Area Agency on Aging of Central Texas
H. Richard McGhee, AAA Director
Thomas Wilson, AAA VD-HCBS Consultant
Jim Reed, CTCOG Executive Director
ADRC Partners
Veteran’s Directed Home and
Community Based Services
The Veteran’s Directed Home and
Community Based Services is a pilot
program for a new Veteran’s directed
approach to home and community services
partnered by:
• U.S. Department of Veterans Affairs
• Administration on Aging
• Texas Department of Aging and Disability Services
• Area Agency on Aging of Central Texas
• Central Texas Veterans Healthcare System => VAMC
VD-HCBS is a Consumer Directed
Program
• The Veteran can recruit, hire,
train and fire their own employees and
backup employees (including family,
friends or neighbors)
• The Veteran sets wages and benefits
for the veteran’s employees based on a service budget
created with the help of the AAA VD-HCBS Consultant
• The Veteran sets schedules and submits time sheets for the
Veteran’s employees to a Fiscal Management Agency (FMS)
Target Population
• All Veterans enrolled in the VA health care
system are eligible
• The Veteran is “in need of nursing home care”
and interested in consumer directed care.
AND
one or more of these conditions is met:
 3 or more deficits with Activities of Daily Living
 Significant cognitive impairment
 Receiving Hospice Services
OR
Two Activities of Daily Living Dependencies and two or more of
the following:




Three or more Instrumental activities of daily living
Recently discharged from a Nursing Facility
75 years or older
2 hospitalizations or 12 outpatient clinic or emergency
evaluations
 Clinically depressed
 Lives alone
*** Even if the Veteran does not meet any criteria but is still
clinically determined by the local VAMC to need services,
the VD-HCBS is a possible program for the Vet.
AAA VD-HCBS Services
AAA VD-HCBS Staff assists the Veteran as a
Service Consultant and provides activities that will:
• Assist the Veteran to develop a Service Plan that works for the
Veteran
• Orients the Veteran to be an Employer
• Assists the Veteran Employer in training and educating the
Veteran’s employee
• Provides support consultation services to the Veteran over
length of approved services
• Provides linkage to Financial Management Services (FMS)
These services are provided for 20% of the Veteran’s budget.
Financial Management Services
• Processes criminal background checks for Veteran’s
Employee applicants
• Process the Veteran employee timesheets/payroll
• Process receipts and invoices for goods & services
• Acts as the Veteran’s agent to pay federal and state
employment taxes
These services are provided for a cost of $25 initial set-up fee
& monthly maintenance fee of $45 and comes out of the 20%
administrative payment paid to the AAA.
Starting VD-HCBS
• Referrals are directly referred by the VA Medical Center
(VAMC) or may come from the community through the
ADRC and are approved by the VAMC. One of the major
tasks of the VAMC is to assure that the Veteran is within
the grouping eligible for medical services and is
recommended for Home Health Attendants (HHA) by their
Primary Care Physician.
• Telephonic Joint Initial Screening completed by the AAA
VD-HCBS Consultant and a VA HHA Social Worker for the
Veteran to verify eligibility and Veteran wishes to direct
their own care and services.
Enrollment Phase
• Visit One: Presentation of VD-HCBS Guidebook, Inhome baseline assessment, release of Information
authorization, and completion of 2060.
• From the completed 2060 form, the Veteran’s
monthly service budget and benefit is established:
2060 Score 17-24 Basic
$2,100
2060 Score 25-39 Intermediate $2,550
2060 Score 40-60 Extensive
$ Case by Case
• Between Visit One and Two the Veteran completes
Support Plan Budget and Worksheets that help the
Veteran to prioritize needs.
Enrollment Phase (Continued)
• Visit Two: The AAA VD-HCBS consultant assists the
Veteran in completing the Support and Budget Plan
and Worksheets. The Employer Orientation is done
and all required forms signed and collected.
• These forms are faxed and originals mailed to PALCO
(the program Financial Management Service). PALCO
registers the Veteran as an employer
with the IRS and the Texas Workforce
Commission.
Enrollment Phase (Continued)
• Visit Three: The AAA VD-HCBS Consultant assists the
Veteran Employer to Orient the Veteran’s employees.
All required Orientation Forms are completed and
submitted to PALCO for criminal background check.
• Criminal background check completed, PALCO
approves the hiring of the worker, a date is set for
the first day of the work. The AAA VD-HCBS
Consultant notifies the VAMC worker who authorizes
the start of funds for the client on that date.
How does VD-HCBS Consultant
Support Work?
• Veteran Employer submits times sheets/ service
billings bi-weekly to PALCO who will pay salaries, IRS
Taxes, Medicare Taxes, and pay authorized budgeted
bills.
• Monthly Support Consultant visits are made in
person or telephonically to assure the program is
working and there are no problems, if problems arise
or the Veteran has new needs arise, the consultant
will work with the Veteran to revise the support plan
and budget as needed.
• Annual Review Month 12: The Consultant meets with
the Veteran to create the service plan and budget
for the next year.
Services, supports and goods NOT COVERED in
VD-HCBS
• Services already being provided to a veteran or their
family caregiver(s) by or through the Department of
Veterans Affairs.
• Services, supports or goods provided to or benefiting
persons other than you
• Room and board, including rent and mortgage payments
• Personal items and services not related to your disability
• Experimental treatments
• Vacation expenses (except for the cost of the services
you may need while you are on vacation)
Transparent and Seamless
System Supported by ServicePoint™ MIS
CONSUMER PATHWAY TO SERVICES
↓
ADRC ↔ VAMC ↔ S&W
↘ ↓ ↙
VAMC Clinic (HHA Consult)
↓
HHA Staff & Veteran
↓
Veteran’s Directed HCBS
Questions?