Long-Term Care Benefits for Veterans and Surviving Spouses
Long-term care costs can add up quickly. For veterans and the surviving spouses of veterans who need in-home care or are in a...
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Takeaways A new federal policy raises urgent questions about care, autonomy, and what it means to serve those who have served. Earlier this month, the Trump administration announced a significant action targeting homeless veterans in the form of a formal agreement between the Department of Veterans Affairs (VA) and the Department of Justice (DOJ). The policy gives VA attorneys new legal power to pursue guardianship over veterans who are homeless or at risk of becoming homeless.
The policy has drawn praise from some quarters as a compassionate lifeline for the most vulnerable veterans. Others are calling it a threat to civil liberties that could strip men and women who served their country of their fundamental right to make decisions for themselves.
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What exactly is happening and what does it mean?
The new initiative gives the DOJ authority to appoint VA lawyers as special assistant U.S. attorneys, allowing them to initiate and participate in state court guardianship cases or conservatorship proceedings. In plain terms, government attorneys can now go to court to ask a judge to appoint a legal guardian – often when a qualified family member is unavailable – over a veteran who is deemed unable to make their own health care decisions.
The stated goal is to help veterans who are stuck in a kind of bureaucratic purgatory. Without a legal decision-maker, some veterans become trapped in limbo. That is, they may be medically stable, but unable to leave a hospital because no one can legally authorize a discharge plan or placement in long-term care. The administration argues that guardianship can break that cycle.
VA officials say the move is intended to help veterans transition from prolonged hospital stays to appropriate care settings. A VA news release states that “the appointment of a legal guardian or conservator can be a lifeline for veterans in this situation.”
Nearly 33,000 veterans are experiencing homelessness in the U.S. Almost 14,000 of them live on the streets, according to a 2024 report from the Department of Housing and Urban Development (HUD).
The VA said in a statement that the agency serves hundreds of veterans who cannot make their own health care decisions and don’t have family or legal representation, including those experiencing homelessness. VA press secretary Peter Kasperowicz has emphasized that the policy is not aimed at homeless veterans broadly, but rather at roughly 700 veterans currently in VA facilities who lack the capacity to make decisions for themselves and who don’t have anyone to make legal decisions for them.
Half of the nation’s homeless veterans have a mental illness, and 70 percent struggle with substance use disorders. These conditions can sometimes impair a person’s ability to advocate for their own care.
While supporters frame this policy as a compassionate intervention, civil rights and advocacy groups are raising serious concerns.
Unlike a civil commitment, which has an expiration date, guardianships are designed to be permanent. These arrangements can be revisited periodically, but the burden falls on the ward (in this case, the veteran) to prove they should get their autonomy back.
Jennifer Mathis, the deputy director at the Bazelon Center for Mental Health Law, questioned whether guardianship is the right solution. She said that if veterans are in VA hospitals and not discharged, it’s likely because there aren’t enough services or housing for them, not because they don’t have guardians to make decisions for them.
The National Coalition for Homeless Veterans warned that “guardianship and other forms of involuntary intervention are serious legal actions that remove significant personal autonomy. They must be used sparingly, with strong safeguards, and always with the best interests and rights of the veteran at the center of the process.”
Veterans’ advocates also say that the phrase “at risk of homelessness” is vague and undefined in the agreement. They worry the definition could expand, such as applying to a veteran behind on rent or others in precarious but not incapacitated situations.
Not everyone opposes the initiative. Michael Figlioli, director of the National Veterans Service for the Veterans of Foreign Wars, applauded the move, telling Newsweek that “some of our nation’s most vulnerable veterans must be approached through a public health and social services framework,” and that guardianships can provide “structured support” for vulnerable veterans.
Stephen Eide, a homelessness expert at the Manhattan Institute, argued in the same Newsweek piece that for some veterans with severe untreated conditions like schizophrenia, “the choices are either no treatment or some kind of involuntary treatment.” He did, however, acknowledge that executing such a policy at the federal level “will require a lot of coordination between police, social workers, state, and local governments.”
The policy’s real-world effects will depend heavily on how the guardianship powers are used, as well as oversight and accountability of the guardians. Veterans who are deemed in need of a guardian may benefit from being able to choose their guardian.
For now, the agreement is in effect. Veterans’ rights organizations, legal advocates, and members of Congress will likely be watching closely. Veterans themselves will need clear information about this policy, what it means for them, and what resources are available to protect their well-being and autonomy.
If you are a veteran who is homeless or at imminent risk of homelessness, help is available 24 hours a day, seven days a week: Call the National Call Center for Homeless Veterans at (877) 4AID-VET (877-424-3838).
Here are other key organizations and programs:
You can also call or visit your local VA Medical Center or Community Resource and Referral Center, where VA staff are ready to help. Use the VA locator tool at va.gov/directory to find the nearest location.
Every veteran deserves a home, health care, and the dignity of making their own choices. If you or someone you know is at risk, please know that help is available.
For additional reading on topics relevant to veterans, check out the following articles:
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