Updated February 1, 2017
Caregiver Support to Veterans
In recognition of the significant role family caregivers play
in providing personal care services and other supports to
veterans, the Caregivers and Veterans Omnibus Health
Services Act of 2010 (P.L. 111-163) was signed into law on
May 5, 2010. The law requires the Secretary of Veterans
Affairs to establish caregiver support services to veterans.
In accordance, the Department of Veterans Affairs (VA)
established the following two programs:
Program of General Caregiver Support Services, which
includes caregiver programs for veterans of all eras; and
Program of Comprehensive Assistance for Family
Caregivers, which provides additional supports and
services to family caregivers of eligible veterans or
servicemembers seriously injured in the line of duty on
or after September 11, 2001.
Congress authorized over $1.5 billion for FY2011 through
FY2015 for caregiver support programs; $625 million for
FY2016; and almost $735 million for FY2017. Actual
obligations for both programs were $31 million for
FY2011; $115 million for FY2012; $226 million for
FY2013; $350 million for FY2014; $454 million for
FY2015; and $622 (estimated) for FY2016.
Program of General Caregiver Support
The Program of General Caregiver Support Services
provides the following selected resources and supports to
family caregivers of veterans of all eras enrolled in VA
health care (for further information, see VA’s Caregiver
website at http://www.caregiver.va.gov/).
Caregiver Support Line
The VA offers a Caregiver Support Line (1-855-260-3274,
toll-free) staffed by licensed social workers who respond to
inquiries about caregiver services and benefits, provide
information and referral to community resources and VA
Caregiver Support Coordinators (CSCs), and provide
emotional support. In FY2015, the VA received more than
57,000 calls and facilitated about 8,000 referrals to CSCs
by the Caregiver Support Line.
Caregiver Support Coordinator
The VA mandates at least one designated CSC at every VA
Medical Center (VAMC). The CSC serves as the primary
clinical and subject matter expert on caregiving issues,
assists caregivers and veterans in accessing VA and nonVA services and benefits available, and coordinates home
visits under the Program of Comprehensive Assistance for
Family Caregivers (described below).
Peer Support for Caregivers
The VA also provides a Caregiver Peer Support Mentoring
Program, which connects caregivers to one another to share
their experience and provide support. Mentors serve as
volunteers with their local VA medical centers and receive
training prior to being paired with another caregiver.
Caregivers agree to participate for a minimum of six
VA Services to Assist Caregivers
Caregivers may be eligible for up to 30 days of respite care
per calendar year, which provides temporary relief to
caregivers. The VA offers respite care in a variety of
settings, such as a veteran’s private home or through
temporary placement of the veteran in a VA Community
Living Center, a VA-contracted Community Nursing
Home, or an Adult Day Health Care Center. In addition to
respite care services, the VA offers a range of long-term
services and supports, geriatric, and extended care that can
directly assist seriously injured veterans (see CRS Report
R44697, Long-Term Care Services for Veterans).
Program of Comprehensive Assistance
for Family Caregivers
The following briefly describes program eligibility,
benefits, and VA oversight for the Program of
Comprehensive Assistance for Family Caregivers. In
FY2015, almost 25,000 family caregivers participated.
Post 9/11 veterans and certain servicemembers eligible for
the program require, at a minimum, six months of
continuous and approved caregiver support that is in the
best interests of the veteran or servicemember based on one
of the following criteria:
inability to perform one or more activities of daily living
(ADLs), such as dressing, grooming, toileting, feeding,
need for supervision, protection, or assistance due to a
neurological or other impairment or injury (including
Traumatic Brain Injury, psychological trauma, or other
have psychological trauma or a mental disorder, as
assessed by a licensed mental health professional; or
have a 100% service-connected disability rating with
special monthly compensation that includes aid and
In addition, veterans and servicemembers must receive care
at home, as well as receive ongoing care from a VA Patient
Aligned Care Team (PACT) or other VA health care team.
In order to receive personal care service from a family
caregiver, veterans or servicemembers may not receive
similar services provided by another entity, individual, or
program at the same time.
Caregiver Support to Veterans
Family caregivers must be 18 years of age or older and a
member of the veteran’s family (e.g., spouse, son, daughter,
parent, step-family member, or extended family member) or
someone who lives full-time with the veteran. Prior to
approval, a family caregiver must satisfactorily complete
caregiver training and demonstrate the ability to carry out
the specific personal care services and other assistance
required by the veteran.
