Program of Comprehensive Assistance for Family Caregivers: Timely Discharges, But Oversight Needs Improvement

The VA Office of Inspector General (OIG) audited the Program of Comprehensive Assistance for Family Caregivers to determine whether the Veterans Health Administration (VHA) took timely and consistent action to discharge veterans and their caregivers from the Family Caregiver Program, and subsequently cancel caregiver stipends following a veteran or caregiver death, or veteran incarceration or hospitalization. The audit team reviewed about 680 cases and found that VHA nearly always acted in a timely manner to discharge veterans and caregivers from the program and cancel caregiver stipends. Still, in about 6 percent of the cases, veterans and caregivers were not discharged in a timely manner, causing VHA to pay at least $356,000 in improper and questionable caregiver stipends. If program controls are not improved, VHA could pay an estimated $583,000 in improper stipends over five years. The OIG also substantiated an OIG Hotline complaint that VHA improperly paid about $71,000 to the caregiver of a deceased veteran because a caregiver support coordinator did not initiate prompt action to discharge the veteran and cancel the stipend. This lapse went undetected for almost three years because the medical facility lacked procedures to ensure caregiver support coordinators took timely action to address changes in participant’s status and initiate actions to stop caregiver payments. The OIG recommended the Under Secretary for Health establish processes to match records of enrolled veterans and their caregivers against the VA’s death, incarceration, and hospitalization data on a regular basis; outline veteran and caregiver responsibilities for promptly notifying their caregiver support coordinator of deaths; and institute a working group to clarify inconsistencies and gaps in program guidance.