A Better Way to
Care for Our Veterans?
By Mary Lazare, Principal Deputy Administrator, Administration
for Community Living, Department of Health and Human Services
I recently visited Bay Aging in Urbanna, Virginia, to learn
more about their current work and receive an update on their Veteran
Directed Care (VDC) program. I met with personnel from Bay Aging,
veterans enrolled in the VDC program, and staff from the U.S. Department of
Veterans Affairs, specifically the Hunter Holmes McGuire VA Medical Center.
Bay Aging, one of Virginia’s Area Agencies on Aging, has been
helping older adults and people with disabilities by providing a long list
of services for more than forty years. Some of their programs have even
spread into nearby states and Washington, D.C. The number of people they
serve has steadily grown to over 26,000, and their VDC program has seen an
impressive 34 percent increase since I last visited in 2017.
The VDC program
was developed by the Veterans Health Administration and the Administration
for Community Living to offer veterans and their caregivers greater access,
choice and control over the long-term services and supports that help
veterans live at home and remain a part of their communities. As I listened
to veterans and their families describe their experiences with Bay Aging’s
VDC program, it was clear that the program is meeting crucial human needs.
Veterans in the VDC program have significant disabilities;
each is eligible for nursing home-level care. However, VDC provides a
community-based alternative that allows them to live and receive care in
their own homes. If an eligible veteran chooses VDC, he or she has access
to a flexible budget that can be used to fund a care plan that best fits
their life, including hiring family, friends and neighbors to provide
individualized support to help meet their needs. Counselors from
organizations in the aging and disability networks, such as Bay Aging,
support the veteran in a variety of ways, including providing financial
management assistance to the veteran as they develop their service plan,
find and train workers, and secure needed goods and services. The veterans
I met emphasized that when they needed help or advice, staff at Bay Aging
answered the phone or quickly returned their calls.
Not only are veterans and their families pleased with the VDC
program, the average cost to support a veteran in the VDC program is $144
per day less
than the cost of living in a local community nursing home. That amounts to
a savings of $52,800 per veteran, per year compared to nursing home costs.
For the 204 veterans in Bay Aging’s VDC program, those savings add up to
over $10 million per year. And, as I said, the program is growing, so the
savings will grow as well.
A survey of veterans in Bay Aging’s VDC program found that 97
percent of them are satisfied. Not one veteran has ever opted out in the
nine years that Bay Aging has operated the program. I’m not surprised,
given what I heard from VDC participants. As the wife of one veteran put
it, “This program gave us our lives back.”
Unfortunately, this win-win program isn’t yet available
everywhere. One veteran, who was considering a move to Florida, put it this
way: “I served the United States, but if I need or want to move to another
part of the United States, most likely I won’t find a program like this.”
The decision to offer VDC is made locally. Currently the program is
available in 68 of the 152
VA Medical Centers.
I came away from my site visit resolved to share the program’s
success and impact. It just makes too much sense; the veterans who choose
VDC remain in control of their own lives, they continue to live with family
in their own homes, and the government saves money. This is not too good to be true.
This is a practical option that Bay Aging and the Hunter Holmes McGuire VA
Medical Center – and other partnerships between VAMCs and the aging and
disability networks across the country – have shown can work.
Bay Aging told me that they are willing to share what they
have learned; lessons that prove the VDC model can work well for veterans,
the VA and community-based organizations. In fact, Bay Aging’s president
and CEO, Kathy Vesley invites calls from colleagues in the aging and
disability networks, including other Area Agencies on Aging. Her phone
number is 804-758-2386, extension 1217.
I believe the financial and operational model Bay Aging
developed can be duplicated across America. All we need is the
determination to make sure that all veterans who are eligible for nursing
home level of care have the same access to supports as the veterans in
Virginia.
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