PART 71—CAREGIVERS BENEFITS AND CERTAIN MEDICAL BENEFITS OFFERED TO FAMILY MEMBERS OF VETERANS Authority: 38 U.S.C. 501, 1720G, unless otherwise noted. Section 71.40 also issued under 38 U.S.C. 111(e), 1720B, 1782. Section 71.47 also issued under 31 U.S.C. 3711; 38 U.S.C. 5302, 5314. Section 71.50 also issued under 38 U.S.C. 1782. Source: 76 FR 26172, May 5, 2011, unless otherwise noted. § 71.10 Purpose and scope. (a) Purpose. (b) Scope. [76 FR 26172, May 5, 2011, as amended at 80 FR 1376, Jan. 9, 2015; 85 FR 46293, July 31, 2020] § 71.15 Definitions. For the purposes of this part: Domestic violence (DV) Eligible veteran Family Caregiver Financial planning services General Caregiver In need of personal care services In the best interest Inability to perform an activity of daily living (ADL) (1) Dressing or undressing oneself; (2) Bathing; (3) Grooming oneself in order to keep oneself clean and presentable; (4) Adjusting any special prosthetic or orthopedic appliance, that by reason of the particular disability, cannot be done without assistance (this does not include the adjustment of appliances that nondisabled persons would be unable to adjust without aid, such as supports, belts, lacing at the back, etc.); (5) Toileting or attending to toileting; (6) Feeding oneself due to loss of coordination of upper extremities, extreme weakness, inability to swallow, or the need for a non-oral means of nutrition; or (7) Mobility (walking, going up stairs, transferring from bed to chair, etc.). Institutionalization Intimate partner violence (IPV) Joint application Legacy applicant Legacy participant Legal services Monthly stipend rate Need for supervision, protection, or instruction Overpayment Personal care services Primary care team Primary Family Caregiver Secondary Family Caregiver Serious injury (1) Is rated at 70 percent or more by VA; or (2) Is combined with any other service-connected disability or disabilities, and a combined rating of 70 percent or more is assigned by VA. Unable to self-sustain in the community (1) Requires personal care services each time he or she completes three or more of the seven activities of daily living (ADL) listed in the definition of an inability to perform an activity of daily living in this section, and is fully dependent on a caregiver to complete such ADLs; or (2) Has a need for supervision, protection, or instruction on a continuous basis. Undergoing medical discharge VA [76 FR 26172, May 5, 2011, as amended at 80 FR 1376, Jan. 9, 2015; 85 FR 46293, July 31, 2020; 87 FR 57608, Sept. 21, 2022] § 71.20 Eligible veterans and servicemembers. A veteran or servicemember is eligible for a Family Caregiver under this part if he or she meets the criteria in paragraph (a), (b), or (c) of this section, subject to the limitations set forth in such paragraphs. (a) A veteran or servicemember is eligible for a Primary or Secondary Family Caregiver under this part if he or she meets all of the following requirements: (1) The individual is either: (i) A veteran; or (ii) A member of the Armed Forces undergoing a medical discharge from the Armed Forces. (2) The individual has a serious injury incurred or aggravated in the line of duty in the active military, naval, or air service: (i) On or after September 11, 2001; (ii) Effective October 1, 2020, on or before May 7, 1975; or (iii) Effective October 1, 2022, after May 7, 1975 and before September 11, 2001. (3) The individual is in need of personal care services for a minimum of six continuous months based on any one of the following: (i) An inability to perform an activity of daily living; or (ii) A need for supervision, protection, or instruction. (4) It is in the best interest of the individual to participate in the program. (5) Personal care services that would be provided by the Family Caregiver will not be simultaneously and regularly provided by or through another individual or entity. (6) The individual receives care at home or will do so if VA designates a Family Caregiver. (7) The individual receives ongoing care from a primary care team or will do so if VA designates a Family Caregiver. (b) For eight years beginning on October 1, 2020, a veteran or servicemember is eligible for a Primary or Secondary Family Caregiver under this part if he or she is a legacy participant. (c) For eight years beginning on October 1, 2020, a veteran or servicemember is eligible for a Primary or Secondary Family Caregiver under this part if he or she is a legacy applicant. [85 FR 46295, July 31, 2020, as amended at 86 FR 52618, Sept. 22, 2021; 87 FR 57608, Sept. 21, 2022; 90 FR 46480, Sept. 