VA Caregiver Program

kimcoble

Registered Member
#1
Please all servicemembers and veterans who are considering the VA Caregiver Program please at least read the short regulation on the VA Caregiver Program, 38 CFR 71 at https://www.gpo.gov/fdsys/search/pa...8-vol2-part71&packageId=CFR-2012-title38-vol2. You can also google the regulation in your search engine and pull it up.

Knowing the process and your rights will ensure you are informed when applying for benefits.

A lot of VA Caregiver Program employees which mainly consist of a Caregiver Program Supervisor and Caregiver Coordinators which are Licensed Clinical Social Workers (LCSW) and a Caregiver Nurse. The Caregiver Program employees are not considered a part of your Primary Care Team for a veteran. You could possibly have a LCSW that is providing care as part of your Primary Care Team if you, veteran, is seeking care directly from a LCSW. Since you are NOT receiving 'direct medical or mental care' from the LCSW of the Caregiver Program they don't qualify to be a part of the veteran's Primary Care Team.

According to 38 CFR 71, 71.15 states that the veteran's Primary Care Team will consist of veteran's Primary Care Doctor and other medical/mental clinical professionals that provide care to the veteran as the Primary Care Doctor deems necessary for the team. For example, you are being treated by a psychiatrist and occupational therapist then based on your Primary Care Doctor he/she might include those individuals as part of the Primary Care Team in making decisions about a veteran's need for a caregiver. Your, veteran, Primary Care Team is responsible for evaluating a veteran for the program, interviewing veteran's primary/secondary caregiver, developing a treatment plan, determining the personal care services and scoring them, etc. A clinician or clinical team will come out to perform a house assessment to ensure your primary/secondary caregiver can perform the required personal services and access the veteran's well-being, read 38 CFR 71.

The evaluation for the program is the responsibility of the veterans' Primary Care Team, not a c&p or a clinical team that doesn't provide care for the veteran - it's the veteran's Primary Care Team led by his/her Primary Care Doctor.

The home assessment/visit is to assess your primary/secondary caregiver's ability to perform the personal care services and assess the veteran's well-being. Don't let the Caregiver Program tell you they need to inspect or look in every room of your house or they are authorized to perform 'environmental' checks/inspections - they aren't authorized to perform these tasks. If in doubt, ask them to show you in writing that they are authorized to do anything other than what the regulation requires them to do.

I'm currently having an issue with my local VA Caregiver Program. I was unaware of their role and responsibilities until my caregiver informed me that his Caregiver Coordinator read my psychotherapy notes without my written authorization (HIPPA and VA Privacy requirement unless otherwise allowed by law) and a medical need to know. That is when I went to googling everything I could find on the VA Caregiver Program. Previously, I had asked twice for documentation on this house 'inspection' requiring them to inspect all my rooms in my house. Then we contacted my doctor's and found out they had no idea about their required involvement in the caregiver program nor were they contacted or consulted about my needs for a caregiver.

Needless to say, I was shocked. I was horrified that the Caregiver Coordinator accessed my records, read them then shared them with the other caregiver coordinators/employees. My VA Caregiver Program holds a monthly board and discusses all veteran's cases prepared for that monthly board to discuss them and make decisions. This is not following the 38 CFR 71 guidelines. The VA Caregiver Supervisor stated to us that she doesn't include our doctors because the doctors wouldn't get any work done, and her employees are fully capable and qualified to pull veteran's records, read them and make personal care decisions all without involving our doctor's.

I am currently fighting this and I haven't gotten a solution yet. I've sent many correspondence out to different agencies seeking their assistance in notifying someone in authority to investigate. The medical director and his leadership staff have all agreed with the Caregiver Supervisor is what his letter to me stated this weekend. I'm so beyond anger and rage. I'm still fighting and have to make a lot of calls this week seeking a solution or someone with the authority to investigate or have the Caregiver Program follow the regulations. A lot of veteran's even at this VA is unaware.

Please take the time to read at least the 38 CFR 71 to understand your rights and the roles and responsibilities of your Primary Care Team. There isn't any mention any the regulations that list the words "Caregiver Supervisor", "Caregiver Coordinator", "Caregiver Nurse", "review veterans' records every 90 days", "review veterans' records for programmatic compliance by the Caregiver Program", "access, review veterans' records", or any other mention of "veterans' records, medical, mental records for compliance, to ensure veteran is seeking care, etc". Absolutely nothing authorizing or discussing or mentioning that the Caregiver Program employees have any duties and responsibilities of a veteran seeking a caregiver.

