Supporting the Department of Veterans Affairs Caregiver Support Program Expansion

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Supporting the Department of Veterans Affairs Caregiver Support Program Expansion

Posted on 12.17.22

An expanding resource program for caregivers needed additional support

PCAFC is a program for Veterans who sustained or aggravated a serious injury or illness in the line of duty. Previously, this program was for Veterans who sustained or aggravated a serious injury in the line of duty  on or after September 11, 2001. Congress recently expanded PCAFC to cover eligible Veterans of all service eras. The program supports caregivers of eligible Veterans through clinical support including skills training, coaching, a financial stipend, respite, mental health counseling and other resources. To qualify, Veterans must meet seven eligibility criteria, including the need for in-person personal care for six continuous months, based on specific areas of need as defined by VA. This level of care is challenging for caregivers, and part of VA’s mission is to give them the resources they need to succeed in their roles. VA needs efficient and effective operations to ensure PCAFC’s success.

Reviewing applications promptly and consistently to determine program eligibility proved to be a challenge. In addition, the program saw an increase in applications with new populations of Veterans suddenly eligible for assistance.

As PCAFC expanded, VA’s policy management capacities also needed to expand to accommodate the changes. All VA staff needed to be guided through the changes simultaneously to have the entire team on the same page. Over 2,400 staff members needed to understand changes to PCAFC and their roles in supporting the program. At the same time, VA needed to communicate the changes to the program’s beneficiaries, potential applicants and the public, including Veterans Service Organizations, strategic partners and Congress.


An expanding program needed a comprehensive support structure to succeed. VA partnered with Aptive, bringing caregiver experts and experienced VA program managers and change management practitioners to the table.

Performance measurement and evaluation

The first step in providing caregivers services and resources is acclimating them once they’ve joined PCAFC. With more eligible Veterans applying, VA needed to process applications promptly.

To address this challenge, Aptive created a unique process to gather national data to streamline and standardize the program acceptance process. Collected data yielded information on program approvals and denials, which informed the creation of a webinar series that highlighted recommendations to improve efficiencies in assessing applicants and ensuring a standard of care for Veterans and their caregivers.

New policy framework

VA and Aptive created an entirely new policy framework to accompany the standardized applicant processing. This system allowed all VA personnel to understand and work within higher operating standards. The new policy framework included a centralized location for all relevant documents, refreshed standard operating procedures, directives, standardized responses and a PCAFC field guide to set the stage for PCAFC’s expansion.

Training and education

Behind the scenes, PCAFC underwent significant changes to move the program forward. However, one of the most critical aspects of the changes was ensuring all staff understood the program direction and how the changes affected specific roles within VA. To this end, Aptive supported VA’s training efforts by developing training plans, course curricula and accompanying materials. VA presented this information to over 2,400 staff through many, multi-day virtual conferences.

Strategic communications

In addition to bringing VA employees up to speed on PCAFC changes, VA needed to communicate these changes and their impact to program participants and applicants.

Aptive created many tools for VA’s communications toolkit, including outreach and engagement plans, guidelines, press releases, talking points, social media and website materials, a host of printable content, videos and messaging options. In addition, we monitored the use and success of various communications practices, focusing efforts on methods that increased information dissemination.

Human resources support

VA needed a larger workforce to support the growing capacities of CSP. Over 18 months, Aptive helped VA hire 40 leaders who were instrumental in leading the program in its newly expanded direction, including a new national executive director and five assistant directors.


PCAFC successfully expanded without sacrificing services to Veteran caregivers

PCAFC’s expansion posed significant challenges for VA. While growing, hiring more employees, providing training to current staff and conducting important public outreach, the program had to continue to meet the needs of caregivers and Veterans without breaks in service.

Aptive facilitated this success by providing support across multiple functional and operational expansion areas. As a result, VA improved the accuracy of determining PCAFC eligibility across the country and updated policies to reflect these procedures.

Training and education ensure that CSP staff nationwide understand these procedures and process changes. Aptive monitored the success of employee educational efforts by developing feedback systems and hosting biweekly webinars with personnel to understand issues and concerns raised by VA staff across the country. Takeaways from these calls with over 1,000 VA employee attendants inspired the creation of monthly training calls that address specific topics of interest or concern.

One of the most important issues was ensuring caregivers knew about PCAFC’s changes and how they could access support services. VA conducted public outreach with goals to:

  • Increase access to information
  • Increase the caregiver community’s use of available resources and services
  • Establish CSP as the go-to community for caregivers

Through these efforts, CSP’s listserv increased by 37,000 subscribers over 12 months.