Proposed Legislation for Caregivers
Proposed Legislation Would Help Caregivers with Financial, Day Care Aid
By MINDY FETTERMAN
June 25, 2007 —
Recognizing that millions of Americans are caring for elderly relatives for free at some financial risk to themselves, members of Congress have proposed legislation over the years to try to help.
Most of the bills would grant tax credits of up to $3,000 a year to caregivers. The money would offset some of the out-of-pocket money people spend when they care for relatives, whether those relatives move in with them or remain in their own homes.
One bill proposes that if you quit your job to care for a relative, you would qualify for Medicare health insurance at age 55 instead of 65.
Another says that if you quit to become a caregiver, your Social Security payments, once you retire, would be based on your highest-earning years, even if those years occurred before you became a caregiver. That would make sure you wouldn't be penalized with smaller Social Security payments because you quit work or worked part time to become a caregiver.
But Congress hasn't passed any of the proposals in final form.
"Unfortunately, none of these pieces of legislation have a lot of traction," says Gail Hunt, CEO of the National Alliance for Caregiving, a non-profit group that represents unpaid caregivers.
"There is not a lot of interest in this administration in 'tax fixes,' or addressing issues through the tax system."
Last year, Congress did pass and President Bush signed the Lifespan Respite Care Act. But it hasn't been funded yet.
The bill would help train and support "respite care" sites, such as elder day care centers, which caregivers could use to get a break from their responsibilities. The goal is about $40 million in funding, says John Rother, policy director of AARP.
"It's pennies," Rother says, "but it might help some people."
Another bill proposes that a tax credit that already exists — the "dependent care credit" — be expanded so people who care for a person who doesn't live with them can still claim the credit. (Currently, you can claim a relative only if he or she lives in your home.)
An unpaid caregiver could claim a $1,200-a-year tax credit. But that hasn't passed, either. "One hundred dollars a month is appreciated, but it's not that much," Rother says.
AARP estimates the value of "free care" of the elderly by relatives and friends at $350 billion in 2006, according to a study out today.
It found that caregivers spend an average of $2,400 a year out of their own pockets. Those who spend the most hours caregiving — more than 40 hours a week — spend more: an average of $3,888.
"There is more recognition in other countries that (caregiving) is a sacrifice people are making, and they need support just like the people who are ill," Hunt says. "No one should have to bankrupt themselves."
Families most affected financially are "the people in the middle," says Suzanne Mintz, president of the National Family Caregivers Association. "They earn too much money for government programs but don't have enough money to pay for services themselves. They're caught between a rock and a hard place."
Medicare, she notes, doesn't cover the costs of many goods and services the elderly require. Only elderly people who are deemed "homebound," meaning they literally can't leave the house without assistance, are eligible for home-care services paid by Medicare.
Another example: Medicare won't pay for a power wheelchair for use outside the home unless the person requires a wheelchair inside the home, too. And it doesn't pay for basic supplies the elderly often need, such as adult incontinence products, Mintz points out.
Medicare is designed to help people recover from short-term ailments, such as hip surgery, not long-term diseases such as dementia or Alzheimer's.
The care of the elderly at home "all comes down to what (financial) resources a family has," Mintz says.
One test project for the elderly poor who are served by Medicaid is gaining some momentum, though, and it may one day help higher-income people.
A pilot program called Cash & Counseling lets elderly people on Medicaid receive grants to pay for and manage their care themselves. It was started nine years ago in three states: Arkansas, Florida and New Jersey. This year, it's being expanded to 12 more states.
And an amendment that was added last year to the Older Americans Act, the law that has long authorized funding for state agencies that counsel and serve senior citizens, should make it easier for states to adopt the program, says Kevin Mahoney, national program director for the Cash & Counseling program.
"States are champing at the bit," Mahoney said.
The program pays Medicaid recipients in cash what the government otherwise would have spent on state-sponsored home care programs for them.
People can use that money to hire health care aides, alter their homes to accommodate disabilities, adapt a car or buy medical equipment.
They can also hire their relatives, instead of a professional aide, to care for them — an option not previously permitted.
States, meanwhile, provide such services as bill-paying and help the elderly find and hire workers.
The Robert Wood Johnson charitable fund provided grants to the states to pay for these back-office needs. The elderly person (or an appointed adviser) gets to decide how the money is used.
"Relatives are providing hundred and hundreds of hours of care," Mahoney says. "This helps them and their caregivers improve their lives."