83 FR 60966 - Notice of Request for Information on the Department of Veterans Affairs Program of Comprehensive Assistance for Family Caregivers (PCAFC)
DEPARTMENT OF VETERANS AFFAIRS Federal Register Volume 83, Issue 228 (November 27, 2018)
Federal Register Volume 83, Issue 228 (November 27, 2018)
| Page Range | 60966-60968 | |
| FR Document | 2018-25763 |
[Federal Register Volume 83, Number 228 (Tuesday, November 27, 2018)] [Notices] [Pages 60966-60968] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2018-25763] ----------------------------------------------------------------------- DEPARTMENT OF VETERANS AFFAIRS Notice of Request for Information on the Department of Veterans Affairs Program of Comprehensive Assistance for Family Caregivers (PCAFC) AGENCY: Department of Veterans Affairs. ACTION: Request for information. ----------------------------------------------------------------------- SUMMARY: The Department of Veterans Affairs (VA) is requesting information regarding its Program of Comprehensive Assistance for Family Caregivers (PCAFC). This notice requests information and comments from interested parties on certain requirements of the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 or the VA MISSION Act of 2018 related to PCAFC. DATES: Comments are due by December 12, 2018. ADDRESSES: Written comments may be submitted through http://www.Regulations.gov; by mail or hand delivery to the Director, Office of Regulation Policy and Management (00REG), Department of Veterans Affairs, 810 Vermont Avenue NW, Room 1063B, Washington, DC 20420; or by fax to (202) 273-9026 (this is not a toll-free number). Comments should indicate that they are submitted in response to ``Notice of Request for Information on the Department of Veterans Affairs Program of Comprehensive Assistance for Family Caregivers (PCAFC).'' Copies of comments received will be available for public inspection in the Office of Regulation Policy and Management (00REG), Department of Veterans Affairs, 810 Vermont Avenue NW, Room 1063B, Washington, DC 20420, between the hours of 8:00 a.m. and 4:30 p.m., Monday through Friday (except Federal holidays). Please call (202) 461-4902 for an appointment (this is not a toll-free number). During the comment period, comments may also be viewed online through the Federal Docket Management System at www.Regulations.gov. FOR FURTHER INFORMATION CONTACT: Margaret Kabat, National Director, Caregiver Support Program (10P4C), Veterans Health Administration, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, (202) 461-6780 (this is not a toll-free number), [email protected]. SUPPLEMENTARY INFORMATION: The Program of Comprehensive Assistance for Family Caregivers (PCAFC) was established by title I of Public Law (Pub. L.) 111-163, Caregivers and Veterans Omnibus Health Services Act of 2010, and is codified in section 1720G(a) of title 38 of the United States Code (U.S.C.). VA has been administering PCAFC continuously since May 5, 2011, and has implemented this program through its regulations in Part 71 of title 38 of the Code of Federal Regulations (CFR). Through PCAFC, VA provides family caregivers of eligible veterans and servicemembers (as defined in 38 CFR 71.20) certain benefits, such as training, respite care, counseling, technical support, beneficiary travel (to attend required caregiver training and for an eligible veteran's medical appointments), a monthly stipend payment, and access to health care (if qualified) through the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) 38 U.S.C. 1720G(a)(3), 38 CFR 71.40. For the purposes of this notice, the term veteran includes servicemembers who apply for or participate in PCAFC. PCAFC is currently available to family caregivers of eligible veterans who incurred or aggravated a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) in the line of duty in the active military, naval, or air service on or after September 11, 2001. 38 U.S.C. 1720G(a)(2)(B). On June 6, 2018, the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 or the VA MISSION Act of 2018 (``MISSION Act''), Public Law 115-182, was signed into law. Section 161 of the MISSION Act amended 38 U.S.C. 1720G to expand eligibility for PCAFC to family caregivers of eligible veterans who incurred or aggravated a serious injury in the line of duty before September 11, 2001, establish new benefits for designated primary family caregivers of eligible veterans, and make other changes affecting program eligibility and VA's evaluation of PCAFC applications. The expansion of PCFAC to family caregivers of eligible veterans who incurred or aggravated a serious injury in the line of duty before September 11, 2001, will occur in two phases, the first of which will begin when VA certifies to Congress that it has fully implemented a required information technology system. During the 2-year period beginning on the date of such certification to Congress, PCAFC will be expanded to include family caregivers of eligible veterans who have a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, or air service on or before May 7, 1975. Two years after the date of submission of the certification to Congress, PCAFC will be expanded to family caregivers of all eligible veterans who have a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, or air service, regardless of when the serious injury occurred. We are issuing this notice to solicit input on changes to the program required by the MISSION Act, as further explained below. This