A New Medicare Proposal Would Cover Training for Family Caregivers

Even with extensive caregiving experience, Patti LaFleur was unprepared for the crisis that hit in April 2021, when her mother, Linda LaTurner, fell out of a chair and broke her hip.

LaTurner, 71, had been diagnosed with early-onset dementia seven years before. For two years, she’d been living with LaFleur, who managed insulin injections for her mother’s Type 1 diabetes, helped her shower and dress, dealt with her incontinence, and made sure she was eating well.

In the hospital after her mother’s hip replacement, LaFleur was told her mother would never walk again. When LaTurner came home, two emergency medical technicians brought her on a stretcher into the living room, put her on the bed LaFleur had set up, and wished LaFleur well.

That was the extent of help LaFleur received upon her mother’s discharge.

She didn’t know how to change her mother’s diapers or dress her since at that point LaTurner could barely move. She didn’t know how to turn her mother, who was spending all day in bed, to avoid bedsores. Even after an occupational therapist visited several days later, LaFleur continued to face caretaking tasks she wasn’t sure how to handle.

“It’s already extremely challenging to be a caregiver for someone living with dementia. The lack of training in how to care for my mother just made an impossible job even more impossible,” said LaFleur, who lives in Auburn, Washington, a Seattle suburb. Her mother passed away in March 2022.

A new proposal from the Centers for Medicare & Medicaid Services addresses this often-lamented failure to support family, friends, and neighbors who care for frail, ill, and disabled older adults. For the first time, it would authorize Medicare payments to health care professionals to train informal caregivers who manage medications, assist loved ones with activities such as toileting and dressing, and oversee the use of medical equipment.

The proposal, which covers both individual and group training, is a long-overdue recognition of the role informal caregivers — also known as family caregivers — play in protecting the health and well-being of older adults. About 42 million Americans provided unpaid care to people 50 and older in 2020, according to a much-cited report.

Read the full article from KFF Health News.

Executive Order Expands Access to Community Living Services, Supports Family Caregivers

On April 18, 2023, President Biden will sign an executive order (EO) that includes more than 50 directives to federal agencies to increase access to affordable, high-quality care, and provide support for care workers and family caregivers.

The EO directs actions to improve job quality for the professionals who provide the critical services that make community living possible for millions of people. It includes actions to improve support for the 53 million family caregivers who provide the overwhelming majority of long-term support to older adults and people with disabilities. It also directs actions to expand availability of home and community-based services, including those funded by Medicaid and the Department of Veterans Affairs.

This exciting EO creates new momentum for ACL’s work to strengthen the care infrastructure that helps people with disabilities and older adults live and fully participate in their communities, including our work leading the National Strategy to Support Family Caregivers and to strengthen and expand the direct care workforce, our partnership with the Veterans Health Administration on the Veteran-Directed Care program, and more.

This White House fact sheet has more of the highlights. (We will share a link to the full text of the EO on our social channels and on ACL.gov as soon as it is available.)

Proposed Rule Will Make More Grandparents and Other Relatives Eligible for Resources to Support Them in Caring for Children Whose Parents Cannot

Yesterday, the Administration for Children and Families (ACF) announced a proposed rule that will make it easier for child welfare agencies to license relatives to foster children whose parents cannot care for them. (Specifically, the rule will allow child welfare agencies to create separate kinship caregiver licensing standards.) This will allow more grandparents and other relative caregivers to access the financial assistance and other resources that are available to licensed foster homes, making it possible for more children to remain with their families during challenging times. ACF is encouraging child welfare agencies to place as few burdens as possible on grandparents and other kin to become licensed, consistent with the safety and well-being of the child.

This rule addresses one of the significant challenges facing grandparents and other relative caregivers, and fulfills a key federal commitment made in the 2022 National Strategy to Support Family Caregivers.

The Children’s Bureau in ACF will hold an information session for title IV-E agencies and the public on Tuesday, February 28 from 3:30 to 4:00 PM ET providing an overview of the Notice of Proposed Rulemaking (NPRM). No advance registration is required. Attendees can join using this Zoom link.

ACF’s announcement is below, and yesterday’s post on their Family Room blog has more information. The proposed rule and instructions for commenting are published in the Federal Register. Comments must be received by April 17, 2023.