Veterans Directed Care: Choice, Independence, and Support

 Veterans deserve the freedom to live where and how they choose. In this episode, ARISE-Exceptional Family Resources CEO Bruce Drake sits down with Lauren Canaro, Assistant Director of Consumer Directed Services, to explore the Veterans Directed Care Program.
 Lauren shares how the program empowers veterans of all ages to remain in their homes by directing their own care, hiring trusted caregivers, and using a personalized budget to meet daily living needs. The discussion walks through eligibility, the VA referral process, and the wide range of supports available, illustrating how Veterans Directed Care promotes independence, dignity, and quality of life. 

Transcript

SPEAKER_01 0:08

This is the Arise Exceptional Family Resources Podcast with your host, CEO Bruce Drake.

SPEAKER_02 0:15

Hi everyone, I'm Bruce Drake, the CEO at Arise and Exceptional Family Resources, and I'm your host for today's Exceptional Talk on Disabilities. I'm excited today to be joined by our Assistant Director of Consumer Directed Services, Lauren Canaro. So Lauren oversees a couple of programs with the agency, but we're here today to talk about Arise's Veteran Direct Care Program. Welcome, Lauren.

Lauren’s Path To Community Work

SPEAKER_00 0:39

Thanks for having me, Bruce.

SPEAKER_02 0:40

So, Lauren, why don't you start off by just telling us a little bit about yourself?

SPEAKER_00 0:44

So I have been with Arise in Exceptional Family Resources now for about eight and a half years.

SPEAKER_02 0:52

Okay. Wow.

SPEAKER_00 0:54

So I have seen some different roles throughout my time. I have worked as a coordinator, a personal assistant, and then the current role that I have now.

SPEAKER_02 1:06

So did you go to school thinking that you would work at a place like what where did you go to school and and what did you go to school for?

SPEAKER_00 1:13

So I went to school for teaching.

SPEAKER_02 1:15

Okay.

SPEAKER_00 1:15

I have a degree in human services. Okay. So I've always wanted to have a job that impacts the community in some fashion.

SPEAKER_02 1:23

All right.

SPEAKER_00 1:24

Um I started out teaching, realized quickly that that was not necessarily the avenue that I wanted to go down.

SPEAKER_02 1:33

We we have a lot of employees who who went to school to become educators and got into the system and it wasn't what they had always thought it would be, and have come to us, and their skills translate you're a perfect example, right? You have fantastic skills and they translate great to the job that you do.

SPEAKER_00 1:49

Absolutely.

SPEAKER_02 1:50

So and did you work anywhere after school before a rise in exceptional family resources?

SPEAKER_00 1:56

I did. So many places. So I've worked at VETS offices as VAT assistants. Um I've been lead teachers at different child care facilities, anywhere from like Head Start on the south side of Syracuse, all the way to the Jewish Community Center over in DeWitt.

What Veteran Directed Care Is

SPEAKER_02 2:16

Okay. And we're here to talk about the Veterans Directed Care program, but what else do you do in your current role?

SPEAKER_00 2:23

So I currently oversee the CDPAP program that we offer. Um, and also another program that the acronym is ISIP.

SPEAKER_02 2:33

Okay. So the CD PAP program, that's a that's a whole nother podcast, right? We can talk about that for hours, especially with the changes that have happened. So we're going to talk about the Veterans Directed Care program, but do you have any personal relationship with people with disabilities or veterans, or this has just been a call in and you really just want to help the community?

SPEAKER_00 2:53

So a little bit of a mixture of both. My grandparents, I've had a grandfather in World War I, World War II, Vietnam. So my heart goes out to the veteran community that is rather underserved, so it just kind of goes hand in hand.

SPEAKER_02 3:10

Aaron Powell Did you ever think of going into the military? No, I'm the same. So why why don't we tell the people a little bit about what the veterans directed care program is?

SPEAKER_00 3:24

Okay. So the veteran directed care program is designed to keep veterans living at home or their chosen community space with the assistance of um their chosen staff and supports.

SPEAKER_02 3:38

Okay. So what does that mean?

SPEAKER_00 3:40

So that means that if a veteran is eligible for services, which eligibility is determined by the Syracuse VA Medical Center, they do an assessment screening to see where that eligibility lies and if they're service connected at any point.

SPEAKER_02 4:00

Okay.

SPEAKER_00 4:01

They then are referred to Arise and Exceptional Family Resources for the program. We then get to meet with them, enroll them essentially in the program, and work with them to ensure that they're meeting their goals of spending their budget appropriately to have them remain in the community.

SPEAKER_02 4:23

So so this is somebody who served for the military who would like to continue, let's say, live in their house where they've lived for the last 30 years, but now might be having some difficulties living there independently. Correct.

