Legislation and Public Policy

New Federal Regulations Related to Caregiving

Feds Want Home Health Agencies to Be More Responsive to Patients and Family Caregivers

Seeking to strengthen patients’ rights and promote more coordinated, patient-centered care, federal regulators issued rules in January that set minimum standards for home health agencies (HHAs). The final rules, which go into effect in July 2017, apply to more than 12,600 HHAs that provide in-home care to roughly 5 million patients through Medicare and Medicaid.  Several provisions in these new regulations have significant implications for family caregivers and their loved ones.  For instance, HHAs must:

  • assess caregivers’ willingness, ability and availability to provide assistance to patients when developing a plan of care

  • ensure that patients and their caregiver(s) receive written information about upcoming visits, medication instructions, treatments administered, and the name and contact information for home health agency clinical managers

  • provide each patient and their caregiver(s) with ongoing education and training, as appropriate, regarding the care and services identified in the plan of care

  • coordinate all services provided by the physicians, nurses and therapists involved in the patient’s care

    Caregiving Bills in the 115th Congress (as of March 1, 2017)

    Caregiver Program Information Dissemination Act of 2017 (S.165): Introduced by Senator Rounds (R-SD). This bill expands the list of topics covered in pre-separation counseling for members of the armed forces to include a description of the support services provided through the family caregiver program of the Department of Veteran Affairs.

    Alzheimer's Caregiver Support Act (S.311): Introduced by Senator Klobuchar (D-MN). This bill authorizes the Department of Health and Human Services to award grants to public and nonprofit private health care providers for training and support services for families and caregivers of Alzheimer's disease or a related dementia patients.

    Building Support Networks for Women Veterans Act (H.R. 91): Introduced by Representative Brownley (D-CA-26). This bill makes permanent a pilot program, established under the Caregivers and Veterans Omnibus Health Services Act of 2010, to provide counseling and reintegration services to women veterans.  

    National Clinical Care Commission Act (H.R. 309): Introduced by Representative Olson (R-TX-22), passed by the House on January 9, 2017 and referred to the Senate. This bill creates a National Clinical Care Commission within the Department of Health and Human Services to evaluate existing federally administered diabetes, metabolic and autoimmune disease initiatives, and make recommendations on how to improve the coordination and implementation of these programs.

    Adult Day Center Enhancement Act (H.R.325): Introduced by Representative Lee (D-CA-13). This bill requires the Administration on Aging to survey adult day programs that provide care and support services to individuals with neurological diseases such as multiple sclerosis and Parkinson's disease and their family caregivers.  The survey will identify successful adult day programs and develop best practices to guide the development of additional successful programs.


    State Legislative Trends in Caregiving

    The Caregiver Advise, Record and Enable (CARE) Act in the States

    In 2014, Oklahoma became the first state to sign into law the Caregiver Advise, Record, Enable (CARE) Act. Since then, another 34 states have followed suit. While slightly different in each state, the CARE Act has three common elements. Hospitals must:

    • provide a patient or their legal guardian with the opportunity to designate a family caregiver or other lay caregiver who can provide aftercare in the patient’s home;

    • inform the family caregiver when the patient is to be discharged;

    • provide the family caregiver with education and live instruction of the medical tasks he or she will need to perform for the patient at home.

Family Caregiver Income Tax Credit - Arizona (HB 2209), California (AB 806), Maine (SP 144) Massachusetts (S 1530)

The bills in these states create a new tax credit of up to $1,000 ($2,500 in Maine and $3,000 in Massachusetts) for eligible expenses incurred by a family caregiver who earns less than $75,000 a year for an individual and less than $150,000 for a joint return.