Directed Care vs SMC

[Lemuel]

Trying to get SMCs and "Directed (not Dedicated) Care".  Now getting 11 hours per week from Home Instead, a VA Health Care contractor.  Was getting another contractor who did not have the staffing to up the hours.

Who knows what about these programs? From what I have read you can get both at the same time.  SMCs is paid to you.  Directed Care can be paid to you for you to pay a family member or friend.  SMCs comes from the VA Benefits Division.  Directed Care comes from the VA Health Care Division.

Edited January 15 by Lemuel
correct error

[broncovet]

This sounds a lot like Aid and Attendance, (SMC L) as far as VA benefits is concerned.  I would be very suprised if VA would provide "dedicated care" for Veterans who did not need aid and attendance.  A and A is filed on this form

https://www.va.gov/find-forms/about-form-21-2680/

[jamescripps2]

The VHA's homemaker care pays a contracted company to come in and do chores for you, that include, but not limited to cooking, cleaning, shoping, and caring for your basic needs in the home and is limited to a predetermined number of hours per week. 

The A&A through the DVA pays you, the veteran. You can then use the money to pay for the services that you need, but the DVA does not tell you how to spend the money. There are three levels of A&A, The lowest 2024 rate is an L rating, paying $4,651.06 for a veteran alone. The next higher rating is A&A at the R-1 rate, paying $9,326.07 for the veteran alone. The R-2 and T ratings pay the lone veteran $10,697.23.

[Lemuel]

1 hour ago, broncovet said:

This sounds a lot like Aid and Attendance, (SMC L) as far as VA benefits is concerned.  I would be very suprised if VA would provide "dedicated care" for Veterans who did not need aid and attendance.  A and A is filed on this form

https://www.va.gov/find-forms/about-form-21-2680/

1 hour ago, broncovet said:

This sounds a lot like Aid and Attendance, (SMC L) as far as VA benefits is concerned.  I would be very suprised if VA would provide "dedicated care" for Veterans who did not need aid and attendance.  A and A is filed on this form

https://www.va.gov/find-forms/about-form-21-2680/

 

43 minutes ago, jamescripps2 said:

The VHA's homemaker care pays a contracted company to come in and do chores for you, that include, but not limited to cooking, cleaning, shoping, and caring for your basic needs in the home and is limited to a predetermined number of hours per week. 

The A&A through the DVA pays you, the veteran. You can then use the money to pay for the services that you need, but the DVA does not tell you how to spend the money. There are three levels of A&A, The lowest 2024 rate is an L rating, paying $4,651.06 for a veteran alone. The next higher rating is A&A at the R-1 rate, paying $9,326.07 for the veteran alone. The R-2 and T ratings pay the lone veteran $10,697.23.

 

Yes, filed that form after beginning what is apparently a form of "Directed" Care:  (not dedicated care.  Sorry to send the searchers on a wild goose chase.  Chalk it up to my needing "Directed Care.")

Veteran-Directed Care - Geriatrics and Extended Care (va.gov)  

Was surprised to be given a form of the directed care where the VA paid for community care services.  Cheyenne Regional Medical Center employes CNA's for this service that live in my town.  You get rated for the number of hours per week.  The CNA's had to do some of the personal care but were limited from shopping and other outside services such as taking you to your appointments, going to pick up your electric wheelchair, anything outside other than taking out the trash.  This is apparently something that is done for Medicare Patients as well by the CRMC.

Had service raised from 3 hours per week to 11 hours per week.  CRMC did not have the staffing for that.  Home Instead, from a nearby town, is what I contacted realizing my wife was going to come home in worse shape than I am.  Directed Care is only for the veteran.  There is SMC for spouses also on that 21-2680 form.  But I was anticipating paying Home Instead extra to take care of both of us in our home using the SMC for both of us.  Now it is only me so Home Instead is paid for from Community Care Services. (I will see an Optimum bill when it is paid)

I have the contractor, Home Instead, providing the 11 hours per week.  But that leaves no care on the weekends.  My caregiver is going to make microwavable meals on Friday for Saturday and Sunday.  I am looking for a live in caregiver that will work for the SMC plus room and board with relief during the week from the Directed Care.  Apparently, the VA has some space in Cheyenne where the provide long term care and will let me stay there when my live in needs a vacation.  Probably take away the SMC during that period because they will be taking care of me.

I am just getting into this.  I do not have the results of the SMC application yet.  Cheyenne VA is up to the old tricks of 2012.  Because of pressure applied when I thought the Benefits section had made an error by muting my SMC claim instead of my wife's on her death.  They called me and scheduled an appointment for consults ordered by primary care on the SMC form with Occupational Therapy and physical Therapy that were not intended to be kept.  On 12/29/23 they printed the "confirmation appointment cards" and a letter telling me to call.  On 1/2/24 they called and hung up on the answering machine.  The appointments were cancelled on 1/2/24 after making that one required phone call. The call recording, I have as well as the billing record for a 0.4 second incoming call.  I cannot believe Cheyenne VA is doing the same thing Phoenix and Cheyenne did in 2012 and expecting those of us who experienced it to not catch it.  I received the confirmation cards on 1/8/24.  The letter to call 1/9/24 too late opening it to call and had to leave to early to call before going to make the first appointment with Occupational Therapy.

I do not know if I will get SMC now.  I was collapsing to the right before getting oxygen therapy because of right side weakness so needed help with bathing and dressing.  Still need to be watched in case my oxygen level gets low but have been able to at least bath myself.  Do not get fully dressed.  Arms sometimes lock in pain when I raise them over my head to put on undershirts, shirts and coats.  So pretty much housebound in a house coat setting in a wheelchair doing this post.  

James, thanks for the input.  There also appears to be an SMC-s that appears to be the second lowest and easiest to get.  Lowest is for erectile dysfunction on the page I remember looking at.

[jamescripps2]

You might check on the PCAFC caregiver program. If you need help with ADLs and can find someone who is willing to move  in and take care of you, you might qualify. The compensation to your caregiver, room and board for the caregiver, and CHAMP VA would make it tempting.

[Lemuel]

2 hours ago, jamescripps2 said:

You might check on the PCAFC caregiver program. If you need help with ADLs and can find someone who is willing to move  in and take care of you, you might qualify. The compensation to your caregiver, room and board for the caregiver, and CHAMP VA would make it tempting.

This is what I had heard about but did not find when I found the others.  Also explains the Social Worker's confusion about what I have now been approved for.  But it looks like I have to line up my own caregiver.  Have been working on that through my religion.