SPEAKER_00 4:37

So it honestly can be of all ages for um the veteran. It just depends on where they score on needing that level of assistance for day-to-day living.

SPEAKER_02 4:49

Okay. And the the scoring, I think that would make people nervous. Is it the the VA who actually does the scoring? They're the ones who determine eligibility? Correct. And what what counties are we providing this service in? And is this service available in the counties where we don't provide the service?

SPEAKER_00 5:08

Yep. So this is a federal program. It's offered throughout New York State. Okay. We currently offer services in Onadaga County, Oswego County, and Cayuga County.

SPEAKER_02 5:20

Okay.

SPEAKER_00 5:20

But there's other ILCs in the area.

SPEAKER_02 5:23

What's an ILC?

SPEAKER_00 5:24

An independent living center that different VA centers can contract with to provide these services.

SPEAKER_02 5:33

In the same counties. So is each county have its a single provider, or can you have multiple providers in a single county?

SPEAKER_00 5:41

Nope. So there's a single provider per county.

SPEAKER_02 5:44

And it's based on the county where the veteran lives?

SPEAKER_00 5:46

Correct.

How Referrals And Assessments Happen

SPEAKER_02 5:47

So if if they live in one of the three counties that we provide services to, they reach out to the VA and the VA connects them to us, or do they reach out to us directly?

SPEAKER_00 5:57

So they would reach out to the VA directly. They can have their care team at the VA do a referral for the program if they're interested in it. Okay. Or they can reach out to our veteran directed care contact at the VA Medical Center. And they can be called at 315-425-6548.

SPEAKER_02 6:21

Why don't you say that number again?

SPEAKER_00 6:23

It's going to be 315-425-6548. And that's on the individual that does our assessments to deem eligibility for the Veteran Direct to Care program. And they are a veteran Direct to Care program coordinator.

SPEAKER_02 6:44

Got it. So let's say uh I'm a veteran and I have this need, I want to continue to live in my home, but I have a medical condition that's making it more and more difficult. Without this program, I might end up in a skilled nursing facility or having to live with a family member who may or may not be happy that I'm going to move in with them. So I reach out to the VA, they do an assessment, and they determine that I'm eligible. So you had mentioned budget. So what do you mean by budgets? Does that mean as a veteran I get a budget of dollars to spend any way that I see fit?

SPEAKER_00 7:17

Yes. Okay. So the VA Medical Center will um determine the level of budget that best fits the needs for that individual.

SPEAKER_02 7:27

So based on their needs, there's a there'll be a determination of how how many dollars should be in the budget.

SPEAKER_00 7:32

Correct. Okay. Yep. And then that budget then is broken up into a 12-month global budget. Okay. That um a Rise and Exceptional Family Resources will meet with that veteran or the authorized representative that is working on behalf of the veteran to determine the best ways to utilize those funds.

SPEAKER_02 7:54

Okay. So w what is a Rise Exceptional Family Resources role in this?

Hiring Family Or Trusted Caregivers

SPEAKER_00 8:01

So we have person-centered counselors. Okay. Those are the two individuals that meet with the veterans or authorized representatives out in the community to help them utilize the program and be successful and be that liaison between the VA Medical Center and the veteran. Trevor Burrus, Jr.

SPEAKER_02 8:22

But the VA is not so let's say somebody's budget is$20,000. The VA is not sending the veteran a check for$20,000. Right. That's not how it works.

SPEAKER_00 8:31

Trevor Burrus, Jr. So it is essentially a I like to describe it as a fictional funds that are available.

SPEAKER_02 8:41

Trevor Burrus For the from the veteran's perspective. Correct. Okay.

SPEAKER_00 8:44

That they're able to utilize. So if it's not used, it's not like it's going to roll over to the next year, but then it's also not funds that are just like vanished and gone.

SPEAKER_02 8:56

Right.

SPEAKER_00 8:57

So because the VA is very tailored on what they are approving for that budget, it really should match the needs of that veteran.

SPEAKER_02 9:08

So as I go through the process, as now I'm speaking as if I was a veteran who who's receiving the service. So I'm going through the process. So then I can use those dollars to hire an aid, but the dollars don't come to me, they go to Arise. Is that where the dollars go? Okay.

SPEAKER_00 9:39

Yep. So the veteran or authorized representative has the autonomy to hire and train veteran care attendants. So that would be their aid.

SPEAKER_02 9:48

Will Arise do that for me if I don't want to hire my aide, or do I is that my responsibility?

SPEAKER_00 9:53

No, it would be your responsibility because it's consumer driven.

SPEAKER_02 9:56

Got it.

