Comment on AN80-Proposed Rule-Johnson, Noemi Miranda

In regards to the proposed rule for Medical Foster homes for military veterans, docket VA-2011-VHA-0013, I think it’s an excellent idea! I love that veterans needing professional medical care have a more intimate, homey option to the dreaded nursing home and are still able to retain a certain level of independence. However, I do have a few concerns. While section 17.74e acknowledges the Medical Foster Home program predates this proposed rule and so approval should not be an issue, should there be no approved home in a veteran’s area, would they have the option of receiving approved care in their own home rather than being forced into a local nursing home? Also, section 17.74d3 talks about only allowing for single occupancy unless the veteran wishes to be in a room with multiple occupants, I wonder, what is the consideration for a veteran who is married but whose medical needs are more than their spouse can handle and therefore placement in the medical foster home is needed or desired instead of a nursing home? Can the spouse move into the home with the veteran or will the couple be forced to live apart? Finally, throughout this proposed rule I see language referring to elderly veterans, however, there are a growing number of young military veterans who are severely injured and in need of daily medical assistance. For many of these young men and women, their only option is a nursing home filled with elderly people. While I applaud the idea of the smaller medical foster home, is there any consideration for the younger disabled veteran in these homes? According to a Deseret News article published Jan. 7, 2011, one in seven nursing home patients are under the age of 65. The article also claims the average of patients under the age of 30 in each of these homes is less than 1% which, if you have ever visited a nursing home, can lead to a very lonely, depressing and miserable existence.