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Independent Living News & Policy from the National Council on Independent Living

Supporting Independence for Veterans: An Update from the NCIL Veterans Subcommittee

By Marsha Unruh, Co-Chair of the NCIL Veterans Subcommittee and IL Program Manager at The Independence Center

Proudly serving her country in the Army for 12 years, Marilyn has spent an entire lifetime taking care of others and living life on her terms. As the years passed, her health began to decline. Soon she found herself struggling with the most basic tasks like bathing, dressing, and navigating stairs.

Marilyn heard about the Veteran-Directed Home and Community Based Services (VD-HCBS) program from her Veterans Administration Social Worker who believed that she would be an excellent candidate for the new program. She was excited to have the opportunity to remain in her home and direct her own services. After meeting with her Veteran Coach, Ashley Billington, at The Independence Center in Colorado Springs to discuss the program and complete enrollment, Marilyn was pleased to find that she could compensate her daughter, who had recently relocated from Florida, to help take care of her needs. 

The Veteran-Directed Home and Community Based Services (VD-HCBS) program offers eligible veterans the opportunity to self-direct the services they need to remain in their home and community. Veterans have the freedom and flexibility to decide for themselves what mix of goods and services best meet their needs. Veterans:

  • Hire their own personal care aides (which can include family, friends, or neighbors)
  • Manage a flexible, individual budget
  • Purchase items or services needed to live independently in the community
    • Services may include: homemaker, personal care, transportation, chores, home-delivered meals, environmental modifications, technology for safety and independence, and health-related services or equipment
    • Services cannot duplicate a service already provided through the VA

Over the past year, Marilyn has accomplished several goals in support of her independence. She has successfully managed a flexible monthly budget, which she uses to pay her daughter as her full-time attendant. With the assistance of her Veteran Coach, she had her bathroom modified to increase her accessibility and safety while showering. She also purchased a stair glide that allows her to access all levels of her home. Marilyn is most proud of the fact that she is able to remain in her home and direct her own services based upon her needs and desires. She looks forward to the next year as she spends time with her family and maintains her independence.

The VD-HCBS program is operated in partnership between the Administration for Community Living and the Department of Veterans Affairs (VA). The decision to offer VD-HCBS is made by VA Medical Centers that work directly with one of the following: Aging & Disability Resource Centers, Area Agencies on Aging, Centers for Independent Living, or State Units on Aging. Currently, VD-HCBS is offered by 63 of the 154 VA Medical Centers in 36 states and territories and partners with 181 Aging & Disability Network Sites. VD-HCBS was recently recognized as a promising practice by AARP, and the VA has announced plans to expand the program in the coming years.

VD-HCBS serves all veterans from all eras. Veterans must be enrolled in the VA health care system and meet the eligibility requirements for the service. Find out if a VA Medical Center near you is offering the program.