STATE VETERANS HOME PROGRAM

[Definition**:**]{.underline}

> State home means a home established by a State for veterans disabled
> by age, disease, or otherwise, who by reason of such disability are
> incapable of earning a living. State homes may provide nursing home
> care, domiciliary care, and/or adult day health care. Hospital care
> may be provided only when the State home also provides domiciliary
> and/or nursing home care.
>
> VA participates in two grant-in-aid programs for States. VA may
> participate in up to 65 percent of the cost of construction or
> acquisition of State nursing homes or domiciliaries or for renovations
> to existing State homes. VA also provides per diem payments to States
> for the care of eligible veterans in State homes. The Secretary of
> Veterans Affairs may adjust the per diem rates each year.

[History:]{.underline}

> Following the Civil War, a number of the States established homes for
> the domiciliation of disabled soldiers and sailors. These were
> originally erected or acquired and operated entirely at State expense.
> The first enactment to provide for payment of Federal aid to States
> was titled: "[An Act to Provide Aid to State or Territorial Homes For
> the Support of Disabled Soldiers and Sailors of the United
> States]{.underline}" and dated August 27, 1888. The federal assistance
> to States under the Act provided \$100 per annum for each eligible
> veteran in a State home. In 1960, per diem rates were established and
> Congress increased them periodically, usually as a result of lobbying
> efforts by State homes. In 1988, Congress authorized the Secretary to
> evaluate per diem rates and increase them as appropriate, not to
> exceed the percentage increase in the cost of care in VA medical
> centers. Federal assistance to States in the cost of construction of
> nursing homes was authorized in 1964 and the annual appropriation has
> been \$5 million to \$105 million. In 1977, State home applications
> for construction funds exceeded the annual appropriations and a
> backlog of eligible applications has been maintained since that time.
> In 1986, Congress established in law a priority system for awarding
> State home construction grants. The backlog of current eligible
> construction grant applications is approximately \$637 million. VA
> expects to participate in the construction of approximately 645 State
> nursing home care and domiciliary beds during fiscal years 2006 and
> 2007.
>
> Current (FY 07) per diem rates are \$67.71 for nursing home and
> hospital care and \$31.30 for domiciliary care. The adult day health
> care per diem rate is \$40.48. The VA share of per diem costs for
> nursing home care is approximately 33%. There are 126 State homes in
> 47 States and Puerto Rico, including 54 domiciliaries in 33 States
> with 5,644 VA-authorized beds; 114 nursing homes in 47 States with
> 21,031 VA-authorized beds; 4 hospitals in 4 States with 287
> VA-authorized beds, and 2 Adult Day Health Care facilities in 2 States
> with 95 VA-authorized beds.

[Legal Authority**:**]{.underline}

Per Diem Grant is Title 38 U.S.C. 1741-1743.

Construction Grant is Title 38 U.S.C. 8131-8137.

[Objectives:]{.underline}

> State homes are established by a State for veterans disabled by age,
> disease, or otherwise, who by reason of such disability are incapable
> of earning a living. The home provides quality of care for eligible
> veterans in need of domiciliary, nursing home, hospital, and adult day
> health care. When a State home accepts VA construction grant
> assistance, at least 75 percent of the bed occupants at any one time
> at the facility must be veterans. As a goal, VA plans to maintain at
> least a 33 1/3 percent share of the States\' cost for the provision of
> such care. VA will also continue to encourage States to construct and
> renovate State homes to provide needed new beds and to maintain a safe
> and healthy environment in existing State veterans homes for eligible
> veterans seeking long term care.
>
> A State home is owned and operated by a State. VA provides federal
> assistance to States by participating in a percentage of the cost of
> construction/renovation and/or per diem costs. In addition, VA assures
> Congress that State homes provide quality care through an annual
> inspection, audit, and reconciliation of records conducted by the VA
> medical center of jurisdiction to assure that VA standards are met.
> The VA medical center of jurisdiction is responsible for ongoing
> quality monitoring. The State home is required to meet VA standards in
> order to continue to receive per diem payments from VA.