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Nick Bonitatibus
If your agency is working with veterans or trying to, this training is for you.
I brought in Carmen Perry, one of the most knowledgeable voices in VA advocacy, to answer the questions home care agencies are actually asking: How do you get more VA referrals? What's changing with the RFP? Who qualifies, and how do you navigate the system without getting stuck?
Carmen has 15 years in this space, sits on multiple national boards, and does not waste your time. Watch the full training below.
Home Care Champions Experience (Sept 23-25th, 2026)
Paradigm
Carmen Perry brings over 15 years of dedicated advocacy for our nation's veterans to this training. She sits on the board for the Certified Senior Advisor Editorial Journal, serves on the Home Care Association of America VA Advisory Council, and chairs the National Aging in Place Council Board of Directors.
This guide captures Carmen's answers to both pre-submitted and live questions from home care agency owners and operators across the country. The content covers the VA Community Care Network, credentialing, referrals, veteran eligibility, and practical business considerations for agencies serving veterans.
The RFP is a Request for Proposal. The VA released one in December to third-party administrators. Currently, Optum and TriWest divide the country between them. The expectation is that going forward there will be up to five different third-party administrators nationwide rather than just two.
The two biggest changes coming from this RFP:
First, there will no longer be a denial of credentials due to oversaturation. Every state has hit the barrier of trying to get credentialed and being told the network is full. That changes. If you are currently providing care to a veteran through the Community Care Network, you are already in. If you have been held out due to oversaturation, or you are in California or Texas where credentialing has been shut down entirely, you will now have the opportunity to get into the Community Care Network.
Second, credentialing will have to be completed within 90 days. The long waits that have stretched into months and years are being addressed. Everyone gets credentialed, and it happens within 90 days.
Important note: if your area gets assigned a completely different third-party administrator than the one you are currently under, you will need to go through recredentialing. There are expected to be some protections for continuity of care, but stay ready. Keep your business license current, keep your insurance up to date, and be prepared to go through the process again.
The VA is also consolidating from 18 regional locations down to five, which will cause some delays during the transition. The submission deadline for the RFP has been extended to April 3rd. Award announcements for the new third-party administrators are expected in January 2027, so there is time to prepare, but start now.
This is the number one question nationwide. Here is the framework:
1. Know your market. Go to VA.gov and pull the state summaries of veteran demographics. There is a heat map showing how many veterans are in your area who need care, what war periods they served in, how many are enrolled in VA health care, and how many are receiving pensions. Start there. It tells you how much time to invest in this and where to go to find veterans. They tend to be at VFWs, senior centers, and in the acute and post-acute care systems.
2. Use the right channels to open communication. If you are already providing care to veterans, communicate proactively with the VA social worker or case manager. Give them updates on how care is going. Let them know about any changes in condition or any issues, whether the news is good, bad, or somewhere in between. Case managers need to report upward on how their veterans are doing. If you give them positive, accurate, and timely information, they will learn to trust you. And when something goes wrong, you want to be the first phone call to that case manager, not the last. Tell them what happened, how you solved it, and how you will prevent it from happening again. That transparency builds real trust.
3. Be a solution for high-acuity cases. Veterans often have complex needs. If you have caregivers trained in PTSD, Alzheimer's, dementia, or other conditions veterans are more likely to experience, make that known. Case managers refer to agencies that can handle the hard cases.
4. Provide exceptional care. Word of mouth is the number one driver of additional business. A veteran telling their case manager or primary care physician that they are receiving outstanding care from your agency will circulate and generate referrals.
Two things to check immediately.
First, make sure you are actually showing up in the VA system. There are cases where an agency is credentialed with TriWest or Optum but is not appearing in the local VA caseworker system. If a veteran requests your agency by name and the caseworker cannot find you in their system, they cannot kick out a referral to you. Contact the local VAMC and confirm that you are visible in their system.
