The number of U.S. service men and women seriously injured Post-9/11 is slowly changing the face of caregiving in the United States, as almost 20% of the 5.5 million “military caregivers” today are caring for younger loved ones injured in conflicts over the past 16 years. While caregivers for older veterans – an estimated 4.4 million who served prior to 9/11 – tend to resemble civilian caregivers, those taking care of Post-9/11 veterans appear to face a unique set of challenges and circumstances.

The Family Caregivers Program

According to recent research by the Elizabeth Dole Foundation, caregivers for Post-9/11 veterans tend to be younger, often caring for a younger individual with a mental health or substance use condition. They tend to still be employed but not connected to a support network. They are more likely to use mental health resources and services, and to use them more often.

Currently, these Post-9/11 caregivers (defined as a child, parent, spouse, step-family member, extended family member, or an individual who lives with the veteran but is not a family member) who meet certain eligibility requirements have the benefit of additional support from the Department of Veterans Affairs (VA) Program of Comprehensive Assistance for Family Caregivers.

Established as part of the Veterans Omnibus Health Services Act of 2010, the program provides a monthly stipend (up to $2,500), access to comprehensive VA caregiver training, health care insurance, mental health services and counseling, respite care and travel reimbursements.

While this additional support is especially helpful to these military caregivers, critics of the program, along with several caregiver advocacy groups, have been pointing out shortcomings of the program. For example, there are numerous complaints of inconsistencies, such as some caregivers not qualifying despite meeting requirements, other caregivers being dropped without explanation and veterans being approved for the program at some VA facilities and not at others.

To apply for the Comprehensive program, caregivers must currently fill out and mail a paper application, participate in a series of evaluations at home and at a VA facility, and be periodically reviewed to see whether they still qualify (their monthly stipends can be reduced based on these evaluations).

Feedback from some advocacy groups pointed out that, due to the nature of many of the post-9/11 injuries, responses often varied during these evaluations, making it especially difficult to consistently apply benefits. Others cited that the VA’s requirements on the type of care needed on a daily basis made it difficult for veterans with these “invisible” types of injuries to get the assistance they needed.

In response, the VA temporarily suspended the program in early 2017 to conduct a three-week review of the program, and released updates and changes to the program when the program was reactivated. While many advocacy groups agreed that three weeks would not yield a substantial amount of research, it was a step in the right direction.

Some of the resulting updates to the program included:

• Additional staff training to ensure that all personnel working with veterans and caregivers are current on all requirements, regulations, and types of assistance available
• Standardizing outreach materials used as well as the communication between facilities and veterans
• Updates to the VA caregiver website to include links to home- and community-based services and resources

More in-depth changes to the program – like those addressing approvals and eligibility issues, and ensuring they are consistently applied across all VA facilities – are continuing to be evaluated and improved by the VA based on the research conducted during the review.

An additional major change to the program being called for by advocacy groups – and from some VA leadership itself – is the extension of the program to military caregivers caring for veterans of all eras, not just Post-9/11. Currently, caregivers of veterans injured in conflicts before 9/11 are eligible for the VA’s Program of General Caregiver Support Services, which offers support and training, but no financial stipends, specialized mental health counseling services or travel reimbursements.

Previous efforts to expand the Comprehensive program have stalled out during legislation due to the forecasted financial impact, with estimated costs ranging between $3-4 billion over the first five years. The VA estimated that as many as an additional 80,000 veterans from previous eras would qualify for the expanded program (the current program covers about 36,000 Post-9/11 veterans). However, proponents of expanding the program explain that helping pay for in-home care for veterans, provided by family caregivers, is substantially less-expensive than wide-spread institutionalized care for the same number of veterans (a recent report by Disabled American Veterans estimated paying a family caregiver costs around $37,000 a year, while it costs $333,000 per-patient at a VA nursing home).

To learn more about the VA’s programs of support for military caregivers, visit: www.caregiver.va.gov or call the Caregiver Support Line at 1-855-260-3274.

Written by Megan Hammons