Long-term care for vets is a pressing issue — how should it change going forward?

Welcome back to our conversation with John Retzer

John, talk to me about, you mentioned the long-term care issue and the issues that is facing the veterans population here

What does that mean in terms of spending and in terms of programs? What are the things that you guys think is needed and will be needed in the coming years

So what we see is comprehensive markups that are going to be providing budget needs for staffing, infrastructure

and really that partnership of these alternative programs that I was speaking about earlier

When we look at our veteran population right now, we have a couple challenges

And the challenges are to address the direct VA care process with long term

And then how does that look for our veterans that are in metropolitan versus those in remote and rural areas

And then at the same time, addressing the very specific needs of our women veterans. It's so important that they have domiciliaries that are very safe, meeting their needs and such

But it's getting that right formula with our partners out there, with the state veterans homes, for example, is one of our best partnerships that we have in the various states

But we have to ensure that we support their budget needs to provide more services for our service-disabled veterans that are needing that long-term care

So, and as we look at the concerns surrounding like state veterans homes, because of our catastrophic issues, we have more veterans getting a 50, 60% rating, which is more severe

indicating that because in the VA healthcare system, when it comes to long-term care

70% is identified as the beginning eligibility into long-term care. But what we've identified in the clinical side

is that these 50, 60% service-connected disabled issues are really catastrophic and they gonna need most likely long care And it not about an aging process either It about a young generation unfortunately that have sustained these catastrophic issues

Yeah, I wanted to ask about that because a lot of people think long-term care, and they think, oh, you're talking about nursing homes for 80-year-olds, 90-year-olds

You're talking about something. But when we're talking about the veterans population, we're talking about a population that has had some catastrophic injuries

Again, not all of them, but the folks who need this kind of care desperately need this support

Yeah, and I think, you know, like I've been speaking to the modern medicine saving lives, but it's leaving us with catastrophic issues

When you look at Paralyzed Veterans of America, one of our partners with the independent budget, they are highly focused on, you know, spinal clinic or spinal cord injuries

And these spinal cord injuries in many cases have paralysis issues for them, loss or loss of use of extremities

So they rely heavily for their membership, rely heavily within the VA direct care system

But what we see with our ongoing combat situations, for example, traumatic brain injury, blast overpressure, when you have these cognitive issues that also create the neurologic problems, those young individual service members, when they become veterans, will need some type of institutional care sooner than they wish

So we need to be able to facilitate that population also. So we can't just look at it in a narrow scope that this is an aging need

No, this is a all veterans needs issue when they have catastrophic issues. So you mentioned traumatic brain injury, post-traumatic stress

You mentioned suicide prevention before. These are all issues that have come under some criticism in recent years because of the lack of success in VA in solving the problem, to put it in a blunt term

I mean this has been a stubborn issue stopping the number of suicides That 17 a day has remained stubbornly around that area There have been some folks who have said this is the time to pull back this is the time to fund less or to fund in a completely different way

The independent budget calls for more investment in this and looking into this. Why is that the right path as opposed to maybe stepping back and reassessing everything

It's a very good question because when we look at the landscape of where we're at with our service-disabled veterans

On average, they have five comorbidities, and many times it's not just a physical issue

There's a psychological component built in. And when you look at the socioeconomics, and that's why we have a transition assistance program within the Department of Defense

to make sure that seamless transition occurs, that all issues are addressed from benefits to addressing the service-connected benefits

addressing employment issues, and then health care concerns, for example. When they then transfer over to the Department of Veterans Affairs as a veteran, those wraparound services exist within the VA

So what's really important with regards to this is that when we look at these topics like mental health, suicide prevention, you don't pull back

You can't stop. We need more to be done because what we're learning is through our research

And that's another component that we talk about in this is the need for more research, the staffing, the infrastructure, and continue to support that because research actually serves not just the veteran population

It serves the nation. Much of what VA has done for research has helped not just our veterans, but the nation itself

So, and there's many things that they have done. However, with the research, it allows us to understand what more can be done with regards

to suicide prevention and mental health issues surrounding our veterans even if it a depression anxiety issue or is it a combat with a TBI and PTSD situation We need to have that in place so that we can better serve the healthcare the individualized care and it got to be very

tailored for that individual. So the reason why we're asking and encouraging Congress and the VA

to continue to move in the forward direction is it's saving lives. Right now with the national

report of suicide prevention coming out for the 2024 report, it was reflected that over 6,400

veteran lives were lost in 2022. That was an increase from the previous year. We can't have

that increase. We need to do more research. We need to do more funding. So one of the things that

we're really talking more and more with Congress and VA is about lethal means safety counseling

lethal means storage, firearms. So we're trying to build that knowledge and have really, frankly

discussions like you and I are having about mental health and suicide, having a discussion and being

open about, we still need to fix it. There's more work to be done. And that's what the independent

budget really does highlight. It's not just one department. It's not just one program we're

talking about. We're talking about the largest integrated healthcare system in our government

that serves a very large population who provide a service by volunteering to do what they do

So again, like I said, it's a promise that we got to keep, and this is how we do it right

We have to look at this packet, this report, as a very comprehensive report to address the holistic concept of taking care of that veteran

There are health care components in this, benefits, wraparound services, infrastructure, IT

That's what we talk about here. But what it's really targeting is being responsible for keeping that promise of what we've been saying that we would do, that we will take care of you when you have taken care of us