29, 2025] § 71.25 Approval and designation of Primary and Secondary Family Caregivers. (a) Application requirement. (2)(i) Upon receiving such application, VA (in collaboration with the primary care team to the maximum extent practicable) will perform the evaluations required to determine the eligibility of the applicants under this part, and if eligible, determine the applicable monthly stipend amount under § 71.40(c)(4). Notwithstanding the first sentence, VA will not evaluate a veteran's or servicemember's eligibility under § 71.20 when a joint application is received to add a Secondary Family Caregiver for an eligible veteran who has a designated Primary Family Caregiver. (ii) Individuals who apply to be Family Caregivers must complete all necessary eligibility evaluations (along with the veteran or servicemember), education and training, and the initial home-care assessment (along with the veteran or servicemember) so that VA may complete the designation process no later than 90 days after the date the joint application was received by VA. If such requirements are not complete within 90 days from the date the joint application is received by VA, the joint application will be denied, and a new joint application will be required. VA may extend the 90-day period based on VA's inability to complete the eligibility evaluations, provide necessary education and training, or conduct the initial home-care assessment, when such inability is solely due to VA's action. (3)(i) Except as provided in this paragraph, joint applications received by VA before October 1, 2020 will be evaluated by VA based on 38 CFR 71.15, 71.20, and 71.25 (2019). Notwithstanding the previous sentence, the term “joint application” as defined in § 71.15 applies to applications described in this paragraph. (ii) Joint applications received by VA on or after October 1, 2020 will be evaluated by VA based on the provisions of this part in effect on or after October 1, 2020. (A) VA will deny any joint application of an individual described in § 71.20(a)(2)(ii), if such joint application is received by VA before October 1, 2020. A veteran or servicemember seeking to qualify for the Program of Comprehensive Assistance for Family Caregivers pursuant to § 71.20(a)(2)(ii) should submit a joint application that is received by VA on or after October 1, 2020. (B) VA will deny any joint application of an individual described in § 71.20(a)(2)(iii), if such joint application is received by VA before October 1, 2022. A veteran or servicemember seeking to qualify for the Program of Comprehensive Assistance for Family Caregivers pursuant to § 71.20(a)(2)(iii) should submit a joint application that is received by VA on or after October 1, 2022. (b) Eligibility to serve as Primary or Secondary Family Caregiver. (1) Be at least 18 years of age. (2) Be either: (i) The eligible veteran's spouse, son, daughter, parent, step-family member, or extended family member; or (ii) Someone who lives with the eligible veteran full-time or will do so if designated as a Family Caregiver. (3) There must be no determination by VA of abuse or neglect of the eligible veteran by the applicant. (4) Meet the requirements of paragraph (c) of this section, and any other applicable requirements of this part. (c) Assessment, education, and training of applicants. (1) Be initially assessed by VA as being able to complete caregiver education and training. Such assessment will consider any relevant information specific to the needs of the eligible veteran, as well as: (i) Whether the applicant can communicate and understand the required personal care services and any specific instructions related to the care of the eligible veteran (accommodation for language or hearing impairment will be made to the extent possible and as appropriate); and (ii) Whether the applicant will be capable of performing the required personal care services without supervision, in adherence with the eligible veteran's treatment plan in support of the needs of the eligible veteran. (2) Complete caregiver training and demonstrate the ability to carry out the specific personal care services, core competencies, and additional care requirements. (d) Caregiver education and training. (1) Medication management; (2) Vital signs and pain control; (3) Infection control; (4) Nutrition; (5) Functional activities; (6) Activities of daily living; (7) Communication and cognition skills; (8) Behavior management skills; (9) Skin care; and (10) Caregiver self-care. (e) Initial home-care assessment. (f) Approval and designation. [76 FR 26172, May 5, 2011, as