EPISODE 46 – Helping Veterans Access In-Home Care Through the VA

Episode 46 – Helping Veterans Access In-Home Care Through the VA

Navigating the VA system can be confusing for veterans and their families, especially when additional help at home becomes necessary. In this episode, Jamie sits down with Joe Sanchez from Home Instead to discuss how veterans can receive in-home caregiving support through the VA’s Homemaker and Home Health Aide program. Joe explains the types of services available and how caregivers help veterans maintain independence and quality of life.

They also talk about how families can get started with the process and how organizations like Home Instead help veterans navigate the paperwork, eligibility requirements, and coordination with the VA.

In this episode, we discuss:

• What the VA Homemaker and Home Health Aide (H/HHA) program is
• Types of in-home care available for veterans
• Help with activities of daily living (ADLs) like bathing, meals, and medication reminders
• How veterans can connect with the VA and begin the process
• Typical caregiving hours veterans may receive
• When additional programs like Medicaid may help supplement care
• How in-home care can also support veterans living in assisted living communities

If you or someone you love is a veteran who may benefit from in-home care, this episode offers practical guidance on understanding available resources and taking the first steps toward getting support.

At Team Senior™, our mission is to guide you and support you through the maze of Southern Oregon Long-Term Care.

📞 For Team Senior resources, call: 541-295-8230

Or visit our website for more information: https://www.teamsenior.org/

Transcript

Team Senior Podcast

Episode: Veterans & In-Home Care with Joe Sanchez of Home Instead

JAMIE: Perhaps you've had a stroke, or you've been diagnosed with cancer, or maybe you're forgetting things and now you have dementia. That's our area of expertise, and we are here to share our insight. Welcome to the Team Senior Podcast.

JAMIE: Hi, this is Jamie, and I'm in the studio today with Joe Sanchez from Home Instead. I am very excited to introduce Joe because he serves a piece of the population that I have a huge heart for and I'm very passionate about. Joe, take a minute and introduce yourself.

JOE: Thank you very much. My name is Joe Sanchez. I work for Home Instead. Home Instead is a really great company. It's been serving Jackson and Josephine County for over 20 years. It's locally owned by a really awesome gentleman named Corey Donovan. What we do at Home Instead is serve the elderly — we provide in-home senior care. One of our big focuses is providing companionship and personal care services.

JAMIE: Home Instead is a caregiving agency, and like most caregiving agencies, they not only provide care in the home but also companionship — they can help with medications. What's really important to know is that they accept all the different payment types. They can serve the Medicaid population, they can serve veterans through several different programs, they can serve the long-term care insurance program, and they can also take private pay when somebody needs a caregiver in the home. Sometimes it's a combination of those things. But today we're here to talk specifically about how they serve veterans, a veteran's unique needs, and how that care can be paid for through the VA.

JAMIE: So let's take a deep dive. What kinds of services can Home Instead provide to veterans, and how does a veteran get connected to them?

JOE: Great question. The services we provide are several. Some are just companionship. We help with bathing, we help with showers, and we do meal prep. It's considered non-medical, even though I think it can be confusing because we do quite a bit of hands-on care when we're in the person's home. A lot of the time, veterans start off first with medication administration — that's usually where someone says, 'Hey, I need a little help; I can't keep track of my pills.' But when they start needing a little extra care, we move into bathing, meal prep, and some light housecleaning. A lot of the veterans we serve need help with laundry and dishes.

JOE: As for how to get connected, there are a couple of things. First, having that conversation with us, because every veteran is at a different level in that process. To start, they usually want to call the VA eligibility department. The VA will require them to locate their DD-214 and fill out a 10-10EZ form. That's actually something we at Home Instead help veterans do. A lot of veterans come to me and say, 'I called the VA, I got transferred six times, I don't know what to do.' What we do at Home Instead is educate. We sit down with a veteran and say, 'Okay, where are we at? Where do we need to start? This is who you need to call.' Usually when I talk to a veteran I ask: do you have a diagnosis? What exactly are you needing help with? And then it's, 'Okay, let's call the VA together.'

JAMIE: This is why I love Joe and I love Home Instead. They go the extra mile. In fact, I've even known Joe to take a veteran to the doctor himself, rather than putting it back on the veteran — which is generally the status quo. I will give the VA all the credit in the world because they are the ones oftentimes paying the bills here, but they simply are not staffed to provide the hands-on services that Home Instead provides when it comes to these caregiving hours. So what does a veteran need to have established in order to qualify?

JOE: A diagnosis of dementia or Alzheimer's is one that would almost automatically guarantee them the ability to get care. Another qualifier is needing help with at least two ADLs — activities of daily living — whether that's transferring, help with showers, or meal prep. The VA would like them to have two. And being connected with a VA doctor is also important.

JAMIE: Let's talk about that quickly, because I come across this all the time. If I'm working with someone who is a veteran and is service connected already, but they see a community doctor — not at the CBOC (the Community Based Outpatient Clinic provided by the VA) — those community doctors would be able to make the referral. However, if a veteran is not seeing a doctor connected with the VA, how do we handle that?

JOE: They'd have to call the VA and say, 'I need to get connected — I need to see a VA doctor.' The VA will then assign that person to a provider.

JAMIE: What does the lead time look like?

JOE: It depends. Usually it's a couple of weeks. Sometimes, if the need is urgent, they can expedite the process and get someone seen within a few days. But typically it's a couple of weeks.

JAMIE: Okay. So a veteran needs caregiving in the home, and the veteran needs to be service connected in order to get caregiving paid for by the VA — correct?

