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Opening Statement of Hon. Michael H. Michaud, Chairman, and a Representative in Congress from the State of Maine

I would like to thank everyone for coming today.

This morning, the Subcommittee on Health will examine the state of VA’s long-term care programs and services. 

In terms of demographics, the veteran population is aging and will require a greater amount of long-term care services. Out of a veteran population in this country of 25 million, nearly 45 percent are over the age of 65, and the number over the age of 85 is expected to reach 1.3 million by 2010.   

In addition, the veteran population is poorer, sicker and older than their non-veteran counterparts.

The VA will also be facing an entirely new generation of veterans in need of long-term care services – some of our wounded returning OEF/OIF veterans, who have different needs than those of our older veterans. 

Medicaid is the principal financer of long-term care.  In 2004, Medicaid spent $90 billion on long-term care services, of which $57.6 billion, or 64 percent, was for institutional care.

The VA has requested $4.6 billion for long-term care services in FY 2008.  Nearly 90 percent is for institutional care.

The VA must, in my view, maintain its nursing home capacity while vigorously expanding its non-institutional care capabilities.

Contrary to the plain evidence of an increasing long-term care demand, this year the VA will again ignore its clear legal responsibility to maintain its nursing home bed capacity.  The VA’s FY 2008 budget estimates a further drop in the average daily census to 11,000, nearly 20 percent below the required level.

I am concerned that VA is not doing enough to maintain its nursing home capacity, while not moving fast enough to provide more home and community-based care.

An integral component to VA’s institutional care services is The State Veterans Home Program.  Currently, State Veterans Homes handle over 50 percent of the VA’s overall patient work load in nursing homes. 

I believe we must maximize this existing resource as well as other resources within our communities to ensure the best possible care for our veterans.

The VA has a long history of providing long-term care services, and I believe that the VA has many lessons it can teach other areas of the federal government, and the private sector, on how best to provide these services.  The VA can indeed be a long-term care model for others.

VA continues to have an obligation to meet the long-term care needs of our veterans.  I look forward to hearing from our witnesses as to how VA should meet this obligation in the future.