Senator Collins Questions VA Secretary on Support Needed for Veterans’ Home


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Washington, D.C. At a hearing to review the Fiscal Year 2025 budget request for the U.S. Department of Veteran Affairs (VA), U.S. Senator Collins, Vice Chair of the Appropriations Committee, questioned VA Secretary Denis McDonough on the need to support veterans’ homes and veterans in rural communities.  During the hearing, Secretary McDonough committed to working with Senator Collins to finds ways to help support financially troubled state veterans' homes and improve transportation options for Maine veterans living in rural areas that require care at the VA hospital.


During Q&A, Senator Collins said:


Mr. Secretary, let me start with two facts.  One, is that Maine has one of the highest percentages based on population in the country of veterans.  That's something I'm very proud of.  Mainers have always stepped forward to serve.


Second, Maine is the oldest state in the nation by median age.  So, when you combine those two factors, you can easily see why our state veterans' homes are so importantIn fact, both of my parents had the benefit of compassionate care, at our state's veterans' homes, at the end of their lives.


In 2022 however, despite the strong demand for these services, Maine considered closing two of its veterans' homesone in Machias and one in my hometown of Caribou.  Fortunately, that was averted, but it would have caused tremendous hardship to veterans and their families.  And Maine is not unique in this regard.  A recent report indicates that other veterans' homes across the country have notified the VA of potential closures, 15 have reduced their bed capacity, and another four have already closed permanently.


The VA raised its per diem rates in 2023, but frankly, that increase has not kept pace with rising medical costs.  And the veterans' homes in Maine, as is true across the country, are struggling financially.


What is the VA doing to support financially troubled state veterans' homes?  And what more can be done at the federal level to prevent closures or reductions in beds?


Secretary McDonough:


I couldn't agree more strongly with you about the importance of state veterans' homes.  That's why we bias, in VA funding streams, for bigger investments in the state-run veterans' homes, than we do in the commercially-run veterans' homes and long-term care facilities.


Among the things that we are doing, obviously, is up to 65% of the cost of the facility construction—remodeling grants, importantly, nurse recruitment grants—and I'll come back to that in a second.  Medical sharing arrangements with considerable cost sharing, when we can get our personnel into those facilities to care for vets, and then continued clinical care education.


Notwithstanding that, and as you pointed out, the per diem has increased 7% in '23, and again another 7% in '24, higher than our increases for other similarly situated programs. 


Nevertheless, I agree with you that there are big challenges out there, especially in two areas.  One, and one of the reasons we're hearing from other states, not in Maine, but from other states that they're closing, is they don't have the staff, because the veterans that they're getting are requiring more complex care.  So, greater funding for staff who can provide more complex care for those veterans is important.  And this is something that we're working, we'll be more than happy to work with you in Maine on, and work with the Committee on.


Secondly, the cost of pharmaceuticals for those veterans who end up in state-run veterans’ homes.  By tradition, the states take on the cost of those pharmaceutical treatment patterns.  They also don't have access to our more price-competitive formularies.  So, we'd like to also work with you on that, to figure out how is it that we address these significant costs associated with pharmaceutical treatments.  Because our veterans are living longer with more complex health care systems.  So, those are two areas where we'd like to try to enhance our support to states like Maine.


Senator Collins continued:


There's also a problem with transporting veterans from rural areas to the one VA hospital that we have in the State of Maine.  And I hope that that that's something that we can also work together on.


Secretary McDonough:


Count on that.  And we have a legislative proposal on that.  I've been studying up on this since you and I discussed.  So, we have some ideas on that.  We'd like to work with you on those.