Care for aging vets worries state's VA

Growth to outpace number of beds

Five months after opening Arkansas' second veterans nursing home, the state Department of Veterans Affairs is exploring how to keep pace with a rapidly aging population of former service members.

By 2034, the number of elderly veterans needing long-term care will peak at about 3,276, up from 2,619 last year, according to a 2016 study by a group of graduate students at the University of Arkansas at Little Rock.

That growth -- attributed to Vietnam War veterans and the military's acceptance of more women -- will outpace the number of available beds. The UALR report estimated that about 657 additional beds will be needed for veterans over the next two decades.

Once both of the existing state veterans homes are fully staffed, Arkansas will have about 200 beds available for former service members.

State VA Director Nate Todd has assembled an ad-hoc committee of state employees, veterans advocates and long-term care experts to consider the department's next steps to caring for elderly veterans.

"We don't have an immediate problem," Todd said in an interview Friday morning after the "exploratory work group" had its first meeting. "We're strategically planning for the future. Effective government is government that prepares."

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Providing long-term care for veterans is part of the agency's three-pronged mission, which also includes operating two veterans cemeteries and identifying services and benefits for veterans statewide.

The group at its first meeting identified several avenues the department should explore.

The first and most expensive option would be to build more veterans homes. The recently built Arkansas State Veterans Home at North Little Rock cost about $24 million, including $8.6 million in state funds.

The UALR report, which made recommendations based primarily on cost-effectiveness, said the state could avoid building additional homes if it leverages existing resources.

The state's second option would be increasing veterans' access to home and community based services.

"People want to be in their homes; they want to be with their families," said Carol Shockley, director of the Arkansas Department of Human Services' Department of Long Term Care. "Anything we can do to bolster that is a good thing."

However, UALR's report notes that some home and community based services have struggled to get timely reimbursements from the U.S. Department of Veterans Affairs. At least one provider, Carelink, stopped catering to veterans dependent on VA benefits because of "habitual delays" in payments from the VA.

Third, the state could encourage current long-term care providers to obtain certifications from the federal VA to receive residents dependent upon federal veterans benefits.

A handful of providers already except VA benefits, which are lucrative for nursing homes because they're able to bill federal VA beneficiaries a greater daily rate than those on Medicaid. This also translates into savings for the state, because it doesn't have to provide matching funds for those with veterans benefits like it does for people on Medicaid.

Some nursing homes are hesitant to apply for federal VA certification because it creates duplicate reporting requirements, according to the UALR study, but pending legislation in Washington D.C. could bring those requirements closer in line with existing state regulations.

The North Little Rock veterans home, for its part, is working to attain federal VA certification. It recently accepted its 24th resident, reaching capacity in two of its eight cottages. Once full, it will house 96 residents.

Lastly, the group on Friday discussed the possibility of re-purposing wings of struggling or defunct hospitals in rural areas into long-term-care facilities for veterans.

Mark Diggs, of Veterans Villages of America, presented the idea, noting that rural community hospitals are struggling financially. Re-purposing those facilities, Diggs said, would also boost their respective communities because it would retain their emergency rooms and provide additional jobs.

Todd expressed plans to have "sub-groups" research each option.

Retired Col. Joy Leapheart, now a veterans advocate and member of the Military Officers Association of America, took interest in the idea of re-purposing old hospitals, but she said a well-rounded approach is necessary.

"I think we should use all available resources, not limit ourselves to just one," she said.

A Section on 06/19/2017

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