As part of the VA MISSION Act of 2018, VA’s Caregiver Support Program (CSP) has undergone bold steps and improvements to enhance the program and increase access to Veterans and their caregivers.

“President Biden has charged us with fighting like hell for Veterans, and that includes their caregivers,” said VA Deputy Secretary Donald Remy. “We’ve come a long way in supporting caregivers, and we have more work to do.”

Expanding support for caregivers

In 2020, the Program of Comprehensive Assistance for Family Caregivers (PCAFC) expanded to Veterans who served before May 5, 1975. This added over 22,000 caregivers of Veterans to PCAFC, more than doubling the program’s size. PCAFC is set to expand to Veterans of all eras beginning October 1, 2022.

Additionally, the resources available in VA’s Program of General Caregivers Support Services (PGCSS) – the core of VA’s caregiver support program – are also undergoing enhancement and expansion.

Reassessing processes, redesigning care

As VA expanded PCAFC to new eras of Veterans under the MISSION Act, VA began reassessing caregivers and Veterans already enrolled in PCAFC. Through this reassessment process, it became apparent the new criteria may not meet the needs of Post-9/11 Veterans and their family caregivers. At that point, VA put a halt on discharges for all legacy applicants, legacy participants, and their family caregiver based on reassessment; it also undertook an effort to put meaningful solutions in place that will have an immediate and positive impact on the caregivers and Veterans participating in PCAFC.

Taking action to improve support

Over the past several months, VA has taken the following actions:

  • Halted discharges for all legacy applicants, legacy participants, and their family caregiver based on reassessment. Legacy participants, legacy applicants and their family caregivers will remain enrolled in PCAFC and continue to receive support and services under PCAFC, unless revoked or discharged for a reason unrelated to the reassessment.
  • Engaged with Veteran Service Organizations, Military Service Organizations, caregivers, CSP staff and other strategic stakeholders via listening sessions.
  • Redesigned the PCAFC wellness contact process to better capture the caregiver and Veteran’s overall needs, and to decrease the length of the contact.
  • Expanded PCAFC to the Northern Mariana Islands, allowing access to caregivers supporting Veterans in all US States and Territories.
  • Expanded the definition of the Safety, Protection, and Instruction (SPI) standard, focusing on inclusivity.

VA is also actively working to:

  • Address the need for better transparency and understanding in PCAFC decisions by updating its notification letter to inform applicants of the granular reasoning behind approval or denial.
  • Streamline its approach to the PCAFC assessment process by reducing the number of questions to ease the burden of completing reassessments, and continuing to further simplify the assessment process.
  • Create a caregiver and Veteran experience survey that will be used to make ongoing improvements.
  • Work across CSP, Office of Mental Health and Suicide Prevention, Geriatrics and Extended Care and other VHA offices to provide wrap-around support to caregivers and Veterans in addition to expanding and enhancing the resources available in VA’s Program of General Caregivers Support Services (PGCSS).
  • Recruit staff needed to fulfill three CSP priorities: timely processing of new applications, appeals of disagreements, and support to caregivers.

There’s a lot to do to build on these steps, and we’ll continue to provide updates throughout this process. VA will stop at nothing to make sure Veterans and their caregivers get the support they need and deserve.

As VA’s Deputy Secretary Remy stated at a recent National Caregiver Convening, “Trust is earned, it’s not given. We hope we can earn your trust through these continued efforts as we work to be good caretakers of the caregiver program.”

Find more information about the VA Caregiver Support Program here:

By Colleen M. Richardson, Psy.D., is the executive director of VA's Caregiver Support Program

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Published on Jun. 3, 2022

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  1. Elisa Zanni James June 6, 2022 at 1:16 pm

    This program has been a lifesaver for my husband, and allowed me to get at least a little stipend since I have to monitor him 24/7, handle and order all of his medical appointments, medication and needs. In the program since 2014 at the highest tier, the feeling of betrayal after the reassessment when we found misrepresentation and lies on the record has been a lot to deal with. VISN 7 and 8 need to get it together. You can’t discharge a 100% P&T who doesn’t drive or handle meds, and has hallucinations and S.I. and also has a fiduciary because of incompetency. I am grateful for Dr. Richardson. She really understands our struggles and needs, and she can get this right and fair for all of us.

    • Jamie Campbell June 26, 2022 at 9:28 am

      My name is Jamie Campbell. I care for my husband we are legacy through the caregiver support and 4th tier and was booted off the program. We are on a pause for now. I’m also my husbands fudicary because of his TBI. It makes me furious I was told by Va he needs a fudicary but not a caregiver. He is also 100% permentantly disabled declared by Va went through all that testing. I did not appeal tired of fighting the Va and its exausting for my husband. Even though I’d love to go to the White House and fight for my husband. Do you have any ideas what we can do?

  2. Maria Davison June 6, 2022 at 9:40 am

    I love this program. They are vary great about including me In my husbands care and I applied for respite and get many days a year in help.

    The team at the hospital are a total lifesavers. Thank you!

    • Teresa June 8, 2022 at 7:14 pm

      None of this will help my husband and I if the pcp doesn’t document in their notes. I can’t make them and apparently denial is certain if there is no documentation by pcp.

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