VA in NM: An Interview from a Provider

by Kristin Rowan | Jun 19, 2026 | Advocacy, Veterans Affairs

by Kristin Rowan, Editor

VA in NM

An Inside Look from an Anonymous Provider

Effective January 1, 2026, the U.S. Department of Veterans Affairs made substantial rate cuts that impacted hundreds of veterans. None moreso than in rural areas of Texas and New Mexico. Reports from national and local news and associations reported a 43% rate cut in rural Texas and a 20% rate cut in rural New Mexico. On paper, those numbers are accurate. In practice, the situation looks much different. The Rowan Report spoke with a provider in New Mexico who asked to remain anonymous to preserve their relationship with both the U.S. VA and their local VA office.

Background and Experience

This anonymous source has worked in the home care space for 10 years. They opened the agency they now own about 3 years ago. The provider agency is strictly non-medical home care, operates in seven states, including their largest location in New Mexico, and has a patient population that is 90% VA.

What's Really Happening with VA in NM

Prior to the rate change, the home health aide (HHA) in New Mexico was $67 per hour. The new HHA rate for 2026 is $54 per hour. The source says if it were just the rate change, they could survive. But, the rate change is only one change impacting the agency.

HHA vs Homemaker

Prior to 2026, the average veteran received set hours of care almost exclusively at the HHA rate of $67 per hour. The rate change in New Mexico also include a split authorization requirement, capping the HHA hours at 60% of the total hours of care provided. The remaining 40% is now billed at the homemaker rate of $36.20 per hour.

Breaking Down the Math

In 2025, agencies billed 100% of care at HHA rates. In 2026, they are billing 60/40 homemaker to HHA rates. For an agency providing 10 hours of care per week, that is a difference of more than $200. The actual rate reduction is just over 30%.

More Hurdles

In addition to the rate cut and the HHA/Homemaker change, this agency and countless others are struggling to find caregivers for remote areas. Hours of drive time for one visit doesn’t pay enough to entice caregivers.

In most agencies, this one included, drive time and mileage are reimbursed between visits but not for the time to the first visit and after the last visit. This model doesn’t work for rural visits when the drive time is as long or longer than the visit and takes the whole day. Especially with the rate cut forcing lower hourly rates for caregivers, reimbursement for rural visits are necessary.

The Reality of VA in NM

My source described the grim reality over the last six months. What it means for agencies in New Mexico, what it means for caregivers, and especially what it means for veterans is disturbing and infuriating. Agencies in New Mexico, especially those whose client base is primarily veterans have few choices. They can stop serving veterans or they can operate at a loss. This agency knew the catastrophic consequences of no longer serving the veteran population and chose to operate at a loss. They are spending more on caregivers in rural areas than they make. The agency has onboarded more clients, more caregivers, and more staff in the last six months because so many agencies weren’t able to continue providing VA services.

Personal Plea

My source asked me to convey this personal message to agency owners in New Mexico and Texas, and to the industry:

“The Albuquerque VA team is exceptional. They are playing the cards that were dealt to them. These decisions were made above their heads. Support and be kind to your local VA offices. They’re not happy about this; they’re fighting this fight with us.”

When asked what agencies can do to support veterans and agencies, he said:

“The important thing for all of us to remember is what we do is important; we make a difference in the lives of veterans every day. It is important to advocate on behalf of providers and veterans.

Get in front of people who can influence. U.S. Reps, U.S. Senators. If enough people talk, they will have to listen. If they reach a threshold of calls, they have to answer.”

Final Thoughts

The thought of veterans, especially rural veterans, losing their in home care is devastating, as I hope it is for you. For some, this is the only human contact they have. For others, it is the only contact they can have. The consistency and familiarity that comes from having the same caregiver visit at the same time in a familiar setting is vital for veterans with PTSD or dementia. Disturbing that care and then claiming the rate change will not impact veteran care is ignorant and irresponsible. Whether you are operating in Texas and New Mexico or not, please consider writing to Secretary Collins and your local officials to ensure someone with decision-making authority is looking at the reality they have created.

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Kristin Rowan is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news. She is also a sought-after speaker on Artificial Intelligence, Technology Adoption and Lone Worker Safety. She is available to speak at state and national conferences as well as software user-group meetings.

Kristin also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. She works with care at home software providers to create dynamic content that increases conversions for direct e-mail, social media, and websites. Connect with Kristin directly at kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2026 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Fight Loss of Rural Veteran Care: An Interview with Angelo Spinola

by Kristin Rowan | May 29, 2026 | Advocacy, Regulatory

by Kristin Rowan, Editor

Fight Against the Loss of Rural Veteran Care

Deep Cuts Impact All

Last November, the U.S. Department of Veterans Affairs (VA) announced the 2026 VA Fee schedule, which became effective January 1st. There were significant changes to the fee schedule compared with previous years. By far the most concerning, though, was the “rate restructuring” for Home Health Aide and Homemaker codes in Texas and New Mexico.

