The Law Will Require Development Of A Strategy To Recognize And Support Family Caregivers
In January, Congress passed and President Donald Trump signed the RAISE Family Caregivers Act. The law creates a strategy to support millions of people who help loved ones remain in their homes.
Here is what the new law will require.
- Require HHS to develop, maintain and update a National Family Caregiving Strategy, offering resources and education opportunities to family caregivers in the United States;
- Require HHS to convene a Family Caregiving Advisory Council to advise it on recognizing and support family caregivers;
- Promote greater adoption of person and family centered care in all health and long-term services and supports settings; and
- Ensure older adults with disabilities and illnesses receive high quality care in their homes.
Senators Susan Collins (R-Maine) and Tammy Baldwin (D-Wis.) and Representatives Greg Harper (R-Miss.) and Kathy Castor (D-Fla.) spearheaded the legislation.
The bill as it moved through congress was also backed by AARP. “Family caregivers are the backbone of our care system in America,” said Nancy A. LeaMond, AARP’s chief advocacy and engagement officer. “We need to make it easier for them to coordinate care for their loved ones, get information and resources and take a break so they can rest and recharge."
These family caregivers have a big job, but some basic support — and commonsense solutions — can help make their big responsibilities a little bit easier.
We are grateful to Congress and “This is forward progress, but it should not be the end of the journey. - Charles Fuschillo, Jr., President and CEO of the Alzheimer's Foundation of America
Across America, family caregivers help parents, spouses, children and adults with disabilities and other loved ones to live independently. They prepare meals, handle finances, manage medications, drive to doctors’ appointments, help with bathing and dressing, perform complex medical tasks and more — all so loved ones can live at home.
So What Will The RAISE Family Caregivers Act Really Do?
The RAISE Family Caregivers Act requires the U.S. Secretary of Health and Human Services (HHS) to develop, maintain and update an integrated national strategy to support family caregivers. According to the Act, HHS will create a national family caregiver strategy by bringing together federal agencies and representatives from the private and public sectors (like family caregivers, health care providers, employers and state and local officials) in public advisory council meetings designed to make recommendations. The agency will have 18 months to develop its initial strategy and then must provide annual updates.
So we can say that the aim of this new law is certainly needed, well intentioned and could be of great help to the 40 million family caregivers with an elder or disabled loved one at home. What could be wrong with that?
What We See Is Wrong With The RAISE Act
Funding, simply put. Implementing any national strategy will create a large cost that our polarized Congress is unlikely to fund. The RAISE Act is supposed to help family caregivers keep working outside the home. The question is: Who is going to pay for the replacement caregiver when the family caregiver goes back to work? Respite options are to be included as part of the Act. That means that the family caregiver gets time off to rest. And what happens to the elder or disabled person when the family caregiver is getting that break? Someone has to pay for the actual cost of placing the care recipient in a facility temporarily or paying someone by the hour to care for them temporarily. We have no such national programs now. Strategizing about programs is not the same as paying for programs.
Age Related Illness and Disease
Alzheimer’s disease and Dementia are affecting seniors in growing numbers. The result is literally millions of people become family caregivers and are quitting their jobs to care for their loved ones part time or full time. Passing a law requiring an integrated strategy is fine, however funding research to find a cure for the sixth leading cause of death in the U.S., Alzheimer’s disease, is hugely important. Caregiving for a loved one with Alzheimer's can last 20 years.
The RAISE Act is an important step toward more fully recognizing the impending crisis in caregiving as the aging population continues to grow. As improved guidelines and policies develop from the legislation, funding will be required to relieve the 2015 AARP estimate of $470 billion in unpaid care and the 2016 AARP estimate of $7,000 in out-of-pocket expenses provided annually by family caregivers. - Kathleen Kelly, Executive Director - Family Caregiver Alliance
We have not seen as part of this new law, any mechanism for Funding caregiver relief, disease research, housing assistance for seniors or any other important caregiver related need. Referring this lack of funding, Charles Fuschillo, Jr., President and CEO of the Alzheimer's Foundation of America is quoted in a press release from GlobeNewswire: “We are grateful to Congress and “This is forward progress, but it should not be the end of the journey.”...This encouraging development is only the tip of the iceberg. A dire need remains for the federal government to pass a Fiscal Year (FY) 2018 budget which includes $2 billion—up from the current amount of $1.4 billion—for Alzheimer’s disease research at the NIH." (National Institutes of Health).
