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New York & Veterans Directed Home and Community Based Services Program. Philip McCallion & Lisa A. Ferretti , Center for Excellence in Aging Services www.albany.edu/aging Gail Koser & Rina Kitazawa NY State Office for Aging. Background.

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new york veterans directed home and community based services program

New York & Veterans Directed Home and Community Based Services Program

Philip McCallion & Lisa A. Ferretti, Center for Excellence in Aging Services

www.albany.edu/aging

Gail Koser & RinaKitazawa

NY State Office for Aging

background
Background

VDHCBS introduced as a new component of AoA’s 2008 Nursing Home Diversion Modernization Grant

NYSOFA worked with VA and AAAs to submit an application for VDHCBS

New York State – one of 10 states to be awarded the VDHCBS grant in September 08

New York also selected in 2009 for Community Living Program & VDHCBS

program goals
Program Goals

To better serve veterans of all ages at risk of nursing home placement

To encourage collaboration and partnerships between Aging and VA networks

To reduce duplication of effort and resources

To replicate and expand program in other areas of the State

elements of vdhcbs
Elements of VDHCBS

Veterans Health Administration will purchase consumer directed and other home and community based services from the Aging Network for eligible veterans of all ages.

Consumer directed personal care services a necessary component

Provider agreement between the local VA Medical Center and counties/AAAs

necessary steps for vdhcbs
Necessary Steps for VDHCBS
  • Development of consumer directed infrastructure
  • Completion & Review of Readiness Tool
  • Determination of services and rates
  • Review and signing of the Provider Agreement
visn 2 counties selected for veteran directed model 10 1 08 3 31 09 fy 09
VISN 2 Counties Selected for Veteran Directed Model 10/1/08 – 3/31/09 (FY-09)
  • Onondaga
    • Currently enrolled in Primary Care 6370
      • Over 80 years old 1340
  • Broome
    • Currently Enrolled in Primary Care 2678
      • Over 80 years old 572
  • Oneida
    • Currently Enrolled in Primary Care 3623
      • Over 80 years old 659
vdhcbs process
VDHCBS Process

VA MC identifies eligible veterans and refers them to the AAA.

AAA contacts the veteran and completes an intake assessment.

AAA develops a care plan and budget.

VA MC authorizes the care plan and budget.

AAA submits invoices to VA MC each month.

VA MC provides payment to the AAA.

challenges of vdhcbs
Challenges of VDHCBS

VDHCBS is an evolving program.

Consumer directed careneeds to be in place before proceeding with VDHCBS.

Aging and VA networks must learn about each other’s systems, processes, and requirements.

Aging network must learn to work with a new population with needs that may differ from older adult clients (e.g. veterans with TBI).

specific challenges
Specific Challenges
  • Using existing case managers versus designated care coordinators
  • Costing services
  • HIPPA
  • Start-up costs
the process
The Process
  • Referral to VDHCBS:

The VA Medical Center determines a veteran’s eligibility for VDHCBS and refers eligible veterans to the Area Agency on Aging.

  • Care plan:Veterans who choose VDHCBS work with a Care Coordinator or Case Manager at the Area Agency on Aging and any others whom the veteran chooses. These individuals help the veteran design a care plan that includes all the care and services needed. This group of people is called a care team.
  • Budget:Veterans have staff from an agency, called a fiscal intermediary, to help them manage a monthly budget. The amount of money in the monthly budget is based on the participant’s care plan.
services
Services
  • Personal care
  • Housekeeping
  • Chore and companion/supervision services
  • Social or medical adult day care
  • Home delivered meals
  • Congregate meals
  • Nutrition education
  • Nutrition counseling
  • Caregiver support including training, counseling, support groups and respite
  • Health promotion
  • Transportation
goods
Goods
  • Appliances
  • Assistive devices/assistive technology

Some at least will be funded through existing VHA programs

opportunities
Opportunities

Increased communication between the Aging and VA networks at local, State, federal level

New and ongoing source of funding for AAAs

Discussion of other partnership opportunities between Aging and VA

Collaboration with other states