WATCH: Kelly Highlights Urgent Need to Improve Long-term Care and Support for Veterans’ Caregivers During Joint Aging and Veterans Affairs Committee Hearing

Today, during a joint hearing of the Senate Aging and Veterans’ Affairs Committees, Arizona Senator Mark Kelly highlighted the critical need to improve long-term care and support services for veterans and their caregivers. Kelly emphasized the importance of addressing the challenges faced by veterans and their families and reaffirmed his commitment to ensuring veterans receive the necessary care and support they earned. 

Kelly addressed the impact of recent changes to the Program of Comprehensive Assistance for Family Caregivers (PCAFC), sharing concerns from Arizona veteran families about their removal from the program during its expansion rollout and urging the VA to fix these issues.  

“One of the most sacred promises our country makes is to care for our servicemembers when they return home,” said Kelly. “I am committed to making sure our country keeps these promises. And that includes ensuring that our veterans’ family caregivers have the support they need to care for their loved ones.”  

Click here to watch his full exchange with witnesses. See the transcript below: 

Sen. Kelly: Thank you, Mr. Chairman, and thank you to all our witnesses for being here today. My first question is for Miss Sawyer.   

So, Miss Sawyer, one of one of the most sacred promises that our country makes is to care for our service members when they return home, and I’m committed to making sure that our country keeps these promises, and that includes ensuring that our veteran’s family caregivers have the support they need to care for their loved ones.   

And I’ve heard from Arizona veteran families that they were removed from the program of Comprehensive Assistance for Family Caregivers during the expansion rollout, and they had previously qualified in some cases for years for this program.   

So, while I’m glad that the VA (U.S. Department of Veteran Affairs) has suspended the reassessments and the discharges for legacy participants, I’m troubled that some of the folks who are disqualified still do not have an expedited appeals process.   

This is an important issue that’s impacting Arizona’s veterans and also their families, and I’ve continued to urge the VA to fix this. So, Miss Sawyer, can you please share your experience with the changes to this program, the program of Comprehensive Assistance for Family Caregivers?  

Andrea Sawyer (Advocacy Navigator for the Quality of Life Foundation’s Wounded Veteran Family Care Program): Thank you, Senator. In the beginning, when the program was first created, the only appeals that were available were clinical appeals and they were governed under VA’s regular clinical appeal guidance.   

When the new regulations were written for the Mission Act in 2020, those appeals, clinical appeals, shifted to the centralized eligibility assessment team that was created with the Beaudette court decision. It opened up multiple more avenues for appeal, so the VHA (Veteran Health Administration), was forced to create supplemental claims, higher level review claims, which all occur under VHA and then there was an avenue opened up for board of Veterans Appeals claims.   

None of those had existed prior to the Beaudette case. Also, because decisions have been governed under regular clinical appeals, clinical appeals in the VA do not require justification. They simply can be listed as approved or denied. So, with the Beaudette decision VA did undertake an effort to do an eight-point letter, so now we know why people are.

Sen. Kelly: Can you describe what the Beaudette decision was?  

Andrea Sawyer: Sure, the Beaudette decision was a court decision where basically a veteran and his spouse sued the VA to say: you said we weren’t eligible for the for the program, but we don’t really know why because the letter that you sent us doesn’t tell us why and we don’t have rights to appeal that we would in other situations.   

The Beaudette decision then created those extra avenues for appeals, and it created the need for the eight-point letter. So, the eight-point letter is a letter that a veteran gets that basically mirrors a process that’s within the VBA, or the Veterans Benefits Administration, that explains exactly why a veteran is denied.   

With the setting up of the of the supplemental claims and higher-level reviews, this was something unique to the VHA that they had never done before, and so that’s kind of what has taken so long. Originally, VHA had to completely set up a process they had never been involved in and then they had to write regulations, write directives, everything administrative that VA does. Then they had to train a staff how to do that.  

In the meantime, they were already accepting those appeals, but weren’t able to act on them. They were accepting appeals for between 12 and 18 months before they could actually act on them. They are actually acting on them now for supplemental claims and higher-level review.   

And so, we are starting to see some decisions come out of there. One of the things the Quality of Life Foundation does is to say, if you had supplemental information that should have been available at the time of your original denial, while we’d urge you to go ahead and submit a supplemental claim we also want you to, if you’ve been denied from the beginning, go ahead and submit a new application using all of that evidence so we can go ahead and get you in the program with that extra information, while at the same time your supplemental claim runs. Which would then, if you were accepted under your new application, you would be back paid from your supplemental claim from the approval of your new application back to your date of your original application.   

However, there is a little bit of a narrow window, that if that information that we consider supplemental should have been available at your first review, you can actually file it as a clinical appeal and have your appeal acted on within 30 days. That would actually get you back paid to your original application, and recently we’ve just at Quality of Life had that happen with a veteran, actually, he was an Arizona veteran, and we got him back paid all the way to his denial in 2021 because they had never contacted his specialist.  

Sen. Kelly: But do you feel this is moving in the right direction?  

Andrea Sawyer: Moving in the right direction, but slowly.  

Sen. Kelly: Ok. Thank you.  

Andrea Sawyer: Thank you, Senator Kelly.