Debra A. Volkmer, LCSW
Caregiver Support Coordinator – VISN 6 Lead
Tara Zollicoffer, LCSW
Caregiver Support Coordinator
What is P.L. 111-163, Caregivers and Veterans
Omnibus Health Services Act of 2010?
• Requires VA to establish a program of comprehensive assistance for family
caregivers.
• Requires VA to establish a program of general caregiver support services.
• Authorizes VA to provide medical care to certain primary family caregivers
through CHAMPVA (under 38 United States Code (U.S.C.) § 1781 (section
102).
• Increased respite services for caregivers, including 24 hour care
• Provide counseling and mental health services for caregivers (under 38
United States Code (U.S.C.) § 1782 (section 103).
• Authorize VA to provide the expenses of travel (lodging and subsistence)
for family caregivers during travel to and from a VA facility for the
Veteran’s medical exam, treatment or care.
VAMC Caregiver Support Coordinator
• Coordinate the VA Medical Center’s Caregiver Support Program and serve
as clinical expert on caregiver issues and resources.
• Assist family caregivers with the psychosocial and emotional stressors of
caring for an ill, injured, or disabled Veteran through contact and
triage/referral to Veterans team.
• Ensure that caregiver awareness is integrated into all programs.
• Provide social services resources linking the caregiver to VA health care
and community services.
• Use clinical skills to assess for caregiver burden provide supportive
counseling, and plan interventions to support Veterans and their
caregivers.
• Responds to referrals received from the National Caregiver Support Line.
• Develop and chair a Caregiver Advisory Board (CAB)
• Coordinate events and programs for National Family Caregivers month.
• Participate in monthly caregiver support and caregiver coaching calls.
P.L. 111-163 Benefits Sections 101-104
General Caregiver Services
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Education and training
Counseling
Support Groups
Lodging if Veteran present
Fisher Houses
Respite Care
Home Based Primary Care
Telehealth
Non-Institutional Care
Caregiver Healthy Living Center
MyHealtheVET
Caregiver Information on VA Health Web
site
Triage/Referral to internal/external
resources
New Benefits – Post 9/11
Primary Caregiver
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Caregiver stipend
-Formalized training program
-Validation of competencies
-Ongoing monitoring
Health care coverage
Mental health services
Travel, lodging, subsistence and respite for
training and for hospital stays
Additional Family Caregivers
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Formalized training
Travel, lodging, subsistence and respite for
training and for hospital stays
Post 911/Veteran Eligibility
• A Veteran or Servicemember undergoing medical discharge from the
Armed Forces: who has a serious injury incurred or aggravated in the line
of duty in the active military, naval, or air service on or after 9/11/2001;
and is in need of personal care services because of an inability to perform
one or more ADLS; a need for supervision or protection based on
symptoms or residuals of neurological or other impairment or injury; or
such matters as VA considers appropriate. (Caregiver may receive a
monthly stipend and additional benefits, once the plan is fully
implemented and if Veteran is approved)
• The stipend for each primary caregiver will be based on a 3 tier system
recognizing the complexity of care required by the Veteran and provided
by the caregiver
• 3,000 Veterans estimated to be eligible, with the possibility of 30-50
applications for this VA Medical Center. However, the exact number is very
difficult to predict at this time.
Model of Categories of Caregivers in P.L. 111-163
(New and expanded benefits and services for general, family and primary family caregivers.)
Program of Comprehensive Assistance for Family Caregivers Process
CSC CG’s - Currently
• Approved Family CG:
• In – Process CG:
• Approved General CG:
57
8
72
Salisbury CSC-Referrals
25
20
15
10
5
0
Salisbury
Winston Salem
Charlotte
Hickory
National VA Caregiver Support Line
Licensed clinical social workers are available to answer questions,
listen to concerns and directly link callers to the Caregiver Support
Coordinator at their local VA Medical Center.
www.va.caregiver.gov
Challenges/Opportunities
Challenges
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Identification and assessment of Veterans to determine eligibility
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Increased respite services , including 24 hour in home care
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Mental Health Services for caregivers (non-prescriptive care)
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Travel, Lodging and Per Diem-VA authorized to provide the expenses of travel, lodging and subsistence for
the duration of medical exams, treatment or episodes of care (eligible veteran caregivers).
– Authorize VA to provide the expenses of travel (lodging and subsistence) for family caregivers
during travel to and from a VA facility for the Veteran’s medical exam, treatment or care.
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Collateral Documentation and note titles entered into CPRS.
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National Tracking Device (CAT)
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Upcoming Performance Measures
– 2 day turn around for all referrals and 10 day turn around for in-home visits.
Opportunities
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Close Collaboration with the OEF/OIF/OND team for referrals/team meetings/ Council meetings.
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RN has been hired and is conducting HV – need to get her functional Statement complete so she will be
considered a mental health provider.
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Home Visits (win/win HBPC /RN – CM for CSC - increase numbers and the home visit gets completed)
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Increased notice and identified needs of Primary caregivers (ineligible for stipend)
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Revenue enhancement / keeping veterans out of the hospital/nursing home setting/ED, etc.
Moving Forward
• Second CSC on board.
• Presentations and Education planned for
external/internal stakeholders.
• Steering committee planned for Caregiver
Support Month
• Council meets bi-monthly with top management
• Strategic planning for the future – date to be
determined.
• Functional Statement/competencies review for
RN/CM and CSC’s.
Questions?