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Opening Statement of The Honorable Jeff Miller, Chairman, Member United States House of Representatives

Thank you, Dan.

    It is a pleasure to be here again with you, the Subcommittee on Health, and all of our witnesses, stakeholders, and audience members to discuss my draft bill, the Long-Term Care Veterans Choice Act.

    The Long-Term Care Veterans Choice Act would authorize the Department of Veterans Affairs (VA) to enter into a contract or agreement with a certified Medical Foster Home (MFH) to pay for the residential long-term care of service connected veterans who are eligible for VA-paid nursing home care.  As a component of such care, eligible veterans would also be required to receive VA home health services.

Medical foster homes (M-F-Hs) are private homes in which a trained caregiver provides twenty four hour, around-the-clock, care to a few individuals.  They are designed to provide a non-institutional long-term care alternative to those who prefer a smaller, more home-like and familial care setting than many traditional nursing homes are able to provide.

    VA has been helping to place veterans in medical foster homes for over a decade.  VA, as part of the placement process, inspects and approves all MFH’s, limits care to no more than three veterans at a time, and  provides veterans living in such homes with home based primary care services.   VA also provides safeguards to ensure veterans receive safe, high-quality care by requiring MFH caregivers to pass a federal background check and VA screening, agree to undergo annual training, and allow VA adult foster home coordinators and members of a VA home care team to  make both announced and unannounced home visits.

    Today, according to VA, over four hundred approved caregivers provide MFH care in their homes to over five hundred veterans daily in over thirty five states.

    The problem, however, is that VA does not have the authority to pay for the cost of the MFH.  So, the veteran who chooses to live in a MFH must pay out of pocket with personal funds – regardless of whether or not such veteran is eligible for VA-paid nursing home care.

    This creates a situation where many service connected veterans with limited financial resources, who would prefer to live in a medical foster home, go to a nursing home institution instead because VA will cover the cost of the nursing home, but not the MFH.   

    And, while traditional nursing homes will always be a vital component of long-term care, medical foster homes provide a worthy alternative for many veterans.   

    According to the Department, many more veterans would elect to receive care in a medical foster home should VA be granted the authority to pay for such care.

     I am sure we all agree that one thing we owe our veterans, particularly those who are service-connected and in need of long-term care, is the luxury of choice - the choice to decide where and how to receive the care they need.

    As the veteran population continues to age, the need for long-term care services will continue to grow.  The Long-Term Care Veterans Choice Act would expand the long term care choices offered to veterans beyond traditional services.  Additionally, in addition to being beneficial for the health and well-being of veterans, the average cost of a MFH is more than half the monthly cost of a nursing home, making this legislation a very cost effective health care option.  

     This is a common-sense, veteran-centric bill that will free many veterans from financial turmoil, and allow them to make their own decisions about what kind of long-term care they want to receive.  

    I look forward to working closely with all interested parties to resolve any issues that may arise during today’s discussion.

    Thank you once again, Dan, for holding this hearing today and for the hard work and leadership shown by you and all of the members of this Subcommittee.   And, with that, I yield back the remainder of my time.