Caregiver Support to Veterans

Caregiver Support to Veterans

Updated February 1, 2017
Caregiver Support to Veterans
In recognition of the significant role family caregivers play
volunteers with their local VA medical centers and receive
in providing personal care services and other supports to
training prior to being paired with another caregiver.
veterans, the Caregivers and Veterans Omnibus Health
Caregivers agree to participate for a minimum of six
Services Act of 2010 (P.L. 111-163) was signed into law on
months.
May 5, 2010. The law requires the Secretary of Veterans
VA Services to Assist Caregivers
Affairs to establish caregiver support services to veterans.
Caregivers may be eligible for up to 30 days of respite care
In accordance, the Department of Veterans Affairs (VA)
per calendar year, which provides temporary relief to
established the following two programs:
caregivers. The VA offers respite care in a variety of

settings, such as a veteran’s private home or through
Program of General Caregiver Support Services, which
temporary placement of the veteran in a VA Community
includes caregiver programs for veterans of all eras; and
Living Center, a VA-contracted Community Nursing
 Program of Comprehensive Assistance for Family
Home, or an Adult Day Health Care Center. In addition to
Caregivers, which provides additional supports and
respite care services, the VA offers a range of long-term
services to family caregivers of eligible veterans or
services and supports, geriatric, and extended care that can
servicemembers seriously injured in the line of duty on
directly assist seriously injured veterans (see CRS Report
or after September 11, 2001.
R44697, Long-Term Care Services for Veterans).

Congress authorized over $1.5 billion for FY2011 through
Program of Comprehensive Assistance
FY2015 for caregiver support programs; $625 million for
for Family Caregivers
FY2016; and almost $735 million for FY2017. Actual
The following briefly describes program eligibility,
obligations for both programs were $31 million for
benefits, and VA oversight for the Program of
FY2011; $115 million for FY2012; $226 million for
Comprehensive Assistance for Family Caregivers. In
FY2013; $350 million for FY2014; $454 million for
FY2015, almost 25,000 family caregivers participated.
FY2015; and $622 (estimated) for FY2016.

Program of General Caregiver Support
Veteran Eligibility
Post 9/11 veterans and certain servicemembers eligible for
Services
the program require, at a minimum, six months of
The Program of General Caregiver Support Services
continuous and approved caregiver support that is in the
provides the following selected resources and supports to
best interests of the veteran or servicemember based on one
family caregivers of veterans of all eras enrolled in VA
of the following criteria:
health care (for further information, see VA’s Caregiver
website at http://www.caregiver.va.gov/).
 inability to perform one or more activities of daily living
Caregiver Support Line
(ADLs), such as dressing, grooming, toileting, feeding,
and mobility;
The VA offers a Caregiver Support Line (1-855-260-3274,
toll-free) staffed by licensed social workers who respond to
 need for supervision, protection, or assistance due to a
inquiries about caregiver services and benefits, provide
neurological or other impairment or injury (including
information and referral to community resources and VA
Traumatic Brain Injury, psychological trauma, or other
Caregiver Support Coordinators (CSCs), and provide
mental disorders);
emotional support. In FY2015, the VA received more than
 have psychological trauma or a mental disorder, as
57,000 calls and facilitated about 8,000 referrals to CSCs
assessed by a licensed mental health professional; or
by the Caregiver Support Line.

Caregiver Support Coordinator
have a 100% service-connected disability rating with
special monthly compensation that includes aid and
The VA mandates at least one designated CSC at every VA
attendance allowance.
Medical Center (VAMC). The CSC serves as the primary
clinical and subject matter expert on caregiving issues,
In addition, veterans and servicemembers must receive care
assists caregivers and veterans in accessing VA and non-
at home, as well as receive ongoing care from a VA Patient
VA services and benefits available, and coordinates home
Aligned Care Team (PACT) or other VA health care team.
visits under the Program of Comprehensive Assistance for
In order to receive personal care service from a family
Family Caregivers (described below).
caregiver, veterans or servicemembers may not receive
Peer Support for Caregivers
similar services provided by another entity, individual, or
The VA also provides a Caregiver Peer Support Mentoring
program at the same time.
Program, which connects caregivers to one another to share

their experience and provide support. Mentors serve as
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Caregiver Support to Veterans
Caregiver Eligibility
infrastructure. A 2016 VA Report to Congress stated that
Family caregivers must be 18 years of age or older and a
VA projected program participation of 4,208 caregivers,
member of the veteran’s family (e.g., spouse, son, daughter,
with a stipend budget of $98 million in 2015. However,
parent, step-family member, or extended family member) or
actual 2015 program data showed 24,771 caregivers with a
someone who lives full-time with the veteran. Prior to
stipend budget of about $388 million. There are no
approval, a family caregiver must satisfactorily complete
limitations on the number of caregivers eligible, as long as
caregiver training and demonstrate the ability to carry out
the caregiver and veteran meet the program’s eligibility
the specific personal care services and other assistance
criteria.
required by the veteran.

