California bill aims to improve mental health care at VA facilities

The West Los Angeles Veterans Home has an 84-bed residential care facility for elderly vets, a 252-bed skilled nursing facility, and other services.
The West Los Angeles Veterans Home has an 84-bed residential care facility for elderly vets, a 252-bed skilled nursing facility, and other services.
Dorian Merina/KPCC

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A bill in the California legislature would try to increase access to care for military veterans in need of complex mental health treatment.

SB 409 would require the state Department of Veterans Affairs to develop a plan to "accommodate more residents suffering from complex mental and behavioral health needs into veterans homes." The measure is a response to a January Legislative Analyst's Office report that found problems at Veterans Homes, which provide skilled nursing and adult day care.

The report, based on investigations into facilities in Yountville, West Los Angeles and Redding, found that veterans with "significant mental or behavioral health challenges" are being denied admission to state Veterans Homes or discharged prematurely due to those facilities' limited resources. 

It said that in 2015-16, a total of 30 applicants were denied admission to the Yountville and Redding facilities, and a total of 32 residents were discharged - 10 involuntarily - "due to behavioral health–related concerns about staffing and care disruption."

"These are the individuals who fought on our behalf for our security in this nation," said Sen. Janet Nguyen (R-Garden Grove), who sponsored SB 409. "They deserve the best."

The report found that the longest wait-list at the Veterans Homes are for the highest levels of long-term care, and that the homes had "limited capacity to serve veterans with complex mental and behavioral health needs." It also found that there is a high unmet demand for skilled nursing at some of the facilities. 

The number of vets with "significant" mental or behavioral issues is expected to rise in coming years, as California's veterans grow older, placing a larger burden on the state's eight Veterans Homes, including the one in West Los Angeles.

The bill calls for the VA to report back by Jan. 1, 2019, but stops short of calling for concrete action in the meantime.

"We need the report first because we need to know what the issues are," said Nguyen. "Do we need more medical doctors in there that can prescribe different types of medication? It's very complex."

California is home to 1.8 million veterans, more than any other state, and as that population ages, Veteran Homes are playing a bigger role in caring for them. About 80 percent of the residents at the state's Veterans Homes were over 65 and 34 percent were over 85 as of July 2016, according to the Legislative Analyst's Office report.

"Usually after every war, people forget about the military veterans," said Pete Conaty, an Army veteran and a Sacramento lobbyist for groups such as the American Legion and Vietnam Veterans of America. He helped draft Nguyen's legislation. 

The state government should give CalVet, the agency that oversees the Veterans Homes, more direction on what kind of care veterans most urgently need and where the emphasis should be, Conaty said.

"We want to take care of our veterans now, when the time is right," he said.

The legislation is part of a broader package of veteran-related bills. For example, SB 410, sponsored by Nguyen, seeks to improve access to state jobs for newly discharged vets. SB 197, sponsored by Sens. Pat Bates (R-Laguna Niguel) and Toni Atkins (D-San Diego), encourages construction of facilities for active duty troops and veterans with significant medical conditions.

So far, the bills have found bipartisan support. Sen. Josh Newman (D-Fullerton), chair of the Senate Veterans Committee, joined with other Democrats on the panel to advance SB 409 on Tuesday. Newman is also highlighting other legislation that addresses different aspects of military and veteran life, such as schooling for children of military families and rules on leaves of absence during illness and injury, according to his office.

More than 150 bills related to veterans have already been introduced during this legislative session.