VA Caregiver Support Program Expansion Begins: What it Means for Veterans and Caregivers

Q. I am a caregiver for my father, a U.S. Navy veteran. He and I recently celebrated Veteran’s Day and my understanding is that it is National Family Caregiver’s Month all through November. In light of these two important observances, I was hoping you could update me on the VA Caregiver Support Program expansion, which I believe recently entered Phase 1, as a result of the MISSION Act of 2018. What should caregivers of veterans know about this expanded program and how do you apply? What other programs are available for senior veterans that need assistance with activities of daily living?

A. You are correct that the VA Caregiver Support Program expansion has recently entered Phase 1, with changes that greatly expand program eligibility.

In 2018, the Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act was signed into law to ensure that veterans could get access to timely care in closer proximity to their homes, among other things. Besides giving veterans more choice over where they access their medical care, the MISSION Act included an expanded caregiver program.

At that time, VA Secretary Robert Wilkie said, “Caregivers play a critical role in the health and well-being of some of our most vulnerable Veterans. Under the MISSION Act, we are strengthening and expanding our program to positively impact the lives of Veterans and deliver the best customer experience to them and their caregivers.”

As part of the MISSION Act, the U.S. Department of Veterans Affairs (VA) Program of Comprehensive Assistance for Family Caregivers (PCAFC) was scheduled to phase-in access to all veterans who have incurred serious injuries while serving during active-duty, not just those serving since September 11, 2001. Part 1 of this program was enacted last month, and became effective on October 1, 2020.

Major Expansion Changes – Big Wins for Veterans and Their Caregivers

In addition to expanding to pre-1975 era veterans, the enhanced PCAFC eliminates the need for a connection between personal care services and the qualifying serious injury that was needed in the past. It also redefines serious injury to now include any service-connected disability — regardless of whether it resulted from an injury, illness, or disease. Both changes have helped to expand program eligibility.

According to the VA, “(i)n most cases, the eligible veteran has multiple conditions that may warrant a need for personal care services. A veteran’s needs may be so complex that it can be difficult to determine what specific condition, out of many, causes the need for personal care services.”  Other specific requirements for a veteran to participate in the program are as follows:

The veteran must have a single or combined service-connected disability rating of 70% or more, and must be in need of in-person personal care services for a minimum of six (6) continuous months based on either:
o An inability to perform an activity of daily living (ADL) each time the activity is performed, or
o A need for supervision, protection, or instruction, which means a functional impairment that directly impacts his/her ability to maintain his or her personal safety, on a daily basis.
The individual must be either a veteran or a current member of the armed forces undergoing a medical discharge.
The individual must receive care at home or will do so if the VA designates a family caregiver.
The individual must receive ongoing care from a primary care team or will do so if VA designates a family caregiver.

The final phase of the expansion will begin two years later in 2022.  It will expand PCAFC to eligible Veterans who incurred or aggravated a serious injury in the line of duty after May 7, 1975 through September 10, 2001.

Family Caregiver Eligibility Requirements for PCAFC

Caregivers play a critical role in enabling veterans to maintain their highest level of independence and remain in their homes and communities for as long as possible. For a family caregiver to be eligible to participate in PCAFC, he or she must:

be at least 18 years of age;
be either the eligible Veteran’s spouse, son, daughter, parent, stepfamily member, or extended family member; or someone who lives with the eligible veteran full-time or will do so if designated as a family caregiver;
be initially assessed by VA as being able to complete caregiver education and training; and
complete caregiver training and demonstrate the ability to carry out the specific personal care services, core competencies, and additional care requirements.
There must be no determination by VA of abuse or neglect of the eligible Veteran by of the eligible Veteran by the caregiver.


Benefits for Primary Family Caregivers

If you and your father meet the requirements, these are some of the benefits available to primary family caregivers who are eligible for PCAFC.

Education and training, including the Building Better Caregivers online six (6) week workshop among others;
Access to healthcare insurance (If caregiver is otherwise uninsured);
Mental health counseling, including Resources for Enhancing All Caregivers Health (REACH) VA;
Expanded caregiver support, including “Annie Caregiver Text Support.”, hotlines, mentoring programs, and more;
Financial stipend;
Wellness contacts; and
Travel and per diem compensation (when traveling for a Veteran’s VA healthcare appointment).

How to Apply

To apply, the veteran and caregiver must both complete the application, which is available here. Both the veteran and caregiver must access and download the application for the PCAFC, as well (VA Form 10-10CG), and locate and contact the Caregiver Support Program Team at the nearest VA health care facility. According to the VA, an eligibility decision will be made within 90 days of application receipt.

Another Veteran’s Benefit Many Don’t Know About: The Veteran’s Aid and Attendance Benefit

The Aid and Attendance benefit is a monetary benefit that helps eligible veterans and their surviving spouses to pay for unreimbursed medical expenses. Aid and Attendance is an incredibly valuable program for those veterans who need assistance with the activities of daily living, such as bathing, dressing, transferring, and toileting, among others. In 2020, qualifying veterans and their spouses could be eligible for a VA Pension of over $2,266 per month to help cover the costs of elder care assistance.

Here at the Farr Law Firm, we work with veterans and their spouses to evaluate whether they qualify or may potentially qualify for Aid and Attendance and/or Medicaid in the future, and we deal with all the paperwork. As a Certified Elder Law Attorney and an Accredited Attorney with the U.S. Dept. of Veterans Affairs, I understand both the Aid and Attendance Benefit and the Medicaid program and the interaction between both entitlement programs — and this interaction between the programs is of crucial importance because most veterans who start off needing Aid and Attendance will eventually need Medicaid. This is why all asset protection planning that is done to make a veteran eligible for Aid and Attendance must take future Medicaid benefits into account. Please call us at any time to make an appointment for an initial consultation:

Veteran’s Aid and Attendance Attorney Fairfax: 703-691-1888
Veteran’s Aid and Attendance Attorney Fredericksburg: 540-479-1435
Veteran’s Aid and Attendance Attorney Rockville: 301-519-8041
Veteran’s Aid and Attendance Attorney Washington, DC: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.

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