Without family caregivers, many elderly patients would not be able to receive care in their own homes.
To help keep patients at home — lower cost of care — the federal government recently unveiled a national strategy to support family caregivers, which has more than two decades of support behind it.
US Department of Health and Human Services (HHS) announce the strategy late last month. It includes nearly 350 federal programs to help more than 53 million Americans who care for loved ones who are seriously ill or with disabilities in their homes, according to the American Administration of Community Life (ACL), a subsidiary agency of HHS.
The strategy It also contains 150 recommendations for state and local government, as well as the private sector.
Supporting family caregivers is an important step toward controlling health care costs, especially for Medicare and Medicaid, according to Greg Link, director of the Office of Provider and Support Services at the ACL.
Family care is estimated to be worth about $470 billion a year. If these family caregivers suddenly disappear, the health care system as we know it could potentially be in trouble for an additional $470 billion in support and service,” Link told Hospice News. “We have an opportunity through some of the data, research, and actions in the strategy to move closer to understanding The real dollar value of providing care, as well as a relatively small investment in supporting caregivers, could ultimately save the health care system. “
The strategy is based on five pillars: increasing awareness and communication with family caregivers, strengthening partnerships with these individuals, ensuring their financial and workplace security, strengthening services and support, and expanding research and evidence-based practices.
HHS has opened a public comment period on the strategy to solicit feedback from stakeholders, meaning hospice and palliative care providers have an opportunity to provide input. The department plans to update the policies every two years and will use this feedback to shape some of these changes.
Link noted that the ACL led the development of the federal government’s strategy, which has its roots in longstanding stakeholder advocacy and a series of legislative actions.
The concept of weaving these programs and future into a unified national strategy originated in the 2016 National Academies of Sciences Report, Families Caring For An Aging America. Congress took the Academies’ recommendations seriously, and in 2018 passed recognition, assistance, inclusion, support, and engagement [RAISE] Family Caregivers Act, directing HHS to develop strategy.
This is not to be confused with the RAISE immigration-focused law that was introduced during the same time period.
Among the stakeholders involved in the development of the National Academic Strategy for Government Health Policy (NASHP). Link told Hospice News that the organization was instrumental in the process. In addition to public advocacy and education, NASHP operates the Family Care Resource Center created through 2018 legislation.
The role of states
Supporting caregivers has been an emerging priority statewide as well, and more so during the COVID-19 pandemic. In light of the limited access to patients that providers had to contend with during the height of the outbreak, the widespread staffing shortage means more reliance on family members, according to Wendy Fox-Garage, a policy fellow at NASHP.
“States have been really called upon to address those crises during this time,” Fox Garage told Hospes News. “States have received pandemic-related funding from the federal government, and we’ve seen them put some of that money into this specifically because family caregivers were already providing that care, particularly in the home.”
Implementing the national strategy will require a hands-on approach on the deck, Fox-Garage explained — which means agencies at all levels of government, health care providers, other businesses, and community organizations.
Providers play an essential role, especially given that they have direct and frequent contact with patients and their families. Assisting supportive caregivers or connecting them to additional resources can help ensure that patients continue to receive goal-aligned care in their own homes.
“There are a lot of great opportunities for providers — especially during any kind of transition into care such as after discharge from the hospital — to make sure that family members understand that they need to provide for some really complex medical care tasks,” Fox and Gregg said. “Often providers don’t think of the family as part of the care team. We’ve rarely heard from family caregivers that they’ve ever been asked about their special needs, so just asking them what they need really goes a long way.”
Current government caregiver policies
At the federal level, the first major commitment to support caregivers was the creation of the ACL The National Program to Support Family Caregivers Through the 2000 Reauthorization Bill of the Older Americans Act.
Over the years, other programs for caregivers have pursued, including developing Lifelong Care Program at the ACL in 2006. In 2010, the US Department of Veterans Affairs also implemented its Carer Support Initiative.
State and local governments have also enacted a range of policies on supporting caregivers. Some include getting temporary care and services from CHWs. Some states have funded carer counseling programs, disseminated information, and implemented 1915(c) waivers to provide a range of home and community services to target Medicaid residents, according to NASHP.
NASHP through its resource center has created a document to serve as a file road map To help countries design their approaches to these issues.
States can pass family leave laws. There is a family medical leave law, but states can override this federal law and enhance family leave requirements. They can also create tax credits for caregiving expenses,” Fox-Grage said. “States are also regulators of many services such as home and community services and have great flexibility in how their Medicaid dollars are used. There is actually quite a bit of government funding as well.”