Advocacy Issue Brief: Comprehensive Benefits for Caregiver of Veterans of All Eras

The situation

  • Family caregivers are an important part of VA’s long term services and supports system and provide the vast majority of the care and support for loved ones with chronic care needs and functional limitations. Although most family caregivers willingly undertake this role, research documents the negative physical, emotional, and financial consequences caregiving can have. Currently, VA only provides comprehensive benefits to caregivers of veterans severely disabled on or after September 11, 2001. Caregivers of veterans who do not meet this eligibility requirement are able to receive limited support and services from VA that do not address fully the burdens and strains of caregiving.

The Challenge

  • In the 1990s, changes in VA’s delivery of medical care from inpatient to outpatient and more home and community services resulted in greater demands on veteran’s families to provide caregiving in the home.
  • According to the National Center for Veteran Analysis and Statistics, the veteran population ages 65 and older will peak at 9.7 million by 2014 and number of veterans 85 and older who are most likely to require long term support and services will remain over 1 million through 2034. As the veteran population ages and continues to increase, the role of caregivers will become even more important.
  • Beyond VA’s comprehensive caregiver program restricted only for the newest generation of severely injured veterans authorized by P.L. 111-163, VA services and support for family caregivers have been restricted. Limitations can been seen in the size and scope of VA programs such as the veteran Directed Home and Community-Based Services, the Medical Foster Home, and the Patient Centered Alternatives to Institutional Extended Care Pilots. Furthermore, VA’s currently statutory authority to provide services directly to caregivers of disabled veterans is limited only to those instances where such services are directly related to the veteran’s treatment.
  • VA does not have a standard needs assessment used consistently nationwide for the veterans and the caregiver to determine the appropriate number of services and hours they need for the veteran to remain in their community. Thus, access to VA financed home and community based services, which are directed at the veteran and supports their caregiver, varies widely because then are driven more by locally available resources rather than clinical need.

The Solution

  • DAV urges Congress to correct the inequity in the eligibility of VA caregiver support benefits and services making them available to veterans of all eras.
  • DAV urges adoption of an evidence-based needs assessment instrument to determine the sufficient level of HCBS services needed for veterans and their caregiver to remain an active participant in their community.
  • DAV urges Congress to conduct rigorous oversight on VA programs and services that support caregiver of disabled veterans.