Veterans Bill with Caregiver, Homelessness Reforms Gets Senate Approval But Needs Second House Vote

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Sen. Jerry Moran, R-Kan., speaks on Capitol Hill.
Sen. Jerry Moran, R-Kan., speaks on Capitol Hill, Tuesday, March 12, 2024, in Washington. (Manuel Balce Ceneta/AP Photo)

A wide-ranging veterans policy bill has passed the Senate, but it will need to be approved by the House for a second time before being signed into law.

On Thursday evening, the Senate voted by unanimous consent to approve the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, which, among other things, would make it easier for aging and disabled veterans to get home- and community-based nursing care.

While the bill previously passed the House last month, the version approved by the Senate had "minor technical changes," meaning the House will need to pass it again before it can head to the president's desk, a Senate aide told Military.com. The bill is on the House's calendar to be approved next week, the last before lawmakers take a holiday break.

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Senators applauded their passage of the bill, which has been a priority of veterans service organizations this year.

"The Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act will better support veterans, caregivers and survivors by improving access to VA health care and benefits, expanding long-term care programs, strengthening programs for student veterans and military family members and more," Sen. Jerry Moran, R-Kan., the ranking member of the Senate Veterans Affairs Committee, said in a statement.

One of the biggest changes in the bill aims to make home nursing care more affordable for veterans by increasing the Department of Veterans Affairs' share of covering the costs of the care from 65% to 100%. The change has been a longtime goal of caregivers and their advocates who say that veterans should be able to live out their final days at home if they choose.

    Another major element of the bill seeks to bolster veterans homelessness support by increasing the per diem rate the VA can pay to organizations providing short-term transitional housing from 115% of costs to 133%. The bill would also give the VA flexibility to provide unhoused veterans bedding, shelter, food, hygiene items, blankets and rideshare services to medical appointments.

    The bill was the result of months of negotiations that got bogged down in election season politics and a broader debate about the future of the VA's community care program, which allows veterans to seek care from private doctors using VA funding.

    The final negotiated agreement includes some provisions aimed at strengthening the community care program, including one that would ban the department from overriding a VA doctor's referral for their patient to get outside care.

    But other controversial provisions related to community care were taken out of the negotiated bill, including one that aimed to allow more veterans to use non-VA residential mental health and substance abuse programs if the wait for a VA program is too long.

    Despite the outcome of the negotiations on the Dole Act, the debate over community care is poised to continue into next year, when Republicans will control the Senate and White House, in addition to the House. House Veterans Affairs Committee Chairman Mike Bost, R-Ill., recently introduced a bill to give veterans more access to private care that is expected to be one of his legislative priorities next year.

    And Moran, who will become the chairman of the Senate Veterans Affairs Committee next year, suggested he will continue pushing for the residential treatment provisions that got taken out of the Dole Act.

    "While I look forward to the enactment of this bill and the good it will do for veterans and their loved ones, I am disappointed that it does not address access to care for veterans in need of residential care to help them overcome mental health or substance use issues," Moran said in his statement about the Dole Act. "As chairman, I will prioritize making certain these veterans receive the support they need to succeed."

    Related: House Approves Wide-Ranging Veterans Bill After Bipartisan Compromise Reached

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