notice and request for information serves as a means for VA to consult with key stakeholders on how to define and implement changes made to the program by the MISSION Act. After [[Page 60967]] receipt of this information, we will use the information to inform any changes to this program and its implementing regulations. This notice and request for information has a comment period of 15 days, during which individuals, groups, and entities may reply to the questions presented below. VA believes that 15 days is sufficient to provide comments, as the individuals, groups, and entities interested in this program likely have information and opinions readily available or can quickly compile and submit such information. Commenters are encouraged to provide complete but concise responses to the questions outlined below. Please note that VA will not respond to comments or other questions regarding policy plans, decisions, or issues regarding this notice. VA may choose to contact individual commenters, and such communications would only serve to further clarify their written comments. To implement changes to PCAFC consistent with, and pursuant to, the MISSION Act, we are seeking information on the following topics and issues: Need for Personal Care Services In addition to expanding PCAFC to eligible veterans who served before September 11, 2001 (subject to the timeline discussed above), section 161 of the MISSION Act amended the eligibility criteria in 38 U.S.C. 1720G to add an additional basis upon which a veteran can be deemed in need of personal care services. Previously, to be eligible for PCAFC, a veteran had to be in need of personal care services because of (1) an inability to perform one or more activities of daily living, (2) a need for supervision or protection based on symptoms or residuals of neurological or other impairment or injury, or (3) such other matters as the Secretary considers appropriate. The MISSION Act amended this section to include ``a need for regular or extensive instruction or supervision without which the ability of the veteran to function in daily life would be seriously impaired'' as another basis upon which a veteran could be deemed in need of personal care services. See 38 U.S.C. 1720G(a)(2)(C)(iii), as amended by Public Law 115-182, section 161(a)(2). Relatedly, the MISSION Act also modified the definition of personal care services to include ``supervision or protection based on symptoms of residuals of neurological or other impairment or injury,'' and ``regular or extensive instruction or supervision without which the ability of the veteran to function in daily life would be seriously impaired.'' See 38 U.S.C. 1720G(d)(4), as amended by Public Law 115- 182, section 161(b). In its regulations, VA has defined ``personal care services'' as care or assistance of another person necessary to support the eligible veteran's health and well-being, and perform personal functions required in everyday living ensuring the eligible veteran remains safe from hazards or dangers incident to his or her daily environment. See, 38 CFR 71.15. VA is seeking public input on how to define this need for regular or extensive instruction or supervision, how to assess whether the veteran's ability to function in daily life would be seriously impaired, and whether and how to change ``personal care services'' as defined in VA's regulations. Legal and Financial Services The MISSION Act also expands upon the benefits available to each family caregiver designated as the primary provider of personal care services for an eligible veteran to include: (1) Financial planning services relating to the needs of injured veterans and their caregivers, and (2) legal services, including legal advice and consultation, relating to the needs of injured veterans and their caregivers. See 38 U.S.C. 1720G(a)(3)(A)(ii)(VI), as amended by Public Law 115-182, section 161(a)(3). VA is seeking public comment on how to define and deliver such additional services. Request for Information Through this notice, we are soliciting information on certain changes made to PCAFC by the MISSION Act. We ask respondents to address the following questions, where possible, in the context of the discussion in this document. Commenters do not need to address every question and should focus on those that relate to their expertise or perspectives. To the extent possible, please clearly indicate which question(s) you address in your response. As previously mentioned, responses to this request will inform our updates to PCAFC. Accordingly, we request comments on the following: 1. How should VA define ``a need for regular or extensive instruction or supervision'' in the new 38 U.S.C. 1720G(a)(2)(C)(iii)? a. Should this be based upon frequency of intervention needed by the veteran or level of complexity of intervention? Should this be based upon the impact to the veteran if such instruction or supervision is not provided? If so, how should this be measured? b. What constitutes ``regular'' instruction or supervision? c. What constitutes ``extensive'' instruction or supervision? 2. How does ``a need for regular or extensive instruction or supervision without which the ability of the veteran to function in daily life would be seriously impaired'' differ from ``a need for supervision or protection based on symptoms of residuals of neurological or other impairment or injury?'' a. How should VA define and assess ``a need for supervision or protection based on symptoms of residuals of neurological or other impairment or injury''? b. Are there established standards VA should model? 