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September 08, 2023

After Push from Maine Congressional Delegation, VA Agrees to Resume Reimbursing Maine Veterans’ Homes for Domiciliary Care

Maine Veterans’ Homes was losing over $100,000 a month after the Department of Veterans Affairs stopped reimbursing domiciliary care for veterans with dementia in 2020

WASHINGTON, D.C.— Following calls from Maine’s Congressional Delegation to reform policy, U.S. Senators Angus King, a member of the Senate Veterans’ Affairs Committee, and Susan Collins and U.S. Representatives Chellie Pingree and Jared Golden announced that the Department of Veterans Affairs (VA) proposed new regulations that would reimburse Maine Veterans’ Homes (MVH) for the costs of nursing home care for veterans with dementia. The VA’s proposed rule would expands the current eligibility for domiciliary care to include veterans suffering with dementia. The rule would also retroactively reimburse MVH for costs associated to domiciliary care dating back to January 2021 when the delegation’s initial law was passed.

In 2020, Congress passed legislation authorizing the VA to cover the costs of nursing home care for veterans with early stage dementia provided by state veterans’ homes, but the VA delayed proposal of the required rulemaking by more than two years. This delay forced MVH, and in some cases veterans and their families, to pay out-of-pocket for the care costing approximately $130,000 per month and over $2.5 million since 2019.

“For decades, Maine Veterans’ Homes has provided world-class care to our state’s veterans. They’ve worked hard to meet America’s commitment to those who served despite rising costs,” said Senators King and Collins and Representatives Pingree and Golden. “This new ruling will ensure the federal government supports our veterans with all of the resources at our disposal so that older Maine veterans struggling to live independently can receive the care and support they earned on behalf of a grateful nation. We hope the VA will move to quickly finalize the new rule to prioritize Maine veterans and meet our nation’s solemn promise to the brave men and women who answered the call of service.”

“This is an important advancement for Maine’s seniors and the right thing to do. Maine Veterans’ Homes is extremely grateful to Senator King and the Maine delegation, and the Veterans Administration for supporting necessary rulemaking changes in domiciliary care stipends,” said Sharon Fusco, the CEO of Maine Veterans’ Homes. “These changes will ensure that Maine’s seniors are able to receive the residential care they need in Assisted Living settings, paid for with the benefits they are due. In spite of years of uncertainty surrounding reimbursement, MVH has continued to ensure that residential care options were available for our Veterans, sheltering them from “falling through the cracks” due to funding gaps. We sincerely appreciate this change and the support that made it possible.”

Domiciliary care was established by the VA after the Civil War as a type of assisted living that is provided to older veterans who are independently mobile or semi-mobile but are incapable of living alone. Over 130 MVH residents receive domiciliary care, 80% of whom are on Medicaid.

The care was federally reimbursed for years, up until 2019, when the VA abruptly ended payments. The Veterans Health Care and Benefits Improvement Act, signed into law on January 5, 2021, authorized the VA to resume reimbursements for domiciliary care at state homes like MVH. Twenty-eight months later, the VA had yet to announce a proposal for the payments.

Created by the Maine Legislature in 1977, Maine Veterans’ Homes is an independent, nonprofit organization that provides services to Maine veterans at six homes in Maine: Augusta, Bangor, Caribou, Machias, Scarborough and South Paris. Their care includes rehabilitative care, domiciliary care, nursing care, and end of life care.

The Maine Congressional delegation has pushed the VA to reimburse Maine Veterans’ Homes for the last several years. In May, the delegation introduced the Reimburse Veterans for Domiciliary Care Act, which would require the Department to begin payments for current care as mandated by law and retroactively provide MVH with the reimbursements for past care.


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