Vets Endure Yearlong Waits for Home Care

Some veterans in Washington, D.C., waited more than a year to receive purchased home- and community-based services (HCBS), according to a new report from the Office of Inspector General (OIG) at the U.S. Department of Veterans Affairs.

The OIG conducted an investigation at the prompting of Sen. Barbara Mikulski (D-MD), who brought attention to a complaint she received involving a nearly yearlong wait for a nurse to assist a particular veteran at home three times per week. The complaint purported that the patient, who was in his 70s, died while on a waitlist and before ever receiving HCBS.

The report concluded that the Washington, D.C., VA Medical Center had wait times longer than one year for patients requiring homemaker/home health aide (H/HHA) services, a component of HCBS. The patient who served as the subject of the complaint was approved for H/HHA and placed on a waitlist in October 2013.

For eligible patients who are determined to require H/HHA, the VA gives priority to veterans who are in need of, or are in receipt of, nursing home care primarily for the treatment of a service-connected disability, or who have a service-connected disability rated at 50% or higher, according to the report.

The report said the patient’s service-connected disability rating and diagnosis did not qualify for H/HHA priority consideration, which is why the patient’s name was added to a wait list. The patient died in April 2014 prior to getting H/HHA services.

The report also revealed that several Veterans Health Administration facilities had patients awaiting HCBS. From September 2014 through March 2015, the national HCBS electronic waiting list totals increased from 1,721 patients to 2,566. As of March 31, 11 facilities had more than 75 patients on their HCBS electronic waiting lists, and five facilities accounted for over 50% of the patients on the national HCBS list.

In its report, the OIG recommended that the Under Secretary for Health require facilities to develop action plans to address the care needs of veterans on home health services waiting lists. It also suggested that the Facility Director guarantee that staff comply with all elements of local and national policies regarding quality of care, communication and documentation related to purchased HCBS, and that management and oversight of purchased HCBS is adequate and in compliance with Veterans Health Administration policies.

Written by Mary Kate Nelson