Senate committee hears bill to allow VA-run medical foster homes for veterans

Senate Health and Long Term Care Committee members heard testimony Jan. 28 on Senate Bill 52100, sponsored by Sen. Keith Wagner, to allow veterans medical foster homes (MFHs) to operate in Washington under an exemption from the state's adult family home licensure when the homes are overseen and annually reviewed by the U.S. Department of Veterans Affairs and care for three or fewer veterans.

The bill would create a state licensure exemption for private residences that participate in the VA's Medical Foster Home program, which places small groups of veterans with trained caregivers who provide 24/7 supervision and assistance with daily living activities. Committee staff Julie Tran told senators the VA MFH program operates in more than 40 states and Puerto Rico and that there are roughly 600 such homes nationwide.

The bill's sponsor, Sen. Keith Wagner, said the measure is narrowly tailored. "This is for veterans only," Wagner said, adding the program is "another tool in the box to make sure that our veterans get appropriate care in their later years." Wagner also told the committee the program is managed by the federal government and limited to veterans, not a blended resident population.

Bea Rector, assistant secretary for the Aging and Long Term Support Administration at the Department of Social and Health Services (DSHS), testified with caution. Rector told the committee that the federal Code of Federal Regulations (CFR) standards that govern VA medical foster homes are lower than Washington's training and criminal-background standards for long-term care workers, and that the CFR list of disqualifying crimes is more limited than Washington's existing list. She warned this mismatch could create gaps in state oversight and in jurisdiction for reports of abuse or neglect.

Rector also said that unless the MFH model were added to Washington's Medicaid state plan as a qualified provider type, Medicaid could not be used to pay for residents in the homes. "In order for the foster homes to be added to the state plan, they would have to comply with other home-and-community-based settings rules," she said, and the CFR, as written, would not meet those rules without additional state requirements.

Supporters included Charles Wharton, legislative director for AMVETS Washington and designee of the veteran legislative coalition, who urged a "due pass" from the committee. Wanda Tapp Krautzer, a retired master sergeant and combat veteran, described MFH oversight by VA teams and training for caregivers and said the program can address social isolation and reduce demand for institutional long-term care.

DSHS offered to provide technical assistance and drafting support to align the bill with state regulatory standards, and committee staff recorded that offer on the record. The committee held public testimony and then closed the hearing; no committee action or vote was taken.

What happens next: The committee accepted testimony and closed the public hearing on the bill. DSHS offered technical assistance on amendments to align federal MFH standards with Washington licensure and Medicaid rules; the bill remains at the hearing stage pending any amendment or referral.