3. How should VA assess whether the ability of the veteran to function in daily life would be seriously impaired without regular or extensive instruction or supervision? a. Are there existing tools or assessments that could be used? b. How should ``seriously impaired'' be defined? i. For example, should there be a standard of time in which a veteran is expected to be able to function without the need for a caregiver, and once that period of time is exceeded, a need for a caregiver is required due to the impairment of the veteran? Is there a minimum period of time lapse that a veteran should be expected to be able to function and upon exceeding that time, might meet this eligibility criterion? ii. Are there standards that should or could be used to determine when a veteran's ability to function in daily life is considered seriously impaired without regular or extensive instruction or supervision? iii. How should ``ability to function in daily life'' be defined? 4. What specific financial planning services relating to the needs of injured veterans and their caregivers should be made available to primary family caregivers under the new 38 U.S.C. 1720G(a)(3)(A)(ii)(VI)(aa)? a. Should entities provide these services for free? b. Are there specific financial planning services that should be excluded? c. How should these services be made available and/or delivered? Should these be provided in person, online, and/or via telephone? d. Should there be a limit as to how many times a primary family caregiver has access to these services? If yes, should it be an annual limit or lifetime limit? Should it be limited by some other measure? e. What types of private organizations provide these services? [[Page 60968]] i. What services do they provide? ii. How are the services provided? iii. Do these organizations provide these services for free? iv. Do these organizations contract with other entities to provide these services? Do these organizations receive grants to provide these services? f. What other Federal/state/local agencies offer these services? i. What services do they provide? ii. How are the services provided? iii. Do these agencies provide these services for free? iv. Do these agencies contract with other entities to provide these services? Do these agencies receive grants to provide these services? 5. What specific legal services relating to the needs of injured veterans and their caregivers should be made available to primary family caregivers under the new 38 U.S.C. 1720G(a)(3)(A)(ii)(VI)(bb)? a. Should entities provide these services for free? b. Are there specific legal services that should be excluded? c. How should these services be made available? Should these be provided in person, online, and/or via telephone? d. Should there be a limit as to how many times a primary family caregiver has access to these services? If yes, should it be an annual limit or lifetime limit? Should it be limited by some other measure? e. What types of private organizations provide these services? i. What services do they provide? ii. How are the services provided? iii. Do these organizations provide these services for free? iv. Do these organizations contract with other entities to provide these services? Do these organizations receive grants to provide these services? f. What other Federal/state/local agencies offer these services? i. What services do they provide? ii. How are the services provided? iii. Do these agencies provide these services for free? iv. Do these agencies contract with other entities to provide these services? Do these organizations receive grants to provide these services? Paperwork Reduction Act This request for information constitutes a general solicitation of public comments as stated in the implementing regulations of the Paperwork Reduction Act of 1995 at 5 CFR 1320.3(h)(4). Therefore, this request for information does not impose information collection requirements (i.e., reporting, recordkeeping or third-party disclosure requirements). Consequently, there is no need for review by the Office of Management and Budget under the authority of the Paperwork Reduction Act of 1995 (44 U.S.C. 3501 et seq.). Signing Authority The Secretary of Veterans Affairs approved this document and authorized the undersigned to sign and submit the document to the Office of the Federal Register for publication electronically as an official document of the Department of Veterans Affairs. Robert L. Wilkie, Secretary, Department of Veterans Affairs, approved this document on November 19, 2018, for publication. Dated: November 19, 2018. Jeffrey M. Martin, Assistant Director, Office of Regulation Policy & Management, Office of the Secretary, Department of Veterans Affairs. [FR Doc. 2018-25763 Filed 11-26-18; 8:45 am] BILLING CODE 8320-01-P
![60966 Federal Register / Vol. 83, No. 228 / Tuesday, November 27, 2018 / Notices
Veterans Health Administration, Office Networks Act of 2018 or the VA of Veterans Affairs (CHAMPVA) 38
of Telehealth, Office of Policy & MISSION Act of 2018 related to PCAFC. U.S.C. 1720G(a)(3), 38 CFR 71.40. For
Planning, Million Veteran Program, and DATES: Comments are due by December the purposes of this notice, the term
Women’s Health Services. On December 12, 2018. veteran includes servicemembers who
13, the Committee will receive briefings ADDRESSES: Written comments may be apply for or participate in PCAFC.
