If you are a family caregiver of a Veteran or know of one, and wish to take part in this study, please sign up at:
www.gwsurvey.com/caregiversofveterans.html

The National Alliance for Caregiving is seeking participants for a new study of family caregivers of Veterans. This study is intended to determine how caregivers of Veterans are coping and what community and VA services, resources, and programs would support and assist them with their caregiving activities.

Caregivers are defined as those providing unpaid assistance, such as personal care, bathing, dressing, feeding, help with medications and other treatments, transportation to the doctors’ appointments, and arranging for services. Caregivers of Veterans from World War II, the Korean War, the Vietnam War through the current conflicts in Iraq and Afghanistan will be included in the study. Caregivers include relatives and friends.

The study will use discussion groups, telephone interviews, and an Internet survey of caregivers of Veterans. The National Alliance for Caregiving is recruiting many family caregivers of Veterans from across the United States, and especially caregivers for the discussions groups living in or near: San Diego, San Antonio, and Washington, DC.

Cash incentives will be available for study participants and Veterans who refer them. Information obtained from the discussion groups, telephone interviews, and Internet survey will be confidential and will not be connected to the individual caregivers participating in the study.

Thank you for your consideration to participate in a study that could make a difference in the lives of caregivers of Veterans. Please contact Kathy Cameron at kathleen56@caregiving.org for more information.

This project is funded by a grant from the United Health Foundation.

Meg Cooch, MPP, director of programs and operations for National Alliance for Caregiving, provided the following update about legislation that would help family caregivers of veterans. If you support this legislation, contact your Senators as soon as possible to ask for their support.

Key Provisions of S.1963, the Caregivers and Veterans Omnibus Health Services Act of 2009
Senate Floor Action Today (November 19, 2009)

S. 1963, the Caregivers and Veterans Omnibus Health Services Act of 2009 was introduced on October 28 by Senator Daniel Akaka (D-HI). The legislation contains a number of provisions to help wounded veterans, their informal caregivers, homeless veterans, women and veterans living in rural areas.

The measure has been blocked by Senator Coburn (R-OK) who objected to a number of provisions, citing the inability to pay for the services, and the duplicative nature of some of the services that the VA already administers. However, an agreement was reached between Senator Akaka, Chairman of the Senate Veterans’ Affairs Committee and Senator Tom Coburn (R-OK) late on November 10.

Highlights of the measure:

The bill merges two omnibus veterans’ health bills, S.801 and S. 252 which passed the committee in September with bipartisan support. One of the key benefits in the measure is caregiver assistance for the nation’s most seriously wounded veterans who were injured after September 11, 2001. The bill also contains provisions to improve access to care for veterans in rural areas by increasing access to telecommunications with the VA doctors and specialists, and by establishing Centers of Excellence in a number of rural areas.

Monthly Stipend for Caregivers of Veterans – Authorizes the VA to pay a monthly stipend (in 2010 up to $2,350) to a family member or friend who is designated as the personal caregiver of a severely injured veteran who meets certain criteria.

Travel Benefits - Allows the VA to pay for transportation, lodging, and subsistence expenses of family members and other caregivers of veterans who are traveling to VA facility or another site for medical or rehabilitative care. Currently, lodging and subsistence expenses of non-veterans are not reimbursable under current law. CBO estimates that in 2010 the VA would reimburse about 34,000 non-veterans about $1,950 a year for travel and lodging expenses. The VA estimates that about 150,000 non-veterans by 2014 would qualify for these benefits.

Caregiver Education, Training and Counseling – Requires the VA to evaluate veterans and their caregivers to determine the type of care veterans need and the training their caregivers require, provide that training, education and counseling and establish an interactive Website with more information.

Oversight of Caregivers – The legislation would also require the VA to conduct regular oversight of caregivers including home visits. The VA is expected to contract with home health care agencies to conduct oversight of 500 caregivers initially at a cost of about $325 a month per caregiver.

Benefits During Caregiver Training – The measure would provide respite care and travel benefits to caregivers while they are undergoing a two week training course at VA facilities throughout the nation.

Respite Care Services – The VA would provide respite care services while the primary caregiver is undergoing training as well as up to 30 days of additional respite care and respite if the primary caregiver cannot carry out their obligations for medical problem.

Medical Care to VA Caregivers – The bill authorizes the VA to provide medical care to caregivers if such caregivers lack any other health plan. The bill also establishes mental health services to both the veteran’s primary personal care attendant, and a family member who provides personal care services. The bill does not prohibit two individuals from serving in those different capacities. Family members would be eligible for training, counseling, respite care services, medical care and mental health services.

Survey of Family Caregivers – The legislation also authorizes the VA and DOD to contract for a national survey of family caregivers of seriously disabled veterans and service members and report to Congress with their findings. The VA estimates the survey would cost approximately $2 million over the four year period.

Veterans’ Administration Opposition
The VA has expressed opposition to many elements of this bill. They cite soaring program costs — $62.5 billion over 10 years; sweeping changes in the role of the VA by permitting family members of veterans to access medical care and mental health services from the VA; and creating a new class of benefits for one group of veterans over another. At this time, the Administration has not indicated its support or opposition to the legislation.

