Injured veterans program faces the ax

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Hundreds of veterans with traumatic brain injuries will get kicked out of assisted living facilities this fall unless policymakers in Washington soon extend an expiring pilot program.

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Lawmakers are in an uproar over reports that dozens of veterans may have died because of obstacles to obtaining medical treatment at Veterans Affairs (VA) hospitals, but Congress may contribute to the problem by failing to act on pending legislation.

The VA has notified Congress that a pilot program for injured veterans will expire at the end of September without congressional action.

A Senate bill that included language to extend the program stalled on the floor earlier this year because of a fight over how to pay for it. The House Veterans’ Affairs panel plans to hold a hearing on two measures to reauthorize the popular program, but time on the legislative calendar is running out.

Theresa Bozeman, a nurse living in Louisiana, said she is worried about who will take care of her husband, Todd, an Army National Guard sergeant who suffered a severe brain injury from a gunshot wound in July 2012.

Bozeman said that “it would be a tremendous stress” if the assisted-living program lapsed.

“This program has been a blessing to have somewhere for him to live and to have quality of life. He is very impulsive and requires one-on-one supervision 24/7. If the program goes away and I have to care from him at home, I don’t know how I would handle it,” she said.

Todd Bozeman joined the military in 1991 and began showing symptoms of post-traumatic stress disorder after witnessing the ravages of Hurricane Katrina and serving a year in Iraq. He shot himself two years ago after seeking help for suicidal thoughts.

He now lives in a house with five other men with traumatic brain injuries under the supervision of a handful of professionals, including a registered nurse and a licensed practical nurse, Theresa Bozeman said.

The arrangement allows him to socialize with people close to his age and have a lifestyle that somewhat resembles what he knew before his injury.

“He likes to be busy and doing something. It’s a big adjustment for him,” she said, adding that her husband still talks about having flashbacks to his military career.

Unlike so many other issues in the nation’s capital, partisanship isn’t an obstacle. Both conservatives and liberals want the program to continue.

Reps. Bill Cassidy (R-La.), who is running for Senate against Sen. Mary Landrieu (D-La.), and Paul Broun (R), who just lost a Senate bid in Georgia, have introduced legislation to extend the program. The House Veterans’ Affairs Committee plans to hold hearings on their legislation this summer, according to GOP aides.

“Folks in Louisiana are worried that they won’t be able to continue receiving services if the program is not extended,” Cassidy said. “It makes sense to extend a successful program that allows a veteran suffering from traumatic brain injury to live at home instead of an institution.”

“If we can get something passed this summer, there will be more pressure on the Senate to act,” said a House GOP aide.

A bipartisan veterans bill that stalled on the Senate floor earlier this year included a provision extending the assisted living program.

Senate Veterans Affairs Committee Chairman Bernie Sanders (I-Vt.) and Sen. Richard Burr (N.C.), the panel’s ranking Republican, have tried to revive it but few bills have passed this year in the bitterly divided upper chamber. It’s uncertain whether Senate Majority Leader Harry Reid (D-Nev.) will attempt to move it again.

Advocates for extending the program say the VA has enough authority to do so on its own. However, the department recently informed lawmakers in an email that Congress must act. The email, provided to The Hill, says it would take up to six months to “carry out individual transition plans for each Veteran currently enrolled in the pilot.”

Burr said the department’s reluctance to move administratively bodes poorly for the program’s future. 

“We’re waiting for some indication from the VA for what their preference is,” he said. “I don’t see us acting on it. If they can extend it on their own, why wouldn’t they?”

The costs of the pilot are relatively small. Proponents estimate the price tag is $100 million to $200 million, adding that it would be easy for Congress to offset those costs.

Sen. Mark Begich (D-Alaska), a member of the Senate Veterans’ Affairs Committee, said assisted-living programs are more expensive in the short term but save money over the long run.

“If you live in a group home you’re living with other veterans, which is a very important support network,” he said. “Once they’re in the group home they become much more receptive to care.

“If you’re living on your own, but have support form a clinical worker, a nurse or whatever, the odds are you’re going to be more productive,” he said.

The alternative is becoming “a 100 percent ward of the state,” he said.

The furor over VA Secretary Eric Shinseki’s job future has not helped the cause, as some have said that political storm has distracted the department.

Consumer advocates and congressional staff say veterans who face getting kicked out of small assisted-living facilities in October face an uncertain future.

A House staffer expressed puzzlement with the VA’s assertion that it could move the military veterans elsewhere: “Right now, I’m not exactly sure what types of programs those are.”

One option would be to send them to poly-trauma rehabilitation centers based in hospitals. The downside is that they don’t give injured veterans access to their communities or to daily-life experiences.

Transitional rehabilitation programs offer another possibility, but they are based on campuses, which are difficult to leave, limiting veterans’ experience with the outside world. A major drawback to these programs is they are usually limited in duration.

Younger veterans usually reject the option to live in community centers sponsored by the VA because they are essentially nursing homes and populated by older residents.

Ralph Ibson, national policy director of the Wounded Warrior Project, said it would be “hugely disruptive” if veterans were pushed out of assisted-living facilities.

“They and their families have been well-served in these facilities with the expectation that they’ll continue to live there and continue to make progress,” he said.

The families of injured veterans worry their loved ones may get hurt if they don’t receive proper attention.

“I have a son and a daughter. If I take my eye off of him and he goes out the door into somebody else’s house, what if someone harms him?” said Theresa Bozeman.

The VA didn’t comment for this article.