By Tom Philpott
Posted May. 10, 2016 at 2:01 AM
A showpiece of the Veterans First package that the Senate Veterans Affairs Committee unveiled last week is a multi-billion-dollar initiative to phase in for older generations of severely injured veterans robust caregiver benefits first enacted in 2010 only for the Post-9/11 generation.
Though it’s only part of a huge omnibus bill containing many veteran reform measures that senators previously introduced as separate bills, the plan to expand caregiver benefit coverage carries the biggest price tag. The early estimate is $3.1 billion over its first five years.
For in-home caregivers of thousands of vets with severe physical or mental injuries, it would mean cash stipends for their time and effort, health insurance if caregivers have none, guaranteed periods of paid respite to avoid caregiver burnout and training to enhance patient safety.
Sen. Patty Murray (D-Wash.), prime architect of the caregiver expansion plan, negotiated with Sen. Johnny Isakson (R-Ga.), the committee chairman, to secure a modified plan that could be funded with budget offsets and gain bipartisan support on the committee. That should improve its chances of becoming law despite still formidable obstacles ahead.
Perhaps the biggest is lingering disappointment over how the current caregiver program operates. Though it is delivering benefits to spouses and parents caring for 31,000 severely disabled veterans of the Post-9/11 era, the program remains underfunded, understaffed and lacking modern software to screen applications, track care needs or verify levels of caregiver support and program managers’ responsiveness.
The Government Accountability Office found many problems including too few Caregiver Support Coordinators who run the program locally. The program remains so “badly mismanaged” as to leave the House Veterans Affairs Committee, chaired by Rep. Jeff Miller (R-Fla.), doubtful that the VA can handle a vast expansion of eligibility, a committee staff member said.
“While the intent of the Senate bill is admirable,” the staffer said, “we have an obligation not to expand existing programs without first ensuring they function correctly.”
But Isakson agreed with Murray that, rather than allow weaknesses in the current program to block expansion to older veterans, they should phase in eligibility for older generations on a schedule that gives VA time to fix problems while it incentivizes Congress to provide needed funding.
VA promises to have a modern IT system in place for the program by December this year. The Senate package would require the VA secretary within a year to certify that problems GAO identified have been fixed. Then within another year VA would begin to accept benefit applications from caregivers of veterans who served during the Vietnam War or earlier. Two years later, VA would start to accept applications from caregivers of severely injured veterans who served in the period between Vietnam and 9/11.
The pool of pre-9/11-era caregivers likely to be eligible for benefits if the program is expanded could be as high as 80,000, VA reported last year.