In addition to workload constraints, GAO’s 2014 report
Caregiver Stipend
noted the VA’s information technology (IT) system
The amount of the caregiver stipend is based on a
capabilities provide limited ability to monitor workload
methodology that considers the amount and complexity of
data or program effectiveness. This is, in part, due to an IT
care required by the veteran and is calculated using the
system designed to manage a smaller program. The VA
Bureau of Labor Statistics wage rate for a Home Health
concurred with GAO’s report recommendations and
Aide using the 75th percentile of the hourly wage rate in the
identified various actions to address them. These actions
veteran’s geographic area of residence. Average caregiver
include prioritizing a new IT system and identifying
stipends range from $652 to $2,371 per month, depending
solutions to alleviate workload burden through changes to
on the veteran’s assessed level of care. The caregiver
program procedures and timelines, as well as identifying
stipend is an enhanced VA service and is not considered
additional staffing support.
taxable income. According to the VA, approved caregivers
do not have an employment relationship with the VA.
Program Expansion

A July 2013 VA report on the feasibility of program
Other Caregiver Benefits
expansion stated that such an expansion would allow
Family caregivers are also eligible for the following:
equitable access to seriously injured veterans from all eras.
However, expansion poses significant challenges for the
Medical care: medical care under the Civilian Health and
VA in accurately estimating the number of eligible veterans
Medical Program of the Department of Veterans Affairs
and their caregivers. Moreover, program eligibility
(CHAMPVA) if the caregiver is not entitled to care under
determinations may be complicated by limited evidence for
another health plan (e.g., Medicare, Medicaid, worker’s
serious injuries that occurred in prior decades and the
compensation, or private health insurance).
extended time needed for such applications, as well as the
staffing and infrastructure to support such an expansion.
Counseling/mental health services: mental health services
The VA estimates an additional 2,000 staff would need to
necessary in connection with the treatment of the veteran
be in place to assist with such an expansion.
(e.g., consultation, professional counseling, marriage and
family counseling, training); also provides mental health
In the 114th Congress, the Senate Committee on Veteran’s
services unrelated to the treatment of the veteran (e.g.,
Affairs reported S. 425, the Veterans Homeless Programs,
group therapy, counseling, and peer support groups).
Caregiver Services, and Other Improvements Act of 2015.
Respite care: up to 30 days annually for respite care
The legislation was subsequently placed on the Senate
services, additional days upon approval; also provides
calendar but did not see floor action. The bill would have
respite care for caregiver training.
phased in expansion of the Program of Comprehensive
Assistance for Family Caregivers in two stages. First, by
Travel expenses: reimbursement for a caregiver’s travel-
expanding eligibility to veterans with a serious injury
related expenses (e.g., transportation, lodging, and per diem
incurred or aggravated in the line of duty in the active
costs) for a single medical examination, treatment, or
military, naval, or air service on or before May 7, 1975.
episode of care of an eligible veteran, as well as to attend
However, the timing for this first stage of expansion would
required training.
be contingent on VA submitting to Congress a certification
Ongoing Support and Monitoring
that is has fully implemented an information technology
system that allows data assessment and program
The VA provides ongoing support and monitoring of the
veteran and caregiver’s physical and emotional state,
monitoring. Two years after VA submits such certification,
the program would expand eligibility to veterans in its
including observing for signs of abuse or neglect, adequacy
second stage, to include veterans with a serious injury
of care and supervision provided by the family caregiver,
incurred or aggravated in the line of duty in the active
adjustment to care in the home, and any signs of caregiver
military, naval, or air service after May 7, 1975, and before
stress. Monitoring is conducted through an initial home
September 11, 2011. It would also add financial planning
visit prior to caregiver approval and periodic home visits to
services and legal services related to the needs of injured
assess the well-being of the veteran and family caregiver.
veterans and their caregivers. CBO estimated that
Issues with Implementation
implementing this expansion would cost $2.9 billion over
the five-year period from 2017 to 2021.
A December 2014 Government Accountability Office
(GAO) report found that demand for the Program of
Kirsten J. Colello, Specialist in Health and Aging Policy
Comprehensive Assistance for Family Caregivers has far
IF10396
exceeded original estimates, leading to VA implementation
issues related to insufficient staff and limited program
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Caregiver Support to Veterans

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