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The Department of Veterans Affairs (VA) is revising its regulations that govern VA’s Program of Comprehensive Assistance for Family Caregivers (PCAFC) to relax the requirement for in-person home visits during the National Emergency related to Coronavirus Disease-2019 (COVID-19).  This change is required to address the safety and well-being of veterans, caregivers, and VA clinical staff as the circumstances regarding COVID-19 continue to evolve, which is in line with the President’s priorities.

Statement of Need:

The Caregivers and Veterans Omnibus Health Services Act of 2010 (P.L 111-163) established 38 U.S.C. 1720G, which directed VA to establish a Program of Comprehensive Assistance for Family Caregivers (PCAFC) and a Program of General Caregiver Support Services. Both programs are managed by the VA’s Caregiver Support Program Office. On March 13, 2020, a National Emergency was declared by the President in response to COVID-19.

COVID-19 is a new disease that causes respiratory illness in people and can spread from person to person. Many individuals and communities across the country have taken steps to reduce the spread of COVID-19, including isolating individuals diagnosed with the disease and implementing physical distancing measures. The priority goal in the VA response to COVID-19 is the protection of veterans, their caregivers, and VA clinical staff. This rulemaking is intended to reduce the risk of exposure to and transmission of COVID-19 to individuals involved in PCAFC, as well as members of their households and others with whom they come into contact who may be affected, by providing the facilities flexibility in the modalities used to conduct home visits other than in-person visits. The intent of this rulemaking is to protect veterans, their families, and VA clinical staff by reducing the spread of COVID-19 for the duration of the COVID-19 National Emergency.

Summary of the Legal Basis:

The legal basis for this rule is Title 1 of Public law 111-163, Caregivers and Veterans Omnibus Health Services Act of 2010 (the Caregivers Act) which established section 1720G(a) of title 38 of the United States Code requiring VA, in part, to establish the PCAFC program. As a result of the National Emergency related to COVID-19 declared by the President on March 13, 2020, VA added a new section 71.60 to title 38 of the Code of Federal Regulations to provide flexibility in the mode by which VA conducts PCAFC home visits during the duration of the National Emergency. These flexibilities include videoconference or other available telehealth modalities.

Alternatives:

Through the interim final rule, VA relaxed the requirements of in-person home visits during the National Emergency related to COVID-19. VA considered leaving the requirement as is, however, it would have the potential to put veterans, their families, and VA staff at greater risk of contracting COVID-19.

Anticipated Costs and Benefits:

The final rulemaking adds flexibility to the required in-home assessments and allows VA clinical staff to conduct in-home assessments through other modalities while remaining compliant with current regulations and policies. Through this rulemaking, VA minimizes risk of exposure and spreading of COVID-19 to VA clinical staff, veterans, their caregivers, their families, and other household members during this National Emergency.

Risks:

The addition of 71.60 was through an IFR. Finalizing the rule will allow us to comply with APA; but the regulation was effective upon publication on June 5, 2020.