VA Caregiver Support Forms, Handouts and Literature

The Caregiver Support (CS), Program of Comprehensive Assistance for Family Caregivers (PCAFC), forms, literature and handouts. These pertain to the clinical responsibilities written by the Social Worker Department (SWD) instead of the Medical Department.

I have listed some of the forms, literature and handouts used in the PCAFC I want to discuss in greater detail in a future post. The discussion will include violations to the law, statue, regulation and directive. You can find these in the documents tab.

First, let’s discuss the forms.

a. Application and clinical eligibility forms in order – all forms except the application is in the VA medical computer system which are used nationwide:

  1. VA Form 10-10CG, Application for Program of Comprehensive Assistance for Family Caregivers (PCAFC).
  2. Caregiver Support Administrative Eligibility Screening Tool
  3. Caregiver Program Clinical Eligibility Assessment (Part 1)
  4. Caregiver Program Clinical Eligibility Assessment Child Note (Part 2)
  5. Caregiver Program Initial In-Home Assessment (B)
  6. Caregiver Program Interim In-Home Monitoring Assessment

b. Other forms used – written or unwritten:

  1. Reassessment Request for Tier Level Changes and Serious Physical and/or Mental Health Injuries. Veteran/Caregiver provide a written reassessment request to the CSC. Not aware of any forms used by the CSC or the Social Worker Board for processing the request.
  2. Revocation. Veteran/Caregiver provide a revocation written request to the CSC. Not aware of any forms used by the CSC to perform the VA revocation.
  3. Appeals. Veteran/Caregiver provide a written appeals request to the CSC. The CSC uses  internal forms for the appeals – Caregiver Support Program Clinical Review and Caregiver Support Program Clinical Appeals Team developed by the SWD used nationwide.

Second, some of the PCAFC literature and handouts:

  1. Caregiver Support, The Program of Comprehensive Assistance for Family Caregivers – Roles, Responsibilities and Requirements July 2017
  2. Caregiver Support, Program of Comprehensive Assistance for Family Caregivers (PCAFC) – Veteran Quick Eligibility Questions May 2016
  3. Caregiver Support Eligibility for the Program of Comprehensive Assistance for Family Caregivers May 2016
  4. Caregiver Support, The Program of Comprehensive Assistance for Family Caregivers, date unknown
  5. Caregiver Support, Fact Sheet – Caregiver Support Program Appeals Process, date unknown
  6. Fact Sheet 11-02, Caregiver Support Program – Stipend Benefit for the Primary Family Caregiver, December 2016

In a later post I will explain the various issues with all of these forms.

 

 

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