‘Relationships Matter’: How Home Care Providers Become Indispensable To The VA

Working with any government agency may require cutting through a lot of red tape. Still, home care providers interested in caring for aging veterans have various opportunities to partner with the Veterans Administration (VA) and make a difference for those who served.

According to the U.S. Census Bureau, as of 2023, there were an estimated 17.9 million veterans in the United States, and nearly half of them were 65 or older. This aging veteran population needs benefits and services to address changing health conditions and their 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) alongside community partners aimed at the most vulnerable veterans to reduce nursing home and medical center stays. A single program or combination of HCBS can assist veterans and their caregivers in remaining in their homes, optimizing their chronic health or rehabilitation potential, and preserving the home and family atmosphere.

“What we’ve learned is that when veterans remain in their homes, their outcomes are better, and this is critical in maximizing veteran health and overall wellbeing,” Terrence Hayes, VA press secretary, told Home Health Care News.

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

The third-party administrators complete a review to determine if a need exists for that provider based on the availability of those in the existing network. If a need is determined, the provider begins the credentialing process to join the CCN. This ensures the organization meets the VA’s qualification requirements before caring for veterans.

For Betsey Morthland, owner of a Visiting Angels franchise in Bettendorf, Iowa, becoming involved with the VA held benefits both personally and professionally.

Bryn Mawr, Pennsylvania-based Visiting Angels is a nationwide provider of home care services to older adults, including assistance with daily tasks, companionship and specialized care.

“Offering this specialized care and helping navigate the process is a way of giving 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 for them, we know those are guaranteed weekly hours, which assists us with staffing and predicting our income stream.”

Aid and Attendance

Aid and Attendance is a tax-free benefit available to veterans who have served 90 days of active duty during a period of war, have less than $160,000 in assets (excluding a home), require assistance with two or more activities of daily living and meet the required income to medical expense ratio.

However, filing the necessary paperwork to receive this benefit can be difficult for veterans and their families. In that case, providers can partner with companies like Lake St. Louis, Missouri-based Veterans Care Coordination (VCC) to help navigate those hurdles.

VCC’s model centers around helping veterans age in place. Owner Kyle Laramie started the company in response to his grandfather, a World War II veteran who missed out on benefits that could have helped him stay home rather than move to a long-term care facility.

“We find families who need care and take them through a screening process to determine if we think we could help them access this program, which could pay for their care,” Laramie told HHCN. “The Aid and Attendance program can be confusing because it is not designed for families who are low income and need care. It’s set up for those currently paying for care month after month and then are reimbursed. This isn’t the way the world works.”

Laramie said that families often find their loved one needs care and must quickly figure out how to pay for it. They are then faced with either paying for it out of pocket or not receiving it.

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

Laramie said that once a client is accepted to receive care, they often still aren’t sure who will fund that care upfront. In that case, VCC created the Advanced Care Program to finance the cost of care while the VA processes the claim.

“These families can’t wait for care,” Laramie said. “The way the program is set up is that VCC will pay for the care monthly until the VA provides the reimbursement, and then the client pays us back for the services rendered. We maintain that monthly medical expense to income ratio, working with the client and the home care agency to ensure adequate care.”

Laramie said that while VCC isn’t necessarily in the business of providing loans, the client does sign an interest-free loan document.

“We serve many different purposes,” Laramie said. “We teach home care agencies how to market veteran’s benefits in their communities. We help navigate the maze of benefits for families. If a family can’t afford care, we fund the cost while the VA processes the claim. Often, because we are used to working with the VA, we can get the claim to move through faster.”

Community of Care Network

VA uses the CCN to provide home care services to veterans. CCN benefits specifically assist with home health care costs. Qualified veterans are assigned a service care coordinator who determines how many hours per week the veteran requires care and will help the family connect with caregivers in their area. CCN benefits are paid directly to partner organizations.

By collaborating with a network of qualified health care providers, the VA’s system improves access to medical, mental health and specialized care, enabling veterans to receive personalized, timely treatment locally.

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

The program prioritizes a patient-centered approach, focusing on each person’s unique needs and preferences and fostering a collaborative relationship between the veteran, their VA care team and community providers.

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

“Home care providers can find VA and contracted network provider processes complex and time-consuming,” Hayes said. “Optum and TriWest may determine they have a sufficient network for a particular geographic area and decline to add new providers. To ensure a high-quality network, providers sometimes experience delays in the credentialing process. Providers also experience challenges with following required protocols to ensure timely service and reimbursement.”

While joining the VA’s CCN can be challenging, it is worth the effort, according to Morthland.

“When the VA contacts us for care, everyone stops what they’re doing because they are such an important referral source that we want them to know we’re there to make their jobs easier by offering a quick response,” Morthalnd said. “We’ve got the attitude that we’re going to say yes to whatever they ask us because once you’ve said yes enough times, the VA schedulers know to call you first because you will make their jobs easier.”

Kerin Zuger, Caretech’s chief operating officer, agreed and said it’s all about relationship-building.

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

“Like anyone else, VA case managers are busy, so if you manage some of the headaches for them, the better off you’ll be,” Zuger said. “Create a partnership and make sure that whatever their pain points are, you fill in the gaps and remove the headache.”

Zuger recommends smaller franchises or independent companies partner with a company like VCC to navigate joining the CCN. This gives clients access to dollars they didn’t know they had, and makes care management easier.

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

Zuger also recommended reaching out to contacts to find out who might be affiliated with the VA and willing to make an introduction.

“Don’t be too proud to tap into your existing resources,” she advised. “Partner with the VA, volunteer, provide sponsorships or get on a board. Relationships matter, and no matter how many home care companies stand up, there will always be more veterans to help and support.”