Veterans Directed Home and Community Based Services VDHCBS

Veterans Directed Home and Community Based Services (VD-HCBS) The Veterans Administration and the Local Community Working Together to Help Veterans Live at Home Susan D. Blevins VD-HCBS Case Specialist Area Agency on Aging Alamo Area Council of Governments San Antonio, Texas sblevins@aacog. com Stella C. Newberger, LCSW Department of Veterans Affairs Contract Adult Day Health Care and Respite Care social worker, VD-HCBS Program Coordinator South Texas Veterans Health Care System San Antonio, Texas Stella. Newberger@va. gov

The term “Veteran” means a person who served in the active military, naval, or air service, and who was discharged or released therefrom under conditions other than dishonorable.

What is VD-HCBS? • Veteran-Directed Home and Community Based Services (VD-HCBS) is a program of the VA for self -directed care. • VD-HCBS empowers Veterans to choose and manage services and supports in their homes as an alternative to living in a long-term care facility. • The Veteran or Veteran Representative hires, supervises, evaluates and pays the Employee to provide specific services and supports that the Veteran needs to live in his or her own home.

Consumer or Self-Direction The Consumer decides: • What services, supports and goods are needed – Buys supports and goods to achieve his or her goals • When the services and supports are to be provided • Who provides those services and supports – Hires and manages his/her own Employees to provide the services and supports • Where the services and supports are provided • How the services and supports are provided

Consumer Direction or Self-Direction Gives the consumer more: • Choice • Control • Flexibility • Freedom

The Veterans Administration Provides Several Community-Based Programs • • • Home Health Aide – Homemaker Program Respite Program Contract Adult Day Health Care Home Telehealth Home Based Primary Care

What Makes VD-HCBS an Attractive Alternative to Traditional VA Care Models? • Cost savings • More efficient use of resources • Consumer satisfaction

VD-HCBS Partnership CBO VA VET FMS

The VA-CBO Partnership VA Initiates Referral to Community. Based Organization(CBO): • Referral from a VA Primary Care Social Worker to VDHCBS Coordinator, who • Performs Case Mix Assessment to Determine Budget • Offers program to Veteran (Veteran must agree) • Refers to CBO: – Area Agency on Aging (AAA) – Aging and Disability Resource Center (ADRC) – State Unit Aging (SUA) CBO Contacts Veteran or Representative to Set Up Service: – Explains VD-HCBS – Conducts Client Needs Assessment – Develops care/service plan • Trains Vet or Rep to be an Employer • Assists with recruiting and hiring for Veteran – Monthly phone calls – Quarterly home visits

Basic Qualifications for VD-HCBS Program **All Veterans in VD-HCBS program must have a PCP through their local VA system Source: Julie Larsen LCSW, VD-HCBS Program Coordinator, SLC VAMC

Once Consumer is Enrolled, VA and CBO have a Continuing Relationship CBO Roles and Responsibilities VA Roles and Responsibilities • Veteran Advocate • Administrative • Inform VA Liaison of any • VA Liaison status changes • Oversight of Rainy Day regarding Veteran Fund and Budget • Monthly case management meetings

CBO’s Role and Responsibilities The CBO assigns a Care Manager who will: • Assess the Veteran’s needs • Educate the Veteran about the program • Help the Veteran create a Consumer-Directed Service Plan and Budget • Provide information and referral to help the Veteran find the services and supports the Veteran needs, including employees • Keep the local VA Medical Center informed about the Veteran’s status

CBO’s Role and Responsibilities • Contract with a Financial Management Service (FMS) to set up the Veteran’s account, through which the Veteran will – Submit bills for the purchase of services/supports – Assure employee(s) receive pay and benefits • Monitor billing to be sure expenditures are within budget and to assure Employees are receiving their pay and benefits • Help the Veteran evaluate how the VD-HCBS is working • Help the Veteran learn how to be an effective employer • Help the Veteran’s employee(s) – Understand their role in relation to the Veteran – Complete the paperwork required by the VA and the state to be an employee of the VD-HCBS • Help the employer and employee resolve problems

