The health reform legislation approved by Congress last week contained numerous provisions that will impact one of the largest (albeit uncompensated) groups of healthcare providers in the country: family caregivers.
Currently, nearly 45 million individuals assist with the care of older family members or loved ones with disabilities.
The legislation is seen as complementary to a proposal in President Obama's fiscal 2011 budget provision introduced in February that would increase by $48 million the National Family Caregiver Support program, said Terrell McSweeny, a domestic advisor to Vice President Joe Biden in a White House blog entry this week. This funding could be used for adult daycare, transportation, disease prevention, home health, retirement counseling or senior center programs.
Four provisions in the health reform bill that would assist caregivers are:
The CLASS Act. The Community Living Assistance Services and Supports (CLASS) Act contained in the reform bill will establish a voluntary long term care insurance program—aimed at assisting individuals when disabilities create barriers to daily life activities.
Following a five year vesting period, participants who encounter limitations could receive a cash benefit that could be used to purchase services and supports for maintaining their independence at home or in the community, including things such as home modifications, assistive technology, accessible transportation, homemaker services, personal assistance services, home care aides, or nursing support.
The CLASS Act benefits could be used to compensate family caregivers, who may make financial sacrifices to assist family members. Receipt of benefits from this program would not have an effect on eligibility for other government programs.
Community Options. Provisions were included under the Community First Choice Option in the reform legislation that would assist Medicaid enrollees. Currently, the Medicaid program favors institutional—rather than home and community based care. With the new option, states can elect to provide—with enhanced federal funding—self directed, home-, and community based attendant services and supports for Medicaid beneficiaries.
Hospital Transitions. The reform legislation created a Medicare pilot program designed to help patients and caregivers negotiate the transition from a hospital stay to their homes or other care settings. New funding is provided for Aging and Disability Resource Centers, which are designed to provide information and assistance to caregivers and individuals with long term care needs.
Background Checks. The reform legislation also will establish a nationwide system to run background checks and screens at state levels for employees of long term care facilities and providers.
The new provisions may be seen as a way to also impact the healthcare of those who provide care services. According to a study released earlier this year by MetLife, healthcare costs of employees who provide care to elderly relatives or friends are 8% higher than those of employees who are not caregivers.