This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h0725b.HCA
DATE: 1/23/2024
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 725 Veterans' Long-term Care Facilities Admissions
SPONSOR(S): Woodson, Snyder & others
TIED BILLS: IDEN./SIM. BILLS:
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Local Administration, Federal Affairs & Special
Districts Subcommittee
15 Y, 0 N Mwakyanjala Darden
2) Health Care Appropriations Subcommittee Aderibigbe Clark
3) Health & Human Services Committee
SUMMARY ANALYSIS
Florida Department of Veterans’ Affairs (FDVA) operates a network of nine veterans’ homes and provides
statewide outreach to connect veterans with services, benefits, and support. State veterans’ home may be
either nursing homes or domiciliary homes. Both veterans of wartime service and of peacetime service are
eligible for admission.
The bill expands the eligibility for residency at a state veterans’ home to include a spouse or surviving spouse
of a qualifying veteran. The bill revises the priority of admittance to veterans’ homes and places the spouse or
surviving spouse of a veteran last in priority. These rankings preserve a higher priority of admittance to
veterans over non-veterans.
The bill does not have a fiscal impact on state or local government.
The bill provides an effective date of July 1, 2024. STORAGE NAME: h0725b.HCA PAGE: 2
DATE: 1/23/2024
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Present Situation
Veterans’ Services
Florida Department of Veterans’ Affairs (FDVA)
FDVA is a nearly 1,500-member constitutionally chartered
1
department with a budget of $201 million for
FY 2023-2024.
2
FDVA operates a network of nine state veterans’ homes and provides statewide
outreach to connect veterans with services, benefits, and support.
3
FDVA offers benefits and services
in the fields of health care, mental health and substance abuse, claims support, education,
employment, housing, burial benefits, and legal assistance.
4
Health Care
The U.S. Department of Veterans’ Affairs (VA) is principally responsible for the delivery of health care
services to veterans.
5
Eligibility for hospital, nursing home, and domiciliary care depends on a number
of factors. Veterans qualify for specified health care services depending on disability status, time of
service, active duty status during service, toxic exposure during service, annual income, and need for
support.
6
Veterans Homes
Cost and Funding of Resident Care
A resident of a state veterans’ home must contribute to the cost of his or her care if the resident
receives a pension, compensation, gratuity from the federal government, or income from any other
source of more than $160 per month.
7
The average cost of care at a state veterans’ nursing home in Florida is $394.15 a day.
8
The cost of
care is funded through multiple sources, including from the resident. Costs charged to residents range
from an average $98.63 a day for a resident with limited income to the average cost of $358.93 a day
for a self-paying resident. If a resident veteran has a disability rating between 70 and 100 percent, the
resident has no out-of-pocket cost.
In addition to the resident’s portion of payment, a VA provides a reimbursement care subsidy
based on a per diem rate.
9
The current VA per diem for basic care is set at $129.97 a day, while per
diem for disabled veterans who are determined to be at least 70 percent disabled is set at $474.45 a
day.
10
To qualify for reimbursement, federal law requires at least 75 percent of the population of the
facility to be veterans. This threshold drops to 50 percent if the facility was constructed or renovated
solely by the state. Federal law authorizes a state veterans’ home to house non-veteran residents who
1
Art. IV, s. 11, Fla. Const.
2
Ch. 2023-239, Law s of Florida.
3
Florida Dept. of Veterans Affairs, Florida Department of Veterans’ Affairs – Our Vision and Mission, https://www.floridavets.org/leadership/ (last visited
Jan. 21, 2024).
4
Florida Department of Veterans Affairs, Benefits & Services, https://www.floridavets.org/benefits-services/ (last visited Jan. 21, 2024).
5
Florida Dept. of Veterans Affairs, Health Care, https://www.floridavets.org/benefits-services/health-care/ (last visited Jan. 21, 2024).
6
38 U.S.C. s. 1710.
7
S. 296.37(1), F.S. This contribution for care may be 100 percent of the cost if an otherw ise eligible veteran is able to fund his or her ow n support. S.
296.37(2), F.S.
8
Florida Dept. of Veterans’ Affairs, 2023 Agency Legislative Bill Analysis, SB 174 (Nov. 7, 2023) (on file w ith the House Local Administration, Federal
Affairs, & Special Districts Subcommittee).
9
38 CFR 51.210 (2023).
10
Supra note 8. STORAGE NAME: h0725b.HCA PAGE: 3
DATE: 1/23/2024
are spouses of veterans or parents whose children died while in military service.
11
These residents are
required to pay for the full cost of their care.
Eligibility for Admission
To be considered for admission to a veterans’ home in Florida, a veteran must have been discharged
from the military with either an honorable or an upgrade to an honorable discharge.
12
The state provides care for veterans’ in both domiciliary homes
13
and nursing facilities.
14
Both veterans
of wartime and peacetime service are eligible for admission.
15
Veterans are admitted to both types of
facilities based on a priority ranking.
16
Domiciliary Homes
Domiciliary care which is defined as shelter, sustenance, and incidental medical care on an ambulatory
self-care basis for eligible veterans who are disabled by age or disease, but not in need of
hospitalization or nursing home care services.
17
A domiciliary home is a type of assisted living facility.
18
To be eligible for admission, a veteran must:
Have wartime service or peacetime service;
Be a resident of the state at the time of application;
Not be mentally ill, habitually inebriated, or addicted to drugs;
Not owe money to FDVA for services rendered during a previous stay at a FDVA facility;
Have applied for all financial assistance reasonably available through governmental sources;
and
Have been approved as eligible for care and treatment by the VA.