Rate Restructure

Prior to 2026, Texas VA had a tiered fee structure. The tiered structure applied different rates for geographical areas based on _____. The restructure for 2026 applied a single statewide rate. This gave a slight increase in rate for some urban and suburban areas. However, the change created a drastic drop in rates for rural areas. For most Texas rural areas, it is a 43% reduction for Home Health Aides. The restructing results in a 19% decrease in New Mexico.

Tiered Rates

2025 VAFS rates were as high as $67 per hour in some rural areas. The hourly rate covered the time spent in the home, greatly increased travel time compared to urban visits, and differential incentives to entice caregivers to take these shifts that are often short and spread apart. The new statewide rate is $38 per hour. For the highest paying rural areas, this is a 43% rate cut.

Hours per Veteran

In addition to the rate cut, the number of hours per veteran has also dropped to an average 3.4 hours per shift. Some veterans are seeing their monthly hours cut by more than 30%.

Advocating for Change

State and national associations and advocacy groups reached out to the VA. Six senators and congresspeople reached out Doug Collins, secretary of the VA, to express their concerns. The VA has largely not responded to inquiries about the validity of the rate reduction and has not provided the analysis used to decide the new rate.

Notice and Comment Period

Most rate changes like this require advanced notice for agencies to adjust as well as a comment period when interested and impacted parties can contact lawmakers to provide feedback and ask questions. The announcement about these rate changes came in December and went into effect in January. The VA provided almost no notice and did not entertain comments or questions.

Fight Against VA Rate Cuts Texas New Mexico

Collins Responds

“[The rate reductions] reflect our assessment that prior rates for these areas significantly exceeded prevailing market rates. Aligning these rates with market conditions is not expected to affect veteran care.”

Doug Collins

Secretary, U.S. Department of Veterans Affairs

Defying His Objective

When Collins accepted the role of Secretary of the VA, he thanked President Trump for the assignment and asked him, “What would you like me to do?” The President answered, “Take care of my Veterans.” In a statement to the press, Collins outlined how he would accomplish that mission. Second on his list is to “put Veterans as the center of everything VA does, focusing relentlessly on customer service and convenience.”

Fail

Creating care deserts in rural areas and forcing veterans to travel up to an hour to get care is not convenient. Reducing home care hours and raising the probability of veterans having to move to care facilities is not service. Secretary Collins is failing in his objective and failing his directive from the President. More importantly, he is failing our veterans.

Coalition with Polsinelli

The Rowan Report spoke with Angelo Spinola and Heather Looby of Polsinelli. Polsinelli has been actively working on getting the rate changes reversed. Spinola, an employment litigator with a special interest in home care, explained the situation in more detail. According to Spinola there has been little information from the VA and what communication exists has been inconsistent. Many of the letters sent to the VA get no response at all. Spinola says there are legal remedies available, but they are challenging and expensive. In a letter to the VA, Polsinelli outlined the risks and consequences of these actions and gave the VA 30 days to respond.

Join the Fight

Next week, we will bring you real stories of agencies and veterans impacted by the changes in Texas and New Mexico. Their stories are powerful and moving. Even still, you may think this isn’t your fight because

A small enough percentage of your business is impacted
You have agencies in other states making up the difference
You don’t operate in Texas or New Mexico

Angelo cautions:

If they can do it in TX and NM, they can do it anywhere

“They” might be the VA changing rates that are unsubstantiated and contrary to the Administrative Procedure Act.

“They” might be CMS following suit and arbitrarily changing rates without analysis, notice, or comment.

“[Whether you are currently impacted by these changes or not,] the industry needs to get together to address this and join the fight before it’s too late; before it becomes the norm. “

Angelo Spinola

Home Health, Home Care & Hospice Chair, Polsinelli

How You Can Help

Write to your congressperson and senator and urge them to push Collins and the VA to reverse this change

Write to Collins and the VA directly with impact statements and concerns

Join the coalition with Polsinelli – PolsinelliHomeCare@polsinelli.com

Final Thoughts

We have interviews scheduled with providers and veterans to bring you real stories of how this is impacting our industry. We will also continue our discussions with Polsinelli to get additional information and keep you updated on the progress of the 30-day deadline and additional action the coalition will take.

Honor our Veterans

It was just a few days ago that our nation celebrated Memorial Day in honor of the ultimate sacrifice made by so many. There are too many service men and women who never came home. The ones who did risked everything for you, for me, for this country, and for the ideals that make the United States what it is. They deserve to come home after that service and age with dignity and grace in their homes for as long as they can. We owe them at least that. We all have our own stories and paths that led us to care at home, but at the core of each of those stories is care. Our veterans need that care now. Reach out, write, advocate, join. Whatever you are able to do, now is the time for action.

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