VA Long-Term Care: Implementation of Certain Millennium Act Provisions Is Incomplete, and Availability of Noninstitutional Services Is Uneven

The Department of Veterans Affairs (VA) spent about $3.1 billion on long-term care in fiscal year 2001, This amount is likely to increase as the veteran population ages. VA provides or pays for long-term care in institutional settings, such as nursing homes, or in veteran's own homes and other community locations. The Veterans Millennium Health Care and Benefits Act of 1999 required VA to offer long-term care services to eligible veterans, including in noninstitutional settings. More than two years after the act's passage, VA has not completely met the act's requirement that all eligible veterans be offered adult day health care, respite care, and geriatric evaluation. Although VA published draft regulations that would make these three services available, the regulations were not finalized as of March 2002. To respond to the act's requirements before its draft regulations were finalized, VA issued a policy directive making these three services available in noninstitutional settings. At the time of GAO's review, however, access to these services was far from universal. Moreover, the availability of all VA noninstitutional long-term care services, including the newly required services, is uneven across the VA system.