19
Residents are admitted in order of priority as follows:
A veteran with wartime service who has a service-connected disability but is not in need of
hospitalization or nursing home care.
A veteran with wartime service who has a non-service-connected disability but is not in need of
hospitalization or nursing home care.
A veteran with wartime service and no disability.
A veteran with peacetime service.
20
An applicant must file with the facility administrator all information necessary for admission, including a
certificate of eligibility, a certified copy of the veteran’s discharge, and any other information the
administrator determines is necessary.
21
Nursing Homes
In addition to assisted-living facilities, Florida law provides for veterans’ nursing homes.
22
Each nursing
home is overseen by an administrator who is selected by the Executive Director (director) of FDVA.
23
11
38 CFR 51.210(d) (2023).
12
Ss. 296.02(9) and 1.01(14), F.S.
13
A Veterans’ Domiciliary Home of Florida is a home for veterans established by the state. Ss. 296.02 (10), and 296.03, F.S.
14
Ch. 296, F.S.
15
Ss. 296.08 and 296.36, F.S. “Wartime service” is defined as is service in any of the follow ing campaigns or expeditions: Spanish-American War (1898-
1902); Mexican Border Period (1916-1917); World War I (1917-1918, w ith qualifying extensions until 1921); World War II (1941-1946); Korean War
(1950-1955); Vietnam War, (1961-1975); Persian Gulf War (1990-1992); Operation Enduring Freedom (2001-date prescribed by presidential
proclamation or by law ); Operation Iraqi Freedom (2003-date prescribed by presidential proclamation or by law ). Peacetime service is defined as any
Army, Navy, Marines, Coast Guard, Air Force, or Space Force service that not in any of the campaigns or expeditions. S. 1.01(14), F.S.
16
Ss. 296.08 and 296.36, F.S.
17
S. 296.02(4), F.S.
18
See Florida Dept. of Veterans Affairs, State Veterans’ Homes, https://floridavets.org/locations/state-veterans-nursing-homes/ (last visited Jan. 21,
2024) (describing care provided by the Robert H. Jenkins Jr. Veterans’ Domiciliary Home).
19
S. 296.06(2), F.S.,
20
S. 296.08, F.S.
21
S. 296.08(2), F.S.
22
Ch. 296, Part II, F.S.
23
S. 296.34, F.S. STORAGE NAME: h0725b.HCA PAGE: 4
DATE: 1/23/2024
To be eligible for admission, a veteran must:
Be in need of nursing care;
Be a resident of the state at the time of application;
Not owe money to the FDVA for services rendered during a previous stay at a FDVA facility;
Have applied for all financial assistance reasonably available through governmental sources;
and
Have been approved as eligible for care and treatment by the VA.
24
Eligible veterans are given priority for admission in the following order:
Residents of the state.
Those who have a service-connected disability as determined by the VA, or who were
discharged or released from service for a disability incurred or aggravated in the line of duty and
the disability is the condition for the nursing home need.
Those who have a non-service-connected disability and are unable to defray the cost of nursing
home care.
25
Veterans Facilities in Florida
The FDVA currently operates nine state veterans’ homes in the state: eight skilled nursing facilities and
one assisted living facility. Nursing homes are located in Daytona Beach, Orlando, Land O’Lakes,
Pembroke Pines, Panama City, Port Charlotte, Port St. Lucie and St. Augustine, Florida.
26
The
assisted living facility is located in Lake City.
Effect of Proposed Changes
The bill expands the eligibility for residency at state veterans’ homes to include the spouse or surviving
spouse of a qualifying veteran. The bill updates the priority order of admission to reflect this change,
placing the spouse or surviving spouse last in the admission priority list, ensuring that higher priority of
admittance will be given to veterans over non-veterans.
The bill revises language relating to residents of state veterans’ homes to reflect that such homes may
have non-veteran residents.
B. SECTION DIRECTORY:
Section 1: Amends s. 296.02, F.S., revising definitions.
Section 2: Amends s. 296.03, F.S., revising eligibility for residency in the Veterans’ Domiciliary
Home of Florida.
Section 3: Amends s. 296.08, F.S., adding spouses and surviving spouses of veterans to the
priority of admittance schedule.
Section 4: Amends s. 296.32, F.S, conforming provisions to changes made by the bill.
Section 5: Amends s. 296.33, F.S., revising the definition of the term “resident”.
Section 6: Amends s. 296.36, F.S., revising the admission eligibility for veterans’ nursing homes to
include spouses and surviving spouses of veterans.
Section 7: Provides an effective date of July 1, 2024.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
24
S. 296.36(1), F.S.
25
S. 296.36(3), F.S.
26
Florida Dept. of Veterans Affairs, State Veterans’ Homes, https://floridavets.org/locations/state-veterans-nursing-homes/ (last visited Jan. 21, 2024). STORAGE NAME: h0725b.HCA PAGE: 5
DATE: 1/23/2024
2. Expenditures:
The bill has no fiscal impact on state revenues or state expenditures, as a qualifying non-veteran
resident will be charged the private resident rate, which is equivalent to the full cost of care and
housing.
27
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
None.
D. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not applicable. This bill does not appear to require counties or municipalities to spend funds or take
action requiring the expenditures of funds; reduce the authority that counties or municipalities have
to raise revenues in the aggregate; or reduce the percentage of state tax shared with counties or
municipalities.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
The bill neither authorizes nor requires administrative rulemaking by executive branch agencies.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES
None.
27
Supra note 8