Beyond Aid and Attendance pension, Texas veterans may access: VA Community Living Centers (VA-operated skilled nursing facilities); the Community Care Network (VA-authorized care at private facilities); State Veterans Homes (state-operated nursing homes with VA per diem); Home and Community-Based Services through the VA; the PACE program (Program of All-inclusive Care for the Elderly) at some VA sites; and VA-funded home health and respite care for enrolled veterans.

VA Community Living Centers (CLCs) are VA-operated skilled nursing facilities that provide short-term rehabilitation, long-term care, and hospice for eligible veterans. Eligibility and copay requirements depend on the veteran’s VA priority group. CLCs provide nursing home level care within the VA system. In Texas, CLCs are located at the Houston, Dallas, and San Antonio VA medical centers. Contact the VA Social Work department at the nearest VAMC to assess eligibility.

Texas operates State Veterans Homes (nursing homes and assisted living facilities) administered by the Texas Veterans Land Board. These facilities are available to Texas veterans who meet service and residency requirements. They offer quality long-term care at reduced rates subsidized by VA per diem payments and state funding. Texas has State Veterans Homes in Amarillo, Big Spring, Bonham, El Paso, Floresville, Lamesa, McAllen, Temple, and Tyler.

The Community Care Network allows eligible veterans to receive VA-funded care from private community providers when VA facilities are not accessible or cannot provide needed services in a timely manner. This can include skilled nursing care, home health, and hospice at community facilities. Approval goes through the VA, and the process requires coordination with the veteran’s VA primary care team. Community Care can fund nursing home care for veterans who meet VA nursing home eligibility criteria.

VA nursing home care eligibility is more complex than Aid and Attendance. Veterans with a service-connected disability of 70% or higher, or who are totally disabled, have priority access to VA nursing home care at no cost. Veterans with lower service-connection ratings or no service connection may be eligible based on VA clinical need and financial means testing. Contact the VA Social Work team at the nearest VAMC to evaluate specific eligibility.

Yes. VA Home-Based Primary Care (HBPC) provides comprehensive primary care in the home for veterans with complex chronic conditions who have difficulty traveling to VA facilities. VA Homemaker and Home Health Aide services provide personal care assistance. VA Skilled Home Health Care provides nursing and therapy visits. Eligibility depends on enrollment in VA healthcare and clinical need. Contact the nearest VA medical center’s Social Work or Care Management department.

The Program of All-inclusive Care for the Elderly (PACE) provides comprehensive medical, social, and long-term care services for people 55 and older who need nursing home-level care but prefer to live in the community. PACE is available at some VA sites for veterans who meet eligibility criteria. Non-VA PACE programs are also available for Medicaid-eligible Texas seniors. Contact the local VA Social Work team or local Area Agency on Aging to identify PACE availability in your area.

Yes. VA covers hospice care for enrolled veterans at VA-contracted community hospice agencies or VA-based hospice programs. Veterans receive hospice services regardless of whether the cause of terminal illness is service-connected. VA hospice may be provided at home, in a Community Living Center, or in a state veterans home. The VA also has We Honor Veterans partnerships with community hospice agencies to ensure veteran-specific end-of-life care.

Veterans Directed Care is a VA program that gives veterans and their families control over a flexible budget to self-direct their care at home. Veterans work with a counselor to create a care plan, hire their own caregivers (including family members in some cases), and manage their care budget. VDC is available at some VA medical centers for veterans who need long-term services and supports. Contact your VA social worker to determine availability.

The VA Caregiver Support Program provides support to family caregivers of eligible veterans. The Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides stipends, healthcare, respite care, and mental health services for caregivers of veterans who were seriously injured in the line of duty. The Program of General Caregiver Support Services provides education and support for all VA-enrolled veteran caregivers. Call the VA Caregiver Support Line at 1-855-260-3274.

Start by contacting the Social Work department at the nearest VA Medical Center. Social workers assess eligibility, explain available programs, and help coordinate enrollment. You can also contact your local Veterans Service Organization (VSO) for assistance — the DAV, VFW, and American Legion all have accredited service officers who provide free claims and benefits assistance. The Texas Veterans Commission also has benefits counselors statewide.

VA benefits and Medicaid can interact in complex ways. Aid and Attendance income counts as income for Medicaid purposes. VA nursing home care and Medicaid nursing home care are different programs with different eligibility criteria. It is possible to use VA benefits before Medicaid eligibility is established, and to plan for eventual Medicaid enrollment. An elder law attorney who understands both VA and Medicaid rules should be consulted for complex situations involving both programs.