amended at 80 FR 1377, Jan. 9, 2015; 85 FR 46295, July 31, 2020; 87 FR 57608, Sept. 21, 2022] § 71.30 Reassessment of Eligible Veterans and Family Caregivers. (a) Except as provided in paragraphs (b) and (c) of this section, the eligible veteran and Family Caregiver will be reassessed by VA (in collaboration with the primary care team to the maximum extent practicable) on an annual basis to determine their continued eligibility for participation in PCAFC under this part. Reassessments will include consideration of whether the eligible veteran is unable to self-sustain in the community for purposes of the monthly stipend rate under § 71.40(c)(4)(i)(A). Reassessment may include a visit to the eligible veteran's home. (b) Reassessments may occur more frequently than annually if a determination is made and documented by VA that more frequent reassessment is appropriate. (c) Reassessments may occur on a less than annual basis if a determination is made and documented by VA that an annual reassessment is unnecessary. (d) Failure of the eligible veteran or Family Caregiver to participate in any reassessment pursuant to this section will result in revocation pursuant to § 71.45, Revocation and Discharge of Family Caregivers. (e)(1) If the eligible veteran meets the requirements of § 71.20(b) or (c) ( i.e., (2) Notwithstanding paragraph (e)(1) of this section, a reassessment will not be completed under paragraph (e)(1) if at some point before a reassessment is completed during the eight-year period beginning on October 1, 2020 the individual no longer meets the requirements of § 71.20(b) or (c). [85 FR 46296, July 31, 2020, as amended at 86 FR 52618, Sept. 22, 2021; 87 FR 57608, Sept. 21, 2022; 90 FR 46480, Sept. 29, 2025] § 71.35 General Caregivers. (a) A General Caregiver is a person who: (1) Is not a Primary or Secondary Family Caregiver; and (2) Provides personal care services to a covered veteran under this section, even if the individual does not reside with the veteran. (b) A covered veteran, for purposes of this section, is a veteran who is enrolled in the VA health care system and needs personal care services because the veteran either: (1) Is unable to perform an activity of daily living; or (2) Needs supervision or protection based on symptoms or residuals of neurological or other impairment or injury. (c) No application or clinical evaluation is required to obtain benefits as a General Caregiver. Veterans or General Caregivers may request any of the benefits listed in § 71.40(a) as needed, from the appropriate VA clinicians and staff at their local VA facilities. (d) A veteran is not required to meet the eligibility requirements in § 71.20 to be considered a covered veteran. [76 FR 26172, May 5, 2011, as amended at 80 FR 1377, Jan. 9, 2015. Redesignated and amended at 85 FR 46296, July 31, 2020] § 71.40 Caregiver benefits. (a) General Caregiver benefits. (1) Continued instruction, preparation, training, and technical support. Caregivers will have access to each of the following services, which may be provided through: (i) Online and in-person educational sessions. (ii) Use of telehealth and other available technologies. (iii) Teaching techniques, strategies, and skills for caring for the eligible or covered veteran. (2) Information concerning the supportive services available to caregivers under paragraph (a) of this section and other public, private, and nonprofit agencies that offer support to caregivers. (3) Counseling and other services, as described under § 71.50. (4) Respite care to eligible and covered veterans in support of the caregiver that is medically and age appropriate for the eligible or covered veteran (including 24-hour per day in-home respite care). (b) Secondary Family Caregiver benefits. (1) General Caregiver benefits described in paragraph (a) of this section, except that respite care under paragraph (a)(4) is limited to veterans enrolled in the VA health care system. Respite care may be provided during a Family Caregiver's training, as described under § 71.25(d). (2) Wellness contacts to review the eligible veteran's well-being, adequacy of personal care services being provided by the Family Caregiver(s), and the well-being of the Family Caregiver(s). This wellness contact will occur, in general, at a minimum of once every 120 days, and at least one visit must occur in the eligible veteran's home on an annual basis. Failure of the eligible veteran and Family Caregiver to participate in any wellness contacts pursuant to this paragraph will result in revocation pursuant to § 71.45, Revocation and Discharge of Family