Photo by Megan Pacer/Peninsula Clarion The Independent Living Center Executive Director Joyanna Geisler explains the ins and outs of Veteran-Directed Home and Community Based Services to a room of veterans and their families on Wednesday, Dec. 16, 2015 at the Ninilchik Senior Center in Ninilchik, Alaska.

Photo by Megan Pacer/Peninsula Clarion The Independent Living Center Executive Director Joyanna Geisler explains the ins and outs of Veteran-Directed Home and Community Based Services to a room of veterans and their families on Wednesday, Dec. 16, 2015 at the Ninilchik Senior Center in Ninilchik, Alaska.

Peninsula VA home services program is first in Alaska

Alaska veterans in need of at-home care can now get those services paid for by the Alaska Department of Veterans Affairs through a program offered by the Independent Living Center of the Kenai Peninsula.

About 10 veterans and family members learned about the program during a presentation at the Ninilchik Senior Center on Wednesday. The Independent Living Center, which has offices in Homer, Soldotna and Seward, was contracted as an Aging and Disability Resource Center to provide the program’s services for the Alaska VA.

Veteran-Directed Home and Community Based Services, commonly referred to as VD-HCBS, allows veterans with long-term care needs to dictate the kinds of services they get, and receive them in their own homes.

The program has been available through the VA in the Lower 48 for years, but the Alaska VA has never implemented it. It took advocacy on the part of the Independent Living Center with the VA since last fall to get the program started on the Kenai Peninsula, according to Independent Living Center Director Joyanna Geisler.

“Before this program, what the VA will support is about 12 hours a week in the home of home health or hospice… and then at the other extreme there’s nursing home care,” she said. “So there was nothing in between, so when you think about it, that’s a huge gap.”

To be eligible for VD-HCBS, veterans must be determined to need nursing home-level care. An initial assessment performed by the VA determines how much money the veteran will get in monthly installments. Those funds can go toward whichever services or equipment the veteran identifies as the most vital, Geisler said.

Geisler cautioned that the program isn’t the best option for all veterans, as keeping track of the services and money allowance is a lot of work. If enrolled veterans are unable to make those kinds of decisions, they can select someone as their representative to the program. They can also pull out of the program at any time, she said.

One positive thing about the VD-HCBS is that it puts control back into the hands of veterans, Geisler said. The Alaska VA has no involvement past making an initial medical assessment to determine whether a person is eligible, and footing the bill, she said.

It is the veteran participating in the program who chooses the caregiver that will work with them.

“Its intention is to support veterans and their families that are enrolled in VA health care to stay in their homes as long as they chose and as safely as possible with various supports rather than going into a nursing home,” Geisler said.

The Aging and Disability Resource Centers across the state can be contracted through the Alaska VA to provide the program, she said.

One drawback where it operates in rural areas of the peninsula is that it won’t function without caregivers, which Geisler said the veterans have to find themselves. Several listeners at Wednesday’s meeting voiced concern about the lack of trained caregivers either in Ninilchik and Clam Gulch or willing to travel that far from Homer or the Central Kenai Peninsula.

Ninilchik Senior Center Director Shelli Ogren said the concern is less with the program and more with the ability to get qualified caregivers to the area.

“This is really nice to have,” Ogren said. “We’ve discussed trying to get community people that will start wanting to do this job. It’s proving a little bit difficult…”

Geisler said the Independent Living Center staff have considered posting notices at Kenai Peninsula College in both Soldotna and Homer in an attempt to attract students making their way through Certified Nursing Assistant programs as potential caregivers. Another solution would be for a veteran to make a family member their caregiver. Often, Geisler said family members are already filling those roles, but the VD-HCBS program allows them to collect a paycheck for it.

“It’s a tough one,” Geisler said of the workforce shortage. “These guys are kind of a central hub in this little tiny community, and I think through word of mouth, if somebody is looking for a job… if there are people who want to work, and work in this arena, and work in this field, there are probably jobs here. You don’t have to drive to Homer or to Soldotna.”

Ninilchik resident Kathy Wallace suggested trying to draw local high school students into the program through jobs in the health care industry. However, she noted this would be difficult because workers under the age of 18 are more restricted.

Since the Independent Living Center got the program together in August, Geisler said four veterans have been enrolled. Wednesday’s attendees complained that there wasn’t enough notice or advertisement for the program itself since it launched.

Geisler said the center will continue to promote the VD-HCBS program during general Alaska VA meetings in the coming months.


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