CBO Cost Estimate: The CBO believes that these provisions would cost $5.6 billion in FY 2010, $26.8 billion in FY 2011, and $62.5 billion over 10 years. For more information, see http://thomas.loc.gov/cgi-bin/cpquery/T?&report=sr080&dbname=111&.

Related articles

• GOP Sen. Tom Coburn, Dr. No, Stands In The Way Of Health Care For Veterans (alan.com)
• Senate Approves Budget for Veterans Programs (abcnews.go.com)

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Happy Veteran’s Day! Two quick tips for your day:

1. Use today to gain insight about your care recipient

As with all holidays, Veteran’s Day offers the opportunity to gain a perspective on your care recipient’s life history and personal experiences. Take time to day to ask questions about your care recipients’ war experiences (regardless of whether they served). You’ll be amazed at what you learn about your care recipient and your country. If your care recipient has dementia, ask simple questions that can lead to a discussion–no matter where the discussion leads.

2. Benefits available to veterans: VA Aid and Attendance Program

Aid and Attendance is a benefit available to veterans, their spouses, or widows. This benefit is available to help offset some of the cost of nursing homes, assisted living communities, personal care homes, or homecare expenses.

Qualifications:

• Veteran, spouse or widow/er served during wartime, including those who served state side.

• Served at least 90 days of active service with one of those days being during wartime. Eligible dates are 4/21/1898-7/15/1903, 5/9/1916-11/11/1918, 12/07/1941-12/31/1946, 6/27/1950-1/31/1955, 8/5/1964-5/7/1975, 8/20/1990-present.

• The veteran received an honorable discharge; a copy of the Discharge Papers must be provided with the application.

• The spouse must not have divorced the veteran.

• If the veteran has died and the widow remarries, benefits may still be available.

• The veteran must need some assistance with at least two activities of daily living such as bathing, meal preparation, etc.

• Applicants must be receiving the assistance or have a doctor’s order before they can apply. Benefits are retroactive to the application date.

• There are some financial qualifications, based on adjusted income for those applying. However, it is based on an adjusted income not the gross income. To figure the adjusted income, medical expenses, insurance premiums, medications, and even the cost of the community where they are residing is taken into consideration. Assets not included are the applicant’s home, pensions, small life insurance policies, prepaid funeral expenses, and annuities in payout status. There is no look back period at this current time. If the veteran exceeds the monthly income level after the adjusted income is figured they still may qualify for benefits, the dollar amount is simply reduced dollar for dollar that they are over.

• Married veterans are eligible for $1,949/month, single veterans $1,632 and widows of veterans $1,055. This is paid directly to the applicant/responsible party as additional income, not to the community where they reside.

• Approval can take from 30 to 90 days. Applications can be expedited based on need.

What are Aid and Attendance and Housebound benefits?
Aid and Attendance (A&A) is a benefit paid in addition to monthly pension. This benefit may not be paid without eligibility to pension. A veteran may be eligible for A&A when:

• The veteran requires the aid of another person in order to perform personal functions required in everyday living, such as bathing, feeding, dressing, attending to the wants of nature, adjusting prosthetic devices, or protecting himself/herself from the hazards of his/her daily environment, OR,
• The veteran is bedridden, in that his/her disability or disabilities requires that he/she remain in bed apart from any prescribed course of convalescence or treatment, OR,
• The veteran is a patient in a nursing home due to mental or physical incapacity, OR,
• The veteran is blind, or so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes, or concentric contraction of the visual field to 5 degrees or less.

Housebound is paid in addition to monthly pension. Like A&A, Housebound benefits may not be paid without eligibility to pension. A veteran may be eligible for Housebound benefits when:

• The veteran has a single permanent disability evaluated as 100-percent disabling AND, due to such disability, he/she is permanently and substantially confined to his/her immediate premises, OR,
• The veteran has a single permanent disability evaluated as 100-percent disabling AND, another disability, or disabilities, evaluated as 60 percent or more disabling.
• A veteran cannot receive both Aid and Attendance and Housebound benefits at the same time.

How to Apply for Aid and Attendance and Housebound:
You may apply for Aid and Attendance or Housebound benefits by writing to the VA regional office having jurisdiction of the claim. That would be the office where you filed a claim for pension benefits. If the regional office of jurisdiction is not known, you may file the request with any VA regional office.

You should include copies of any evidence, preferably a report from an attending physician validating the need for Aid and Attendance or Housebound type care.

The report should be in sufficient detail to determine whether there is disease or injury producing physical or mental impairment, loss of coordination, or conditions affecting the ability to dress and undress, to feed oneself, to attend to sanitary needs, and to keep oneself ordinarily clean and presentable.

In addition, it is necessary to determine whether the claimant is confined to the home or immediate premises.

Whether the claim is for Aid and Attendance or Housebound, the report should indicate how well the individual gets around, where the individual goes, and what he or she is able to do during a typical day.

Resources:

National Association of Area Agencies of Aging

U.S. Department of Veteran’s Affairs

Veterans-Express