Mr. Chairman and other Distinguished Members of the Subcommittee on Health of the U.S. House of Representatives Committee on Veterans’ Affairs, thank you for inviting me to testify at this legislative hearing. 

As the Legislative Officer of the National Association of State Veterans Homes (NASVH) and as the Administrator of the Nevada State Veterans Home (NSVH), I am honored to be here with you this afternoon to request your support for H.R. 4241, a bill to amend chapter 17 of title 38, of the United States Code, to allow for increased flexibility in payments for state veterans homes. 

When Public Law 109-461 passed in 2006, its intent was to correct the inequities that existed in the system, whereby veterans with a 70 percent or greater service connected disability rating couldn’t come to a state veteran home at no cost, but they could go to a community nursing home at no cost.  This was a well-intended law and we thought it would correct this inequity. 

However, when Public Law 109-461 took effect, on April 29, 2009, the regulations implementing it created more inequities than it corrected.  In essence, state veterans homes are being offered a flat rate to assume all responsibility for the veteran's care, which has and will continue to create financial hardships on state veterans homes.

Previously, we were able to admit veterans with a 70 percent or greater service connected disability as “private pay” residents.  Now, we are being required to admit them under a program intended to cover their total cost of care, but one which actually places the cost of their care on the state.  Consequently, many states can’t admit these veterans because of this financial burden. 

It is difficult to calculate the actual cost of this burden and/or the number of states currently impacted because many states aren’t accepting these veterans because they don’t have the funds to provide the required care.  They are simply unwilling to assume the risk by exposing their states to the financial uncertainties of this new program.   

Let me assure you, this is not an issue confined to any one state.  This is a nation-wide problem.  NASVH is comprised of the 137 state veterans homes across the country.  Since Public Law 109-461 was implemented, I have been contacted by administrators and directors of state home programs from all over the United States requesting my assistance, as NASVH’s Legislative Officer, with the financial challenges this law has created for their states. 

And, while I am very concerned as the Legislative Officer for NASVH, I am also very concerned as the Administrator of the Nevada State Veterans Home in Boulder City.  Let me share with you just one of the many experiences I have had in Nevada in recent months.

The wife of an applicant, who we’ll call Mr. Disabled Veteran (D.V.), came to our Home on July 21, 2009, seeking admission for her husband, a World War II veteran.  She was desperate to get him in our Home where she could be confident he would receive quality care and have opportunities to socialize with other vets who he could relate to. 

We gave her a tour and brought her back to the office to review our Home’s offerings and application process.  As we began discussing our daily cost of care, Mrs. D.V. indicated her husband had a 100 percent service connected disability rating and, consequently, she was not being charged for his care at the community nursing home where he currently resided.  We explained to Mrs. D.V. the difference between the community nursing home’s and the state home program’s reimbursement arrangement with VA and shared with Mrs. D.V. that we cannot, under the current law, provide care for her husband because of the potential financial implications for the State of Nevada.    

At this point, Mrs. D.V. began crying and asked how this could be possible, since we aren’t just a nursing home, but a nursing home especially for veterans.  I gave Mrs. D.V. a history of how we arrived at this point and indicated I was working with other state home programs and Congress to fix this problem, but until it’s fixed, we simply can’t assume the risk of admitting 70 percent or more disabled veterans.    

Mrs. D.V. then reached in her purse and retrieved her check book.  As she waived it in the air she stated, “But I’ll pay for his care if you’ll just admit him.”  We then shared with her that VA Regulations won’t allow her to pay for the cost of her husband’s care.  She began sobbing as she tried to come to terms with what we were telling her.  At this point, I looked this woman in the eyes and I promised her I would do everything possible to get this fixed.

As our meeting concluded, we encouraged Mrs. D.V. to check back with us periodically to see if the law had been fixed.  Mrs. D.V. called me back in August, then again in September, and again in October, and again in November, each time asking if “the 70 percent thing” was fixed yet.  Each time, we had to tell her “no, but we’re still working on it.” 

Mrs. D.V. doesn’t call me anymore.  Her husband died on December 16, 2009, never able to access the care he deserved as a 100 percent service connected disabled veteran.  

It is impossible to convey how difficult it is to turn these folks away.  State home administrators across the country are unwilling to assume the risk of bankrupting their programs, which would have the catastrophic effect of displacing their current residents.    

Mr. Chairman and Members of the Committee, I implore you – please correct this injustice.  We are turning away the people who most deserve and need care in state veterans homes.  H.R. 4241 corrects the inequities and achieves the end result we were all hoping for and, most importantly, that our veterans deserve. 

Mr. Chairman, this concludes my statement.  Thank you for permitting me to testify today on behalf of the National Association of State Veterans Homes and the Nevada State Veterans Home Program.  I will be pleased to answer any questions.