This article is part of the HHCN+ Membership
Working with a government agency can involve a lot of red tape, but home care providers interested in caring for elderly veterans have a variety of opportunities to partner with the Department of Veterans Affairs (VA) and serve those who have served.
According to the U.S. Census Bureau, as of 2023, there are an estimated 17.9 million veterans in the United States, about half of whom are over age 65. Aging veterans need benefits and services to help them manage their changing health conditions and the associated economic challenges. VA provides assistance with personal care benefits through its Assistance and Attendance and Community Care Network (CCN) programs.
For our most vulnerable veterans, VA Medical Centers work with community partners to coordinate home and community-based services (HCBS) to reduce stays in nursing homes and medical centers. A single program or a combination of HCBS can help veterans and their caregivers remain in their homes, optimize chronic health conditions and rehabilitation opportunities, and maintain a home and family atmosphere.
“We know that veterans have better outcomes when they remain in their homes, which is critical to optimizing their health and overall well-being,” VA spokesman Terrence Hayes told Home Healthcare News.
When setting up home care services, VA medical centers are required to utilize contracted network providers when available, and providers are encouraged to work with the appropriate local third-party administrators, Optum and TriWest, to inquire about joining the network and receiving veteran referrals.
The third-party administrator completes a review to determine if there is a need for that provider based on the availability of providers in the existing network. If a need is determined to exist, the provider begins the eligibility process to join the CCN, which ensures that the organization meets VA eligibility requirements before providing care to Veterans.
For Betsy Morthland, owner of a Visiting Angels franchise in Bettendorf, Iowa, being involved with the VA has paid off both personally and professionally.
Based in Bryn Mawr, Pennsylvania, Visiting Angels provides in-home care services for seniors nationwide, including assistance with daily tasks, companionship and skilled care.
“Providing this specialized care and helping them through the process is a way we give back to our veterans,” Morthland told Home Health Care News. “Another benefit is that once a veteran is enrolled in our system and we provide care, we guarantee them hours for that week, which helps with staffing and revenue projections.”
Assistance and Attendance
Aid and Assistance is a tax-free benefit provided to veterans who served 90 days of active duty during a period of war, have assets less than $160,000 (excluding housing), require assistance with two or more activities of daily living, and meet the required income-to-care-expense ratio.
But submitting the necessary paperwork to receive this benefit can be difficult for veterans and their families, which is where providers can partner with companies like Lake St. Louis, Missouri-based Veterans Care Coordination (VCC) to help navigate these obstacles.
VCC’s model is focused on helping veterans retire in their own homes: Owner Kyle Laramie founded the company after his grandfather, a World War II veteran, missed out on benefits that would have allowed him to live at home instead of in a long-term care facility.
“We find families who need care and put them through a screening process to determine if we can help them access this program that can help them pay for care,” Laramie told HHCN. “The Assistance and Attendance program can be confusing because it wasn’t designed for low-income families who need care. It’s set up for people who currently pay for care every month and then get reimbursed. That’s not how the world works.”
Laramie said families often find out their loved ones need care and then immediately have to figure out how to pay for it, and are forced to choose between paying out of pocket or not receiving the care.
“We’re teaching referral sources, social workers, veteran planners and rehabilitation centers how to instruct their providers to ask if their client is a veteran or a spouse of a veteran and let them know there may be financial assistance available, and then they’ll come to us,” Laramie said.
Laramie said even after a client is selected for treatment, it’s often unclear who will pay for that care up front, so in those cases, VCC has created the Advanced Treatment Program to cover the costs of treatment while the VA processes the claim.
“These families can’t wait for care,” Laramie says. “The way the program works is that VCC pays the cost of care monthly until the VA reimburses them, and then our clients reimburse us for the services we provide. We maintain a monthly cost-to-income ratio and work with our clients and the home care agency to ensure appropriate care.”
Laramie said VCC isn’t necessarily in the business of providing loans, but customers sign interest-free loan documents.
“Our purpose is many-fold,” Laramie says, “We teach home care agencies how to market VA benefits in their communities. We help families navigate the benefits maze. If a family can’t afford the care, we’ll cover the costs while the VA processes the claim. Because we’re used to working with the VA, we can often process claims quickly.”
VA uses CCNs to provide in-home care services to veterans. CCN benefits specifically help with the cost of in-home care. Eligible veterans are assigned a service care coordinator who determines how many hours of care the veteran needs per week and helps families connect with caregivers in their area. CCN benefits are paid directly to partner organizations.
By working with a network of qualified providers, the VA system improves access to medical, mental health and specialty care, ensuring veterans receive timely, personalized care in their local area.
“CCN allows for an expanded network, shorter wait times for services and higher quality care,” Hayes said. “Being part of the network allows providers to expand their customer base and serve our nation’s veterans.”
The program prioritizes a patient-centered approach, focusing on each person’s unique needs and preferences and fostering collaborative relationships between veterans, their VA care teams and local providers.
The network maintains the highest standards of care, ensuring all participating providers meet rigorous quality and safety standards, and VA is continually refining and optimizing the program to improve health outcomes and streamline the process of accessing care.
“Home care providers sometimes find the VA and contracted network provider processes complicated and time-consuming,” Hayes says. “Optum and TriWest may determine that they have sufficient networks in certain areas and decline to add new providers. To ensure a high-quality network, providers sometimes experience delays in the credentialing process. Providers also have challenges following the protocols required to ensure timely services and reimbursement.”
Morthland said getting into the VA’s CCN can be difficult, but it’s worth the effort.
“When the VA calls for care, it stops everyone’s work, and because they’re such an important referral source, we want them to know we’re there to make their job easier with a quick response,” Mosalund says. “We’re willing to say yes to anything they ask, because if we say yes enough times, the VA schedulers will start calling you first because you make their job easier.”
CareTech chief operating officer Kerryn Zueger agreed, saying it’s all about building relationships.
Caretech, based in Omaha, Nebraska, offers non-medical home care services such as personal care, companionship and household assistance.
“VA case managers, like everyone else, are busy, so if you can help ease some of their pain points, it’s a good thing for you,” Zuger says. “Build a partnership and try to fill in the gaps and ease their pain points, whatever they may be.”
Zueger encourages small franchises and independents to partner with companies like VCC to advance their participation in CCN, which gives clients access to funds they didn’t know they had and makes care management easier.
“For independents and small franchises, partnering with a company like VCC takes the hassle out of it and means you don’t have to worry about applications, follow-up and administration. You can just focus on providing quality care to your clients,” she said.
Zuger also recommended reaching out to your contacts to find people who have connections with the VA and might be able to give you a referral.
“Don’t take pride in leveraging existing resources,” she advised. “Partner with the VA, volunteer, sponsor, or serve on the board. Relationships matter. No matter how many home care companies pop up, there will always be more veterans who need help and support.”
