On May 23, 2018 the Senate passed the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (The VA MISSION ACT of 2018) by a 92-5 vote. The bill was previously passed by the House. President Trump has said that he will sign the bill.

The Act is a 55 billion dollar Veterans reform bill that addresses the way that the VA will pay for a Veteran’s care at non-VA providers, expands the VA’s caregiver program, and provides for a review of the VA’s assets and infrastructure.

Relevant to the elder law attorney, particularly the attorney whose clients do not live close to VA facilities, the Act changes the way the VA will pay for private care. It aims to deal with issues in delayed scheduling and lapses in healthcare services for veterans.

The Act allows the Veteran to receive community care if the referring VA care provider and the veteran agree that it would be in the best medical interest of the veteran to receive care in the community based on a list of factors that include:  the distance between the VA facility and the veteran, the nature and/or frequency of the services, timeliness and availability of appointments, and an unusual or excessive burden on the veteran to receive care (including, for example, excessive driving, medical conditions that affect ability to travel, and any other considerations the VA considers appropriate).

The bill also provides for assistance, including financial stipends, access to health care insurance, mental health services and counseling, caregiver training, and respite care for family caregivers of veterans with a serious injury incurred or aggravated in the line of duty in active service on or before May 7, 1975 and on or after September 11, 2001, during the two year period following the date on which the VA has certified full implementation of an information technology system required by the bill. After the date that is 2 years from the certification, this will expand to veterans on or before September 11, 2001. This program is currently in place for those caring for seriously injured post-9/11 veterans and serves as an expansion of that program.

While proponents of the bill hope it leads to better care in the community for Veterans, those that were against the bill cite a loss of funds to the VA by referring Veterans to private care, thereby eroding the VA’s ability to care for Veterans, and causing more and more Veteran’s to end up with non-VA providers.