Administration for Community Living, 2022: National Strategy to Support Family Caregivers
Category:
Proposal Overview
Name: Administration for Community Living: National Strategy to Support Family Caregivers
Year: 2022
Sponsoring Organization and Key Author(s):
Sponsoring Organization:
The RAISE Family Caregiving Advisory Council and the SGRG Advisory Council developed the National Strategy to Support Family Caregivers together with 15 federal agencies, led by the Administration for Community Living. The John A. Hartford Foundation (JAHF), the National Academy of State Health Policy (NASHP), Community Catalyst, the LeadingAge LTSS Center @UMass Boston, and the National Alliance for Caregiving provided financial, technical, and practical assistance.
Key Authors:
Not specified
Program Details
Overview: Federal report to Congress outlining the issues family caregivers face. It provides recommendations for policy and program changes at the federal, state, local, and private sector levels to better meet the needs of family caregivers. The report was developed by the Advisory Councils created by the Recognize, Assist, Include, Support, and Engage (RAISE) Act and Supporting Grandparents Raising Grandchildren (SGRG) Act together with 15 federal agencies.
It also received input from family caregivers and the organizations that serve them. Included are commitments by federal agencies and actions for Congress, states, communities, and other stakeholders to support caregivers that align with the Strategy. The recommendations for Congress are discussed below; a full discussion of the National Strategy is in the Appendix.
Major Legislative Recommendations
Expand/Enhance Caregiver Programs
Infrastructure
Recommends increasing funding for state, territorial, tribal, and local health departments to systemically embed family caregiving into public health infrastructure and planning. Also recommends establishing a federal interagency task force to develop a direct care workforce development plan.
Recommends that Medicaid, the VA, and Medicare Advantage plans expand community-based long-term care options, including expanding self-directed opportunities that allow for the hiring of family caregivers and funding long-term care services at rates that attract and retain a skilled direct care workforce.
Recommends a review of current funding levels for federal caregiver support programs.
Recommends increased funding for caregiver support services under the National Family Caregiver Support Program, the Lifespan Respite Program, and the Alzheimer’s Disease Program Initiative.
Medicaid
Recommends increasing the asset limit for Medicaid eligibility so the care recipient does not have to deplete most of their assets to qualify
For Medicaid.
Medicare
Recommends expanding Medicare to include respite, adult day services, home modifications, home delivered meals, and other long term
services and supports to help individuals safely age in place.
Older Americans Act
Recommends financial support for caregivers through federal funding opportunities, including the expansion of the Older Americans Act (OAA) and the Elder Justice Act.
Financial Supports for Family Caregivers
Tax Credit/Deduction for Caregiver Expenses
Recommends a tax credit for out-of-pocket care expenses incurred by family caregivers. Proposes tax incentives to encourage employers to adopt caregiver-friendly practices. Proposes tax deductions to help pay for family members providing HCBS, including family members who are not claiming the care recipient as a dependent. It also suggests allowing kin and grandparent caregivers with primary responsibilities for a child to claim the federal Child Tax Credit.
Workplace Supports
Expanded Family Medical Leave
Recommends federal paid family leave and expanding the Family and Medical Leave Act (FMLA) to include small employers. Promotes definition of family to include grandparent and kin caregivers. Recommends changes to COBRA so wage earners who leave employment to care for family members still have access to benefits at
their previous level.
Retirement/Social Security
Recommends allowing family caregivers who leave the workforce for caregiving to accrue Social Security credits.
Other
Caregiver Assessments
Recommends encouraging clinicians and providers to conduct formal assessments of family caregiving needs.
Inclusion in Care Teams
Recommends creating incentives for health care systems to incorporate family caregivers into health care decision making for the care recipient.
Miscellaneous
Recommends funding the development, implementation, and evaluation of a national public health awareness campaign on caregiving.
Also recommends: (1) updating language in existing federal caregivingrelated legislation to ensure it aligns with the goals of the National Strategy; (2) launching a national public long-term care social insurance program that includes benefits for kin and grandparent caregivers; and (3) convening a task force to develop a consensus definition of family caregiver and a standardized set of survey questions that provide a minimum data set on the caregiver, care recipient, and caregiving situation.