Open Letter to SVAC

Chairman Moran and Ranking Member Tester,On behalf of the Elizabeth Dole Foundation and the 5.5 million military and veteran caregivers, thank you for allowing Jennie Beller and me to testify before the Senate Veterans Affairs Committee today about the importance of the VA MISSION Act implementation. As Jennie and I both emphasized, it’s so important that we get this right so caregivers of all eras can access important benefits and resources.At the conclusion of the hearing, Chairman Moran asked an important question that I would like to follow up on—what are the top three things the committee can do for caregivers? In the lead up to this question, the Chairman recognized that caregivers should be included in policy recommendations for mental health and suicide. The Elizabeth Dole Foundation could not agree more. Caregivers serve on the front lines of the veteran suicide epidemic. They monitor for environmental triggers, step in when no one else can, and advocate tirelessly to get their veterans the treatment they need when they need it. My response outlined three recommendations that we would like for the committee to consider to improve the health of caregivers:

• Expediting VA MISSION Act implementation: Caregivers of the pre-9/11 generation have waited long enough for this program to become available to them. With the phased expansion approach, those caring for veterans who served between May 8, 1975, and September 11, 2001, will not be eligible to apply until October 2022, four years (1460 days) after the VA MISSION Act was signed. This program provides access to crucial benefits that can help caregivers who have had to suffer alone for so long. We recommend that the Committee require the Department of Veterans Affairs (VA) to open the program to the Phase 2 veterans and caregivers in October of 2021, one year after initial implementation.
• Mental health care for all caregivers: While the Program of Comprehensive Assistance for Family Caregivers provides access to mental health support, there is little available for caregivers who do not qualify. Caregivers can access a peer-to-peer mentoring program through the Program of General Caregiver Support Services, but not professional mental health care. This is a major challenge for caregivers who feel isolated and alone during their journey. We recommend that the Committee create legislation that requires the VA to provide access to mental health, in addition to peer support, regardless of enrollment in either caregiver support program. Caregivers will be identified in the veterans' record as the Electronic Health Record system is finalized. If a veteran has a caregiver listed in their record, they should be eligible to access this vital support.
• Research on the impact of caregiving on caregivers: Caregiving can be a grueling journey that is often walked alone. There is no roadmap or how to guide that can help navigate the complex VA system. We know that caregivers face higher rates of depression and anxiety than their non-caregiving peers, but what are the other long lasting impacts of stepping into the caregiving role? Anecdotally, EDF has heard that caregivers turn to substance abuse or other destructive coping tactics. But what are the quantitative numbers of caregivers facing depression, anxiety, substance abuse, and even suicidal isolation? We recommend that the Committee request that the VA conducts a longitudinal study that looks at the lasting effects of caregiving on caregivers. This level of research would be beneficial as organizations, Congress, and the VA itself create programs and benefits that better support these hidden heroes long term.

It is our sincere hope that the Committee takes these recommendations into consideration for legislative and policy action. Caregivers like Jennie Beller keep our veterans alive and well, and they cannot do this alone. Jennie was very open about the extreme isolation caregivers like her face. She shared the difficult decision to step away from her career to provide care for Chuck because he would not survive if he had to go into a home. Jennie also acknowledged that if she continued to care for Chuck while working herself, she would likely meet her own death.Caregivers are the lifeline to our veterans and deserve this nation’s full support for the free and selfless care they provide for their loved one who served. I often say caregivers didn’t sign up for this life, they were drafted. Five and a half million military and veteran caregivers are depended upon every day and now they depend on us to step up for them.Thank you for the opportunity to provide testimony to the committee and share our thoughts on the implementation of the VA MISSION Act. We look forward to working with both of you towards our shared goal of adequately serving our nation’s hidden heroes.Warmest Regards,Steve SchwabCEO, Elizabeth Dole Foundation