Dole Act Update: Congressional Hearing Examines Year-One Progress

On March 4, the House Committee on Veterans' Affairs Subcommittee on Oversight and Investigations held a hearing reviewing the VA's progress implementing the Senator Elizabeth Dole Act a year after it was enacted. HCAOA's federal lobbying firm, Buchanan, was present for the hearing and issued a memo on the proceedings. Here's a brief summary of what happened; read the full memo to learn more.

How much has been implemented?
The VA has fully implemented 25 of 72 sections. Officials cited the law's complexity and gaps in dedicated funding as contributing factors.

What provisions were examined?
Several are directly relevant to home care and caregiver support:

• Caregiver mental health grants (Sec. 122): $10 million was appropriated in each of the 2025 and 206 fiscal years; no grants have been issued. The Government Accountability Office (GAO) found caregivers continue to face challenges accessing mental health services.
• Physician pay waivers (Sec. 142): Zero of 300 authorized waivers have been issued. The VA said criteria could be in place within one to two months.
• Assisted living pilot (Sec. 127): The VA is still developing purchasing authority and a fee schedule.
• Rural ambulance coverage (Sec. 143): Not fully implemented; the provision sunsets in September.
• Staffing models (Sec. 146): Not yet developed. GAO called them "incredibly important" for aligning resources with program needs — a recommendation that remains open.

What does this mean for HCAOA members?
Unissued caregiver grants, incomplete staffing models, and stalled rural provisions all affect the environment in which home care providers operate. GAO's finding that community care administrative processes remain labor-intensive is also relevant for providers within VA referral systems.

What's next?
HCAOA will monitor developments. The rural ambulance provision's September sunset is the most immediate deadline.