I am reading all over the internet on the advancements our government policymakers are making in addressing the caregiver crisis we are facing. This new legislation is being promoted as a landmark shift. While Medicare, operated by the Centers for Medicare & Medicaid Services (CMS), is acknowledging the crucial role of family caregivers in the healthcare system. This recognition marks a significant change in policy, as Medicare will, for the first time, financially support the families of individuals with specific medical needs.

Key proposals include Medicare covering the costs for doctors and other healthcare providers to offer vital support and training to family caregivers. This marks a departure from the traditional approach, where Medicare payments were restricted to services directly provided to beneficiaries, excluding family caregivers.

The transformative measures by CMS encompass:

Caregiver Training: A new billing code will enable Medicare providers, including physicians, nurses, and therapists, to train family members in caregiving. Starting next year, this initiative aims to equip families with necessary skills for home-based patient care, though it raises questions about the practicality of training delivery and the potential role of community-based organizations. OF course, this training will be needed as Medicare Advantage cost sharing platform is going to put pressure on family caregivers to provide levels of care they are not equipped to provide. The high copays, the high out of pocket expenses is leaving the family caregiver to provide care at levels that were onced provided by professional health care providers.  When a family is told that the copays for skilled care is going to cost them $250 a day to provide care, it leaves the family caregiver overwhelmed and feeling helpless.   

Every senior will have at least one admission to a skilled care unit in their lifetime. Some will need to be admitted for short stays after an illness. Others will need a few weeks to 90 days in a skilled unit to recover from a stroke or other chronic illness. While the government policy makers are trying to cut health care costs by rationing care, the family caregivers and the elderly and disabled are the ones that suffer. The wealthy will be fine. THey will be able to pay for the care they need. The diminishing middle class will remortgage their homes and use their savings and spend down to qualify for Medicaid. The poor and disabled will do without and delayed proper care. It is happening now and has been for those on Medicaid for decades.

 Care Navigation: Medicare will fund assessments of social needs and care navigation for patients with certain high-risk conditions. This initiative allows for collaboration with non-medical providers, though its current scope is limited. This means, the family caregiver will have to jump through stangulating government hoops to get some type of limited funding 

Integrated Dementia Care: The GUIDE program, set to launch in a year, targets families caring for dementia patients, offering coordinated care and support services. However, this model's limitation to dementia raises questions about its applicability to other chronic conditions.
While these initiatives by the Biden administration signify progress, several concerns remain, such as the extent of Medicare's financial commitment, the frequency of these services, the definition of a family caregiver, and the willingness of medical practices to participate. THere is also a glaring omission in this so called landmark proposal over 10 years is missing the need for respite care. It does not address the critical issues of the family caregiver. 

The National Alliance for Caregiving (NAC) has responded positively to these developments, highlighting the significant economic and social contributions of America's 53 million family caregivers. The proposed budget includes substantial investments in paid family and medical leave, Medicaid services expansion, and support for veteran family caregivers, among others. 

However, challenges persist. The ongoing caregiver crisis, the shortage of direct care workers, and the rising costs of Medicare benefit cost sharing  present hurdles. The current plan, though promising, is not fully address the immediate needs of middle-class family caregivers. Delays in accessing benefits and bureaucratic complexities further exacerbate the situation, underscoring the need for a unified voice among caregivers.

In conclusion, while these measures represent a critical step forward in recognizing and supporting family caregivers, a comprehensive approach is needed to address the broader public health crisis and the escalating pressures on caregivers and the healthcare system.

We have created the Caregiver Relief Family Caregiver and Direct Care Workers petition. We must unify and become one voice 

Here is one caregiver's story of stress, strain and emotional health 

THe unmet needs of the family caregiver a call for support and solutions

Please share this petition with others. One in five people are providing support for another. Please share your caregiver challenges and obstacles you face to make others aware.

Here's a podcast to listen to about Caregiver Stress Syndrome