Is Assemblyman Devon Mathis Defrauding the VA on Caregiver Benefits?
Throughout our investigation into sexual assault and child abuse allegations involving Assemblyman Devon Mathis (R-Visalia) we have repeatedly stumbled upon reports that his wife, Aubrey, was receiving some sort of monthly benefit to serve as his caregiver.
It made us ponder the question: can someone really be a "caregiver" to another person when that individual lives more than 200 miles away for more than half the year?
Is Wounded Warrior Project (WWP) Providing Monthly Stipend?
Some have reported or suggested that the caregiver benefit Aubrey receives comes from the Wounded Warrior Project, a non-profit that helps men and women injured while serving our nation.
Mathis received a Purple Heart for his service in the military when he was injured in a roadside bomb attack in 2008.
It was reported that Mathis was ruled 100 percent disabled by the Veterans Administration (VA) as a result of traumatic brain injuries sustained in the attack. On top of the $40,188 a year he receives in tax free VA benefits, his wife also is alleged to reportedly receive a $2,000 a month benefit from the Wound Warrior Project (WWP) to help care for him.
It is these financial benefits that Mathis' wife allegedly receives that deserves some scrutiny.
We don't begrudge Mathis receiving a VA disability, even if he is earning around $150,000 a year in salary and per diem as a member of the California legislature.
But we do have a problem with his wife receiving a "caregiver" stipend when her husband spends at least four days a week, often times more, in Sacramento. So, we started investigating these reports about the financial support allegedly provided by the WWP.
Let's be honest. It isn't a good look for an elected official earning a combined $200,000 in salary and VA benefits, obviously capable of caring for himself for multiple days at a time, to also have a non-profit with limited funding sending his wife a check for $2,000 each month when she isn't even providing any care to her husband.
We contacted WWP via email and received a call back this morning. The WWP representative explained that it was highly unlikely that Mathis' wife was receiving a monthly stipend since their primary method of distributing monetary benefits was through "one-time" checks to help recipients pay their utilities or catch up on housing expenses.
The representative went on to explain that based on how I described the situation that it sounded like Mathis' wife was receiving something called a VA caregiver stipend benefit. It was his understanding that the benefit went as high as up to $2,500 a month.
Based on this conversation, I feel very comfortable in saying that I believe we can put the Wounded Warrior Project rumors to rest.
Caregiver Support Program – Stipend Benefit for the Primary Family Caregiver
However, the conversation opened another can of worms.
Is Mathis' wife actually receiving a monetary stipend from the Department of Veterans Affairs to care for her husband who is away from home more than half the year?
If true, it sure seems like a case of fraud to me. It might not technically be deemed as such, but it sure seems to violate the spirit of the intended benefit.
Let's take a look at the VA "Caregiver Support Program" which provides a stipend benefit for the primary family caregiver and examine this fact sheet published by the department in December 2016.
What is a Primary Family Caregiver stipend?
A Primary Family Caregiver stipend is monetary compensation paid to a Primary Family Caregiver for providing personal care services to an eligible Veteran enrolled in the Caregiver Support Program. The stipend benefit is not intended to replace career earnings, and receipt of the stipend payments does not create an employment relationship between VA and the Primary Family Caregiver.
How does Aubrey provide personal care services to her husband when they spend half the year or more living separately?
Who determines the number of hours of personal care services a Veteran requires?
The Veteran’s Patient Aligned Care Team (PACT) at your assigned VA Medical Center (VAMC) will make a determination after evaluating the eligible Veteran. The PACT provides a clinical evaluation of the Veteran’s level of dependency, based on the degree to which the eligible Veteran is unable to perform one or more activities of daily living, or the degree to which the Veteran is in need of supervision or protection, based on symptoms or residuals of neurological or other impairment or injury. As a result of the clinical evaluation and score, the eligible Veteran will be rated as follows:
- High Tier: Equates to a maximum of 40 hours of care per week.
- Medium Tier: Equates to a maximum of 25 hours of care per week.
- Low Tier: Equates to a maximum of 10 hours of care per week.
There are two major components to consider here. First, stipend amounts are allocated based on the tier or severity of the injury. Second, and most importantly for this discussion, the benefit is designed to help injured veterans perform one or more activities of daily living.
Again, how is it possible for a primary caregiver who is tasked with ensuring daily needs of a veteran are met perform this task if they spend more than half the year living in different cities more than 200 miles apart?
How will my stipend amount be determined?
The stipend amount is based on the weekly number of hours of personal care services that an eligible Veteran requires during the month. It is calculated by multiplying the Bureau of Labor Statistics hourly wage for home health aides, Skill code 311011, for the geographic region in which the eligible Veteran resides by the Consumer Price Index Cost of Living Adjustment (COLA), and then multiplying that total by the number of weekly hours of Caregiver assistance required (assigned tier level hours).
This product is then multiplied by the average number of weeks in each month (4.35).
For example: If an eligible Veteran requires 10 hours of personal care services weekly (Tier 1) and the Caregiver’s hourly wage (including COLA) is $10 per hour, then the monthly stipend would be: (10 hours x $10) x 4.35 = $435.
According to the BLS, the median hourly wage for home health care workers is around $11.69 cents in the Visalia-Porterville area.
Assuming reports Aubrey earns $2,000 a month are true, tax free by the way, we can figure out that Assemblyman Mathis has been categorized as "high tier" requiring 26 to 40 hours of care per week.
Take the $2,000 stipend and divide by 4.35, which gives us $460 per week. Now, take the $460 and divide by $11.69 to get 39.35 hours per week.
Is Mathis Defrauding the VA?
Again, how is it that Aubrey can provide daily care to her husband who has apparently been assigned to the highest tier of care?
For the record, we have been unable to learn whether or not Mathis' wife is receiving or still receiving this benefit. Numerous news reports and statements by individuals we have spoken to suggest that this benefit is being claimed and received.
Assemblyman Mathis should confirm whether or not his wife is receiving these benefits.
Additionally, we are unsure if this is technically fraud according to the VA. We have been unable to locate any language where fraud is defined.
However, we believe it is reasonable to assume fraud is taking place when benefits designed for personal care of daily needs of veterans can't possibly be provided in return for the stipend.
We would encourage news reporters to seek out a comment from the VA on this matter.