New Standards for the VA Caregivers Program Are Still in Limbo. Advocates Want Them Released.

Advocates for family members and friends who support severely ill or injured veterans who need daily care are pushing the Biden administration for answers on the future of a Department of Veterans Affairs program that provides benefits to those caregivers.

Twelve organizations, including the Elizabeth Dole Foundation, Veterans of Foreign Wars and Wounded Warrior Project, wrote President Joe Biden on Wednesday asking him to publish new program standards for the VA's Program of Comprehensive Assistance for Family Caregivers, which have been in the works for more than two years.

The VA program, established in 2011 for seriously injured post-9/11 veterans, provides monetary stipends and health benefits to the caregivers of veterans who otherwise would need full-time care to remain in their homes or be institutionalized.

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The PCAFC, or Family Caregiver Program, as it is commonly known, was expanded in 2018 to combat veterans of all eras, beginning in 2021 with veterans through the Vietnam War, and again in 2022, for veterans who served from 1975 through 2001.

To accommodate the number of additional veterans, the VA tightened eligibility rules for all participants, focusing mainly on a veterans' ability to perform physical activities needed for daily function, such as bathing, eating, grooming and mobility, as well as their personal safety.

Under the new criteria, many original caregivers, known as "legacy participants," were dropped from the program. The VA had estimated that roughly one-third of the 19,000 participants at the time would no longer meet eligibility standards, but a review found that up to 90% may no longer have qualified.

The VA announced it would halt dismissals from the program for legacy participants under the new criteria until fall 2025 while it reassessed the requirements. But the department has yet to release a final decision on eligibility, leaving caregivers concerned.

"Uncertainty over PCAFC's future continues to have a real and meaningful impact on the well-being, quality of life, and financial security of thousands of current and prospective PCAFC participants," wrote the advocacy groups in the letter.

Biden signed an executive order in April 2023 designed to encourage federal agencies and states to embrace programs that better support caregivers, with an aim to provide them appropriate compensation, health care support and child care services.

The order required the VA to develop and implement a pilot program to offer telehealth psychotherapy for caregivers enrolled in the program and suggested that the VA secretary issue the new eligibility rules for PCAFC by the end of fiscal 2023.

The new criteria have yet to be published, however.

VA Press Secretary Terrence Hayes said Friday that, while the rulemaking process proceeds, the department continues to care for and support veterans and caregivers.

"Veteran caregivers are vital to the care and recovery of veterans, and we at VA are proud to promote the well-being of caregivers through financial support, education, resources, mental health support, coaching and many other services," Hayes said in a statement.

During a press conference in Washington, D.C., on June 25, VA Secretary Denis McDonough said the program is a "major priority" for the department, adding it has brought in experts to review the program and plans to publish new criteria "on time and consistent with the Administrative Procedure Act," which requires that interim rules and final rules be published in the Federal Register.

"We're still deliberating," McDonough said. "We obviously will put that out pursuant to the Administrative Procedure Act, and that's why you'll see us all be very careful in not characterizing the content of any proposed rule."

With the Biden presidency winding down, the groups urged the president to pressure the VA to publish the pending rules "as soon as possible."

"Further delay, layered with a change in presidential administration, would only serve to prolong the strain that so many veterans and caregivers have felt while PCAFC continues to fall short of its intent and potential," they wrote.

The nine additional organizations that signed the letter were the Quality of Life Foundation; Paralyzed Veterans of America; National Veterans Legal Services Program; Blinded Veterans Association; Veteran Warriors; Public Health Service Commissioned Officers Foundation; Disabled American Veterans; the Military Officers Association of America; and WiseHealth.

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