Caregiver Training, Medical Assistance And Financial Relief
According to AARP, family caregivers “commonly experience emotional strain and mental health problems, especially depression, and have poorer physical health than non-caregivers.” And they rarely receive training in providing care.
And 78% of them incur out-of-pocket costs due to caregiving, spending $6,954 a year, on average, according to AARP. That’s estimate of $470 billion in unpaid care each year. Recognizing and strategizing about this with a new law is not the same as funding a solution.
What Concerns Me Is What’s Missing In This Law
To be effective and not just a list Advisory Councils, Strategies, and Unfunded Departments, I see several main things that could be put in place rather quickly and which would provide much needed help for families faced with a senior caregiving situation. Consider the following:
- Allow family caregivers an amount stipulated on their tax return that funds their lost wages in regards to social security. In other words fill those gap years in their ss earnings with a stipend so they do not lose benefits they will need when they themselves retire.
- Congress needs to pass a law allowing Medicaid funds to be used to pay for Adult Foster Care Homes and not just nursing homes. These homes cost on average ½ of the cost of a nursing home, which is the only option open to those whose funds have run out. The care in these homes as good and many times proven to be better than traditional nursing homes. The smaller environment can be a great benefit to patients with forms of dementia and Alzheimer’s disease and the staff to patient ratio usually much better. Just ask, me I am a huge advocate for these homes.
- Allow family caregivers who leave work to care for a loved one to draw a caregiver wage from the government if they meet certain income requirements. If a person cannot financially leave a job to care for someone, that person ends up in a nursing home and that cost the government and the economy on average 8-10,000 per month per resident! Again you could pay a family caregiver a fraction of that, save money and the patient gets better care! It’s a win win solution.
Does experience mean we are better at what we do? Not according to one auto insurance company.
It seems what Progressive Insurance wants to do to seniors in the state of Maine is sending the message “If you get a year older it only means you are a bigger risk.” However their plan to raise auto insurance rates for seniors who turn 65 is running into opposition from the state's AARP director, who opposes any action that could limit healthy seniors' mobility. Their vice president of communications says "Mature drivers are some of the safest on the road –“. Amen to that.
Yet Progressive Insurance wants to go forward with a plan that would substantially increase car insurance rates charged to seniors, even though such rates are already going up, according to a CBS News MoneyWatch report. The hypothetical proposal from Progressive Insurance Company shows that a 65-year-old driver would pay 6 percent more just because he or she celebrated a birthday. Such an increase would especially hurt Maine drivers given that this rural state has few transportation alternatives to driving. More than 20 percent of Mainers over age 65 are still on the road, according to state motor vehicle statistics.
And the opposition to Progressive Insurance grows.
State Rep. Henry Beck, who is also chairman of the legislature's committee on insurance and financial services, has submitted a proposed amendment to his state's insurance code that would prohibit insurance companies from charging older Mainers higher premiums based solely on age, according to newspaper Portland Press Herald.
Further opposition comes from J. Robert Hunter, director of insurance for the Consumer Federation of America, who stated, "The focus for insurers should be on driving record, mileage and type of car -- things clearly related to risk," and he said. "Age is questionable. And all the actuarial data I have seen indicates less risk for the older drivers."
Nevertheless, Progressive says that age isn't the only criterion it is looking at in proposing to raise rates on Maine seniors.
"As an industry practice, rates are developed using well accepted actuarial principles that consider numerous factors relating to a person's risk of loss," a Progressive Insurance spokesman said. "A major factor is loss experience, which Progressive and industry data clearly shows deteriorates as people grow older." But will this kind of argument be enough to get past some hurdles?
Further complicating the Progressive Insurance proposal is the fact that the state of Maine already prohibits insurers from boosting existing customers' premiums as they age, and the state Bureau of Insurance already denied Progressive's initial request in June for a rate hike. Yet Progressive Insurance still is trying to charge seniors more for auto insurance by pressing for an amendment to the law!
Are you a senior who is also an active driver? How does this make you feel when you may be charged more for auto insurance simply because of your age and not your excellent driving record? Perhaps it is time to let your state representatives know before they change the law in favor of what some may call “Progressive Insurance Rates”.