January 7, 2019
Veteran Directed Home and Community Based Services (VD-HCBS) in Colorado
If you’ve read Stephen Ambrose’s book Band of Brothers or seen Steven Spielberg’s and Tom Hank’s HBO miniseries production of that story, you’re familiar with the person and character of Cpt. Herbert Sobel. Sobel served nine years in the U.S. military, was a member of the 101st Airborne Division and the famed volunteer-based Easy Company, 506th Parachute Infantry. Regardless of what you think about his infantry training and leadership skills, the last decades of his life were tragic.
Herbert Sobel attempted suicide by shooting himself through the temple in 1970. He survived the attempt, but the bullet passed behind his eyes, severing the optic nerves. He experienced complete blindness for the remaining 17 years of his life. Herbert Sobel spent his last 17 years in a VA nursing home, where he died of malnutrition in 1987. No funeral was held.
If you know the Band of Brothers account, Sobel was not remembered well by the soldiers under him. However, no veteran should suffer a demise such as Sobel’s. And while VA nursing homes have come a long way since the 1980’s, there are now options for veterans to receive homemaker, personal care, meal delivery, transportation, and health related goods and services in their own homes.
Home and Community Based Care As an Alternative to Institutionalization for Veterans
A lot has changed for the better on the Long Term Services and Supports front since the 1980’s. Veterans at risk of nursing home placement are now able to access these services and supports in the comfort of their own homes for as long as possible. Traditional home health agency services are a good option. Those services are all decided on and managed by the agency.
However, many veterans would prefer to have control over their own home health care, and with the new participant-centered model of home health care service delivery, you can. I’m talking about the arrival of Veteran Directed Home and Community Based Services (VD-HCBS) in Colorado.
Specifically, if you’re in the Pikes Peak region which includes El Paso, Park, Elbert, Kiowa, Teller, Kit Carson, Cheyenne, or Lincoln counties, you may be eligible for The Independence Center’s Veteran In Charge program. Veteran in Charge program is one of Colorado’s top VD-HCBS programs because The Independence Center is all about advocating for your right to have choice, control, and independence if you have a disability. Click here to read the success story of how The Independence Center’s Veteran in Charge program came into existence.
What ‘Veteran Directed’ Means
Veterans enrolled in VD-HCBS have more control than participants of traditional home health service delivery over which mix of goods and services they need to keep them living independently in their own homes. No matter your age, if you meet qualification criteria for the program, you are given a flexible monthly personal budget with which to purchase goods and services, including hiring of caregivers. You are in charge of who you hire, as well as training and scheduling of your home health caregivers. You are allowed to hire family members (including spouses) or friends to provide these home care services.
How the Program works
To get started, contact your Colorado VA social worker, who will determine your eligibility for the VD-HCBS program. If you don’t have a social worker, you can contact the main Rocky Mountain VA social work line at 720-723-3018.
Once your eligibility has been determined, the VA program coordinator will orient you to the program. The VA will then give you a referral to either the local Area Agency on Aging, Aging and Disability Resource Center, or Center for Independent Living. In the case of the Veteran in Charge VD-HCBS program in the Pikes Peak region, The Independence Center is the Center for Independent Living that you will be referred to. There, you’ll receive an options counselor who will work with you to develop a personalized service plan with the goal of keeping you independent in your home for as long as possible. The counselor at The Independence Center is called a Veteran Coach. Your counselor will provide an in-home assessment and will help you with care and service planning.
Through a collaborative effort between you, your counselor and the VA medical center, a monthly budget and plan for home health care expenses and services will be authorized by the VA. With VD-HCBS, you are not confined to typical home health care service packages. You can completely customize your services to your needs.
If you need help finding a caregiver, your counselor will assist with that. The counselor will also arrange for a Financial Management Services (FMS) company to help with the financial side of things. Your counselor/coach will be there for ongoing support for both you and your caregiver(s), so you never have to go it alone.
With VD-HCBS, you become the employer for your home health caregiver(s). The FMS will prepare paychecks for your home health caregiver(s), tax returns, and other payroll documents. Payments to caregivers are authorized by the veteran and the FMS. Your counselor and the VA coordinator will help identify other VA benefits that can help you live independently. The VD-HCBS program does not allow duplication of other VA benefits.
Types of Goods and Services You Can Receive With VD-HCBS
With the goal of keeping you out of a nursing home for as long as possible, VD-HCBS gives you a VA authorized budget with which to purchase the following types of services:
- In-home personal care such as assistance with bathing and toileting
- Homemaker services such as laundry and housekeeping
Chore and maintenance service such as yard and snow removal
- Health maintenance costs such as dietary counseling or massage therapy
- Caregiver education, training, and support
- Home modifications such as bathroom grab bars and wheelchair ramps
- Adult day care
- Nutritional services prescribed by a doctor or dietician
- Respite care to relieve caregivers
- Assistive or monitoring devices
- Environmental support
- Grocery and/or meal delivery
- Transportation for socialization or medical appointments
- Emergency response system
How To Qualify for Veteran Directed Home and Community Based Services (VD-HCBS)
To qualify for the VD-HCBS program you must:
- Be enrolled in Veterans Health Administration. If you are not already enrolled in Veterans Administration Health Care (VAHC), click here to find out if you are eligible for VAHC and how to apply.
- Meet eligibility criteria that show you are at risk of nursing home placement. Typically this means that you require assistance with at least three activities of daily living, although there can be other criteria like cognitive impairment or needing hospice.
- Be interested in and able to manage your own care or able to appoint someone who can direct your care on your behalf
- You must live at home or with a loved one or in an independent living facility that does not offer home care support
Why Choose The Independence Center’s Veteran in Charge VD-HCBS Program
As a Center for Independent Living, The Independence Center (The IC) is designed to be an advocate for people with disabilities and their caregivers and families. This means we are always advocating for independence, choice, and control in your own life and health care.
“The IC’s experience in disability and independent living services, self-advocacy and consumer direction positions them to operate a successful VD‑HCBS program….
Ultimately, building relationships with veterans within the program is at the heart of the success. These relationships are nurtured at every step of the process….
The IC invested time to ensure the best structure and foundation to administer their Veteran In Charge program. Building relationships with the Denver VAMC was critical for the launch and the ongoing success and growth of the program. The IC leadership reached out to other VD-HCBS sites to ask for recommendations and lessons learned before launching the program and the insights shared from experienced peers proved invaluable. Additionally, The IC dedicated substantial time to researching various Financial Management Service (FMS) agencies, an integral partner in the VD-HCBS program (FMS agencies are third-party entities that assist veterans with managing their self-direction budgets and can help with various employment responsibilities).”
To learn more about The Independence Center’s Veteran in Charge Program, call us at 719-471-8181.