OPINION: With expansion approved, why did the VA respond by cutting deserving caregivers?

Eye on Veterans
December 18, 2018 - 2:21 pm

Image courtesy of Hidden Heroes

The Department of Veterans Affairs' Caregiver Program claims to offer support to family members of wounded veterans. Spouses, children, parents, friends--all of whom have quit their jobs and put their lives on hold to care for their loved ones. 

Yet with a Congress-approved expansion plan in place, why are caregivers being dropped from the program?

The VA MISSION Act gives the VA the ability to make changes to participants of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) while expanding the program to those who care for Pre 9/11 veterans. The problem is that the definition of a caregiver fluctuates depending on the veteran's needs, making eligibility for the program "complex" according to one Tennessee VA spokesperson Chris Vadnais. 

Veterans who need help with the tasks of daily living depend on their caregivers. The stipend and support provided by the program (to those lucky enough to hold onto a spot) are minimal compared to nearly $14 billion dollars in estimated annual home health care it would cost the VA otherwise.  Additionally, the RAND Military Caregivers report states that 20% of caregivers who spend over 40 hours/week performing caregiving duties provide society with a value of at least $3 billion. 

Though there is an appeals process for caregivers who've been dropped to a lower tier of support or completely dropped from the program,  many of them are too tired to continue the fight. In an interview with NPR, Jenn Wilmot, caregiver to her husband George, said her last appeal was exhausting and "it's just too tiring to fight."

Image courtesy of Hidden Heroes

Just because they've been dropped from the program doesn't mean they stop caregiving, or that their wounded warriors are suddenly healed. Though there are caregivers that move on from the program as their veterans heal, the majority of caregivers in the program depend on the stipend, health care coverage and nurse visits as a part of their life for the foreseeable future because amputees and those struggling with PTSD don't exactly have a specific recovery duration.

The VA research on caregivers states "VA investigators are continuing to improve their understanding of the care caregivers provide and the support they need...as well as how caregiving has affected the caregiver, the Veteran receiving care, and the Veteran's entire family."

Image courtesy of RAND

Its hard to tell what the VA is researching and whether or not their understanding of caregivers has improved when Tier 3 caregivers, providing upwards of 40 hours of care each week, are dropped from the program. 

Recent news stories highlight triple amputees like JD Williams and his wife & caregiver Ashlee going from Tier 3 in the program to being completely denied assistance, although their story has a happy ending thanks to a Facebook post gone viral. Not every veteran is lucky enough to have this experience, including two friends of Williams who are both caregivers of double amputees and still waiting on appeals decisions to reinstate their official VA caregiver status.

 

Earlier this year, Republican Dean Heller of Nevada and Democrat Bob Casey of Pennsylvania sent a letter to the VA requesting that all caregivers who were removed before the program was revised last year get a second look. They noted that although steps were being taken to improve PCAFC, those changes failed to address inconsistent discharges. 

"We believe these caregivers and the veterans they care for should have their cases re-evaluated using the improved and standardized procedures [adopted by the VA] following its internal review and they deserve to have any inconsistent or inaccurate eligibility decisions rectified," states the memo from Sen. Casey and Sen. Heller.

Secretary Robert Wilkie's response stated that the VA shares their concerns regarding inaccurate assessments and in order to rectify the issue they will be working to strengthen the Clinical Appeals Process. 

The VA's own Inspector General Report from August 2018 states that about half the time, the VA wasn't adequately monitoring the veteran's health when it dropped them. This negates a previous claim that the heavy-handed disenrollment was due to program standardization and PCAFC was removing veterans who never should have qualified for the program, to begin with. 

Image courtesy of RAND

The most recent announcement from the VA comes today in response to the outcry from the veteran community. Secretary Wilkie has halted all discharges from the Caregiver Program, similar to suspensions instated earlier in the year when the program came under review for inconsistencies in wait time and acceptance into the program. There is no definitive timeline on the suspension and also doesn't affect caregivers currently in the application process. 

While the VA continues its plan to expand the PCAFC, citing a one to three-year wait for Pre-9/11 veterans' acceptance, Post 9/11 caregivers brace for impact as this under-staffed and overwhelmed program tries to implement new standards. 

 

Have you had experience with the VA Caregiver Program? If you'd like to share your story, send us an email here

 

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