Caregivers. (3) Continuing instruction, preparation, and training to maintain or improve the personal care services provided to the eligible veteran. (4) Ongoing technical support, consisting of information and assistance to address, in a timely manner, the routine, emergency, and specialized needs of the caregiver in providing personal care services to the eligible veteran. (5) Counseling, which for the purposes of paragraph (b) of this section includes individual and group therapy, individual counseling, and peer support groups. Counseling does not include the provision of medication, inpatient psychiatric care, or other medical procedures related to mental health treatment. Counseling does not have to be in connection with the treatment of a disability for which the eligible veteran is receiving treatment from VA. (6) Primary and Secondary Family Caregivers are eligible for beneficiary travel under 38 CFR part 70 if the eligible veteran is eligible for beneficiary travel under 38 CFR part 70. (c) Primary Family Caregiver benefits. (1) Secondary Family Caregiver benefits, as listed under paragraph (b) of this section. (2) Respite care includes 24-hour-per day care of the eligible veteran commensurate with the care provided by the Family Caregiver to permit extended respite. Respite care will be available for at least 30 days per year and may exceed 30 days per year if clinically appropriate and if requested by the Primary Family Caregiver. Respite care provided shall be medically and age-appropriate and include in-home care. (3) Primary Family Caregivers are eligible for enrollment in the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) pursuant to 38 U.S.C. 1781, unless they are entitled to care or services under a health-plan contract (as defined in 38 U.S.C. 1725(f)). (4) Primary Family Caregivers will receive a monthly stipend for each month's participation as a Primary Family Caregiver. (i) Stipend amount. 1 2 ( 1 ( 2 (B) Except as provided in paragraph (c)(4)(i)(C) of this section, for eight years beginning on October 1, 2020, if the eligible veteran meets the requirements of § 71.20(b) or (c), ( i.e., ( 1 ( 2 ( 3 (C) For eight years beginning on October 1, 2020, if the eligible veteran meets the requirements of § 71.20(a) and (b) or (c), the Primary Family Caregiver's monthly stipend is the amount the Primary Family Caregiver is eligible to receive under paragraph (c)(4)(i)(A) or (B) of this section, whichever is higher. If the higher monthly stipend rate is the amount the Primary Family Caregiver is eligible to receive under paragraph (c)(4)(i)(A) of this section, the stipend rate will be adjusted and paid in accordance with paragraph (c)(4)(ii)(C)( 2 i (D) Notwithstanding paragraphs (c)(4)(i)(A) through (C) of this section, for eight years beginning on October 1, 2020, if the eligible veteran meets the requirements of § 71.20(b), the Primary Family Caregiver's monthly stipend is not less than the amount the Primary Family Caregiver was eligible to receive as of the day before October 1, 2020 (based on the eligible veteran's address on record with the Program of Comprehensive Assistance for Family Caregivers on such date) so long as the eligible veteran resides at the same address on record with the Program of Comprehensive Assistance for Family Caregivers as of the day before October 1, 2020. If the eligible veteran relocates to a different address, the stipend amount thereafter is determined pursuant to paragraph (c)(4)(i)(A), (B), or (C) of this section and adjusted in accordance with paragraph (c)(4)(ii)(B) of this section. (ii) Adjustments to stipend payments. (B) Adjustments to stipend payments that result from the eligible veteran relocating to a new address are effective the first of the month following the month in which VA is notified that the eligible veteran has relocated to a new address. VA must receive notification within 30 days from the date of relocation. If VA does not receive notification within 30 days from the date of relocation, VA will seek to recover overpayments of benefits under this paragraph (c)(4) back to the latest date on which the adjustment would have been effective if VA had been notified within 30 days from the date of relocation, as provided in § 71.47. (C) The Primary Family Caregiver's monthly stipend may be adjusted pursuant to the reassessment conducted by VA under § 71.30. ( 1 ( i ( ii ( 2 ( i 2 i Veteran Warriors, Inc. Sec'y of Veterans Affairs, ( ii Note 1 to paragraph ( c ii 2 If an eligible veteran who meets the requirements of § 71.20(b) or (c) is determined, pursuant to a