Should Administration of the VA’s Family Caregivers Program be Improved to Ensure Better Support for Service-Disabled Veterans & Their Caregivers? (S. 2216)

What is S. 2216?

(Updated December 22, 2020)

This bill, known as the TEAM Veteran Caregivers Act, would provide training, counseling, mental health services, respite care, and monthly stipends to veterans’ caregivers under the Program of Comprehensive Assistance for Family Caregivers and those participating in the Program of General Caregiver Support Services. Veterans and their caregivers are eligible for the program if the veteran requires assistance in daily living activities (e.g., bathing, eating, or grooming) due to service-related injuries. 

Additionally, this legislation would require the Dept. of Veterans Affairs (VA) to temporarily extend this program’s benefits for 90 days to veterans who become ineligible because they no longer require a caregiver.

Caregivers would be identified in each veteran’s electronic health record at the VA. The VA would be required to use standardized letters to inform veterans, their caregivers, and applicants for the program about decisions affecting the provision of assistance under the Program of Comprehensive Assistance for Family Caregivers. These letters would be subject to a minimum standard of information when they are notifying caregivers and veterans of downgrades.

Argument in favor

This bill codifies important existing practices at the Dept. of Veterans Affairs (VA) providing support and resources to help caregivers take care of veterans with service-related injuries. While the VA is already generally acting in accordance with this bill’s provisions, codifying them into law will give veterans and their caregivers an important degree of certainty about continued support from the Program of Comprehensive Assistance for Family Caregivers. This is especially important in light of reports that veterans and their caregivers have been arbitrarily discharged or downgraded from the program in the past.

Argument opposed

As the VA is already generally acting in accordance with this legislation’s provisions, there’s no need to waste Congress’ time on this bill when it has bigger issues, such as COVID-19 relief, to tackle before the end of the year. Additionally, to the extent that this legislation is meant to improve the Family Caregiver Program and ensure that eligible veterans and their caregivers are well-served by the program, it also fails in this goal because it does not include most of the VA Office of Inspector General’s recommendations from an April 2018 report detailing problems with the Family Caregiver Program.

Impact

Veterans with service-related injuries; caregivers of veterans with service-related injuries; the Dept. of Veterans Affairs (VA); Program of Comprehensive Assistance for Family Caregivers; and Program of General Caregiver Support Services.

Cost of S. 2216

The Congressional Budget Office (CBO) estimates that it would cost less than $500,00 to implement this legislation.

Additional Info

In-Depth: Sponsoring Sen. Gary Peters (D-MI) introduced this legislation to improve the Dept. of Veterans Affairs’ (VA) caregiver program, ensure that caregivers and veterans have the opportunity to appeal any downgrade or termination of benefits, and recognize caregivers’ role as part of veterans’ clinical teams:

“Veterans and their families have sacrificed so much for our country, and we must ensure they have the quality care and support they deserve. Caregivers often provide home health care for severely injured veterans every day, and issues with the VA’s program must be addressed so that caregivers can be involved in important decisions impacting the well-being and health of these veterans. I’m proud to lead this bipartisan effort to ensure caregivers are treated fairly and make sure the VA is held accountable.”

After this bill’s Senate passage on November 18, 2020, Sen. Peters said:

“Veterans and their families have given so much for our country, and we must make sure they have the quality care and support they deserve. Caregivers are on the frontline of home health care every day for our veterans and there’s no question we can take steps to improve the VA Caregiver Program. This bipartisan bill would help address problems with the VA Caregiver Program by making sure caregivers are treated fairly and that our severely injured veterans receive the services they have rightfully earned. Now that my bipartisan legislation passed the Senate, I look forward to ensuring it is enacted into law.”

Lead Republican cosponsor Sen. Marsha Blackburn (R-TN) added:

“Strong communication between our veterans’ caregivers and their providers should be complemented by thorough information in their medical records that reflects caregiver participation. The Department of Veterans Affairs exists to serve those who served our country. It is vitally important we give it the much-needed tools to be successful in that aim.”

Joy Ilem, National Legislative Director at Disabled American Veterans, expressed her organization’s support for this legislation:

“In far too many instances, policies and procedures of the VA Program of Comprehensive Assistance for Family Caregivers has resulted in the untimely disruption or termination of needed benefits for our nation’s veterans and their caregivers. DAV has long advocated for improvements to this program, and is proud to support the TEAM Veteran Caregivers Act in order to provide clear standards of communicating VA’s decisions, provide smoother transitions along the program’s continuum of care for beneficiaries, and fully incorporate family caregivers within the veteran’s care team. We are grateful to the bill’s cosponsors for their commitment to disabled veterans and to the nation’s unsung heroes, their family caregivers.” 

This legislation unanimously passed the Senate with the support of 18 bipartisan Senate cosponsors, including 10 Democrats and eight Republicans. Its House companion, sponsored by Rep. Andy Biggs (R-AZ), has 12 bipartisan House cosponsors (eight Republicans and four Democrats) and has not yet received a committee vote.

This legislation is endorsed by a number of veterans’ advocacy organizations, including Disabled American Veterans and Paralyzed Veterans of America.

Of Note: The VA provides stipends and support to caregivers of wounded veterans who sustained or aggravated serious injuries in the line of duty on or after September 11, 2001. Caregivers can include family members of other members of a veteran’s support group that regularly helps them recover from their injuries.

Currently, the Dept. of Veterans Affairs (VA) provides caregiver benefits for 90 days after a veteran is discharged from the Program of Comprehensive Assistance for Family Caregivers due to becoming ineligible, dying, or being permanently institutionalized. As a result of this existing practice, this legislation would generally codify the VA’s existing practice.

In April 2017, the VA Secretary ordered an internal review after Congress and the media reported that veterans and their caregivers were being inappropriately discharged from the Family Caregiver Program. In 2018, the VA Office of the Inspector General released a report in which it found that the VA had indeed failed to adequately manage the program, and that better communication and improved discharge processes were needed.

In light of the problems it identified, the VA OIG recommended the establishment of politics and procedures to improve the operation of the Family Caregiver Program. Among the OIG’s recommendations were: 

• Establishing a governance environment for the program;
  
• Ensuring that all veteran eligibility determinations are accurate;
  
• Establishing the need for care assessment guidelines;
  
• Designating program leads at the Veterans Integrated Service Network level, and
  
• Assessing current program staffing levels.
  

Media:

• Sponsoring Sen. Gary Peters (D-MI) Press Release
  
• Sponsoring Sen. Gary Peters (D-MI) Press Release After Committee Passage
  
• House Sponsor Rep. Andy Biggs (R-AZ) Press Release
  
• CBO Cost Estimate
  
• Dept. of Veterans Affairs Office of Inspector General Report (Context)