A lack of accountability resulted in caregivers for injured veterans being blocked for months – and sometimes years – from a Department of Veterans Affairs program created to assist them, a VA watchdog reported.
Last year, lawmakers demanded the VA inspector general investigate the Comprehensive Assistance for Family Caregivers program following news reports of the VA dropping veterans from the program with little notice. The program pays a stipend to family members or friends of injured post-9/11 veterans who provide personal care.
The inspector general released findings Thursday that caregivers wait too long to be approved for the program. Once they’re in, the VA doesn’t consistently monitor veterans’ conditions and whether they still need assistance.
“As a nation we make a promise to have our veterans’ backs when they return home from war, and this report confirms that VA has not been holding up their end of the deal,” Sen. Patty Murray, D-Wash., said in a statement.
The findings come as the VA is planning a major expansion of its caregiver program. Congress passed legislation earlier this year to open eligibility to all eras of veterans. The measure was part of a major VA reform package titled the VA Mission Act. In 2019, caregivers to veterans injured before May 7, 1975 will become eligible for benefits. Once that happens, it’s estimated 16,900 additional caregivers will enroll.
Two years later, people who care for veterans injured between 1975 and 2001 can participate. At that time, the Congressional Budget Office estimates the program will grow by another 24,700 caregivers.
“Considering the anticipated growth of the program, it is more important than ever that VA ensure the family caregiver program is operated effectively,” the inspector general report states.
Sen. Jon Tester, D-Mont., urged the VA on Thursday to overhaul the way it manages the program.
“The VA has one year before our bipartisan VA Mission Act expands the Caregiver Support Program to veterans of all eras,” Tester said in a statement. “The VA knows what it must do before then: fix it.”
To investigate the program, the inspector general’s office reviewed 500 cases – 250 caregivers who were enrolled into the program from January to September 2017, and 250 who were dropped from it.
The VA is supposed to approve or deny an application within 45 days. Of the 1,822 applications approved during that time, 1,189, or 65 percent, were delayed, the inspector general found. Of the delayed cases, 654, or 55 percent, weren’t finished until three to six months after a caregiver applied.
In one instance, a veteran and spouse in North Las Vegas, Nev., waited 238 days for the VA to approve their application for assistance. The spouse had quit their job to care for the veteran, who was diagnosed with post-traumatic stress disorder.
Another couple applied for the program in November 2014 through the Huntington VA Medical Center in West Virginia. The veteran, who struggled with mental health disorders, waited nearly three years to be approved.
Thursday’s report exposed another problem with the program. In some cases, caregivers were receiving assistance that they no longer needed. During an eight-month period last year, the VA likely overpaid caregivers approximately $41.6 million, collectively.
“With the expected expansion of the family caregiver program… this dollar amount will be significantly higher if VA does not take steps to improve its management,” the report reads.
Inspectors found one veteran with PTSD and traumatic brain injury had been receiving 25 hours per week in assistance since 2013. In 2014, a nurse noted the veteran was working full time. One year later, a different nurse documented the veteran required less care. No action was taken until 2017, the report states. During that time, the veteran’s caregiver was potentially paid $31,000 for care they didn’t need.
The inspector general made six recommendations to VA officials, one of which is to ensure there’s enough staff at VA medical centers to run the caregiver program. The VA was also asked to meet the 45-day standard to approve or deny applications and to better monitor veterans who benefit from the program.
Carolyn Clancy, the former executive in charge of the VA health care system, said in response to the inspector general that the agency was already working to improve the program. The VA plans to implement all of the recommendations by June 2019 – the month the program is set to expand to more caregivers.
“It is clear that it is beyond time for VA to begin implementing the report’s recommendations and running the caregivers program as Congress intended to help meet the critical needs of our veterans,” Murray said. “We will be watching to make sure they do.”
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