and updates from the Office of Diversity submitted through http:// PCAFC is currently available to family
& Inclusion, Leadership Development www.Regulations.gov; by mail or hand caregivers of eligible veterans who
Programs, Ex-Officios Update and hold delivery to the Director, Office of incurred or aggravated a serious injury
an exit briefing with VBA, VHA and Regulation Policy and Management (including traumatic brain injury,
NCA. The Committee will receive (00REG), Department of Veterans psychological trauma, or other mental
public comments from 10:00 a.m. to Affairs, 810 Vermont Avenue NW, disorder) in the line of duty in the active
10:15 a.m. After the Leadership Exit Room 1063B, Washington, DC 20420; or military, naval, or air service on or after
Briefing, the Committee will continue to by fax to (202) 273–9026 (this is not a September 11, 2001. 38 U.S.C.
work on their report. toll-free number). Comments should 1720G(a)(2)(B). On June 6, 2018, the
A sign-in sheet for those who want to indicate that they are submitted in John S. McCain III, Daniel K. Akaka, and
give comments will be available at the response to ‘‘Notice of Request for Samuel R. Johnson VA Maintaining
meeting. Individuals who speak are Information on the Department of Internal Systems and Strengthening
invited to submit a 1–2 page summary Veterans Affairs Program of Integrated Outside Networks Act of
of their comments at the time of the Comprehensive Assistance for Family 2018 or the VA MISSION Act of 2018
meeting for inclusion in the official Caregivers (PCAFC).’’ Copies of (‘‘MISSION Act’’), Public Law 115–182,
meeting record. Members of the public comments received will be available for was signed into law. Section 161 of the
may also submit written statements for public inspection in the Office of MISSION Act amended 38 U.S.C. 1720G
the Committee’s review to Ms. Juanita Regulation Policy and Management to expand eligibility for PCAFC to
Mullen, Department of Veterans Affairs, (00REG), Department of Veterans family caregivers of eligible veterans
Center for Minority Veterans (00M), 810 Affairs, 810 Vermont Avenue NW, who incurred or aggravated a serious
Vermont Avenue NW, Washington, DC Room 1063B, Washington, DC 20420, injury in the line of duty before
20420, or email at Juanita.Mullen@ between the hours of 8:00 a.m. and 4:30 September 11, 2001, establish new
va.gov. Because the meeting will be in p.m., Monday through Friday (except benefits for designated primary family
Federal holidays). Please call (202) 461– caregivers of eligible veterans, and make
a Government building, anyone
4902 for an appointment (this is not a other changes affecting program
attending must be prepared to show a
toll-free number). During the comment eligibility and VA’s evaluation of
valid photo ID for checking in. Please
period, comments may also be viewed PCAFC applications. The expansion of
allow 15 minutes before the meeting
online through the Federal Docket PCFAC to family caregivers of eligible
begins for this process. Any member of
Management System at veterans who incurred or aggravated a
the public wishing to attend or seeking
www.Regulations.gov. serious injury in the line of duty before
additional information should contact
September 11, 2001, will occur in two
Ms. Mullen or Mr. Dwayne Campbell at FOR FURTHER INFORMATION CONTACT: phases, the first of which will begin
(202) 461–6191 or by fax at (202) 273– Margaret Kabat, National Director, when VA certifies to Congress that it has
7092. Caregiver Support Program (10P4C), fully implemented a required
Dated: November 21, 2018. Veterans Health Administration, information technology system. During
Jelessa M. Burney, Department of Veterans Affairs, 810 the 2-year period beginning on the date
Federal Advisory Committee Management
Vermont Avenue NW, Washington, DC of such certification to Congress, PCAFC
Officer. 20420, (202) 461–6780 (this is not a toll- will be expanded to include family
[FR Doc. 2018–25783 Filed 11–26–18; 8:45 am]
free number), Margaret.Kabat@va.gov. caregivers of eligible veterans who have
SUPPLEMENTARY INFORMATION: The a serious injury (including traumatic
BILLING CODE P
Program of Comprehensive Assistance brain injury, psychological trauma, or
for Family Caregivers (PCAFC) was other mental disorder) incurred or
DEPARTMENT OF VETERANS established by title I of Public Law (Pub. aggravated in the line of duty in the
AFFAIRS L.) 111–163, Caregivers and Veterans active military, naval, or air service on
Omnibus Health Services Act of 2010, or before May 7, 1975. Two years after
Notice of Request for Information on and is codified in section 1720G(a) of the date of submission of the
the Department of Veterans Affairs title 38 of the United States Code certification to Congress, PCAFC will be
Program of Comprehensive Assistance (U.S.C.). VA has been administering expanded to family caregivers of all
for Family Caregivers (PCAFC) PCAFC continuously since May 5, 2011, eligible veterans who have a serious
and has implemented this program injury (including traumatic brain injury,
AGENCY: Department of Veterans Affairs. through its regulations in Part 71 of title psychological trauma, or other mental
ACTION: Request for information. 38 of the Code of Federal Regulations disorder) incurred or aggravated in the
(CFR). Through PCAFC, VA provides line of duty in the active military, naval,
SUMMARY: The Department of Veterans family caregivers of eligible veterans or air service, regardless of when the
Affairs (VA) is requesting information and servicemembers (as defined in 38 serious injury occurred.