SPEAKER_00 9:57

So different than a home care agency, we wouldn't be staffing a case, but we are there to help support that veteran with honestly any questions regarding the hiring process. Um they then will do the interviews with those individuals if they are not already family members.

SPEAKER_02 10:20

So I could hire I could hire a family member?

SPEAKER_00 10:22

Oh, absolutely.

SPEAKER_02 10:23

Even if they're already maybe helping me around the house?

SPEAKER_00 10:26

Yeah. So that is one of the biggest obstacles that we see when individuals come to this program is that they already have caregivers in place, so maybe their daughter, son, things of that nature that are not working their day-to-day job because they are working with the veteran. Got it. So this is a nice way for them to be compensated appropriately for the work that they're already doing with that loved one.

SPEAKER_02 10:56

Okay. But it it could also be someone that so it could be a family member, it could be someone who's already helping them or not, or it could be a neighbor, or someone they could place an ad and and get someone that they've never met before.

SPEAKER_00 11:07

Correct.

SPEAKER_02 11:08

Okay. Who determines what the pay amount is and are there benefits that go for the staff as well? How does that work?

SPEAKER_00 11:17

So the pay rate is set by the veteran or authorized representative. So that person-centered counselor from Arise or Exceptional Family Resources will meet with them to go over the budget amount, what they're able to utilize monthly for direct care services. Okay. And then from that point, they're able to say if they want to pay someone, say, twenty dollars an hour, their budget then could support X amount of hours of direct care per week. Um and then they offer the position to that veteran care attendant.

Beyond Staffing: Covered Supports

SPEAKER_02 11:53

So just like just like anybody, right? They they have a a single pot of money to spend on staff, and then based on how many hours of need they need, they they can kind of calculate what the pay rate can be based on how much need they have and how much how many dollars are available. Got it. All right. That that must be very popular with the veterans. I would think having the ability to hire, you know, your your neighbor or your niece or your your sister to come and provide some assistance, right? You're feeling more comfortable with who who's coming into your house. Uh it's somebody that you know, uh and at the same time they're able to live a life because they're not giving up their opportunity to work to help you out. So there's less guilt guilt involved, I would think, as well.

SPEAKER_00 12:38

Oh, absolutely. And it gives the veteran the level of autonomy to make those choices on their own behalf versus if they were in a rehab situation or not in their home.

SPEAKER_02 12:52

Aaron Ross Powell That's great. Uh we only have a couple minutes left. So are there other things other than staffing that veterans are able to pay for that allows them to continue to live independently in their communities?

unknown 13:04

Yep.

SPEAKER_00 13:04

So the budget is able to accommodate um different personal care supplies, so things that will help with daily living skills. Um meal preparations, um, transportation, meal delivery services, um there's respite care for family and caregivers. There's also assistive technology, so like communication boards, um pill dispensers.

Determining Medical Necessity Together

SPEAKER_02 13:36

So there's a a list of things that they can How about things like somebody mowing the lawn or shoveling the walk when it snows, things like that?

SPEAKER_00 13:44

Trevor Burrus If it's deemed medically necessary for them to leave their home in lovely Syracuse in the winter in order.

SPEAKER_02 13:54

It never snows in Syracuse in the winter.

SPEAKER_00 13:56

So we could justify potentially plow services if they're leaving for medical appointments. Obviously, if care attendants are coming to the home as well, we need to make sure that they're able to leave and enter driveways safely.

SPEAKER_02 14:11

Sure. Who who makes that determination? Is it the the VA? Is it a Rise Exceptional Family Resources? Is it you as a veteran? How do you just distinguish that?

SPEAKER_00 14:19

It's a collaboration of all three. So the veteran would voice that need, and then the person-centered counselor would have that conversation with them about why they feel as though it may be medically necessary, and then they relay that to the VA Medical Center. The VA Medical Center is the one who ultimately at the end of the day has the final say, but we can do that legwork to make sure that they have all the information needed for a success.

SPEAKER_02 14:51

It sounds like a fantastic program, and I would imagine for the veterans who receive it, uh, it really changes their lives. It allows them to live the independent life that they want to continue to live. And I really thank you for coming in today to talk about the program. Uh thank you for finding the time. Ladies and gentlemen, that was Arise Exceptional Family Resources, Assistant Director of Consumer Directed Services, Lauren Canaro. As always, thank you all for listening, and we hope you join us next time as well.

SPEAKER_01 15:22

This has been the Arise Exceptional Family Resources Podcast with CEO Bruce Drake, recorded and produced at the WCNY public broadcasting studios. For more information, visit our website at contactefr.org. You can also follow us on Facebook. Thank you for listening.