A Range of Home and Community-Based Care
The VA's Geriatrics and Extended Care (GEC) department oversees a variety of home-based services that fall under the VA Medical Benefits Package. These programs are designed to help Veterans who have chronic or disabling health issues, are isolated, or have a caregiver experiencing burden. Each service has a specific purpose and set of eligibility criteria.
Homemaker and Home Health Aide (H/HHA) Program
This program provides trained aides to assist Veterans with daily living activities like bathing, dressing, grooming, eating, and meal preparation, enabling them to remain safely at home. A registered nurse supervises the aide. Services are based on individual needs and can be combined with other programs.
Home-Based Primary Care (HBPC)
HBPC offers team-based care at a Veteran's home for those with complex health needs who find it difficult to travel to a VA facility. The team includes various specialists to manage medical conditions, provide rehabilitation, mental health support, and case management. Eligibility may not always require being homebound.
Skilled Home Health Care
For Veterans requiring short-term, medically necessary care, skilled home health care is provided in the home by non-VA professionals contracted by the VA. Services can include skilled nursing, physical therapy, occupational therapy, and speech therapy, prescribed by a VA provider.
Respite Care
To support family caregivers and prevent burnout, the VA offers respite care, providing a temporary break. Respite can be given at home, an Adult Day Health Care center, or temporarily at a VA or community nursing home, with up to 30 days available per calendar year.
Veteran-Directed Care (VDC)
Also known as Veteran-Directed Home and Community Based Services, VDC allows eligible Veterans to manage a personal care budget to hire and direct their own care workers, including family members in some cases. A counselor assists with creating a spending plan, and the budget is based on individual needs, not exceeding nursing facility costs.
Comparison of VA Home Care Programs
| Program | Type of Care | Key Features | Primary Goal |
|---|---|---|---|
| Homemaker/Home Health Aide | Non-medical personal care | Help with daily living activities, light housekeeping, meal prep. Supervised by a nurse. | Assist with daily tasks to enable independent living at home. |
| Home-Based Primary Care | Comprehensive medical care | Team-based care (MD, NP, SW) for complex conditions delivered at home. | Provide ongoing medical management for homebound or isolated Veterans. |
| Skilled Home Health Care | Short-term medical care | Nursing services, physical therapy, occupational therapy provided by community partners. | Restore health status after an illness or injury. |
| Respite Care | Temporary relief for caregiver | Short-term professional care provided at home, in adult day health, or a nursing home. | Offer a break to the family caregiver to prevent burnout. |
| Veteran-Directed Care | Flexible, veteran-managed care | Veteran controls a budget to hire their own caregivers and services. | Empower Veterans with choice and control over their long-term care needs. |
How to Determine Eligibility and Apply
Enrollment in VA health care is typically the first step for accessing most VA home care services. Eligibility for specific programs depends on a clinical assessment by a VA provider or geriatrics team demonstrating a need for the service. Some services delivered through community agencies also require meeting community care eligibility criteria. Availability may vary by location.
Veterans should consult their VA primary care provider or a VA social worker to begin the process. A social worker can help coordinate the required geriatric evaluation and assist with the Application for Extended Care Benefits (VA Form 10-10EC). To enroll in VA health care, Veterans can apply online, by phone, mail, or in person using VA Form 10-10EZ.
Understanding Costs and Payments
While many services within the VA Medical Benefits Package are free, some long-term care services may involve a copayment based on a Veteran's service-connected disability status and financial information. Copayments for geriatric and extended care, like H/HHA, may begin after a certain period of care for non-service-connected conditions. In the Veteran-Directed Care program, Veterans manage their allocated budget and pay their care workers directly. The Aid and Attendance pension benefit may also help eligible Veterans and surviving spouses pay for home care. For cost details, contact a VA social worker or case manager.
Conclusion
The VA offers a comprehensive suite of home care services designed to support Veterans in aging at home and managing daily challenges. These programs provide essential support, from personal care and caregiver respite to complex medical management. By understanding the available options and navigating the application process, Veterans and their families can access the vital care they need and deserve. More information is available on the official VA Geriatrics and Extended Care website.