reassessment conducted by VA under § 71.30, to not meet the requirements of § 71.20(a), the monthly stipend payment will not be increased under paragraph (c)(4)(ii)(C)( 2 i 2 ii (D) Adjustments to stipend payments for the first month will take effect on the date specified in paragraph (d) of this section. Stipend payments for the last month will end on the date specified in § 71.45. (iii) No employment relationship. (iv) Periodic assessment. (5) Primary Family Caregivers are eligible for financial planning services as that term is defined in § 71.15. Such services will be provided by entities authorized pursuant to any contract entered into between VA and such entities. (6) Primary Family Caregivers are eligible for legal services as that term is defined in § 71.15. Such services will be provided by entities authorized pursuant to any contract entered into between VA and such entities. (d) Effective date of benefits under the Program of Comprehensive Assistance for Family Caregivers. (1) The date the joint application that resulted in approval and designation of the Family Caregiver is received by VA. (2) The date the eligible veteran begins receiving care at home. (3) The date the Family Caregiver begins providing personal care services to the eligible veteran at home. (4) In the case of a new Family Caregiver applying to be the Primary Family Caregiver for an eligible veteran, the day after the effective date of revocation or discharge of the previous Primary Family Caregiver for the eligible veteran (such that there is only one Primary Family Caregiver designated for an eligible veteran at one time). (5) In the case of a new Family Caregiver applying to be a Secondary Family Caregiver for an eligible veteran who already has two Secondary Family Caregivers approved and designated by VA, the day after the effective date of revocation or discharge of a previous Secondary Family Caregiver for the eligible veteran (such that there are no more than two Secondary Family Caregivers designated for an eligible veteran at one time). (6) In the case of a current or previous Family Caregiver reapplying with the same eligible veteran, the day after the date of revocation or discharge under § 71.45, or in the case of extended benefits under § 71.45(b)(1)(iii), (b)(2)(iii), (b)(3)(iii)(A) or (B), and (b)(4)(iv), the day after the last date on which such Family Caregiver received caregiver benefits. (7) The day after the date a joint application is denied. [76 FR 26172, May 5, 2011, as amended at 80 FR 1377, Jan. 9, 2015; 85 FR 46296, July 31, 2020; 86 FR 52618, Sept. 22, 2021; 87 FR 57608, Sept. 21, 2022; 90 FR 46480, Sept. 29, 2025] § 71.45 Revocation and discharge of Family Caregivers. (a) Revocation of the Family Caregiver Bases for revocation of the Family Caregiver For cause. (A) The Family Caregiver or eligible veteran committed fraud under this part; (B) The Family Caregiver neglected, abused, or exploited the eligible veteran; (C) Personal safety issues exist for the eligible veteran that the Family Caregiver is unwilling to mitigate; (D) The Family Caregiver is unwilling to provide personal care services to the eligible veteran or, in the case of the Family Caregiver's temporary absence or incapacitation, fails to ensure (if able to) the provision of personal care services to the eligible veteran. (ii) Noncompliance. (A) The eligible veteran does not meet the requirements of § 71.20(a)(5), (6), or (7); (B) The Family Caregiver does not meet the requirements of § 71.25(b)(2); (C) Failure of the eligible veteran or Family Caregiver to participate in any reassessment pursuant to § 71.30; (D) Failure of the eligible veteran or Family Caregiver to participate in any wellness contact pursuant to § 71.40(b)(2); or (E) Failure to meet any other requirement of this part except as provided in paragraph (b)(1) or (2) of this section. (iii) VA error. (2) Revocation date. (i) In the case of revocation based on fraud committed by the Family Caregiver or eligible veteran under paragraph (a)(1)(i)(A) of this section, the date of revocation will be the date the fraud began. If VA cannot identify when the fraud began, the date of revocation will be the earliest date that the fraud is known by VA to have been committed, and no later than the date on which VA identifies that fraud was committed. (ii) In the case of revocation based on paragraphs (a)(1)(i)(B) through (D) of this section, the date of revocation will be the date VA determines the criteria in any such paragraph has been met. (iii) In the case of revocation based on noncompliance under paragraph (a)(1)(ii) of this section, revocation takes effect as of the effective date provided in VA's final notice of such revocation to the eligible veteran and Family Caregiver. The effective date of revocation will be no earlier than 60 days after VA provides advanced notice of its findings to the eligible veteran and Family Caregiver. (iv) In the case of revocation based on VA error under paragraph (a)(1)(iii) of this section, the date of revocation will be the date the error was made. If VA cannot identify when the error was made, the date of revocation will be the earliest date that the error is known by VA to have occurred, and no later than the date on which VA identifies that the error occurred. (3) Continuation of benefits. (b) Discharge of the Family Caregiver Discharge due to the eligible veteran Bases for discharge. (A) Except as provided in paragraphs (a)(1)(ii)(A) and (b)(1)(i)(B) of this section, the eligible veteran does not meet the requirements of § 71.20 because of improvement in the eligible veteran's condition or otherwise; or (B) Death or institutionalization of the eligible veteran. Note: VA must receive notification of death or institutionalization of the eligible veteran as soon as possible but not later than 30 days from the date of death or institutionalization. Notification of institutionalization must indicate whether the eligible veteran is expected to be institutionalized for 90 or more days from the onset of institutionalization. (ii) Discharge date. (B) For discharge based on paragraph (b)(1)(i)(B) of this section, the date of discharge will be the earliest of the following dates, as applicable: ( 1 ( 2 ( 3 (iii) Continuation of benefits. (2) Discharge due to the Family Caregiver Bases for discharge. (ii) Discharge date. (A) Date of death of the Family Caregiver. (B) Date that the institutionalization begins, if it is determined that the Family Caregiver is expected to be institutionalized for a period of 90 days or more. (C) Date of the 90th day of institutionalization. (iii) Continuation of benefits. (3) Discharge of the Family Caregiver by request of the Family Caregiver Request for discharge. (ii) Discharge date. (iii) Continuation of benefits. (B) If the Family Caregiver requests discharge due to domestic violence (DV) or intimate partner violence (IPV) perpetrated by the eligible veteran against the Family Caregiver, caregiver benefits will continue for 90 days after the date of discharge when any of the following can be established: ( 1 ( 2 ( 3 e.g., (4) Discharge of the Family Caregiver by request of the eligible veteran or eligible veteran's surrogate Request for discharge. (ii) Discharge date. (iii) Rescission. (iv) Continuation of benefits. (c) Safety and welfare. (d) Overpayments. (e) Transition and bereavement counseling. (f) Multiple bases for revocation or discharge. [85 FR 46298, July 31, 2020] § 71.47 Collection of overpayment. VA will collect overpayments as defined in § 71.15 pursuant to the Federal Claims Collection Standards. [85 FR 46300, July 31, 2020] § 71.50 Provision of certain counseling, training, and mental health services to certain family members of veterans. (a) Benefits provided under this section. (1) All benefits will consist of psychotherapy, counseling, training, or education; VA will not provide prescriptions or medications to family members. VA also will not provide inpatient services under this section. (2) This section does not authorize the provision of clinical evaluation or treatment that is not necessary in connection with the veteran's treatment or that involves treatment other than consultation, professional counseling, marriage and family counseling, training, and mental health services. (3) Marriage and family counseling includes services to help the veteran address mental health issues, manage physical health problems, and strengthen environmental supports as specified in the veteran's treatment plan. It also includes interventions to reduce the negative impact for the veteran of mental illnesses or other medical conditions in family members. (b) Definition of family member. (1) A person related to the veteran by birth or marriage who lives with the veteran or has regular personal contact with the veteran; (2) The veteran's legal guardian or surrogate; (3) A Primary or Secondary Family Caregiver or a General Caregiver; or (4) The individual in whose household the veteran has certified an intention to live. (c) Family members or caregivers who need treatment not related to the treatment of the veteran. [76 FR 26172, May 5, 2011, as amended at 85 FR 46300, July 31, 2020]