Innovation in integrated care is happening everywhere. From hospitals to health plans, doctors’ offices to outpatient clinics, traditional health care players are increasingly partnering with community-based organizations (CBOs) to deliver critical services that keep people living independently and with dignity in their homes and communities for as long as possible. The Veterans Health Administration (VHA) is no stranger to this exciting movement toward greater integration; with its Veteran-Directed Home and Community Based Services program (VD-HCBS), the VHA has committed to accelerating innovative care for veterans and their families and caregivers. An exciting VD-HCBS program in Colorado is charging ahead to deliver on this commitment and embrace the opportunities it opens up for serving veterans.
The VD-HCBS program involves Veterans Administration Medical Centers (VAMCs) partnering with local CBOs in the Aging and Disability Networks to provide long-term supports and services (LTSS) using a participant‑directed approach. Colorado’s VD-HCBS program was launched in 2010, as a partnership among the state’s Division of Aging & Adult Services, the Pikes Peak Area Council of Governments Area Agency on Aging (PPACG‑AAA) and The Independence Center (The IC), a Center for Independent Living (CIL), serving individuals with disabilities and their families and caregivers. Working together, these agencies have built a strong and widely-marketed program that is improving the quality of life of the veterans it serves and delivering on the promise of integrated, holistic and person-centered care.
The IC’s experience in disability and independent living services, self-advocacy and consumer direction positions them to operate a successful VD‑HCBS program. The IC uniquely branded the program using language familiar to those who have served in the military—Veteran In Charge (VIC). As of October 2017, 71 veteran consumers, with ages ranging from 28 to 96 years old, were enrolled.
The dedication, talent and consistency of the interdisciplinary team contributed greatly to the program’s success. The VIC team includes:
- VIC Program Manager
- Veteran Coaches (case managers) 2.5 FTE
- Peer Support .5 FTE
- Fiscal personnel .5 FTE
- Denver VAMC VD-HCBS Coordinator
The Veteran Coaches provide all in-home assessments and communicate closely with the VD-HCBS Coordinator. Weekly conference calls and close contact keep the team working closely together and up-to-date on each veteran’s status.
Preparing for the Program
The IC invested time to ensure the best structure and foundation to administer their VIC program. Building relationships with the Denver VAMC was critical for the launch and the on-going success and growth of the program. The IC leadership reached out to other VD-HCBS sites to ask for recommendations and lessons learned before launching the program and the insights shared from experienced peers proved invaluable. Additionally, the IC dedicated substantial time to researching various Financial Management Service (FMS) agencies, an integral partner in the VD-HCBS program (FMS agencies are third-party entities that assist veterans with managing their self-direction budgets and can help with various employment responsibilities). The IC developed a formal Request for Proposal to find an FMS that would be the right fit for their program and its unique local circumstances.
Getting the Word Out to the Community and Veterans!
The VIC Program Manager collaborated with the Denver VAMC, the local Veterans Health Administration (VHA) outpatient clinic and Veteran Service Organizations to raise awareness and promote the newly launched program. This type of collaboration provided a strong on-the-ground approach in identifying and serving veterans’ long- term service and support needs.
Indicative of the person-centered and holistic emphasis of the VD-HCBS program, even the language the IC used when designing and marketing its program strove to connect with veterans’ experiences and priorities. There was a conscious effort to incorporate military vocabulary – “Veteran in Charge” (VIC) is a spin on familiar military terms relating to “Officer In Charge” (OIC) and Non-Commissioned Officer In Charge (NCOIC). And the attention to detail and sensitivity to the unique circumstances of each veteran paid off in terms of spreading the program: Direct marketing to veterans has become the biggest source of referrals to the program. Satisfied veterans championed the program amongst peers and the community and they’ve been far and away its most powerful advocates.
Ultimately, building relationships with veterans within the program is at the heart of the success. These relationships are nurtured at every step of the process; it begins with honoring military language, extends through the targeted outreach at veteran-sponsored functions, and is realized most fully in the monthly in-home visits veterans receive from the veterans Coaches. These monthly in-home visits address any changing needs of the veteran and help build trust and mutual understanding. View the VIC brochure here.
The Aging and Disability Business Institute has developed an in-depth Success Story on this program. Read the Success Story.