According to the U.S. Census Bureau, there are more than 9.2 million veterans ages 65 or older in the United States. These Veterans, like you, served in conflicts around the world including World War II, the Korean War, the Vietnam War, and even in the Persian Gulf War.
To help you meet the challenges of aging, the VA offers a wide variety of benefits and services. While some are income-based, many programs aren’t. As the son of a veteran, I’m happy to provide this article (and others in the series) to VA Benefits for Home and Long-Term Care in recognition and honor of your service to our country.
VETERAN-DIRECTED HOME AND COMMUNITY-BASED SERVICES (VD-HCBS)
Veteran-Directed Care is another program available from the VA if you need skilled services, case management, and assistance with activities of daily living (e.g., bathing and getting dressed) or instrumental activities of daily living (e.g., fixing meals and taking medicines); are isolated or if your caregiver is experiencing a burden.
Depending upon your location, it may also be referred to as Cash and Counseling for Veterans, Veterans Community Living Program, CLP-VDHCBS, Veterans Independence Plus Program or Veteran Directed Home Services (VDHS).
This program provides you with a budget, helps you continue to live in your home, that of a loved one or in an independent living community (which does not offer care support) and allows you to choose your own care providers instead of receiving care services from the VA health care system.
In some cases, your own adult children, siblings, grandchildren, spouse, neighbors or friends can be paid for the care they provide. Caregivers are paid an hourly rate set nationally by the VA and adjusted for local geographic factors. The hourly rate is referred to as the “reimbursement rate” and caregivers can expect compensation in the range of 50-75% of the average hourly rate for home care for your region. In general terms, this may be between $8 – $22 / hour.
You would authorize the agency to pay service providers on your behalf and not personally receive the cash payments. The maximum amount allowed varies from state to state. Typically, the cost of this care cannot exceed the cost for the same care provided by the VA in a skilled nursing facility. In real dollar terms, budget maximums rarely exceed $4,500/month. However, as this is more than the MAPR for Aid and Attendance and Housebound, it is a viable alternative.
As part of this program, you and your caregiver have more choice and control over their long term care services. The following products and services are typically paid for under this program:
- Adult day care
- Caregiver education, support, and training
- Chore and maintenance services such as yard debris and snow removal
- Electronic monitoring services and products such as bed and room monitors, emergency response systems and voice-activated phones
- Health maintenance costs such as health club memberships, health counseling, massage therapy, and weight reduction programs.
- Home modifications such as bathroom grab bars, railings, vehicle modifications, walk-in tubs, and wheelchair ramps.
- Home safety services
- Homemaker services such as laundry, house cleaning
- Nutritional services such as home-delivered meals and supplements provided they have been prescribed by a physician or dietitian
- Other services or products needed in the home to allow you to live independently
- Personal care services which include assistance with bathing, toileting, personal grooming and dressing
- Respite care in-home, out-of-home and overnight
- Shopping, errand and escort assistance
- Socialization support services such as having a caregiver accompany you to education or exercise classes and on social engagements
- Transportation to medical support or socialization activities
Since Veteran-Directed Care is part of the VHA Standard Medical Benefits Package, all veterans enrolled in the VA healthcare system and assigned to a Priority Group are eligible IF you meet the clinical need for the service and it is available in your area.
Developed by the U.S. Department of Veterans Affairs Veterans Health Administration (VHA) and the U.S. Department of Health and Human Services Administration for Community Living in 2008 and is currently offered at 77 VA Medical Centers in 42 states.
To find out if a VA Medical Center near you is offering the program, talk your VA social worker or click here. If it is not available in your area, you can go outside of their immediate geographic area or to neighboring states to participate in veteran-directed care programs.
Note: You cannot participate in both VD-HCBS and in a Medicaid’s Cash and Counseling program (also referred to as Consumer Directed Medicaid Waivers) at the same time. You can, however, participate in VD-HCBS and still be eligible for the Aid & Attendance benefit.
If you are a veteran or are helping someone who is, there are a wide variety of benefits and service available to you. While some are income-based, many programs aren’t. By becoming familiar with all of the benefits in this article and the other four in the series, you can take full advantage of everything you’re entitled to—making your journey along the gray mile easier and more affordable.