Macabre news of bodies stacked in a makeshift morgue. Federal emergency teams swooping in to take control of state veterans homes where the coronavirus has killed scores. For veterans, getting care in their own homes has gone from a preference to a matter of survival.
“It’s definitely scary,” says Rob Grier.
His father, Robert Grier Sr., served in Korea and Vietnam, and Rob says if he weren’t taking care of him, his dad would probably need to be in a nursing home. The VA has been good to them over the years, Rob says, especially when his father got lung cancer.
“We were just blessed to have a great team at the VA during his care for that, “he says, “but still, a pre-existing condition, that’s not good for COVID.”
Grier wants to keep taking care of his dad, but he’s not sure he can without help from the VA caregiver program, which is not yet open to older veterans.
Since 2011 the VA has helped caregivers with a stipend, but only for Iraq and Afghanistan vets. In 2018 the VA MISSION Act promised to expand to veterans of Korea and Vietnam, and eventually all veterans who need it.
But who needs it? The VA finally announced its highly technical answer to that question in March after a two-year wait. Anyone with at least a 70% disability rating from the VA can apply. It’s now available to veterans disabled by illness, not just injury. That’s particularly important to Vietnam vets suffering from cancer and other diseases linked to the defoliant Agent Orange.
VA says this will significantly expand the program. Veterans advocates had a mixed reaction to the 56 pages of newly proposed rules.
“This looks to me like a significant restriction of eligibility for the program,” said Bob Carey, a navy vet with the Independence Fund.
Carey says under the rules, vets qualify if they need help with one basic activity like eating or bathing, but only if they need help every single time they do it. And the caregiver in the program has to be doing all the vet’s care and supervision, or they don’t qualify. Carey says he’s afraid rules like that will keep thousands of deserving vets out.
“We and other (Veterans Service Organizations) have been pushing for a long time for fundamental reforms to the caregiver program, and none of those were addressed,” Carey says.
Among their requested changes was a permanent designation for catastrophically injured vets, so they don’t have to check in yearly to reconfirm their status.
“I’ve been missing the same three limbs since June 26, 1965,” says Dennis Joyner, who lost his legs and one arm to a landmine in Vietnam. He’d like to be able to get his wife Donna on to the new expanded caregiver program. After taking care of him for decades, she finally had to quit her full time job in 2008.
“I gave up my job, my pension. It’s just everything that snowballed from that,” she says. “You take on a lot when you’re a caregiver. I might be getting older, but I’m doing probably more than ever.”
The Joyners got excited in 2018 when Congress voted to expand the caregiver program to include Vietnam-era vets.
“They passed it, the president signed it. I’m thinking wow, I’m ready to go file,” Dennis Joyner says. “Well, talk about taking the wind out of your sail — it’s been a couple years now.”
Joyner is pretty sure he’ll qualify, but he still can’t apply – the VA estimates that the new IT system to run the caregiver program won’t be ready until later summer or early fall. The VA is not starting this process with a great foundation of trust — the current caregiver program was administered inconsistently, and the now the new one has kept older vets waiting — some have died since the law passed in 2018.
“Delay, deny, until they die,” says Rick Weidman, with Vietnam Veterans of America. “It shouldn’t have been this complicated.”
He says VA shouldn’t need a new IT system to see that a triple amputee like Joyner needs a caregiver. But the VA and many in congress have agreed that getting the system to work well is just as urgent as getting it done soon.
“When you expand to a very different population the challenges grow exponentially,” says Meg Kabat, the former director of the caregiver program, now with Atlas Research.
Kabat says it’s crucial for the VA to be transparent in how it implements the caregiver expansion.
“If I’m the caregiver of a veteran, I have to have a sense of whether we’re going to qualify even before we apply. To do that VA has to make it crystal clear, more black and white,” Kabat says. “It’s a trade-off, though. The result of that may be that some veterans who were in the program previously may no longer meet that criteria.”