The amount of the caregiver stipend is based on a
methodology that considers the amount and complexity of
care required by the veteran and is calculated using the
Bureau of Labor Statistics wage rate for a Home Health
Aide using the 75th percentile of the hourly wage rate in the
veteran’s geographic area of residence. Average caregiver
stipends range from $652 to $2,371 per month, depending
on the veteran’s assessed level of care. The caregiver
stipend is an enhanced VA service and is not considered
taxable income. According to the VA, approved caregivers
do not have an employment relationship with the VA.
Other Caregiver Benefits
Family caregivers are also eligible for the following:
Medical care: medical care under the Civilian Health and
Medical Program of the Department of Veterans Affairs
(CHAMPVA) if the caregiver is not entitled to care under
another health plan (e.g., Medicare, Medicaid, worker’s
compensation, or private health insurance).
Counseling/mental health services: mental health services
necessary in connection with the treatment of the veteran
(e.g., consultation, professional counseling, marriage and
family counseling, training); also provides mental health
services unrelated to the treatment of the veteran (e.g.,
group therapy, counseling, and peer support groups).
Respite care: up to 30 days annually for respite care
services, additional days upon approval; also provides
respite care for caregiver training.
Travel expenses: reimbursement for a caregiver’s travelrelated expenses (e.g., transportation, lodging, and per diem
costs) for a single medical examination, treatment, or
episode of care of an eligible veteran, as well as to attend
Ongoing Support and Monitoring
The VA provides ongoing support and monitoring of the
veteran and caregiver’s physical and emotional state,
including observing for signs of abuse or neglect, adequacy
of care and supervision provided by the family caregiver,
adjustment to care in the home, and any signs of caregiver
stress. Monitoring is conducted through an initial home
visit prior to caregiver approval and periodic home visits to
assess the well-being of the veteran and family caregiver.
Issues with Implementation
A December 2014 Government Accountability Office
(GAO) report found that demand for the Program of
Comprehensive Assistance for Family Caregivers has far
exceeded original estimates, leading to VA implementation
issues related to insufficient staff and limited program
infrastructure. A 2016 VA Report to Congress stated that
VA projected program participation of 4,208 caregivers,
with a stipend budget of $98 million in 2015. However,
actual 2015 program data showed 24,771 caregivers with a
stipend budget of about $388 million. There are no
limitations on the number of caregivers eligible, as long as
the caregiver and veteran meet the program’s eligibility
In addition to workload constraints, GAO’s 2014 report
noted the VA’s information technology (IT) system
capabilities provide limited ability to monitor workload
data or program effectiveness. This is, in part, due to an IT
system designed to manage a smaller program. The VA
concurred with GAO’s report recommendations and
identified various actions to address them. These actions
include prioritizing a new IT system and identifying
solutions to alleviate workload burden through changes to
program procedures and timelines, as well as identifying
additional staffing support.
A July 2013 VA report on the feasibility of program
expansion stated that such an expansion would allow
equitable access to seriously injured veterans from all eras.
However, expansion poses significant challenges for the
VA in accurately estimating the number of eligible veterans
and their caregivers. Moreover, program eligibility
determinations may be complicated by limited evidence for
serious injuries that occurred in prior decades and the
extended time needed for such applications, as well as the
staffing and infrastructure to support such an expansion.
The VA estimates an additional 2,000 staff would need to
be in place to assist with such an expansion.
In the 114th Congress, the Senate Committee on Veteran’s
Affairs reported S. 425, the Veterans Homeless Programs,
Caregiver Services, and Other Improvements Act of 2015.
The legislation was subsequently placed on the Senate
calendar but did not see floor action. The bill would have
phased in expansion of the Program of Comprehensive
Assistance for Family Caregivers in two stages. First, by
expanding eligibility to veterans with a serious injury
incurred or aggravated in the line of duty in the active
military, naval, or air service on or before May 7, 1975.
However, the timing for this first stage of expansion would
be contingent on VA submitting to Congress a certification
that is has fully implemented an information technology
system that allows data assessment and program
monitoring. Two years after VA submits such certification,
the program would expand eligibility to veterans in its
second stage, to include veterans with a serious injury
incurred or aggravated in the line of duty in the active
military, naval, or air service after May 7, 1975, and before
September 11, 2011. It would also add financial planning
services and legal services related to the needs of injured
veterans and their caregivers. CBO estimated that
implementing this expansion would cost $2.9 billion over
the five-year period from 2017 to 2021.
Kirsten J. Colello, Specialist in Health and Aging Policy
Caregiver Support to Veterans
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan shared staff to
congressional committees and Members of Congress. It operates solely at the behest of and under the direction of Congress.
Information in a CRS Report should not be relied upon for purposes other than public understanding of information that has
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