Second, make sure the veteran is going in with your name and the name of your agency clearly in hand, whether that is a business card or a flyer. When they state your name to their primary care physician, case manager, or social worker, it gets entered into their electronic health record. That is how the referral gets connected back to you.
If you are in the system and the veteran is requesting you by name and still not coming back, have the family reach out to the patient advocate at the local VA. Veterans have a right to choose their care provider. That right should be enforced.
This is one of the most important issues to understand. Veteran choice is not a suggestion. It is a legal right. A veteran has the right to choose who provides their care, and local VA staff cannot override that.
If that right is not being honored, have the veteran or their family reach out immediately to the patient advocate at the local VA. Every VA has one on staff specifically to advocate for patient rights, and veteran choice falls squarely within that.
If the patient advocate is being ignored or the family is not making progress, escalate the complaint up to the chief of the geriatric care line. Do not let this go unchallenged. Veteran choice is a right, and it needs to be treated as one.
Three things are required:
1. The veteran must be enrolled, or eligible to enroll, in Veterans Health Administration (VHA). If they are not currently enrolled, they will need to go through the enrollment process at the local VA or clinic.
2. They must demonstrate a medical need for in-home support.
3. They must have an established primary care physician at the VA. That PCP is the one who prescribes and authorizes the in-home support.
If the veteran is already enrolled in the VHA system, they simply need to make an appointment with their VA primary care physician and explain why they need home care. That is the starting point.
If they are not enrolled, they need to complete a VA Form 1010EZ to get into the system. To be eligible for VHA, a veteran generally needs to have limited income and must have served under anything other than a dishonorable discharge.
However, if the veteran has a service-connected disability, the income requirement does not apply. Even a 10% VA disability rating removes the income limitation entirely, and any veteran with a service-connected disability can enroll in VHA regardless of income.
No. A veteran can maintain their civilian primary care physician. However, to receive a Community Care Network referral for home care, they will need to establish a VA primary care physician. That VA PCP does not have to become their primary doctor. They just need one on record for the purpose of getting referred to home care services.
Yes. In some cases, especially in rural areas or areas with limited access to care, a nurse practitioner functions as the veteran's primary care. If they are acting as primary care, they can make referrals to the Community Care Network just as a physician would.
Transportation is not included in the Community Care Network HHA, homemaker, or respite authorizations. Veterans will need to either pay out of pocket or look at other benefit sources such as Aid and Attendance or Area Agency on Aging programs.
Every county has different transportation resources for seniors and often additional benefits specifically for veterans. Find out what is available in your area. Connect with your local community and identify those programs, because this is an extremely common need. Nearly every veteran on the Community Care Network wants transportation.
Importantly, you cannot provide transportation during the hours you are authorized to provide care. If you are authorized for 10 hours a week of personal care for a veteran, you cannot put them in a car and drive them to a doctor's appointment during those 10 hours. Outside of those authorized hours, you can provide transportation at no cost if you choose to.
Each VA operates differently. Your job is to learn how your local VA handles hour increases. Some VAs want you to go directly to the primary care physician. Others route requests through the PACS team. Still others want you to contact the social worker or case manager directly. Find out what the process is for your VA and follow it.
If you have done everything on your end and are not getting traction, have the veteran's family contact the patient advocate. The patient advocate's role is to serve the patient, not the provider. A request coming from the veteran or their family will carry more weight than one coming from the agency.
Medicaid and Medi-Cal are always the payer of last resort. If the VA is involved, the VA benefit must be fully exhausted before Medicaid or Medi-Cal will step in. Always bill VA first.
Veteran-Directed Care allows veterans to control and direct their own care. It is not a bad program, but there are significant trade-offs that veterans need to understand before choosing it.
If a veteran enrolls in Veteran-Directed Care, they leave the Community Care Network entirely. You will lose them as a client. More importantly, they essentially become a home care employer. They are now responsible for scheduling, paying their caregiver, handling taxes, and managing all the administrative responsibilities that go with it.