If you find out that anyone other that those medical professionals had a medical reason, a medical need to know, for treatment purposes or billing accessed your records you can file a HIPPA violation with the Health and Human Services (HHS), https://www.hhs.gov/hipaa/filing-a-complaint/index.html. You can file online or by mail. They also allow you to provide documents in support of your complaint. You can also file a complaint with your local VA Privacy Officer. But, remember if you don't get anywhere with the VA then you can file with HHS.

For noncompliance to applicable regulations you can file a complaint with your VA Patient Advocate.

You can also reach out to veteran organizations and your elected officials in your area.

Please spread the word.
 

armyof11

Registered Member
#2
Interesting post. we had difficulty with the Caregiver program, and we were not approved. My husbands PCM referred him to another resource, Mid east Agency on Aging, and we were approved for their Caregiver program. What was the difference? Nothing I can tell, but the Agency gets a % of the money. I felt no support whatsoever from the VA Caregiver program.
 

kimcoble

Registered Member
#3
I agree with you on the VA Caregiver Program. Did his VA Caregiver Support Coordinator do all the procedures for the program? We, veterans, are having major issues right now with the VA Caregiver Program because the VA employees feel that should do the entire process instead of a veterans primary care team led by veterans primary care doctor. The Caregiver Program provide support to those veterans caregivers not the veterans themselves. Sure they can assist you filling out the form but the rest, eligibility, determine/rate personal care services, approve/train caregiver. If you feel like reading about 10 pages of the regulation to inform yourself about the program google 38 CFR 71. I know nationwide people are having problems with being dropped and/or denied. The reason, the Caregiver Program are performing the functions of the veterans primary care team led by veteran primary care doctor. The Licensed Clinical Social Workers (LCSW) in the Caregiver Program are not following any of the rules, 38 CFR 71, and they are performing all medical and mental health aspects. LCSWs do not provide treatment or care to the veteran in a medical or mental health capacity, so, no need for them to access veterans records, read them then make the determinations - there not the veterans doctors who are stated in the 38 CFR 71 that is their job. Also, think of it like this, caregiver assistance isn't a compensation or pension benefit, a stipend is paid directly to the caregiver that has been appointed by the veterans primary care doctor/team and are eligible for caregiver assistance and benefits.

So, to simplify, there are 2 aspects of the VA Caregiver Program; 1. Veteran - everything done by veterans primary care doctor/team and 2. Caregiver - caregiver stipend, assistances, and benefits.

The LCSW are calling it a 'clinical intervention' but it isn't and they are calling it these so it appears justifiable to anyone who challenges them on what they are doing. A veteran can be treated for mental health issues by a LCSW which is in a clinical setting and can be a part of the veterans primary care team, if applicable, when making the veterans determinations/approvals for the caregiver program. Ok, but the Caregiver Program LCSWs are not providing 'clinical' services or treatment to the veteran, only the caregiver if they wish to seek counseling with one of the Caregiver Program LCSWs.

I would recommend that you contact your congressman for your area, you can google it to find out who he/she is and let them know of your concerns/issues.

I'm waiting for my congressman to contact me for an appointment - I requested to talk to him face to face.

What the VA Caregiver Program is doing to us veterans isn't within their scope of duty. Their VHA Directive 1152, dated June 2017, is their policy that came from the regulations, 38 CFR 71, which for the most part follows the roles of a veterans primary care team but you will not find a section in there - Yes, the VA Caregiver Program left out what a veterans' Primary Care Doctor/Team are required to do but they did but all the requirements of each position in the Caregiver Program.

Kim
 

kimcoble

Registered Member
#4
Please all servicemembers and veterans who are considering the VA Caregiver Program please at least read the short regulation on the VA Caregiver Program, 38 CFR 71 at https://www.gpo.gov/fdsys/search/pa...8-vol2-part71&packageId=CFR-2012-title38-vol2. You can also google the regulation in your search engine and pull it up.

Knowing the process and your rights will ensure you are informed when applying for benefits.

A lot of VA Caregiver Program employees which mainly consist of a Caregiver Program Supervisor and Caregiver Coordinators which are Licensed Clinical Social Workers (LCSW) and a Caregiver Nurse. The Caregiver Program employees are not considered a part of your Primary Care Team for a veteran. You could possibly have a LCSW that is providing care as part of your Primary Care Team if you, veteran, is seeking care directly from a LCSW. Since you are NOT receiving 'direct medical or mental care' from the LCSW of the Caregiver Program they don't qualify to be a part of the veteran's Primary Care Team.

