Letter to Debbie Wasserman Schultz, Chairwoman of the House Appropriations Subcommittee on Military Construction, Veterans Affairs and Related Industries, and John Carter, Ranking Member - Requesting Provisions for Long-Term Care for Veterans Suffering from Traumatic Brain Injuries


By: Madeleine Dean, Peter DeFazio, Shontel Brown, Bill Johnson, Joe Morelle, Claudia Tenney, Elise Stefanik, Antonio Delgado, Alexandria Ocasio-Cortez, Nicole Malliotakis, Nydia Velázquez, Thomas Suozzi, Andrew Garbarino, Steven Horsford, Dina Titus, Melanie Stansbury, Mikie Sherrill, Don Payne, Jr., Tom Malinowski, Chris Smith, Andy Kim, Annie Kuster, Chris Pappas, Donald Bacon, Ted Budd, Richard Hudson, Jr., Greg Murphy, Rashida Tlaib, Debbie Dingell, Lisa McClain, Elissa Slotkin, Peter Meijer, Anthony Brown, Bill Keating, Stephen Lynch, Ayanna Pressley, Seth Moulton, Lori Trahan, Jim McGovern, Richard Neal, Sharice Davids, André Carson, Frank Mrvan, Brad Schneider, Jan Schakowsky, Danny Davis, Marie Newman, Cindy Axne, Kai Kahele, Alex Mooney, David McKinley, Gwen Moore, Marilyn Strickland, Kim Schrier, Cathy Rodgers, Abigail Spanberger, Eddie Johnson, Sylvia Garcia, Pete Sessions, Veronica Escobar, Al Green, Lizzie Fletcher, Pat Fallon, Louie Gohmert, William Timmons, Joe Wilson, Sr., Jim Langevin, Mike Kelly, Jr., GT Thompson, Jr., Dan Meuser, Susan Wild, David Scott, Carolyn Bourdeaux, Lucy McBath, Hank Johnson, Jr., Brian Mast, Gus Bilirakis, Darren Soto, Bill Posey, Al Lawson, Jr., Matt Gaetz, Lisa Blunt Rochester, Eleanor Norton, Jahana Hayes, Jim Himes, Joe Courtney, Jason Crow, Ken Buck, Diana DeGette, Sara Jacobs, Linda Sánchez, Karen Bass, Raul Ruiz, Ted Lieu, Tony Cárdenas, Jimmy Panetta, Zoe Lofgren, Ro Khanna, Jerry McNerney, Ami Bera, Mike Thompson, Doug LaMalfa, Tom O'Halleran, Aumua Amata Radewagen, Terri Sewell, Mike Rogers, Greg Steube
Date: April 28, 2022
Location: Washington, DC

Dear Chairwoman Wasserman Schultz and Ranking Member Carter,

We write to request inclusion of language in the fiscal year 2023 Military Construction, Veterans Affairs, and Related Agencies Appropriations Act to ensure adequate care for veterans suffering from severe traumatic brain injuries (TBIs) who require long-term residential care.

Each year, thousands of veterans are diagnosed with a TBI. While veterans with mild or moderate TBIs may return to full health after appropriate care, veterans with severe TBIs will be affected for the rest of their lives. Those veterans are likely to exhibit changes in memory, reasoning, impulse control, appropriate behavior, language, and emotional regulation. As a result, they will require an intensive level of long-term care.

After sustained pressure from Congress, we are pleased to see that the Department of Veterans Affairs has made progress in implementing Veterans Care Agreements to allow private providers to contract with the VA to provide appropriate long-term care. However, more needs to be done to educate case managers and families about options available to them. The GAO recognized this need for further efforts in specialty care in its February 2020 report titled "Veterans' Use of Long-Term Care is Increasing, and the VA Faces Challenges in Meeting the Demand" (GAO-20-284). The report states that the VA's Geriatric and Extended Care Office "has not established measurable goals for its efforts to address difficulties meeting veterans' needs for specialty care" and that "without measurable goals…VA is limited in its ability to better plan for and understand progress towards addressing the challenges it faces meeting veterans' long-term care needs."

Accordingly, we request that the following language be included in the fiscal year 2023 Military Construction, Veterans Affairs, and Related Agencies appropriations bill:

Long-Term Care for Veterans with Severe Traumatic Brain Injury (TBI). -- The Committee continues to note the increasing prevalence of deployment-related traumatic brain injuries. This increase continues to demonstrate the longstanding need for providing adequate long-term specialty care for Veterans suffering from severe TBIs. The Committee is encouraged by the Department's progress in using agreements with non-VA providers to ensure all Veterans receive such long-term specialty care in their communities and directs the Department to continue entering into such agreements, to educate case managers on all tools available to provide Veterans with long-term specialty care outside the VA system, and to provide quarterly updates to Congress on the Department's progress on providing access to long-term care to veterans with severe TBIs.