VA Veteran-Directed Care Program: Can It Pay Family? (2026)

The VA Veteran-Directed Care program gives a veteran a flexible budget to hire their own personal care aides, and VA says those aides might include the veteran's own family member. If you're the spouse or adult child already helping with bathing, dressing, and meals, that may be the first time anyone has suggested the care you give could be paid. It can be, in some places, for some veterans. Veteran-Directed Care is only available in certain locations, and VA decides who qualifies.1 Under the Administration for Community Living's model Veteran-Directed Care handbook, the budget is usually managed through a counselor and a payroll agent rather than handed to you.2

In This Guide

• What Is the VA Veteran-Directed Care Program?
• Who Qualifies for Veteran-Directed Care?
• Can Veteran-Directed Care Pay a Family Member?
• How the VDC Budget and Hiring Work, Step by Step
• Where Veteran-Directed Care Is Offered
• What Veteran-Directed Care May Cost
• How to Get Started With Veteran-Directed Care
• Other Ways Families Get Paid to Give Care
• Frequently Asked Questions
• Learn More

What Is the VA Veteran-Directed Care Program?

Most families come to this program tired. You've been doing the lifting, the pill organizers, the night checks, and somewhere along the way you started wondering whether there's help that doesn't mean a stranger in the house on someone else's schedule. Veteran-Directed Care speaks to that wish: control.

In VA's own words, Veteran-Directed Care "gives Veterans of all ages the opportunity to receive the Home and Community Services they need in a consumer-directed way."1 VA's Veteran-Directed Care fact sheet (revised February 2022) says the program is for veterans who need help with activities of daily living, such as bathing and getting dressed, or with instrumental activities of daily living, such as fixing meals; for veterans who are isolated; and for veterans whose caregiver is experiencing burden.1 That last group matters. If you're the one wearing down, VA names your strain as a reason the program exists.

The Administration for Community Living (ACL) developed Veteran-Directed Care with VA in 2008. ACL says veterans enrolled in VDC decide what mix of goods and services best meets their needs, and can hire, schedule, and supervise their own workers.1 The engine is a flexible budget: VA says the Veteran-Directed Care budget can be managed by the veteran or by the family caregiver.1

Who Qualifies for Veteran-Directed Care?

It's natural to want a yes-or-no answer here. The honest one is that VA sets a few conditions you can check yourself, and then makes a clinical call you can't.

The first condition is enrollment in VA health care. VA's VDC fact sheet says Veteran-Directed Care is part of the VHA Standard Medical Benefits Package, so every veteran enrolled in VA health care is eligible for VDC if they meet the clinical need for the service and the service is available.1 ACL says the same thing in its own words: all veterans, regardless of age, who are enrolled in the VA health care system and meet the clinical need for the service are eligible to participate in Veteran-Directed Care.1

Enrollment has its own rules. To enroll in VA health care, a veteran generally must have served in the active military, naval, or air service and not received a dishonorable discharge, and veterans who enlisted after September 7, 1980, generally must also meet a minimum-service requirement, with exceptions such as a discharge for a disability caused or made worse by active-duty service.3 After enrolling, VA assigns each veteran to one of eight priority groups based on military service history, disability rating, income level, whether the veteran qualifies for Medicaid, and other benefits the veteran may receive.3 Our guide to VA health care enrollment and priority groups walks through that step in detail.

Enrollment and clinical need are not the whole test, though. VA's Caribbean Healthcare System says on its own Veteran-Directed Care page that some medical and administrative criteria must be met, and tells veterans to ask their social worker whether the program is for them.1 That's one VA medical center's page, not a national rulebook, but it's a fair warning that the conditions on the fact sheet aren't the whole decision. Your VA social worker is the person who can tell you whether Veteran-Directed Care fits your veteran, and that conversation is where you'll learn what your local program looks for.

Can Veteran-Directed Care Pay a Family Member?

This is the question most readers came with, so here's what the sources say, word for word.

• VA's fact sheet: veterans in Veteran-Directed Care can hire their own personal care aides, "which might include their own family member or neighbor."1
• ACL's program page: through the management of a flexible service budget, veterans enrolled in VDC "may also hire family, friends, and/or neighbors to provide services."1
• ACL's model VDC handbook: "You may hire your own service workers, a family member, or a friend."2

So yes: VA and ACL both describe Veteran-Directed Care as a program where a veteran can hire family to provide care. If you're a daughter who cut her hours to help Dad, or a son who drives over every morning, Veteran-Directed Care is a VA program under which that care could become paid work, if your veteran qualifies and your local program offers it.

If the person you hope to hire is the veteran's spouse, ask the VDC counselor directly whether your local Veteran-Directed Care program allows a spouse to be hired. The VA and ACL materials quoted above use the words "family member" and "family," and your local program is the place to get a definite answer for a spouse. Our guide on how to get paid to care for your spouse covers the other routes married couples look at.

