March 1, 2022

WASHINGTON, DC – Today, Julia Brownley (D-CA-26), chair of the House Veterans’ Affairs Subcommittee on Health, introduced the Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act of 2022. The legislation would establish partnerships between Programs of All-Inclusive Care for the Elderly (PACE) and Veterans Affairs Medical Centers (VAMCs) that are within the service area of a PACE program.

“This timely, critically needed bill will enable many more of our nation’s veterans to age in place with the care and services they need, as well as support their family caregivers,” said Shawn Bloom, president and CEO of the National PACE Association (NPA). “This provision not only will ensure all care and services received by veterans currently enrolled in PACE will be well coordinated with their local VAMCs but also will facilitate substantial increases in the number of veterans and their caregivers benefiting from the innovative PACE model of care.”

“Over half of all veterans that use VA are over the age of 65,” said Rep. Brownley in a statement. “Age, combined with their unique health needs, makes many elderly veterans especially vulnerable to going into nursing homes and institutional care. Our nation’s veterans deserve the right to age comfortably and with dignity in their homes. The research is clear: providing health services and assistance in home settings improves health outcomes and delays, if not prevents, nursing home placement for people with disabilities and the elderly. However, VA’s current programs need to be improved and expanded to ensure that all veterans have access to these types of services."

She introduced the Elizabeth Dole Home and Community Based Services for Veterans and Caregivers Act, along with Rep. Jack Bergman (R-MI-1), ranking member of the Subcommittee on Health, "to ensure that every veteran has access to the care they need, when and where they need it. The focus of my legislation is to keep veterans in their homes for as long as possible, if they want, bringing them the care they need to the place they feel most comfortable, and ensure that every VA medical center has these necessary support programs," she said. "By expanding home- and community-based services, veterans will have the assistance needed to remain members of their communities, to be present in their family lives, to support their caregivers, and to age with dignity." 

“Reps. Brownley and Bergman are passionate champions of America's veterans, their families and caregivers,” said Elizabeth Dole, a former senator who established the Elizabeth Dole Foundation, which is dedicated to helping caregivers of veterans. "This transformative bill reinforces that our nation can only provide world-class care for our veterans if we also provide world-class, systemic support to their caregivers. I am humbled that this legislation bears my name, and I am hopeful the bill receives the support it deserves.” 

PACE programs use an interdisciplinary team approach to keep older Americans with complex, chronic conditions and long-term services and supports (LTSS) needs as healthy as possible while living independently in their own homes. PACE enrollees typically receive care at home and in the PACE center, including primary care, therapies, meals, socialization, medication management, transportation, and any other care or service needed to maintain the highest level of functioning. Ninety-five percent of PACE enrollees are able to live in the community and outside of a nursing home with the support of PACE.

Despite the pandemic, PACE programs demonstrated the strength of the person-centered PACE model of care by keeping enrollees safe at home. The rates of COVID-19 infection and death among PACE enrollees were one-third of those incurred by nursing home residents.

A recent report titled Comparing Outcomes for Dual-Eligible Beneficiaries in Integrated Care, which was released by the assistant secretary for Planning and Evaluation at the U.S. Department of Health and Human Services (HHS), stated, “The PACE program, known for its focus on HCBS provision and full integration of a range of medical services and LTSS, stands out from our analysis as a consistently ‘high performer.’ We found that full-benefit, dual-eligible beneficiaries in PACE are significantly less likely to be hospitalized, to visit the emergency department, or to be institutionalized, while their mortality risk is not significantly higher, compared to regular Medicare Advantage enrollees.”

Earlier this year, the Milken Institute, a leading think tank, recommended PACE growth as a solution to the nation’s long term care crisis. “Americans often underestimate the type and level of care they will need as they age, specifically the services and supports necessary to maintain the essential functions of daily life,” noted the report, titled New Approaches to Long-Term Care Access for Middle-Income Households, from the Financial Innovations Lab at the institute.

The National PACE Association (NPA) works to advance the efforts of PACE programs, which coordinate and provide preventive, primary, acute and long-term care services so older individuals can continue living in the community. The PACE model of care is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. For more information, visit and follow @TweetNPA.

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