According to 38 CFR 71, 71.15 states that the veteran's Primary Care Team will consist of veteran's Primary Care Doctor and other medical/mental clinical professionals that provide care to the veteran as the Primary Care Doctor deems necessary for the team. For example, you are being treated by a psychiatrist and occupational therapist then based on your Primary Care Doctor he/she might include those individuals as part of the Primary Care Team in making decisions about a veteran's need for a caregiver. Your, veteran, Primary Care Team is responsible for evaluating a veteran for the program, interviewing veteran's primary/secondary caregiver, developing a treatment plan, determining the personal care services and scoring them, etc. A clinician or clinical team will come out to perform a house assessment to ensure your primary/secondary caregiver can perform the required personal services and access the veteran's well-being, read 38 CFR 71.

The evaluation for the program is the responsibility of the veterans' Primary Care Team, not a c&p or a clinical team that doesn't provide care for the veteran - it's the veteran's Primary Care Team led by his/her Primary Care Doctor.

The home assessment/visit is to assess your primary/secondary caregiver's ability to perform the personal care services and assess the veteran's well-being. Don't let the Caregiver Program tell you they need to inspect or look in every room of your house or they are authorized to perform 'environmental' checks/inspections - they aren't authorized to perform these tasks. If in doubt, ask them to show you in writing that they are authorized to do anything other than what the regulation requires them to do.

I'm currently having an issue with my local VA Caregiver Program. I was unaware of their role and responsibilities until my caregiver informed me that his Caregiver Coordinator read my psychotherapy notes without my written authorization (HIPPA and VA Privacy requirement unless otherwise allowed by law) and a medical need to know. That is when I went to googling everything I could find on the VA Caregiver Program. Previously, I had asked twice for documentation on this house 'inspection' requiring them to inspect all my rooms in my house. Then we contacted my doctor's and found out they had no idea about their required involvement in the caregiver program nor were they contacted or consulted about my needs for a caregiver.

Needless to say, I was shocked. I was horrified that the Caregiver Coordinator accessed my records, read them then shared them with the other caregiver coordinators/employees. My VA Caregiver Program holds a monthly board and discusses all veteran's cases prepared for that monthly board to discuss them and make decisions. This is not following the 38 CFR 71 guidelines. The VA Caregiver Supervisor stated to us that she doesn't include our doctors because the doctors wouldn't get any work done, and her employees are fully capable and qualified to pull veteran's records, read them and make personal care decisions all without involving our doctor's.

I am currently fighting this and I haven't gotten a solution yet. I've sent many correspondence out to different agencies seeking their assistance in notifying someone in authority to investigate. The medical director and his leadership staff have all agreed with the Caregiver Supervisor is what his letter to me stated this weekend. I'm so beyond anger and rage. I'm still fighting and have to make a lot of calls this week seeking a solution or someone with the authority to investigate or have the Caregiver Program follow the regulations. A lot of veteran's even at this VA is unaware.

Please take the time to read at least the 38 CFR 71 to understand your rights and the roles and responsibilities of your Primary Care Team. There isn't any mention any the regulations that list the words "Caregiver Supervisor", "Caregiver Coordinator", "Caregiver Nurse", "review veterans' records every 90 days", "review veterans' records for programmatic compliance by the Caregiver Program", "access, review veterans' records", or any other mention of "veterans' records, medical, mental records for compliance, to ensure veteran is seeking care, etc". Absolutely nothing authorizing or discussing or mentioning that the Caregiver Program employees have any duties and responsibilities of a veteran seeking a caregiver.

If you find out that anyone other that those medical professionals had a medical reason, a medical need to know, for treatment purposes or billing accessed your records you can file a HIPPA violation with the Health and Human Services (HHS), https://www.hhs.gov/hipaa/filing-a-complaint/index.html. You can file online or by mail. They also allow you to provide documents in support of your complaint. You can also file a complaint with your local VA Privacy Officer. But, remember if you don't get anywhere with the VA then you can file with HHS.

For noncompliance to applicable regulations you can file a complaint with your VA Patient Advocate.

You can also reach out to veteran organizations and your elected officials in your area.

Please spread the word.

Update, so the 38 CFR 71, regulation for the VA Caregiver Support Program, has an amendment FR Vol 80 38 CFR parts 17 and 71 dated Jan 2015. I like the amendment because it discusses each section of the regulation in greater detail of the changes and the intent.
 
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