‘Relationships Matter’: How Home Care Providers Are Becoming Indispensable to the VA

Working with any government agency can be a lot of red tape to navigate. Still, home care providers interested in caring for aging veterans have a variety of options to partner with the Veterans Administration (VA) and do something for those who have served.

According to the U.S. Census Bureau, there were approximately 17.9 million veterans in the United States in 2023, and nearly half of them were age 65 or older. This aging veteran population needs benefits and services to cope with changing health conditions and corresponding financial challenges. The VA offers assistance with personal care benefits through the Aid and Attendance and Community Care Network (CCN) programs.

VA Medical Centers coordinate Home and Community Based Services (HCBS) with community partners to provide the most vulnerable veterans with reduced length of stay in nursing homes and medical facilities. A single program or a combination of HCBS can help veterans and their caregivers remain in their homes, optimize their potential for chronic health or rehabilitation, and maintain a homely and familiar atmosphere.

“We’ve learned that when veterans stay in their homes, their outcomes are better, and that’s critical to maximizing veterans’ health and overall well-being,” Terrence Hayes, VA press secretary, told Home Health Care News.

When setting up home care services, VA medical centers are required to use contract network providers, if available. Providers are encouraged to work with third-party administrators, Optum and TriWest, in the appropriate region to learn about joining the network and receiving veteran referrals.

Third-party administrators conduct a review to determine whether there is a need for such a provider based on the availability of those in the existing network. If a need is determined, the provider begins the accreditation process to join the CCN. This ensures that the organization meets VA eligibility requirements before providing care to veterans.

For Betsey Morthland, a Visiting Angels franchise owner in Bettendorf, Iowa, getting involved with the VA has brought both personal and professional benefits.

Based in Bryn Mawr, Pennsylvania, Visiting Angels is a nationwide provider of home care services for seniors, including assistance with daily living activities, companionship and specialized care.

“Offering that specialized care and helping them navigate that process is a way to give back to our veterans,” Morthland told Home Health Care News. “Another benefit is that once a veteran is in our system and we provide care, we know they have guaranteed hours per week, which helps us with staffing and predicting our revenue stream.”

Help and presence

The Carer’s Allowance and Humanitarian Assistance is a tax-free benefit available to veterans who have served 90 days of active duty during a war, have assets worth less than $160,000 (excluding their home), require assistance with at least two activities of daily living, and meet a required income-to-medical care cost ratio.

However, filing the necessary paperwork to receive this benefit can be difficult for veterans and their families. In that case, providers can work with companies like Veterans Care Coordination (VCC), based in Lake St. Louis, Missouri, to help overcome these obstacles.

The VCC model focuses on helping veterans age in place. Owner Kyle Laramie started the company in response to his grandfather, a World War II veteran who lost benefits that would have helped him stay at home rather than move to a long-term care facility.

“We find families who need care and we take them through a screening process to determine if we think we can help them get access to this program that could cover the cost of their care,” Laramie told HHCN. “The Assistance and Care program can be misleading because it’s not designed for low-income families who need care. It’s designed for those who currently pay for care month by month and then get reimbursed. That’s not how the world works.”

Laramie said families often discover their loved one needs care and must quickly find a way to pay for it. Then they are faced with a choice: either pay for it out of pocket or not get it.

“We teach providers how to instruct referral sources, social workers, hospital discharge planners or rehabilitation facilities, to ask if the client is a veteran or spouse and let them know there may be funding for them, and then they come to us,” Laramie said.

Laramie said that once a client is accepted for care, they often still aren’t sure who will fund that care up front. In that case, VCC has set up the Advanced Care Program to fund the cost of care while the VA processes the application.

“These families can’t wait for care,” Laramie said. “The program is designed so that the VCC will pay for care each month until the VA reimburses, and then the client reimburses us for the services we provide. We maintain that monthly medical expense-to-income ratio by working with the client and the home care agency to ensure appropriate care.”

Laramie said that while VCC is not necessarily in the business of making loans, the client signs a loan document with no interest.

“We serve a variety of purposes,” Laramie said. “We teach home care agencies how to promote veterans’ benefits in their communities. We help families navigate the maze of benefits. If a family can’t afford care, we cover the costs while the VA processes the application. Often, because we’re used to working with the VA, we can expedite the application.”

The VA uses CCN to provide home care services to veterans. CCN benefits specifically help cover the cost of home health care. Eligible veterans are assigned a care coordinator who determines how many hours of care each week the veteran needs and helps the family connect with caregivers in their area. CCN benefits are paid directly to partner organizations.

By working with a network of qualified health care providers, the VA system improves access to medical, mental health and specialty care, enabling veterans to receive personalized and timely treatment in their community.

“Using CCN allows for a broader network, reduced wait times and high quality care,” Hayes said. “By joining the network, providers have the opportunity to expand their customer base, which includes serving our nation’s veterans.”

The program emphasizes a patient-centered approach, taking into account the individual needs and preferences of each person and fostering collaboration between the veteran, the VA care team, and community providers.

The network maintains the highest standards of care by ensuring that all participating providers meet rigorous quality and safety standards. VA continually refines and optimizes the program to improve health care outcomes and streamline the process of accessing care.

“Home care providers may find the VA and contract provider processes complicated and time-consuming,” Hayes said. “Optum and TriWest may decide they have a sufficient network for a specific geographic area and decline to add new providers. To ensure a high-quality network, providers sometimes experience delays in the accreditation process. Providers also struggle to follow the required protocols to ensure timely service and reimbursement.”

According to Morthland, while joining CCN VA can be difficult, it is worth the effort.

“When the VA contacts us about care, everyone stops what they’re doing because they’re such an important referral source that we want them to know we’re there to make their job easier by offering a quick response,” Morthalnd said. “We have this attitude that we’ll say ‘yes’ to anything they ask us to do because if you say ‘yes’ enough times, the VA planners know they’ll call you first because you make their job easier.”

Kerin Zuger, COO of Caretech, agreed and said it’s all about building relationships.

Omaha, Nebraska-based Caretech provides non-medical home care services such as personal care, companionship and household assistance.

“VA case managers are busy like everyone else, so if you can address some of the issues, all the better for you,” Zuger said. “Build a partnership and make sure that whatever their issues are, you fill the gaps and fix the problem.”

Zuger recommends that smaller franchises or independent businesses partner with a company like VCC to transition to CCN. This gives clients access to dollars they didn’t know they had and makes it easier to manage care.

“If you’re an independent or small franchisee, partnering with someone like VCC takes the hassle out of it, so you don’t have to worry about applications, follow-up and management. You worry about providing high-quality care to the client,” she said.

Zuger also recommended reaching out to people who may be affiliated with the VA and would like to make an introduction.

“Don’t be too proud to use your existing resources,” she advised. “Partner with the VA, volunteer, sponsor or join a board. Relationships matter, and no matter how many home care companies rise to the occasion, there will always be more veterans to help and support.”