Progress in 2014 for Veteran-Directed Home and Community-Based Services
2014 ended on an upbeat note for the Veteran-Directed Home and Community-Based Services (VD-HCBS) program when Congress passed and President Obama signed legislation advancing this veterans service program. Veterans‑Directed Home and Community‑Based Services were developed by the Veterans Health Administration (VHA) and the Administration for Community Living (ACL). The program is based on the Cash and Counseling service model for which Boston College and NRCPDS conducted foundational research. Boston College and its National Resource Center for Participant Directed Services have worked closely with the VHA in the implementation of Veterans‑Directed HCBS. There are now 49 VHA sites serving over 800 Veterans nationwide.
The Consolidated and Further Continuing Appropriations Act, 2015 was signed into law just prior to Christmas. The bill, along with its associated committee language, identified the Veteran‑Directed program as a central part of the VA’s long‑term care rebalancing initiative. Veteran Direction is a service delivery option that allows Veterans to have more control and flexibility in their community services and supports. Much of VHA long‑term care services are delivered in institutions instead of in Veterans’ homes and communities. In recent years, the VHA has worked to balance these two service delivery options, and has partnered with the Aging and Disability Network, overseen by the ACL, to launch and expand the program. NRCPDS works with both the VHA and ACL to provide technical assistance and to promote the development of new local VD-HCBS programs.
This legislation came on the heels of the Veterans Choice Act, which passed in the summer of 2014. This act, among other things, centralized funding allocations for purchased non-VA care services, which includes VD-HCBS. As a result, funds will be allocated to all VA Medical Centers from the VA Central Office, and allocations explicitly include funding for VD-HCBS. Historically, new VD-HCBS programs have had to rely on special purpose funding to start their programs. Now all VA Medical Centers have the funds available to begin serving Veterans utilizing the VD-HCBS approach.
NRCPDS continues to support both the VHA and ACL to accelerate preparation for Aging and Disability Agencies seeking to serve Veterans in the VD-HCBS program. The VHA and ACL’s work has helped lay a foundation so that the budget legislation, along with the Veterans' Choice Act, can help the VHA to expand its HCBS options much more rapidly. NRCPDS leaders and staff look forward to playing a significant role in that accelerated expansion. This should allow many more Veterans to have the services and supports they need to stay in their own homes.
Richard Petty, Executive Director of NRCPDS, stated, “This is important recognition and an affirmation in the legislative language and committee reports of the ground‑breaking participant‑direction research and ongoing development work of Kevin Mahoney and of other NRCPDS staff.” Mahoney is the Founding Director of NRCPDS and a faculty member of the BC School of Social Work who conducted the first demonstrations of the cash and counseling program. Backed with rigorous research, the program demonstrated the efficacy of participant direction and led to a wave of new programs across the nation using this new model. Mahoney said that highlighting this important veterans program in the new law is an important success for Veterans and for the cash and counseling model.Mahoney said that highlighting this important program in the new law is a big victory for NRCPDS, Boston College and Veterans.