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Program of Comprehensive Assistance for Family Caregivers - FAQs

Resumption of Full Program Operations - Department of Veterans Affairs (VA)
July 2017

Frequently Asked Questions (FAQs)

1. Question: What does “resuming full operations for the Program of Comprehensive Assistance for Family Caregivers” mean?

  • Answer: Returning to full operations means that medical centers will carry out all parts of the program, including program revocations, or discharges, and tier reductions as authorized by Veterans Health Administration (VHA) Directive 1152. On Monday, April 17, 2017, VA suspended removals initiated by medical centers based on eligibility for the Program of Comprehensive Assistance to Family Caregivers. This strategic pause allowed us the opportunity to hear stakeholder concerns and evaluate current processes.

2. Question: What were the findings of the program review?

  • Answer: The program review included an internal audit as well as meetings with caregivers, Veterans, Veteran Service Organizations, Military Service Organizations, VA staff and medical center leadership. VA’s review indicates the need for improved communication with Veterans and caregivers, enhanced internal processes and procedures, and additional staff training.

3. Question: Now that the program has resumed full operations, will there be discharges from the Program of Comprehensive Assistance for Family Caregivers program?

  • Answer: Yes, discharges from the Program of Comprehensive Assistance for Family Caregivers are based on clinical eligibility criteria, as well as Veteran request, Veteran death, for cause, such as intimate partner violence or fraud, non-compliance with program requirements, caregiver death, and Veteran institutionalization.

4. Question: What would initiate a discharge or revocation from the program?

  • Answer: VA may revoke the designation of a family caregiver if the eligible Veteran or individual designated as a family caregiver no longer meets the requirements, or if VA makes the clinical determination that participating in the Program of Comprehensive Assistance for Family Caregivers is no longer in the best interest of the Veteran. VA will provide assistance in transitioning to alternative health care coverage and mental health services as appropriate. If removal is due to improvement in the Veteran's condition, death, or permanent institutionalization, the family caregiver will continue to receive additional support and services through the Program of Comprehensive Assistance to Family Caregivers, including access to beneficiary travel, Civilian Health and Medical Program (CHAMPVA), (if eligible), and stipend payments for 90 days, unless one of the following occurs:
    • VA determines that the family caregiver committed fraud or abused or neglected the Veteran, in which case benefits will terminate immediately.
    • If the revoked individual who had been living with the eligible Veteran moves out, or the revoked individual abandons or terminates his or her relationship with the Veteran, these benefits will terminate immediately.
    • If VA suspects that the safety of the eligible Veteran is at risk, then VA may suspend the caregiver's responsibilities, and remove the eligible Veteran from the home if requested by the eligible Veteran. Other appropriate action may be taken to ensure the welfare of the eligible Veteran, prior to making a formal removal.

5. Question: Recent media stories have reported proposed changes to the Program of Comprehensive Assistance to Family Caregivers. What are the proposed changes currently planned?

  • Answer: Secretary Shulkin has expressed an interest in extending the Program of Comprehensive Assistance to Family Caregivers to Veterans of all eras. A change like this would require legislative action by Congress. VA is evaluating ways to increase consistency across the life cycle of participation in this program as well as ensure it supports those caregivers of Veterans most in need.

6. Question: How does this impact Veterans and caregivers who are appealing recent removal or tier reduction from the Program?

  • Answer: VA’s suspension of removals based on clinical eligibility for the Program of Comprehensive Assistance for Family Caregivers was effective April 17, 2017. Removals from Program of Comprehensive Assistance to Family Caregivers prior to that date were not impacted by this strategic pause. If a Veteran and caregiver disagree with a removal prior to April 17, they can file an appeal. The clinical appeals process was not impacted by this temporary suspension.

7. Question: What if a Veteran and caregiver were removed from the program and disagree with the decision?

  • Answer: Persons who disagree with the decision may appeal to the Department of Veterans Affairs (VA) medical center where they are receiving care. Attempts will be made to resolve clinical disputes at the clinical team level. Clinical disputes not resolved at the clinical team level will be elevated to the medical center’s Chief of Staff. If persons are not satisfied with the VA medical center’s decision, he/she may request to have the decision reviewed by the Veterans Integrated Service Network (VISN) Director or his/her designee. To avoid delays, the appeal should be submitted in accordance with the local clinical appeals process. Please contact the local Caregiver Support Coordinator or the Patient Advocate for local VA medical center policy, procedures and timelines for appeals. For more information regarding appeals, visit our website at: Caregiver Appeals Fact Sheet

8. Question: How would a Veteran and caregiver learn more about eligibility for the Program of Comprehensive Assistance for Family Caregivers?

  • Answer: The Program of Comprehensive Assistance for Family Caregivers offers enhanced support for caregivers of eligible Veterans seriously injured in the line of duty on or after September 11, 2001. For specific details on eligibility criteria, go to Caregiver Support Benefits

9. Question: How are caregivers and Veterans being notified of the decision to resume full operations of the Program of Comprehensive Assistance to Family Caregivers, including discharges and tier reductions?

  • Answer: VA published a press release regarding the reinstatement of the full program. It can be found on the Department of Veterans Affairs website: https://www.va.gov/opa/pressrel/pressrelease.cfm?id=2933
  • The press release was also disseminated on the Caregiver Support Program email communication service which has over 80,000 subscribers.

10. Question: Can you explain the difference between the Directive, Public Law and Regulations that Caregiver Support Program is based upon?

  • Answer: The Caregiver Support Program is governed by statute (38 U.S.C. § 1720G), regulations (38 C.F.R. Part 71) and the recently-issued VHA Directive 1152. Federal regulations specify the details and requirements necessary to implement legislation enacted by Congress, and they have the force and effect of law. Directives establish national VHA policy, establish a definite course of action for VHA, and assign responsibilities to identifiable VA individuals or groups. VHA Directives are an example of a VHA policy.

11. Question: Who should caregivers contact if they have questions?

  • Answer: Caregivers should contact their local Caregiver Support Coordinator with any questions or concerns. Contact information for Caregiver Support Coordinators can be found at www.caregiver.va.gov, using a zip code lookup. The Caregiver Support Line is also available by calling toll free 1-855-260-3274.