How the VDC Budget and Hiring Work, Step by Step

A lot of the worry around this program is simply not knowing how the money moves. Here's the path, drawn from ACL's model VDC handbook and VA's own pages. ACL publishes that handbook as a template for local agencies to modify to fit their local situation, so the details can vary by program.2

1. A local agency partners with VA. ACL says VA medical centers work directly with one of four types of aging and disability network agencies to deliver Veteran-Directed Care: aging and disability resource centers, area agencies on aging, centers for independent living, and state units on aging.2
2. You're assigned a counselor. Under ACL's model VDC handbook, everyone who participates in Veteran-Directed Care has a Person-Centered Counselor.2
3. VA sets the budget. ACL's model handbook says the VDC budget is the amount of available funding for each participant, based on the veteran's needs, and the counselor receives that individual budget from VA. VA's Caribbean Healthcare System page says its budget amount is based on the veteran's activities-of-daily-living needs.2
4. You build a spending plan. Under ACL's model handbook, the Person-Centered Counselor helps the veteran develop a spending plan for the Veteran-Directed Care budget.2
5. Approval and a background check come before any hiring. ACL's model handbook says a veteran in Veteran-Directed Care cannot hire an individual until the spending plan and budget have been approved and background checks on that individual have been completed. The same spending-plan approval and background check apply before a veteran can hire a family member through Veteran-Directed Care.2
6. A payroll agent pays the worker. Under ACL's model handbook, everyone who self-directs in Veteran-Directed Care must use the financial management services (FMS) provider, which acts as the veteran's payroll agent: it handles timesheets, payroll, and taxes, issues W-2 forms to employees, pays payroll taxes on the veteran's behalf, and arranges workers' compensation coverage where a jurisdiction requires it.2

The Caribbean Healthcare System page describes the same flow from one medical center's side: its VDC budget goes to a VA provider that manages and distributes employees' payments, and payments are sent electronically to the employee the veteran or the veteran's representative hired.2

If the veteran can't manage it alone

Many veterans who need this program also can't easily run a payroll. That's expected. ACL's model VDC handbook says a veteran who doesn't want to manage hiring, supervising, or the budget can appoint a representative, someone they trust such as a family member or friend, and a representative who supports the veteran in Veteran-Directed Care becomes the legal employer.2 If you're both the likely representative and the likely paid worker, raise that with the counselor early, since local programs set their own details.

Where Veteran-Directed Care Is Offered

Here's the hard part, and it's better to hear it now than after weeks of hoping. VA's fact sheet says Veteran-Directed Care "is only available in certain locations," and availability is one of the conditions of eligibility.1 ACL describes Veteran-Directed Care as delivered by VA medical centers working directly with local aging and disability network agencies, so the practical question is whether your VA medical center offers it.2

ACL points veterans to find out whether a VA medical center near them offers Veteran-Directed Care.1 Your VA social worker can confirm it for your specific medical center. If it isn't offered where your veteran lives, that doesn't mean you've run out of options; the routes in the table below are worth a look.

What Veteran-Directed Care May Cost

VA's fact sheet says a copay for Veteran-Directed Care services may be charged based on the veteran's VA service-connected disability status.1 Ask the VA social worker what your veteran would owe before the spending plan is final, so there are no surprises in the first month.

For VA's long-term care services more broadly, the federal extended-care copay rule at 38 CFR 17.111 lists veterans and care that are not subject to those copays, including a veteran with a compensable service-connected disability, a veteran whose annual income is below the VA Veterans Pension rate set under 38 U.S.C. 1521(b), and care for a veteran's noncompensable zero-percent service-connected disability.4 Ask the social worker whether your veteran falls in one of those exempt groups and how VA applies them to a Veteran-Directed Care copay.

How to Get Started With Veteran-Directed Care

You don't have to have every answer before you make the first call. VA's own instruction is simple: if Veteran-Directed Care seems right, talk with your VA social worker and find out whether it's available in your location.1

1. Make sure the veteran is enrolled in VA health care. A veteran applies for VA health care with the Application for Health Benefits (VA Form 10-10EZ), online at VA.gov, by phone at 877-222-8387, by mail, or in person at a VA medical center or clinic.3
2. Ask the VA social worker about Veteran-Directed Care by name. Say you're asking about VDC, describe the daily help the veteran needs, and ask whether the local VA medical center offers the program.1
3. Bring your questions about family hiring. Ask whether you (or a spouse) can be hired, who would act as the employer, and what the copay would be.
4. Wait for approval before anyone starts paid work, since hiring comes only after the approval and background-check step described in step 5 of the budget-and-hiring section above.2

Other Ways Families Get Paid to Give Care

Veteran-Directed Care is one route among several. Each of these has its own rules, so we cover them in separate guides.

Learn More

Find personalized help figuring out whether Veteran-Directed Care can pay your family to give care at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.