# Evaluating Cash Benefit Programs for Veterans' Long Term Care

> **NIH VA IK2** · PROVIDENCE VA  MEDICAL CENTER · 2020 · —

## Abstract

This is an application for an HSR&D Career Development Award (CDA) for Dr. Kali Thomas, a Research
Health Scientist in the Center of Innovation for Long-Term Services and Supports (LTSS) at the Providence VA
Medical Center. Dr. Thomas' long-term career goal is to conduct rigorous research that will inform policies and
practices aimed at advancing the VA's home and community-based service delivery, thereby improving the
quality of life and health outcomes of Veterans needing LTSS. The demand for LTSS within VA is expected to
continue to grow dramatically as the Veteran population ages. This CDA will focus on understanding the role of
participant-directed (PD) cash benefit programs provided by VA to meet the growing need for LTSS. The VA,
through its Veterans Health Administration (VHA) and Veterans Benefits Administration (VBA), offers separate
and distinct PD cash benefit programs for LTSS. The VHA's Veteran-Directed Home and Community Based
Services program (VD-HCBS) provides Veterans with a monthly budget based on the extent of their disability
giving them the opportunity to purchase goods and services that best meet their needs. The VBA offers two
enhanced monthly benefits to disabled and homebound Veterans receiving pension or compensation: the Aid
and Attendance (A&A) and Housebound benefits. In non-VA populations, similar programs have been cost-
effective and improved participants' outcomes. However, in VA, information about effectiveness and access to
these programs is limited: there remains little to no understanding of who receives these PD cash benefits,
how Veterans are utilizing these benefits, their satisfaction with the benefits, their consumption of medical and
institutional care, nor the outcomes associated with receiving these cash benefits. Therefore, the objective of
this application is to establish a foundation of research about the VA's PD cash benefit programs in order to
develop interventions aimed at improving access to these benefits, promote a national understanding of
Veterans' experiences with these benefits, and set the stage for a research career evaluating and improving
the delivery of LTSS to Veterans. This CDA will provide Dr. Thomas with the support necessary to accomplish
the following goals: (1) to become an expert in conducting rigorous, practical program evaluation and
implementation research; (2) to achieve proficiency in comparative effectiveness research, primary data
collection, and qualitative research methodologies (3) to become familiar with delivery of LTSS at VAMCs and
(4) to reach research independence. These goals will be achieved through the training and applied, mixed
methods formative research she has proposed in this award. Specifically, her research seeks to (1) use
administrative data to determine which eligible Veterans being served by which Medical Centers enroll in VA's
PD cash benefit programs, (2) explore reasons for variation in enrollment in VD-HCBS, A&A and Housebound
benefits across...

## Key facts

- **NIH application ID:** 10046255
- **Project number:** 5IK2HX001775-04
- **Recipient organization:** PROVIDENCE VA  MEDICAL CENTER
- **Principal Investigator:** Kali St. Marie Thomas
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2016-10-01 → 2021-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10046255

## Citation

> US National Institutes of Health, RePORTER application 10046255, Evaluating Cash Benefit Programs for Veterans' Long Term Care (5IK2HX001775-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10046255. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*