VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

Quick Facts

• What caregivers receive: Monthly stipend payments, access to the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) if not otherwise covered, 30 days of respite care per year, mental health counseling, and travel benefits when accompanying the Veteran to appointments.
• Tiers of support: Veterans are assigned to Tier 1 or Tier 2 based on the number of hours of personal care needed, driving stipend amounts.
• Coverage expansion: As of October 2022, the program includes eligible Veterans from all service eras, not just post-9/11.
• Reassessment cycle: Eligibility is reviewed every three years, or sooner if the Veteran’s condition changes significantly.
• Best first step: Work with a local Caregiver Support Coordinator to prepare for the clinical evaluation and home visit.

Program Overview

PCAFC recognizes the essential role family caregivers play in enabling severely injured or ill Veterans to live at home. The program pairs financial support with structured training and case management so caregivers can deliver safe, effective care while maintaining their own wellbeing. Local VA medical centers administer the program through specialized Caregiver Support Programs that coordinate evaluations, training modules, and respite services. Caregivers often use stipends to offset lost wages, hire backup help, or cover adaptive equipment that improves the Veteran’s independence.

Eligibility Pathway

1. Qualifying Veteran: Must have sustained or aggravated a serious injury or illness in the line of duty and require personal care services for at least six continuous months. Conditions include traumatic brain injuries, severe PTSD, neurological disorders, and chronic illnesses that impair daily functioning.
2. Care need documentation: VA clinicians assess the Veteran’s ability to perform activities of daily living (ADLs) such as bathing, dressing, mobility, and medication management, or evaluate the need for supervision for safety.
3. Eligible caregiver: Primary caregivers must be at least 18 years old and either a spouse, child, parent, stepfamily member, extended family, or someone who lives full-time with the Veteran. Up to two secondary caregivers can also be approved.
4. Enrollment in VA health care: The Veteran must be enrolled in VA health services and receive care at a facility able to support PCAFC oversight.

Application Steps

1. Connect with a Caregiver Support Coordinator: Each VA medical center has a coordinator who can explain requirements and help assemble evidence before submission.
2. Submit VA Form 10-10CG: Applications can be completed online, via mail, or in person. Provide detailed descriptions of the Veteran’s daily care needs and caregiver responsibilities.
3. Complete caregiver training: Once preliminarily approved, caregivers must finish the online or classroom training modules covering safety, self-care, and VA resources.
4. Participate in evaluations: A clinical team conducts interviews and a home visit to verify care needs, environmental safety, and the caregiver’s capacity.
5. Receive approval and tier assignment: After the assessment, VA issues a decision letter outlining the tier level, stipend amount, and effective date. Payments are retroactive to the application submission date when approved.
6. Set up support services: Coordinate respite care, mental health appointments, and peer support groups through the Caregiver Support Program.

Stipend Calculation and Payment Tips

• Base rate: Stipends are tied to the General Schedule (GS) pay scale for the geographic area. Tier 1 equals 62.5% of the GS-4 step 1 hourly wage multiplied by 40 hours per week; Tier 2 equals 100%.
• Direct deposit: Payments arrive on the first business day of each month. Use a dedicated bank account to simplify budgeting and documentation.
• Tax considerations: Stipends are not taxable income, but caregivers should still track payments for financial aid or benefit applications that may ask about household resources.

Maximizing Program Value

• Document changes promptly: If the Veteran’s condition worsens, request a reassessment to potentially move from Tier 1 to Tier 2. Conversely, notify VA if care needs decrease to remain compliant.
• Leverage respite care: Schedule the 30-day annual respite benefit proactively—using a mix of in-home aides and short-term VA Community Living Centers can prevent burnout.
• Join peer support: VA’s Caregiver Support Line and virtual workshops provide community and coping strategies. Participation also demonstrates engagement when recertifying.
• Coordinate with other benefits: Explore Aid and Attendance, VA disability compensation increases, and state caregiver stipends to enhance overall support.
• Self-care plan: Create routines for exercise, counseling, and backup caregiving to avoid crises that could disrupt the Veteran’s care plan.

Renewal and Compliance

VA reviews each case at least every three years. Maintain organized records of medical appointments, medication lists, and caregiver logs to streamline re-evaluations. Attend all scheduled check-ins and respond quickly to VA correspondence; failure to do so can lead to discharge from the program. If you disagree with a decision, you may file a request for clinical review or appeal through the Veterans Health Administration clinical appeals process.

PCAFC recognizes caregiving as vital service. By staying engaged with VA resources, documenting care needs thoroughly, and advocating for timely reassessments, families can secure long-term support that honors the Veteran’s sacrifice and sustains home-based care.