HOBBLED VA CAREGIVER PROGRAM DIMS CHANCE OF EXPANSION
For older generations of spouses, mothers and other family caregivers of severely disabled veterans, the startling feature of the Family Caregiver Program that Congress enacted in 2010 was its exclusivity.
The unprecedented package of caregiver benefits includes training to help to ensure patient safety; cash stipends to partially compensate for caregiver time and effort; caregiver health coverage if they have none, and guaranteed periods of respite to protect against burn out.
The comprehensive package, however, isn’t available to most family members who are primary caregivers to severely ill and injured veterans.
To control costs, Congress opened the program only to caregivers of veterans severely “injured,” either physically or mentally, in the line of duty on or after Sept. 11, 2001. It is not open to families of severely disabled vets injured before 9/11. It also is not open to post-9/11 veterans who have severe service-connected illnesses, rather than injuries.
Advocates for these forgotten families had hoped a successful launch of a limited program would spur Congress to expand eligibility and end the obvious inequity it created. That hope is set back by a new Government Accountability Office report on the three-year-old Family Caregiver Program, which finds its under resourced and, for the most part, in disarray.
For starters, officials woefully underestimated the number of veterans eligible for the program, for which Congress set aside $1.5 billion to fund it through fiscal 2015. VA forecast 4000 approved caregivers by September this year. Instead, by last May, 15,600 had been approved out of an applicant pool of 30,400. Roughly 500 more are being approved monthly, GAO said, with no slowdown in sight.
Eight of every 10 approved caregivers are spouses of veterans. Ninety-two percent of them care for veterans with mental health diagnoses, mostly post-traumatic stress disorder (63 percent) or traumatic brain injury (26 percent). Stipends, based on local hourly caregiver wages, are set at three levels. Caregivers providing a maximum of 40 hours of care per week receive an average of $2320 a month, or $27,830 annually. About 6000 caregivers qualify for this level.
An equal number provide a maximum of 25 hours’ care per week and draw an average $1470 a month. And 3,600 caregivers provide 10 hours of care weekly and receive on average $600 a month or $7200 a year.
Because VA “significantly underestimated caregivers’ demand for services,” GAO reports, VA medical centers were unprepared to meet program demands, particularly the work load on primary care physicians and nurses who must form into teams and visit homes of applicants to assess health needs and determine appropriate levels of caregiver support.
GAO also found that the computer system hastily adopted to track caregivers and work loads is inadequate and must be replaced if officials are to have data needed to monitor and resource the program effectively.
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