many veterans eligible for nursing home care may not need the high level of skilled nursing care in an institutional setting and may prefer a more appropriate level of care in a home-like, independent and social care model such as assisted living.”

She added that the pilot will demonstrate the value of assisted living, which is home to two million older adults, 42% of whom are veterans or the spouses of veterans.

Jeanne McGlynn Delgade, ASHA vice president of government affairs, told McKnight’s Senior Living that she is optimistic about the possibilities of the pilot program.

“While small in scale and a short-term program, it is designed to evaluate the impact the assisted living experience will have on costs, options of settings, and quality of care for our nation’s veterans,” she said. “We are confident the results can inform future policies, such as the home- and community-based services programs and others, in a meaningful and positive way that creates a higher level of awareness about the benefits of assisted living.”

NCAL Executive Director LaShuan Bethea told McKnight’s Senior Living that the bill, if it becomes law, will offer veterans greater opportunities and options to experience the high-quality care offered in assisted living communities.

“It is important that everyone, including veterans, have access to the long-term care services they need, and this bill moves us in the right direction,” she said.

The bill also has the support of the National Rural Health Association, the National Association of State Veterans Homes, the AARP, the Military Officers Association of America, the Paralyzed Veterans of America, the Afghanistan Veterans of America and the Disabled American Veterans.