The Department of Veterans Affairs healthcare system should meet most new demands for long-term care by expanding contracts with home health agencies and nursing homes, according to an advisory committee.
The Federal Advisory Committee on the Future of VA Long-Term Care recently released a report that said the VA should be able to meet new demand by expanding noninstitutional care, and because of tight budgets, it should not fund nursing home construction.
Contracting out more of the VA's long-term care would parallel trends in the agency's provision of primary and inpatient care. The VA has expanded the number of outpatient clinics that veterans can use, partly by contracting with private physicians (Nov. 23, 1998, p. 48).
The number of veterans 65 and older is expected to peak at 9.3 million in 2000. In 2010, 8.5 million veterans will be in that age group, constituting 42% of the veteran population.
Today, however, the VA is meeting the long-term-care needs of only 21.4% of disabled and poor veterans who need such care, the report said.
The committee-composed of representatives of veteran and senior groups, healthcare academics, long-term-care executives and top VA officials and clinicians-said that because of growing need, the VA should expand its home- and community-based care to 7.5% of its total budget from 2.5%, or to 35% of its total long-term-care budget.
The VA now spends about $2 billion per year on long-term-care services.
Some veterans groups oppose the expansion of long-term-care contracting.
Richard Fuller, national legislative director of the Paralyzed Veterans of America, said the VA has developed the ability to treat catastrophically disabled patients, but many community nursing homes may be unable to do so.
Provider groups, however, approve of the committee's recommendations: "Using home health is a smart way to go because the government will avoid increasing taxpayer costs from creating new VA provider entities," said Eric Sokol, assistant government affairs director with the National Association for Home Care.