November 8, 2023 Veteran Directed Care Program

Veteran Directed Care The VDC program serves Veterans of any age who are at risk of nursing home placement
Veterans hire workers, including family, friends, and neighbors, to provide personal care services in accordance with a Veteran-developed and VA-approved spending plan
Veterans receive assistance to manage their employer responsibilities from person-centered counselors and financial management services (FMS) providers
Veterans Affairs Medical Centers (VAMC) purchase VDC services from VA-approved Aging and Disability Network Agencies (ADNA) using Veterans Care Agreements<br>

VDC Program Components The Veteran is evaluated for their support needs with activities of daily living
The level of need determines the amount of money the Veteran can spend for support
The VDC provider works with the Veteran to develop a spending plan to address needs and goals
The VDC provider purchases supports on behalf of the Veteran and bills VHA for reimbursement
The VHA also purchases administrative services from VDC providers
Spending and Veteran well-being are monitored on a monthly basis<br>

VDC Providers VAMCs purchase VDC from VA-approved ADNAs
Area Agencies on Aging
Aging and Disability Resource Center/No Wrong Door Systems
Centers for Independent Living
State Units on Aging
Before offering VDC, ADNAs complete a VA Readiness Review, conducted by the VA Central Office
Ensures ADNAs have demonstrated the skills and competencies to deliver VDC to Veterans<br>

Role of ADNA Counselors Person-centered counselors (PCC) perform assessments, assist with enrollment, facilitate completion of employee new hire packets, and help develop spending plans
PCCs maintain at least monthly contact with Veterans and conduct quarterly in-home visits
PCCs alert the VA to any changes needed to promote overall Veteran health, including a need for supplies, ramps, or a budget increase
PCCs inform Veterans of other services that may be available to them, such as caregiver respite and homemaker and home health aide services<br>

VDC Characteristics Veterans in VDC generally are younger and live in more rural areas compared to other VA personal care service programs
50% are younger than 75
Over 50% of Veterans live in rural areas
The average Veteran in VDC spends $26K per year on personal care services and other goods and services
66% of Veterans designate an authorized representative (which can be a primary/secondary caregiver) to manage VDC responsibilities<br>

“Just knowing that the VA was going to take care of Dad relieved a major amount of stress for my mom.” – Daughter of Veteran enrolled in VDC
https://www.youtube.com/watch?v=GNtQEGUBIEY “100% of Veterans and caregivers report being able to choose who provides care and control how they want services done.” – VDC Experience Analysis Higher levels of satisfaction with services
Flexibility to customize services to meet individualized needs
Reduction of inpatient utilization
30% decrease in inpatient services one year after enrollment (37% decrease in nursing home care)
Greater ability to provide respite services to caregivers
Shown to reduce caregiver stress/burnout VDC Benefits<br>

VDC vs. Agency Target populations to serve in VDC include:
Veterans that require more than 15-20 hours of personal care per week
Veterans with frequent nursing home and hospital utilization
Veterans in rural areas
Veterans that would benefit from self-directing and the increased level of choice and control<br>

VDC Expansion The VDC program has been optional for VAMCs
There is planned expansion to every VAMC in the country by October 2024
President Biden, members of Congress, and top VHA leadership all support expansion<br>

Questions? If you would like to learn more about VDC:
VA VDC Website:
https://www.va.gov/GERIATRICS/Guide/LongTermCare/Veteran-Directed_Care.asp
ACL No Wrong Door (NWD) Website:
https://nwd.acl.gov/vdc.html
VDC mailbox:
veterandirected@acl.hhs.gov<br>