Support for Caregivers in Health Care Reform

As frequent readers of this blog know, the Middle Class Task Force developed a new Caregiver Initiative in the FY 2011 Budget to address the needs of the estimated 65 million Americans that provide unpaid care to seniors or people with disabilities. The historic health care legislation signed by the President  last Tuesday will complement and enhance the Task Force’s Initiative.  Let’s take a quick look at the ways in which health reform will help family caregivers and their loved ones.

First, the health reform legislation includes a provision called the CLASS Act, which establishes a new, voluntary long-term care insurance program for workers aimed at allowing them in the event of a disability to assist them in accomplishing life’s daily activities. After a 5-year vesting period, participants who experience a functional limitation would receive a cash benefit that could be used to purchase services and supports needed to maintain their independence at home or in the community including things like home modifications, assistive technology, accessible transportation, homemaker services, personal assistance services, home care aides, and nursing support. CLASS Act benefits can be used to compensate family caregivers, who often make huge financial sacrifices. And receiving benefits from this program would not have any effect on eligibility for other government programs.
   
Health reform will also provide much-needed support to Medicaid enrollees seeking home and community based services. Right now, there is a bias in the Medicaid program in favor of institutional rather than home and community-based care.  Under the Community First Choice Option in the health reform legislation, States can elect to provide with enhanced Federal funding self-directed, home and community-based attendant services and supports to Medicaid beneficiaries.  Additionally, the law provides additional funding for the Money Follows the Person program, which provides grants to states to help transition Medicaid-enrolled nursing home residents back into their communities.

The health reform legislation also creates a new Medicare pilot program aimed at helping patients and caregivers successfully negotiate the transition from a hospital stay to their homes or other care settings. And it provides new funding for Aging and Disability Resource Centers, which provide information and assistance to caregivers and people with long-term care needs.

Finally, the legislation establishes a nationwide system for States to run background check programs for employees of long-term care facilities and providers.  This proposal builds on a successful pilot program, which operated in seven states and kept thousands of individuals who had disqualifying records out of the long-term care workforce.  This new national system will give family members peace of mind by ensuring that all employees with direct access to patients have been screened.

As we have said on this blog before, the Middle Class Task Force’s Caregiver Initiative is just one modest step towards addressing the needs of caregivers.  Health care reform marks another important step forward.

Terrell McSweeny is Domestic Policy Advisor to the Vice President