Veterans’ Options for Independence, Choice and Empowerment
Southeast Alaska Independent Living (SAIL), in partnership with the Alaska Veterans Administration Healthcare System, is proud to offer the Veteran-Directed Home and Community Based Service program in Southeast Alaska. The goal of VOICE is to provide Veterans flexible home and community‐based services which enable you to remain in your homes and communities. Click here for a printable, pdf flyer explaining SAIL’s VOICE program, or continue reading below. To enroll or ask questions, contact the SAIL office nearest you.
What is Veteran-Direction?
Veteran‐Direction is a service model that puts Veterans and their families in the driver seat, expanding your options and control over the long‐term services and supports you need to successfully live at home. More than other programs this model allows you, the Veteran, greater decision-making authority over your services. If found eligible, you are granted a monthly budget from the VA which you can use to hire workers and purchase a range of goods and services to meet your needs. If you choose to hire workers, you or your chosen representative serve as the employer. Therefore, you or your representative hire, set wages, train and supervise your choice of individual workers (e.g., personal care assistants and other in-home workers).
You will be linked to an Independent Living Advocate (IL Advocate) from SAIL who will help you create your personal budget using your monthly allocation from the VA and provide ongoing information and assistance to understand this process. In addition, if you choose to hire a personal care assistant or others for in-home supports, you will be assisted by SAIL’s partner payroll company for this program in the employment processes.
YOU ARE IN CHARGE!
You or your designated representative will choose the supports and services you need. You will:
- Create your own budget (which includes what services you want to buy)
- Choose where, when and how your services are provided
- Choose who to hire and what you will pay them
- Check bills and employee time sheets to make sure they are accurate
- Save money in your budget for more expensive items like equipment or modifications to your vehicle or home
Eligibility for VOICE:
Eligibility for VOICE is determined by the Alaska VA Healthcare System. To qualify you must be enrolled in Alaska VA Healthcare, assigned a primary care provider, and meet the medical and functional eligibility as determined by the Alaska VA Healthcare System (e.g. need assistance with activities such as bathing and getting dressed, fixing meals and taking medicines).
FREQUENTLY ASKED QUESTIONS:
Is this program income-based?
To qualify for this program you must qualify for Alaska’s VA Healthcare. Eligibility is then based on the criteria above. Your monthly budget amount is based on your level of need as determined by the VA (not your income).
Budget? Does this mean I receive a check each month?
No. Your monthly “budget” is an amount set by the VA which you may spend each month on your in-home care and approved goods and services. You will not receive any additional cash through this program.
How does this program affect my other benefits and insurance?
Veteran-Directed Care is supplemental to any other benefits you may receive (Social Security, Supplemental Security Income, Social Security Disability Income, Veteran’s Benefits, Adult Public Assistance, Medicare, Medicaid, etc.). This program will not affect your other benefit amounts or your eligibility for benefits or insurance. However, you may only receive in-home care services through one program (e.g. Medicaid Waiver, Homemaker Home Health Aide, Veteran-Directed Care, etc.).
How is my budget determined?
Your primary care doctor will complete an assessment of your needs and submit it to the Alaska VA Healthcare System. Based on your assessed medical and functional need, you will be assigned a monthly budget amount. In our Alaskan communities, the monthly amount ranges from $1,107 to $4,791/month for federal fiscal year 2020 (October 1, 2019 – September 30, 2020).
What can I buy with my budget?
You may purchase goods and services that will assist you to be more independent in your home and community. You cannot purchase goods or services that are already covered by your VA medical services or some other funding source (e.g. Medicaid-paid in-home care). SAIL’s IL Advocate will assist you in finding local resources available to you and provide you with a sample list of allowable goods and services. All goods and services must be approved by the VA when you create your budget or as needs arise.
What happens if I don’t spend my full monthly budget?
You will work with the IL Advocate to create your personal budget based on your budget amount allocated to you by the Alaska VA Healthcare System. There may be months in which you do not spend your entire monthly budget. VA policy says you can accumulate up to $100 less than your monthly budget amount for an Emergency Back-up and Planned Savings Fund. You can use this account for emergencies such as when your employee is unable to work for you and you need to hire a substitute. You can also save money for a big purchase to support your needs, such as disability related modifications to your home. Any unspent funds over this amount will be returned to the Alaska VA at the end of each federal fiscal year (September 30). Your IL Advocate can assist you to stay on track with your spending.
Can someone help me with these responsibilities?
Yes. If you feel that making these decisions and carrying out these responsibilities, such as training and supervising employees and signing time sheets, are more than you can do on your own, you can ask someone to serve as your designated representative. Many people choose a spouse or one of their children to serve in this role. You can also choose a friend or anyone else you trust. You can work as closely as you like with this person to clarify your wishes and desires. Ultimately, you give that person authority to make decisions on your behalf. Please note: your designee may not be paid to provide you in-home care through this program.
Can I hire anyone I want?
Yes. You or your representative are the employer and are responsible for finding, hiring, training, managing and dismissing your in-home support workers. You may hire family members, friends, neighbors or other providers. You may already have in mind someone you want to hire to assist you. If not, the IL Advocate can provide information and assistance regarding existing providers or ways to recruit workers. You may decide to run a background check on an employee, but you are not required to do so for this program.
How do I purchase the goods and services using my budget?
Goods and services must be approved by the VA prior to being submitted for payment/reimbursement. Items are purchased and paid for by our payroll company using funds from your account. Employees will be paid from their timesheets and payment can be either direct deposited into their bank account or they can be mailed a check. For purchase of other goods and services, you will submit an invoice or a receipt and the payroll company will make payment or reimbursement.
How do I ensure I can get care in the event that my worker gets sick?
If you decide to hire personal assistants to assist you in your activities of daily living (e.g. bathing, etc.), it is a good idea to set up an emergency back-up plan in case they are sick or otherwise unable to provide services for you. Your back-up plan could be to use unpaid family or friends, but you should also plan to put away some of your budget for alternate paid supports. You may need to use a more expensive personal care agency as back-up and will need to have funds available to pay them. Your IL Advocate can assist you with locating participating agencies and their rate of pay.
How will I receive ongoing support from SAIL?
You are welcome to contact SAIL at any time to get questions answered or support with the VOICE program. Your IL Advocate can meet with you in person at our office or in your home as needed. Additionally, your IL Advocate will contact you monthly to ensure your services are stable and to see if you have any questions or concerns during your first six months in the program. After that time, your IL Advocate will contact you at least quarterly to check-in.
Is there somewhere I can read more about this program online?
Yes. You can find it explained on the VA’s website:
www.va.gov/GERIATRICS/pages/Veteran-Directed_Care.asp
How do I enroll in VOICE?
To enroll in VOICE you should contact your local SAIL office. They can help determine whether you meet the eligibility requirements, and if you do, help you with the full enrollment process!
What if I don’t want to continue with VOICE?
You may terminate your services with VOICE at any time. You will need to contact your IL Advocate and he/she will complete the Disenrollment Form including the reason for your disenrollment and send it to the Alaska VA Healthcare System and our payroll company. Any unused funds will be returned to the VA and you will be referred back into the Alaska VA Healthcare System to receive other services.
