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Elderly Vets Face Uncertain Future
By Dennis Camire, Gannett News Service
April 12, 2005
Helen Comer/The Jackson Sun
Paul Webster, a resident at the Tennessee State Veterans Home in Humboldt, bags candy for volunteers on Friday with Christy Baughman, activity director, and Laura Waehler, activity assistant. April is volunteer appreciation month at the home, which has more than 100 volunteers who help out.
Veterans' nursing homes run by states and the federal Veterans Affairs Department - havens for more than 40,000 former service members - are under fire in this year's budget battles.
President Bush's proposed 2006 budget would drastically cut financial support for up to 80 percent of the veterans in the nation's 129 state-run homes - including Tennessee's two facilities in Humboldt and Murfreesboro - and allow the VA to reduce the number of its nursing home beds from the 13,391 now required by law.
However, the Republican-dominated House and Senate adopted budget plans that do not include the Bush proposal to cut support to the state veterans' homes - and among those chiming in is West Tennessee Congressman John Tanner.
''Proposed veterans' care cuts like these are an indication of the misfocused priorities in the budget President Bush proposed to Congress,'' Tanner, D-Union City, said in a statement released through his office in Washington. ''The president's budget would require that we borrow billions of dollars more from foreign investors and still fails to fund the programs that Tennesseans depend on.
''More spending control is an important part of balancing our federal budget, but that burden should not lie on the backs of the men and women who have served our country when we needed them.''
Rod Wolfe, the executive director of Tennessee's State Veterans Homes, says that both the Humboldt and Murfreesboro facilities will break ground soon on new, 20-bed facilities specifically designed for veterans dealing with Alzheimer's disease or other dementia.
''We have talked with legislators in Washington and Nashville, and there is no sentiment for a cut in veterans care,'' said Wolfe, based in Murfreesboro. ''Any cuts would have to be approved by the federal legislature, and we're being told that will not happen.''
At issue is the ''per diem'' of $59.36 per day for a veteran being cared for in a state-run nursing home. The Bush Administration has proposed limiting the per diem to those needing care because of service-related injuries, or catastrophic conditions such as spinal cord or brain injuries.
Dr. James F. Burris, the VA's chief consultant for geriatrics and extended care, said the nation is facing a time of ''constrained national resources'' and that the VA does not have enough money to provide nursing home care to all the veterans who might need it.
''It's not just in VA but throughout the federal government that we're facing a very large deficit, and government has to make responsible decisions about how to allocate the resources that are available,'' he said.
At the same time, the VA - like the long-term care industry - is turning to more care being provided in the home and community.
''Nursing home care really should be reserved for a situation where a veteran cannot be safely maintained in a home setting,'' Burris said.
Like every department in the government, Wolfe said, the VA was told to make some cuts.
''And that's what you see in the proposed budget,'' Wolfe said. ''They tried to set the priority for care in terms of the per diem, and nobody argues those injured in combat should have first priority.
''But at the same time veterans, by nature of their service, which we are seeing today, it is the belief of the veterans' community that all veterans should be provided a benefit of some of their care being paid for as they have in the past.''
As with proposed Social Security changes, Burris indicated that only those veterans who enter the system after the proposal is adopted would face the tougher standards. Those already in facilities would have no change in their benefits.
That's the ''Baby Boomer'' bubble that's rapidly approaching retirement age - and the time when long-term care is needed - that looms large as the federal government grapples with huge budget deficits.
The problem will only get worse as veterans, while shrinking in total number, get older, said Lourdes E. Alvarado-Ramos, assistant director for the Washington Office of Veterans Affairs. Within the next decade, the number of veterans age 75 and older is going to double - and that is the group that is going to need more care, she said.
''Not all of them live at a place where they can just receive services and have a spouse who can take care of them, especially our Vietnam veterans, many of whom burned their bridges with their families,'' said Alvarado-Ramos, also president of the National Association of State Veterans Homes. ''It's going to create a bigger dilemma for both the VA and the states.''
Burris said veterans who don't have disabilities related to active duty service or who are not considered in need of catastrophic care would still be able to use Medicare, Medicaid and private funds to pay for the nursing home care.
Alvarado-Ramos said about 80 percent of the veterans currently in state-run nursing homes would no longer qualify for the VA daily support grants if the Bush proposal is approved.
She said some state veterans' homes could be forced to shut down because the VA money provides an average of about 29 percent of a home's revenue.
Sen. Barack Obama, D-Ill., said the four state-run veterans' homes in Illinois would lose about $16 million if the proposal is adopted.
''This would shut down nursing homes that are serving veterans in Illinois,'' Obama said. ''It doesn't strike me that that's a tenable position to take, particularly because the states simply can't pick up the slack.''
In addition, the VA wants to hold back $104 million in grants it would provide in fiscal 2006 to rehabilitate and build new state veterans' homes until it can finish a study on the system's capacity and future needs. Under an arrangement with the states, the cost of such projects is split 65-35, with the federal government picking up the larger portion of the tab.
The estimated savings to the government with such changes would be $496 million, according to Veterans Affairs Secretary Jim Nicholson.
Wolfe said federal funds have already been approved for the expansion in Humboldt, which will cost approximately $3.5 million, and the center in Murfreesboro, which has a price tag of about $4 million. The state will issue bonds to cover their portion of the tab, he said.
''We're hoping to break ground at Humboldt in May, and shortly after that in Murfreesboro,'' said Wolfe, who estimated it would take nine months to complete construction.
Currently, there are only 96 patients at the 120-bed Humboldt facility (80 percent capacity), while Murfreesboro has 112 of 120 beds filled (93.3 percent capacity). He said the state average is about 87 percent occupancy.
''We've had a bit of a lull in the number of patients at Humboldt, but we think that will change shortly,'' said Wolfe, who indicated there had been some staff reduction at the facility through attrition.
He added that the new facility was needed ''in order to give the kind of proper atmosphere and care for our patients dealing with Alzheimer's or other dementia, and at the same time a better situation for those in intermediate (long-term) care.''
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