JOE: Actually, no. Service connection is different from getting approval and authorization through the HAHA program. A veteran could have a 0% disability rating or 100% and still might not qualify for this. This is really a separate thing — it's the community care side of the VA. The qualifiers here are: two ADLs, or a diagnosis of dementia, and being connected with a VA doctor. That's it. They can get connected regardless of whether they're service connected or what their disability percentage is.

JAMIE: So comp and pension, or disability ratings — none of those are necessarily required to utilize this program?

JOE: Correct. There are some veterans who don't want to go through the process of getting service connected or having a disability rating. They really just want in-home caregivers. This is a separate department.

JAMIE: That is good to know. I honestly had assumed they needed to be service connected to get the HAHA hours. What does HAHA stand for?

JOE: It's Homemaker Home Health Aid. That's why it's called HAHA. It's home health aid — or more specifically, homemaker and home health aid combined.

JAMIE: I always make the joke about not knowing why they call it the HAHA program. Okay, let's talk about spouses. Can spouses qualify for this program?

JOE: No, not through this program.

JAMIE: Can they qualify through the program if the veteran is deceased?

JOE: No.

JAMIE: So there is no way to get HAHA hours through the VA if it's just the spouse?

JOE: Correct.

JAMIE: What else do we need to know about the program?

JOE: The program is really great. It can handle veterans from very low acuity to pretty high acuity. The care plans we create at Home Instead are flexible and they evolve as the veteran's needs evolve. It's not a one-size-fits-all situation — there are multiple ways to use it and to get the care that's needed.

JAMIE: Where can this be utilized? If a veteran is at home, they can get the hours — but what if they're in assisted living and struggling to have all their needs met by the facility staff? Can they use HAHA hours there?

JOE: Yes, great question. We do have some clients in assisted living who require a little extra help beyond what the facility's caregivers can provide.

JAMIE: How many hours are typically available to a veteran each week?

JOE: Every situation is different, but the average veteran uses about 15 hours a week. We have some using 12 hours a week, and 18 hours is about as high as it typically goes. We do have some veterans in the twenties or even thirties, but 15 to 18 hours a week is the typical range.

JAMIE: Is there any consistent reason you see a veteran get denied HAHA hours?

JOE: It really comes down to need. If they don't have a need involving two ADLs — if it's just 'I want someone to come over and clean my house or do my yard' — that's one we see denied a lot. But if they have a need with two ADLs and they're connected with a VA doctor, I haven't seen a situation where they get denied.

JAMIE: A lot of veterans don't really know what help they need until a caregiver comes out.

JOE: Exactly. Some veterans I talk to say, 'Oh no, I'm fine. I can handle things.' But as soon as a caregiver gets in, they're saying, 'Wow, I do need help with my meals. I need help with showers. I need help with light housecleaning.' That's when it clicks — that's the need right there.

JAMIE: Let's say there's a veteran who's been with Home Instead for two years and their care needs are really increasing. They need more hours than what they've been getting. How do they get more?

JOE: We can also work with veterans who qualify for Medicaid. We can bill both Medicaid and the VA. So let's say we're getting 15 hours from the VA — we might be able to add 20 hours from Medicaid. That's something we've been able to do successfully. Beyond that, when a veteran maxes out on the hours allotted, that's when we start having different conversations: Do we need to work more with home health? Does hospice make sense? Does the veteran need to transition to a facility?

JAMIE: They could also just pay privately for more caregiving, right?

JOE: Right, although the VA generally prefers that a veteran not pay privately while also using the HAHA program. They'd rather the veteran transition to hospice or assisted living.

JAMIE: That's very interesting — and a bit of a disappointment.

JOE: Yes, but it is what it is.

JAMIE: Okay, let's talk about the actual experience of connecting with Home Instead. This is part of the reason we are so loyal to them when it comes to veterans' needs. When I'm working with a family and I can sense that they need caregiving and the client is a veteran, I do not want the veteran to have to do any more work than is absolutely necessary. We refer almost exclusively to Home Instead because I can trust that Joe, and Corey Donovan — the owner — and several other people at this organization will take the ball and run with it. They'll do everything in their power to connect all the dots on the back end so that the veteran is benefiting from the service without having to jump through a whole bunch of hoops.

JOE: That's really what we do. My role at Home Instead is two parts: one is to educate the family and the community on what they might possibly need. The other is helping them get through the process. My owner allows me the time to sit down with the family and say, 'Let's look at your options. What does the next week, month, or six months look like?' That's really what I do — educate and guide them through the process.

JAMIE: I love that. And we should note that Joe himself is a veteran, so he truly empathizes with the folks he's meeting with. That makes a real difference, especially if someone is homebound. We're very grateful to all of the staff at Home Instead for everything they do. Joe, if someone is interested in this program, how do they get in touch with you?

JOE: They can call our office. We're located in Medford and we cover Grants Pass, Medford, Klamath Falls, and Ashland. We have a very capable management team who can answer those calls, answer questions, and set up the next steps.

JAMIE: That's great. And you can always call Team Senior as well. As I've said many times on this podcast, if you have any questions — if you remember the podcast but can't remember the name of the company we talked about today — please just call us. We will absolutely help you get connected. Joe, thank you so much for coming on today. This is really important information for our community.

JOE: Thank you very much for having me. You guys do an amazing job with veterans, and you're an awesome resource that we're lucky to have.

JAMIE: Thank you. And thank you for listening to the Team Senior Podcast. We're here every week sharing new and relevant information. Remember, we're just a phone call away. Team Senior can be reached at 541-295-8230. Again, that's 541-295-8230. Until next time, this is Jamie Callahan.