Veteran Roles and Responsibilities in VD-HCBS Veteran or Veteran Representative

Veteran Roles & Responsibilities The Veteran is responsible for • Cooperating with the CBO Care Manager to plan and direct the Veteran’s Service Plan and budget • Functioning as the employer – – Recruiting, hiring and firing employees Planning employee work schedules, training and assignments Keeping time sheets and other employee records Submitting time sheets to Financial Management Service for employee payment – Performing annual evaluations • Managing finances, to include – Submitting purchase requests to Financial Management Service – Managing a Rainy Day Fund

What If a Veteran Is Unable to Manage an Employee? • The Veteran’s family or friends can help the Veteran as – Legally Authorized Representatives, who have Power of Attorney, – Court Appointed Guardians – A designated Representative to help with decisions or the management of the VD-HCBS program, or – An Employee of the Veteran – One person can’t be both Representative/ Guardian and Provider

States with VD-HCBS Programs updated April 2018 States with VD-HCBS Programs (updated April 2018) 1. Alabama 2. Alaska 3. Arkansas 4. California 5. Colorado 6. Connecticut 7. District of Columbia 8. Florida 9. Hawaii 10. Idaho 11. Illinois 12. Indiana 13. Iowa 14. Kentucky 15. Louisiana 16. Massachusetts 17. Maryland 18. Maine 19. Michigan 20. Mississippi 21. Missouri 22. Montana 23. New Hampshire 24. New Jersey 25. New Mexico 26. Nevada 27. New York 28. North Carolina 29. Ohio 30. Oklahoma 31. Oregon 32. Pennsylvania 33. Puerto Rico 34. South Carolina 35. South Dakota 36. Tennessee 37. Texas 38. Utah 39. Virginia 40. Vermont 41. Washington 42. Wisconsin

CURRENT LOCATIONS PARTICIPATING IN THE VD-HCBS PROGRAM AS OF APRIL 2018. 1. Central Alabama, AL 2. Tuscaloosa, AL 3. Anchorage, AK 4. Fayetteville, AR 5. Little Rock, AR 6. San Diego, CA 7. Denver, CO 8. Grand Junction, CO 9. West Haven, CT 10. Washington, DC 11. Bay Pines, FL 12. Miami, FL 13. Gainesville, FL 14. Tampa, FL 15. West Palm Beach, FL 16. Orlando, FL 17. Honolulu, HI 18. Boise, ID 19. Hines, IL 20. Danville, IL 21. Marion, IL 22. North Chicago, IL 23. Chicago, IL 24. Fort Wayne, IN 25. Louisville, IN 26. Indianapolis, IN 27. Iowa City, IA 28. Lexington, KY 29. Shreveport, LA 30. Bedford, MA 31. Boston, MA 32. Perry Point, MD 33. Augusta, ME 34. VA Ann Arbor, MI 35. Battle Creek, MI 36. Detroit, MI 37. Iron Mountain, MI 38. Saginaw, MI 39. Biloxi, MS 40. Saint Louis, MO 41. Kansas City, MO 42. Fort Harrison, MT 43. Manchester, NH 44. Lyons, NJ 45. Albuquerque, NM 46. Las Vegas, NV 47. Reno, NV 48. Albany, NY 49. Syracuse, NY 50. Fayetteville, NC 51. Durham, NC 52. Chillicothe, OH 53. Toledo, OH 54. Muskogee, OK 55. Portland, OR 56. White City, OR 57. Roseburg, OR 58. Coatesville, PA 59. Philadelphia, PA 60. Erie, PA 61. San Juan, PR 62. Charleston, SC 63. Sioux Falls SD 64. Nashville, TN 65. Temple, TX 66. San Antonio, TX 67. Houston, TX 68. Salt Lake City, UT 69. Richmond, VA 70. Hampton, VA 71. White River Junction, VT 72. Seattle, WA 73. Spokane, WA 74. Wallawalla, WA 75. Milwaukee, WI 76. Tomah, WI

Veteran’s Directed Home and Community Based Services CASE STUDIES

Veteran’s Directed Home and Community Based Services http: //www. bc. edu/schools/gssw/nrcpds/tools/videos. html#pstory VIDEO: CENTRAL TEXAS VD-HCBS FEATURING THOMAS WILSON, LCSW, CENTRAL TEXAS AAA/ADRC

