VA social workers identify factors predictive of enrollment and variability in Veterans' access to aid and attendance benefits

The Aid and Attendance (A & A) benefit is a cash entitlement for Veterans who served in the U.S. military to obtain personal care services. Our objective was to identify factors contributing to variation in A & A enrollment across VA Medical Centers (VAMCs). We used VA data to calculate the enrollment rate among older Veterans receiving a VA pension or compensation in 2015, then purposefully sampled social work leaders at 15 VAMCs with the highest (n = 7) and lowest (n = 8) enrollment rates for interviews. All respondents viewed A & A as an important benefit. Participants at high-enrollment sites indicated strong working relationships with Veterans Benefits Administration (VBA) and Veterans Service Organizations (VSOs) with onsite presence and education about A & A facilitate access. Participants at low-enrollment sites indicated they desired education around A & A eligibility criteria and collaboration with VBA/VSOs. VA and non-VA social workers would benefit from education about VBA's benefits, and this requires collaboration with VBA representatives.