Commitment to Caring

The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028/H.R. 3759) requires the Secretary of Health and Human Services to develop, maintain and update a strategy to recognize and support family caregivers. The law brings representatives from the private and public sectors, such as family caregivers; older adults and persons with disabilities; veterans; providers of health care and long-term services and supports (LTSS); employers; state and local officials; and others together to advise and make recommendations regarding this new strategy. The advisory council meetings will be open to the public, and there will be opportunities for public input. The strategy will identify recommended actions that communities, providers, government, and others are taking and may take to recognize and support family caregivers, including with respect to:

• promoting greater adoption of person- and family-centered care in all health and LTSS settings, with the person and the family caregiver (as appropriate) at the center of care teams
• assessment and service planning (including care transitions and coordination) involving care recipients and family caregivers
• information, education, training supports, referral, and care coordination
• respite options
• financial security and workplace issues

The development of the initial strategy will take up to 18 months, followed by updates of the strategy biennially. The law will improve the collection and sharing of information, including information related to evidence-based or promising practices and innovative models regarding family caregiving; better coordinate, assess, maximize the effectiveness, and avoid unnecessary duplication of existing federal government activities to recognize and support family caregivers. The strategy and work around it could help support and inform state and local efforts to support family caregivers.

The National Family Caregiver Support Program (NFCSP), established in 2000, provides grants to States and Territories, based on their share of the population aged 70 and over, to fund a range of supports that assist family and informal caregivers to care for their loved ones at home for as long as possible.

Families are the major provider of long-term care, but research has shown that care-giving exacts a heavy emotional, physical and financial toll. Many caregivers who work and provide care experience conflicts between these responsibilities. Twenty two percent of caregivers are assisting two individuals, while eight percent are caring for three or more. Almost half of all caregivers are over age 50, making them more vulnerable to a decline in their own health, and one-third describe their own health as fair to poor.

The NFCSP offers a range of services to support family caregivers. Under this program, States shall provide five types of services:

• information to caregivers about available services,
• assistance to caregivers in gaining access to the      services,
• individual counseling, organization of support groups,      and caregiver training,
• respite care, and
• supplemental services, on a limited basis

These services work in conjunction with other State and Community-Based Services to provide a coordinated set of supports. Studies have shown that these services can reduce caregiver depression, anxiety, and stress and enable them to provide care longer, thereby avoiding or delaying the need for costly institutional care.

While the Aging Network has always been involved with meeting the needs of both care recipients and family caregivers, by creating the National Family Caregiver Support Program, Congress explicitly recognized the important role that family caregivers occupy in our nation’s long-term services and supports system. As of the 2006 Reauthorization of the Older Americans Act, the following specific populations of family caregivers are eligible to receive services:

• Adult family members or other informal caregivers age      18 and older providing care to individuals 60 years of age and older;
• Adult family members or other informal caregivers age      18 and older providing care to individuals of any age with Alzheimer’s      disease and related disorders;
• Grandparents and other relatives (not parents) 55 years      of age and older providing care to children under the age of 18; and
• Grandparents and other relatives (not parents) 55 years      of age and older providing care to adults age 18-59 with disabilities.