regarding its Program of Comprehensive CFR 71.20) certain benefits, such as We are issuing this notice to solicit
Assistance for Family Caregivers training, respite care, counseling, input on changes to the program
amozie on DSK3GDR082PROD with NOTICES1
(PCAFC). This notice requests technical support, beneficiary travel (to required by the MISSION Act, as further
information and comments from attend required caregiver training and explained below. This notice and
interested parties on certain for an eligible veteran’s medical request for information serves as a
requirements of the John S. McCain III, appointments), a monthly stipend means for VA to consult with key
Daniel K. Akaka, and Samuel R. Johnson payment, and access to health care (if stakeholders on how to define and
VA Maintaining Internal Systems and qualified) through the Civilian Health implement changes made to the
Strengthening Integrated Outside and Medical Program of the Department program by the MISSION Act. After
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![60968 Federal Register / Vol. 83, No. 228 / Tuesday, November 27, 2018 / Notices
i. What services do they provide? d. Should there be a limit as to how Paperwork Reduction Act of 1995 at 5
ii. How are the services provided? many times a primary family caregiver CFR 1320.3(h)(4). Therefore, this request
iii. Do these organizations provide has access to these services? If yes, for information does not impose
these services for free? should it be an annual limit or lifetime information collection requirements
iv. Do these organizations contract limit? Should it be limited by some (i.e., reporting, recordkeeping or third-
with other entities to provide these other measure? party disclosure requirements).
services? Do these organizations receive e. What types of private organizations Consequently, there is no need for
grants to provide these services? provide these services? review by the Office of Management and
f. What other Federal/state/local i. What services do they provide? Budget under the authority of the
agencies offer these services? ii. How are the services provided? Paperwork Reduction Act of 1995 (44
i. What services do they provide? iii. Do these organizations provide U.S.C. 3501 et seq.).
ii. How are the services provided? these services for free?
iv. Do these organizations contract Signing Authority
iii. Do these agencies provide these
services for free? with other entities to provide these
services? Do these organizations receive The Secretary of Veterans Affairs
iv. Do these agencies contract with approved this document and authorized
other entities to provide these services? grants to provide these services?
f. What other Federal/state/local the undersigned to sign and submit the
Do these agencies receive grants to document to the Office of the Federal
agencies offer these services?
provide these services? i. What services do they provide? Register for publication electronically as
5. What specific legal services relating ii. How are the services provided? an official document of the Department
to the needs of injured veterans and iii. Do these agencies provide these of Veterans Affairs. Robert L. Wilkie,
their caregivers should be made services for free? Secretary, Department of Veterans
available to primary family caregivers iv. Do these agencies contract with Affairs, approved this document on
under the new 38 U.S.C. other entities to provide these services? November 19, 2018, for publication.
1720G(a)(3)(A)(ii)(VI)(bb)? Do these organizations receive grants to Dated: November 19, 2018.
a. Should entities provide these provide these services?
services for free? Jeffrey M. Martin,
b. Are there specific legal services that Paperwork Reduction Act Assistant Director, Office of Regulation Policy
should be excluded? This request for information & Management, Office of the Secretary,
c. How should these services be made constitutes a general solicitation of Department of Veterans Affairs.
available? Should these be provided in public comments as stated in the [FR Doc. 2018–25763 Filed 11–26–18; 8:45 am]
person, online, and/or via telephone? implementing regulations of the BILLING CODE 8320–01–P
amozie on DSK3GDR082PROD with NOTICES1
VerDate Sep<11>2014 17:45 Nov 26, 2018 Jkt 247001 PO 00000 Frm 00148 Fmt 4703 Sfmt 9990 E:\FR\FM\27NON1.SGM 27NON1](https://thefederalregister.org/doc/83_FR_61194/page/3.svg)
Document Created: 2018-11-27 01:25:37
Document Modified: 2018-11-27 01:25:37
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Request for information. | |
| Dates | Comments are due by December 12, 2018. | |
| Contact | Margaret Kabat, National Director, Caregiver Support Program (10P4C), Veterans Health Administration, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, (202) 461-6780 (this is not a toll-free number), [email protected] | |
| FR Citation | 83 FR 60966 |
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