WASHINGTON, D.C – U.S. Senator Angus King, a member of the Senate Veterans’ Affairs Committee, is urging the Department of Veterans Affairs (VA) to resume payments for domiciliary care as permitted by law. Congress passed legislation in 2021 authorizing the VA to cover the costs of domiciliary care after the Department suddenly stopped reimbursements for the long-supported care in 2019. Now, with organizations like Maine Veterans’ Homes (MVH) forced to carry the financial burden, King is pushing VA Secretary Denis McDonough to follow Congressional guidance and authorize reimbursements as quickly as possible.

Domiciliary care was established by the VA after the Civil War to serve economically disadvantaged veterans. It is a type of assisted living that is provided to seniors who are independently mobile or semi?mobile, but are incapable of living alone, typically because of a disability that makes it difficult to accomplish certain daily activities. Over one-hundred and thirty MVH residents receive domiciliary care, 80% of whom are on Medicaid.

“I am writing to again bring to your attention to the Department of Veterans Affairs (VA) delay in implementing a waiver for eligible veterans to receive per diem domiciliary care payments at state veterans homes,” wrote Senator King in a letter to Secretary McDonough. “This service was reimbursed by the VA for 15 years. However, in 2019, the VA abruptly decided that these payments were not legal. The bipartisan fix for this issue was contained in the Veterans Health Care and Benefits Improvement Act signed into law on January 5th 2021. Section 3007 of the law authorizes the VA to waive existing eligibility requirements for a veteran to receive per diem payments for domiciliary care at a state home. Twenty-sixth months later, the VA has yet to announce a proposed rule, let alone a final rule.”

“This delay is causing financial harm to our veterans, their families, and to Maine Veterans’ Homes (MVH) who have continued to serve deserving veterans while waiting for the proper implementation of this law. There are currently 132 residents requiring domiciliary care at Maine Veterans’ Home,” Senator King continued. “For the 78 veterans who were not grandfathered in prior to 2020, they, their families, or Maine Veterans’ Home must pay out of pocket for their needed care which can easily be over $1,500 a month. This is an unacceptable cost that unnecessary burdens veterans and Maine Veterans’ Homes.”

“Between January 2020 and March 2023, Maine Veterans’ Home lost $2.5 million caring for their domiciliary care residents. Due to the increasing number of residents requiring this care, and the rising costs of inflation and wages on healthcare costs, Maine Veterans’ Homes is losing approximately $130,000 per month due to denied VA domiciliary care per diem reimbursements. At this rate, Maine Veterans’ Home are expecting to lose a total of $3.8 million by the end of this fiscal year if nothing is done,” concluded Senator King. “I am asking you to prioritize implementing section 3007 of the Veterans Health Care and Benefits Act, and ensure that the payments are retroactive to the signing of the law.”

“Maine Veterans’ Homes (MVH) appreciates Senator King’s advocacy efforts to expedite the rulemaking around this waiver,” said Sharon Fusco, MVH Chief Executive Officer. “MVH made the decision when the Veterans Health Care and Benefits Improvement Act was passed in 2019 to do the right thing and continue to admit veterans so they would get the care they were promised when they enlisted. That decision is projected to cost us $3.8M by the end of this fiscal year if this rule making is not done and not made retroactive. Senator King took the time necessary to understand the issue and then advocated on behalf of MVH and all veterans. I am grateful for his tenacious support!”

Created by the Maine Legislature in 1977, Maine Veterans’ Homes is an independent, nonprofit organization that provides services to Maine veterans at six homes in Maine: Augusta, Bangor, Caribou, Machias, Scarborough and South Paris. Their care includes rehabilitative care, domiciliary care, nursing care, and end of life care.

You can read the full letter here or below.

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Dear Secretary McDonough,

I am writing to again bring to your attention the Department of Veterans Affairs (VA) delay in implementing a waiver for eligible veterans to receive per diem domiciliary care payments at state veterans homes. This service was reimbursed by the VA for 15 years. However, in 2019, the VA abruptly decided that these payments were not legal.

The bipartisan fix for this issue was contained in the Veterans Health Care and Benefits Improvement Act signed into law on January 5th 2021. Section 3007 of the law authorizes the VA to waive existing eligibility requirements for a veteran to receive per diem payments for domiciliary care at a state home. Twenty-sixth months later, the VA has yet to announce a proposed rule, let alone a final rule.

This delay is causing financial harm to our veterans, their families, and to Maine Veterans’ Homes (MVH) who have continued to serve deserving veterans while waiting for the proper implementation of this law. There are currently 132 residents requiring domiciliary care at Maine Veterans’ Home. For the 78 veterans who were not grandfathered in prior to 2020, they, their families, or Maine Veterans’ Home must pay out of pocket for their needed care which can easily be over $1,500 a month. This is an unacceptable cost that unnecessary burdens veterans and Maine Veterans’ Homes.

Between January 2020 and March 2023, Maine Veterans’ Home lost $2.5 million caring for their domiciliary care residents. Due to the increasing number of residents requiring this care, and the rising costs of inflation and wages on healthcare costs, Maine Veterans’ Homes is losing approximately $130,000 per month due to denied VA domiciliary care per diem reimbursements.

At this rate, Maine Veterans’ Home are expecting to lose a total of $3.8 million by the end of this fiscal year if nothing is done. That is why it is critical that Section 3007 must not only be implemented swiftly, but that it also include retroactive payments from when the law was implemented in January 2021, which the VA has said is allowable under the law.

Maine Veterans’ Homes provides world class rehabilitative and care services at six homes in Maine: Augusta, Bangor, Caribou, Machias, Scarborough and South Paris. Most importantly, MVH provides peace of mind for Maine veterans and their families. They have earned the Gold Excellence in Quality certifications through the American Health Care Association/National Center for Assisted Living National Quality Award Program at their Bangor, Scarborough, and Machias locations. These homes are three of only 49 organizations nationwide to reach the Gold status in 25 years– a true testament to their hard work and dedication on behalf of our veterans.

I am asking you to prioritize implementing section 3007 of the Veterans Health Care and Benefits Act, and ensure that the payments are retroactive to the signing of the law. The delay in rulemaking of this law puts Maine Veterans’ Homes in jeopardy of making difficult decisions to either close facilities or reduce the quality of care they can provide to veterans. Both options are unacceptable, particularly since the VA has the authorities it needs to provide the needed relief.

                                                            Sincerely,