For a veteran who is organized and healthy enough to manage that, it may work well. But for anyone with even mild cognitive impairment, or who is simply too ill to manage those responsibilities, it is not a good fit. And there is no backup when a caregiver calls out sick. No one else is coming.
When a veteran asks you about the difference, have the full, transparent conversation with them. Explain what they would be taking on. That honesty is in their best interest.
This is happening coast to coast right now. The VA system is overloaded, and response times are not keeping up with expiring authorizations. A lapse in coverage is a real possibility for more than one of your veterans.
As a business owner, you need to make this decision proactively. Your options are:
Continue providing care, knowing you may not be reimbursed for the gap period. New authorizations are often coming in after the expiration date and are not being backdated, which means days of unreimbursed care are a real risk.
Stop services, knowing what that means for a veteran who depends on your care.
Get the family involved in reaching out directly to the primary care physician or patient advocate to push for a renewal.
Escalate the request up the geriatric care line and try to reach a supervisor who can initiate a new authorization.
Decide your policy before this happens. Know what your agency will do so you are not making that call in the middle of a crisis. And continue reaching out to every contact you have at the VA to try to resolve it before the authorization expires.
The most important advice here: if you do not know the process, do not try to guide a veteran through it. Veterans already have a built-in distrust of the VA system. If you give them the wrong direction or make the process harder, you damage that trust and you may delay or derail their benefits.
Instead, direct them to professionals who know the process. Every county has a VA-accredited agent, commonly called a Veterans Service Officer or VSO. They are county employees, not VA employees, and they are in your community. You can find them at VA.gov by entering your zip code. These are the right people to help veterans with paperwork.
The American Legion and VFW posts also have people in every county who assist with VA paperwork. Point veterans there.
If you want to learn the process yourself so you can explain it, reach out to a local VSO and ask them to walk you through it. You can become a resource for your clients without becoming their paperwork guide. Know the process. Know where to send them. Know when to bring in professional help.
What you should not do is drive a sick veteran around the VA campus trying to figure out where to turn in paperwork. VA facilities are large, spread across multiple buildings, and difficult to navigate even when you are well. Figure it out yourself first. Walk the campus, learn which buildings are for what, and then you can actually give a veteran useful, specific guidance.
Connect with a local Veterans Service Officer. They know the local process, and the process does differ by location. In some places you can call, go online, walk paperwork in, or mail it. The VSO in your county knows what works best in your area.
Also go to the VA campus yourself. Navigate it like a veteran would. You will quickly understand what our veterans face, and you will learn which buildings handle which services. Once you know that, you can give veterans real, practical guidance instead of general advice.
The reality is that the vast majority of VA care managers are working remotely nationwide. You cannot market to them. You cannot come in and do a lunch and learn or introduce your staff. They are not there.
The most effective way to open communication with a care manager is to call them about the care. Call to tell them how a veteran is doing. If Veteran Smith is thriving under your care, that is a great reason to pick up the phone. Care managers need to report upward on veteran outcomes. If you are giving them good, accurate information about how their veteran is doing, they will take that call. Use the good news, the bad news, and everything in between as your opening to build a relationship. Over time, that consistent communication becomes trust.
You will receive an email notification. The notification typically comes approximately 90 days in advance of when recredentialing is required. Make sure the email on file with your third-party administrator, whether that is TriWest or Optum, is current and actively monitored. Recredentialing is required every few years, so it is worth putting a reminder on your calendar to verify your contact information is current well before that cycle.
No. Credentialing is state by state. Even if your service area crosses the state line, your Alabama credentialing covers Alabama. To serve veterans in Florida, you would need to establish credentialing in Florida. If you want to extend your coverage area within the same state, you can reach out to local VAs in the areas you cover and provide your zip codes. They may be able to add those areas. But crossing state lines requires either separate credentialing or opening a physical office in the other state.
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