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Hon. Steve Buyer

Hon. Steve Buyer, and a Representative in Congress from the State of Indiana, Ranking Republican Member, Full Committee on Veterans' Affairs

Upon introduction of H.R. 5641, I made the following introductory statement:

“Today, I am introducing H.R. 5641, a bill to allow the Department of Veterans Affairs (VA) to enter into contracts with adult foster homes to provide life-long care to veterans unable to live independently.

Adult foster homes are designed to provide non-institutional long-term care to veterans who prefer a more personalized, familial setting than traditional nursing homes are able to provide.

VA has been helping to place veterans in adult foster homes since 2002 and over time more than 600 veterans in need have paid to receive such care. As we speak, 219 veterans are living in these special homes. 

The need for long term care is increasing as veterans from past conflicts get older, and it will continue to grow as wounded warriors return home from Iraq and Afghanistan with severe injuries that require life-long assistance. While nursing homes will always be a valuable tool for providing lasting care, for some the individualized, home-like atmosphere of an adult foster home is a much more attractive alternative than the prospect of moving into a traditional nursing home.

The advantages of adult foster homes are clear.  Veterans who opt for foster home care will move into a home owned or rented by their chosen foster home caregiver. The caregiver – who has passed a VA screening, federal background check, and home inspection and agreed to undergo annual training– resides with the veteran and provides them with 24-hour supervision and personalized care.  For as long as that veteran resides in the home, VA adult foster home coordinators and members of a VA Home Care Team will make both announced and unannounced visits at least three times every month to ensure the veteran is safe and the home and caregiver are in compliance with VA’s high quality standards.

Additionally, the Home Care Team will provide veterans with comprehensive, interdisciplinary primary care and provide the caregivers with supportive education and training.

Many veterans who choose to reside in an adult foster home would otherwise be in need of nursing home care and would qualify for VA benefits to receive it. However, because VA is not authorized to provide veterans with assisted living benefits, these veterans must pay for the care they receive in adult foster homes out of their own pockets.

Twenty four percent of veterans who have received care in a Medical Foster Home qualify for VA’s highest priority group due to having disabilities rated 50% or more service connected or having otherwise been found unemployable due to service connected conditions. Given that many of the veterans who are benefitting from this individualized, non-institutional care are disabled, afflicted with chronic disease, often elderly, and frequently 70% or more service connected, placing the entire cost burden for adult foster homes on their backs is no way to thank them for their valiant years in service. What’s more, it creates an inequity of benefits between those who can afford to pay for such care and those that cannot.

The legislation I am introducing today would give VA the authority to enter into a contract with a certified adult foster home to pay for care for certain veterans already eligible for VA paid nursing home care. By doing so, it would ensure more veterans have the option to choose a treatment setting that best suits their needs free of financial constraints.

Our veterans in need of life-long care have earned the right to decide which long-term care environment would make them feel most at home. And, I encourage my colleagues to join with me in cosponsoring this legislation to make that decision easier.

Thank you and I yield back the balance of my time.”

Further, upon introduction of H.R. 6127, I made the following introductory statement:

“Today I am introducing a bill, H.R. 6127, the Extension of Health Care Eligibility for Veterans who Served at Qarmat Ali Act, to extend the VA healthcare enrollment period for certain veterans who served in the Qarmat Ali region of Iraq. 

Soon after the conflict in Iraq began in 2003, Army National Guard units from my home state of Indiana as well as units from Oregon, West Virginia, and South Carolina and National Guardsmen mobilized as individual augmentees from across the nation were called up and tasked with guarding the Qarmat Ali water treatment facility.

For six months – from April to September – these National Guardsmen from across the nation bravely guarded the plant, located just outside Basra. Their mission was to secure the facility and provide protective services for the independent contractors who were working throughout the region to restore Iraqi oil production.

Recently, they have been notified of their possible exposure to a toxic chemical known as sodium dichromate and are being asked to come forward, be evaluated, and enroll in VA’s Gulf War Registry.  Health problems associated with such exposure include respiratory issues, skin lesions, and burns. Contact may cause increased rates of lung cancer and other ear, nose, throat, and skin disorders.

The men and women of these National Guard units completed their mission - and served our country - well. It was hard for me to discover that despite their safe return, their service may continue to be put them at risk. In particular, I am very sensitive to the Hoosiers who may have been injured.

Under current law, combat veterans who served on active duty in a theater of combat operations during a period of war after the Persian Gulf War or in combat against a hostile force during a period of “hostilities” after November 11, 1998 are eligible to enroll in the VA health care system, notwithstanding sufficient evidence of service-connection, for five years following separation from service. 

This includes members of the National Guard and Reserve who were activated and served in combat support or direct operations as long as they meet certain requirements.

When Congress established the five year period of open enrollment for VA health care it was with the understanding that some wounds of war may not manifest themselves until years after a veteran leaves military duty.

But despite our best intentions, we are finding that some veterans are faced with combat-related health problems that were not apparent even five years after the veteran re-entered civilian life. This creates a gap in services that unfairly penalizes these men and women for conditions out of their control.

I commend the VA for their efforts to contact these veterans and create the Qarmat Ali Registry to aggressively track and treat veterans exposed to this toxic chemical as part of the Gulf War Registry.

However, it is also important for them to have immediate access to VA’s high quality health care system.  The use of VA health care will help to identify potential medical conditions, and provide counseling, immunizations, and medications to prevent illness. Appropriate preventative care can substantially improve health outcomes and the quality of life for our honored heroes.

But, some of the Qarmat Ali veterans who separated from service following their deployment in 2003 may no longer be eligible to enroll in VA health care under the five-year open enrollment period.  As a result, they must first file a claim and seek a service-connected disability rating before enrolling in the VA health care system and gaining access to the comprehensive medical care VA provides.

Unfortunately, the claims process can be both time-consuming and daunting. It is unacceptable that the Qarmat Ali veterans, already subjected to harmful toxins during service to our country, must now await the outcome of a lengthy and sometimes adversarial claims processing system before they can enroll in VA health care.  

The VA was established expressly to care for veterans like these who willingly left their homes, families, and lives to protect and defend our nation and may find themselves sick or injured as a result of such selflessness

 H.R. 6127 would correct this unintended gap in services by extending the enrollment eligibility period for Qarmat Ali veterans by five years from the date of notification. This would allow them to immediately begin receiving services at VA medical facilities for any and all of their health care needs.

Breaking down barriers to needed care is the very least we, as a grateful nation, can do for the men and women who fight for our freedoms, in Qarmat Ali and around the world.

I urge my colleagues to join me in supporting H.R. 6127 and these brave American heroes. Thank you, and I yield back the balance of my time.”