This bill makes it easier and more affordable for veterans to receive care at home instead of in nursing homes. Right now, the VA can only spend up to 65% of what a nursing home would cost on home care alternatives. This bill removes that strict limit and allows the VA to spend whatever is necessary if it's better for the veteran's health and wellbeing.

The bill requires the VA to expand home and community-based care options in several ways. It needs to partner with programs that help elderly people stay in their communities, expand existing programs that let veterans direct their own care, and make sure caregivers of disabled veterans get proper support and benefits. The VA also has to create a special program to help veterans in areas where there aren't enough home health aides available, and ensure Native American veterans have access to these services too.

When veterans or their family caregivers leave the VA's main caregiver assistance program, someone must help them transition smoothly to another appropriate program so they don't fall through the cracks. Additionally, the VA needs to review all its programs for elderly and long-term care to make sure they're run consistently across different medical centers, eliminate gaps in services, and guarantee that home and community-based care is actually available and accessible to veterans who need it.

Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act

Moran, Jerry

Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act of 2023 or the Elizabeth Dole Home Care Act This bill addresses home care and caregiver programs provided by the Department of Veterans Affairs (VA). Under the bill, the cost of providing noninstitutional alternatives to nursing home care may not exceed the cost that would have been incurred if a veteran had been furnished VA nursing home care, unless the VA determines that a higher cost is in the best interest of the veteran. (Under current law, these expenditures are limited to 65% of the cost.) Among other requirements, the VA must <ul> <li>establish a partnership with the Program of All-Inclusive Care for the Elderly in certain areas to furnish noninstitutional alternatives to nursing home care;</li> <li>implement various programs (e.g., the Veteran Directed Care program) to expand access to home- and community-based services;</li> <li>provide specified support and benefits to caregivers of certain disabled veterans;</li> <li>implement a pilot program to provide homemaker and home health aide services to veterans who reside in communities with a shortage of home health aides; and</li> <li>ensure the availability of home and community-based services for Native American veterans.</li> </ul> For veterans or family caregivers who are discharged from the Program of Comprehensive Assistance for Family Caregivers, a caregiver support coordinator must provide for a personalized transition to an appropriate program. The Veterans Health Administration must review programs administered through the Office of Geriatric and Extended Care to ensure consistency in program management, eliminate service gaps at the medical center level, and ensure the availability of and access to home and community-based services.