Transforming the Delivery of Resources for San Antonio’s Transitioning Service Members, Veterans and Their Families February 2018 San Antonio, TX

The TXServes Solution Quickly navigate veterans, service members, and military families to the right services, resources, and care America. Serves provides a series of place-based efforts focusing on coordination of service and care delivery across 15 service domains Using technology and a person-powered backbone of support, America. Serves streamlines referrals between participating providers Identifies appropriate services for clients from providers that can actually meet those needs Ensures a positive connection between the client and providers and confirms that the clients’ needs are addressed

The TXServes Solution TXServes COORDINATES SERVICES AND CARE Our network includes providers offering a comprehensive range of services, such as: Benefits Clothing & Household Goods Education Employment Food Health Housing Individual & Family Support Services Legal Money Management Social Enrichment Spiritual Enrichment Sports & Recreation Transportation Utilities

TXServes: Building Tangible Impact Veteran/Military Family Walks Into Network Provider Self-Refers via Web or Phone Sends Referral to Coordination Center Sends Referral to Network Provider Referral Delivered to Coordination Center For Intake

TXServes – San Antonio Registered Providers By assembling providers across service categories in our network, we are able to ensure that all service gaps – specifically in our core 5 focus areas – are addressed to ensure impact. TXServes – San Antonio Providers Onboarded Thus Far Greater Randolph Area Service Work. Source Solutions Bexar The Ecumenical Center Program County Allied Universal Security VETTED Foundation Vet TRIIP, Inc. Military Officer Association of America Alamo Chapter San Antonio Food Bank Military Veteran Peer Network San Antonio Bar Association Bexar County Veteran Service Office Guadalupe County Veteran Service Office Lone Survivor Foundation The Next Horizon American GI Forum SACVF Alamo Call-A-Ride 4 Vets 10000 Strong PTSD Foundation of America Onward to Opportunity The Lift. Fund Operation Supply Drop AVANCE- San Antonio Wounded Warrior Project Texas A&M San Antonio STVHCS Haven for Hope American GI Forum Crosspoint Inc Bexar County Behavioral Health The Inspiration Center Alamo Community Group Military Child Education Coalition (MCEC) United Way Project Mend The Center for Health. Care Services (CHCS) Family Endeavors JBSA (DOD) Hire Heroes USA Texas Veterans Commission IVMF/VCTP Vets 4 Warriors Hope for the Warriors Texas Veterans Commission. Employment Division U. S. Small Business Administration Northwest Vista College City of San Antonio Alamo Colleges - NLC Notable Highlights: • 65 provider organizations have firmly committed to, are in process, or have completed onboarding • All 5 Workforce Solutions offices covering Bexar County are committed • The San Antonio organizations run the gamut from Animal Care to health and human service providers. A few of our best providers currently participating in the network are – Veteran Affairs, United Way, SA Food Bank, Family Endeavors, SAMMinistries, TVC, Bexar County VSO, UTSA, UIW, and Alamo Colleges. • HIPAA Compliant

Provider Enrollment Information TXServes Link: http: //sanantonio. americaserves. org/ - This is the direct link to the TXServes website Phone: 1 888 SA 4 VETS (888 724 8387) Provider Training Link: https: //www. uniteus. com/training/ - This is the direct link to webinar training for the Unite. US platform that is used to navigate the TXServes program. Designated staff that will be utilizing the Unite Us platform will need to complete a one hour training. Provider Enrollment Link: http: //americaserves. org/provider-registration/ - This is the direct link to set up your profile.

Contact Information Ø Gary Timpson, Veterans Program Coordinator Bexar Area Agency on Aging 210 -572 -5713 GTimpson@aacog. com Ø Philip Jones, Manager Bexar Area Agency on Aging 210 -362 -5318 pjones@aacog. com

Veterans Directed Home and Community Based Services Susan D. Blevins VD-HCBS Case Specialist Area Agency on Aging Alamo Area Council of Governments San Antonio, Texas sblevins@aacog. com Stella C. Newberger, LCSW Department of Veterans Affairs Contract Adult Day Health Care and Respite Care social worker, VD-HCBS Program Coordinator South Texas Veterans Health Care System San Antonio, Texas Stella. Newberger@va. gov