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Federal Register / Vol. 86, No. 181 / Wednesday, September 22, 2021 / Rules and Regulations
Caregivers for one additional year.
Legacy applicants, legacy participants, and their Family Caregivers will remain eligible for PCAFC in accordance with revised 71.20b and c and will continue to receive benefits in accordance with revised 71.40 for the additional one-year period.
Accordingly, we are amending 71.20b and c regarding program eligibility, 71.30e regarding reassessments, and 71.40c4iB
through D, c4iiC2i and ii, and the note to c4iiC2 regarding the stipend methodology, to account for the additional one-year period through September 30, 2022.
Discussion When the prior rulemaking became effective on October 1, 2020, VA
intended to complete reassessments for all legacy participants, legacy applicants, and their Family Caregivers within a one-year period to determine their eligibility under new 71.20a;
however, this is no longer achievable.
For the reasons explained below, VA is unable to conduct all necessary reassessments of legacy applicants, legacy participants, and their Family Caregivers within the one-year period. It is therefore necessary to extend PCAFC
eligibility of legacy applicants, legacy participants, and their Family Caregivers under 71.20b and c and their applicable benefits, including the monthly stipend calculation under 71.40c4, for an additional one-year period through September 30, 2022.
The VA MISSION Act of 2018
expanded 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 in a phased approach. The first phase, which became effective on October 1, 2020, expanded PCAFC eligibility to include eligible veterans who incurred or aggravated a serious injury in the line of duty on or before May 7, 1975. Since the onset of this first phase of expansion, VA has seen a dramatic increase in new applications for PCAFC. This increase is significantly higher than VA
anticipated.
We acknowledge that anticipating the number of applications that may be received is subject to significant variability and subjectivity. An individual need not be eligible to apply for PCAFC; there is no restriction on who may choose to apply. However, VA
estimated that it would receive 76,635
applications in FY 2021, and as of July 1, 2021, VA has received approximately 90,500 applications. The number of applications received so far exceeds the
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total number of applications PCAFC
received in any previous year and exceeds VAs projections for the entire FY 2021. For reference, in FY 2020, VA
received approximately 22,900
applications, with an average of 1,900
applications per month. Between October 1, 2020 and July 1, 2021, VA
has received an average of approximately 10,000 applications per month.. We note that, of the approximately 90,500 applications VA
received between October 1, 2020 and July 1, 2021, approximately 11 percent of these veteran applicants were born in 1983 or later, demonstrating that new applicants are not only from those veterans who have been waiting for expansion to begin, but also from veterans who may have incurred or aggravated a serious injury in the line of duty on or after September 11, 2001, and are newly interested in the Program.
As part of planning for PCAFC
expansion, a staffing model was developed to guide and inform staffing decisions to augment resources available to administer, monitor, and oversee PCAFC. In particular, this action was necessary to prepare for the anticipated increased workload associated with expanding PCAFC, to include application processing, completion of wellness contacts, completion of reassessments, and supporting delivery of clinical care. The first phase of the staffing augmentation called for an additional 680 field based and Veteran Integrated Service Network VISN level staff to support administration and delivery of caregiver support programming. The second phase of staffing augmentation began in August 2020 and sought to add over 750
additional field-based front-line staff. As of July 2021, over 90 percent of staff had been hired.
Despite these staffing augmentations, given the significantly larger volume of applications than was anticipated, VA
focused its resources on processing new applications versus reassessing eligibility of legacy applicants, legacy participants and their Family Caregivers. As a result, as of July 1, 2021, VA has only completed 4 percent of the estimated 19,800 reassessment needed for the legacy cohort. VA will be unable to complete reassessments of each legacy applicant, legacy participant, and their Family Caregivers within the one-year period provided in 71.30e.
While VA received higher than anticipated applications, it is important to note that educating and training new staff as well as educating and training existing staff on the program changes has continued, culminating in more
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streamlined processes, implementation of best practices, and increased efficiencies. As a result of these efforts, VA has significantly increased the rate in which applications are being adjudicated. During the first quarter of FY 2021, VA adjudicated an average of 4,075 applications per month. In comparison, during the third quarter of FY 2021, VA adjudicated an average of 10,663 applications per monthan increase of 162 percent in adjudications made. While VAs rate of application adjudication has been increasing, there has been a corresponding decrease in the number of new PCAFC applications being received. The average number of applications received each month in the third quarter of FY 2021 was approximately 7,300 compared to an average of approximately 11,600 each month during the first quartera decrease of approximately 59 percent in the average number of new applications received each month during third quarter compared to first quarter. As noted above, VAs rate of adjudicating applications has increased with the passage of time during FY 2021. With the rate of new application submissions decreasing and adjudications of such new applications increasing, VA has been able to devote more resources to reassessments of legacy participants, legacy applicants, and their Family Caregivers. With these continued efforts, VA believes that reassessments of legacy participants, legacy applicants, and their Family Caregivers will be able to be completed with the extension of an additional one-year period.
Extending the eligibility period of legacy participants, legacy applicants, and their Family Caregivers from a oneyear period to a two-year period from October 1, 2020 will ensure that all legacy participants, legacy applicants, and their Family Caregivers have the same transition period and the same effective date for any termination or reduction in benefits, regardless of when VA conducts the reassessment during the two-year period. Without this extension, legacy applicants, legacy participants, and their Family Caregivers who are reassessed and found to be no longer eligible for PCAFC
under 71.20a or who have their stipend reduced under 71.40c4
would be impacted at different times, resulting in unequal treatment in the provision of PCAFC benefits. As noted above, VA has already begun conducting some reassessments. If those individuals were determined through a reassessment completed before October 1, 2021, to be no longer eligible for PCAFC or to be eligible but the Primary
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