Sending Office: Honorable TJ Cox
Co-Leads: Congressman TJ Cox and Congressman Greg Steube
Deadline 12pmEST March 9th
Please join me in requesting the Appropriations Subcommittee on Military Construction, Veterans Affairs and Related Agencies to include language to ensure adequate long-term treatment for veterans diagnosed with traumatic brain injuries (TBI) in the fiscal
year 2021 appropriations bill.
Since 2014, over 470,000 veterans have been diagnosed with a TBI. While those with a mild or moderate TBI can return to full health with proper care, veterans suffering from severe TBIs require intensive, long-term care. The Department of Veterans Affairs
(VA) has not been able to articulate a plan to provide the necessary long-term care for veterans diagnosed with severe TBIs. Urging the inclusion of this language in the fiscal year 2021 appropriations bill will require the VA to research long-term care options
for these veterans.
If you have any questions or to sign onto the letter, please contact Nandini Narayan at
TJ Cox & Greg Steube
Members of Congress
Dear Chairwoman Wasserman Schultz and Ranking Member Carter,
We write to request inclusion of language in the fiscal year 2021 Military Construction, Veterans Affairs, and Related Agencies Appropriations Act to ensure adequate care for veterans suffering from severe traumatic brain injuries (TBI) who require long-term
Since 2014, over 470,000 veterans have been diagnosed with a TBI. From 2016, when the Department of Veterans Affairs (VA) began tracking severe TBIs as a separate category, until August 2019, 3,375 veterans were diagnosed with severe TBIs. These men and
women served our country bravely, and now require long-term care. The VA must anticipate and be prepared for the needs of these veterans and their families.
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.
For some severe TBI veterans, the VA’s Caregiver Program is an acceptable option. However, not every veteran with severe TBI has a caregiver who can provide the level of daily attention required. Further, as caregivers age, veterans will find themselves
in need of professional long-term care. Given that most veterans who experience severe TBIs are young and physically active, traditional long-term care facilities, such as nursing homes, are not usually a good fit. A more appropriate option for such veterans
is high-quality specialty residential facilities that cater services for individuals who have suffered severe TBIs. Access to such facilities provides every veteran with the best chance for a fulfilling and independent life.
Despite repeated inquiries from Congress, the VA has been unable to articulate how it plans to provide this type of care for veterans with a severe TBI; VA caseworkers and stakeholders are unaware of programs that would pay for long-term care; and families
of veterans in need of such services are unable to clearly identify programs that will help their loved ones.
On February 19, 2020, the GAO released a report entitled “Veterans’ Use of Long-Term Care is Increasing, and the VA Faces Challenges in Meeting the Demand” (GAO-20-284) which identified long-term care for specialty needs as an area that needs to be addressed.
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.”
As a result, we request that the following language be included in the fiscal year 2021 Military Construction, Veterans Affairs, and Related Agencies appropriations bill:
The Committee notes the increasing prevalence of deployment-related traumatic brain injuries (TBI) including those resulting from the recent attack on servicemembers stationed at the Ain Al-Asad airbase in Iraq. This increase continues
to demonstrate the longstanding need for providing adequate long-term specialty care for veterans suffering from severe TBIs. The Committee further notes the GAO report entitled “Veterans’ Use of Long-Term Care is Increasing, and VA Faces Challenges in Meeting
the Demand” (GAO-20-284) which reached a similar conclusion. The Committee remains concerned about the Department’s inability to articulate a plan to provide such care to veterans with severe TBIs. The Committee directs the Department to publish and make publicly
available its long-term contract for care for severe TBI survivors in non-VA facilities no later than 30 days after enactment of this Act. If no such contract exists, the Committee directs the Department, through consultation with external stakeholders, to
establish such a contract no later than 180 days after enactment of this Act. The Committee also notes the GAO’s conclusion that the Department faces challenges providing long-term care to veterans in rural areas, and directs the Department to submit a report
on the current and projected need for residential care for veterans with severe TBI, especially in rural areas, no later than 180 days after enactment of this Act.
We appreciate your consideration of our request. Please contact Nandini Narayan in Rep. Cox’s office with further questions at
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