Military Update: Many angles to caregiver bill
By TOM PHILPOTT | SPECIAL TO STARS AND STRIPES Published: April 24, 2010
Primary in-home caregivers to severely wounded veterans of current wars in Iraq and Afghanistan will be paid a stipend by the Department of Veterans Affairs, under a bill Congress has passed unanimously
The stipend, payable to a spouse, parent, child, friend or even a hired caregiver, will be based on number of hours and level of care. But it will at least match pay for caregivers in the private sector.
The Caregivers and Veterans Omnibus Health Services Act (S. 1963) also will direct VA to provide training and medical coverage to caregivers, to include stress counseling, if needed. The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) would be made available to caregivers who have no health insurance option.
VA also will pay lodging and meals to those who accompany severely injured veterans on long trips for VA health care evaluation and treatments. And when a caregiver needs respite, VA will pay for temporary caregiver replacements for up to 30 days a year.
Two thousands caregivers are expected to benefit from the full range of initiatives. Caregivers of veterans severely injured in earlier wars will gain access only to the more modest support services in the legislation including care training. But to hold down costs, they will not be eligible for the stipend, the new travel reimbursements and several other benefits.
The House passed the bill Wednesday and the Senate on Thursday, forwarding it to the White House for the president’s signature.
Other parts of the comprehensive new law will:
• Expand VA services for 1.8 million women veterans currently receiving VA care or expected to enroll in the system. VA for the first time will cover up to seven days of newborn care for enrolled female veterans. Other initiatives will force changes to the VA health system to make it respectful of privacy and other needs of female veterans. VA is directed to launch a pilot for providing patient childcare services too
• Improve health care options to rural veterans by authorizing stronger partnerships with community providers and the Department of Health and Human Services. VA also will establish a grant program for veteran service organizations to provide transportation options to veterans in highly rural areas needing medical care.
• Expand VA locations that provide support services to homeless veterans.
• Require VA to study veterans’ suicides and provide counseling referrals for members of the armed forces who are not otherwise eligible for VA readjustment counseling.
Sen. Daniel Akaka (D-Hawaii), chairman of the Senate Veterans Affairs Committee, endorsed House changes to the original Senate bill, passed last November, and swiftly shepherded it through final passage.
“For too long, the families of wounded warriors across America have paid the cost of war without sufficient support from the government [that] their loved ones risked all to serve. I look forward to President Obama signing this important bill for the families of disabled veterans, and for women veterans, veterans in rural areas, and those veterans sleeping on the streets tonight,” Akaka said.
Rep. Bob Filner (D-Calif.), chairman of the House committee, said caregivers of “heroes” who returned from Iraq or Afghanistan brain-damaged or with other severe wounds have had to quit their jobs, putting financial strain on families. As voluntary caregivers, they also have received little or no training in care delivery.
“We had a young lady who testified she hurt her back because she didn’t know how to get her husband out of the wheelchair,” Filner said. “And when you’re dealing with this for 24 hours a day, you need some rest yourself [and] to bring in people to take care of that.
The new law, he said, will provide pay “to make up for loss of income; training to the caregiver; funds for respite care and some other expenses. It’s not just the young man or woman who comes home [who is changed]. It’s the whole family involved and we’ve got to help the whole family.”
Filner said other parts of S. 1963 focus on VA health care “access for people who don’t normally have access. Like women. It’s time to think about childcare, privacy curtains, to think about respect, basically.”
Older veterans will find it refreshing, he said, to see children of women veterans, from time to time, in waiting areas of VA medical facilities.
“It changes the whole ambiance of the place,” Filner said. “It’s no longer a bunch of dying people. There’s life! And so…childcare not only helps the families with kids but the whole atmosphere.”
The cost of S. 1963 will be about $750 million a year in discretionary spending, Filner said, adding less than one percent to VA’s $120 billion budget which already is to rise by 5 or 6 percent a year.
“We’ve increased the [VA] budget 60 percent in three years and we put the advanced funding in” to ensure yearly political battles no longer interrupt flow of funds to VA clinics and hospitals, Filner said.
“Now we’re making sure neglected parts of the system get some attention with the extra money we’ve added,” the House chairman said.
Eligibility for the stipends, he added, “will have to expand because as soon as you start them someone will say, ‘I’m a caregiver 12 hours a day too and my guy was injured in the Persian [Gulf] War.’ But right now it’s for [Operation Enduring Freedom and Operation Iraqi Freedom] vets.”
Service veterans groups were united in praise of the House-Senate compromise, though some noted the VA secretary will have considerable flexibility to set final details of the stipend program.
“We’re just feeling great relief that they got to it, finally,” said John Bradley, a consultant on legislative affairs for Disabled American Veterans.
MEDICARE FEE HIKE DELAYED – Congress once again has blocked a 21.2 percent cut in Medicare reimbursements to doctors, this time until June. The scheduled fee cuts would impact TRICARE too in its ability to retain participating physicians. The lowered fees are tied to a controversial formula for setting Medicare physician rates adopted in 1997. Congress has blocked its full effect since 2002 so threatened fee cuts only grow larger each year.
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