lifespan respite: who, what, why, where and how?
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Lifespan Respite: Who, What, Why, Where and How?. ARCH National Respite Network and Resource Center. Presenter. Jill Kagan, MPH Program Director ARCH National Respite Network and Resource Center 703-256-2084 [email protected]. Family Caregiving in the US. - PowerPoint PPT PresentationTRANSCRIPT
ARCH National Respite Network and Resource Center
Presenter
Jill Kagan, MPHProgram DirectorARCH National Respite Network and Resource [email protected]
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Family Caregiving in the US65.7 million unpaid family caregivers
Provide 80% of long-term care in the US.
Valued at over $375 billion a year in uncompensated care, more than was spent on Medicaid in 2007.
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Family Caregiving is Lifespan!
Majority of family caregivers caring for someone under age 75 (56%).
28% of family caregivers caring for someone between the ages of 50-75.
28% are caring for someone under age 50, including children
Source: Caregiving in the U.S. 2009. Bethesda, MD: National Alliance for Caregiving and Washington, D.C.: AARP, 2009.
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Family Caregiving in [State}
In 2007, at anytime during the year, nearly 1.4 million family caregivers were providing care in [State].
The value of their caregiving is estimated at $[ ] billion annually.
But they cannot do it alone!Source: Gibson, MJ and Houser, A., (2008). Valuing the Invaluable: The Economic Value of Family Caregiving,
2008 Update, AARP Public Policy Institute Issue Brief Insight on the Issues, November, 2008.(Washington, DC: AARP)
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What is Respite?For family caregivers who provide ongoing care to
someone with a chronic or disabling condition or for a family facing undue hardship or crisis, respite means:
… planned or emergency care provided to a child or adult with a special need in order to provide temporary relief to the family caregiver of that child or adult.
Lifespan Respite Care Act definitionPL 109-442
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Benefits of RespiteImproves family caregiver physical and
emotional health;Improves overall family well-being and
stability;Improves marriages, sibling and other
family relationships;Reduces hospital costs and helps avoid
or delay more costly foster care, nursing home or other out-of-home placements;
Gives care recipient a break, too!7
What is Lifespan Respite??
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Lifespan Respite …not just care or a service, but…..
Lifespan Respite Definition: Coordinated SYSTEMS of accessible,
community-based respite services for all family caregivers regardless of age or special need.
Original Lifespan Respite Programs for Best Practice: OR, OK, WI, and NE designed to improve respite access
Twenty-four (24) New Federal Grantees9
Why Do We Need Lifespan Respite Systems?
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Respite: Too Little, Too Late89% of family
caregivers (those 65 million I mentioned earlier) do not receive respite.
Survey did not ask these families why they do not receive respite, but we know from research and experience what the barriers are.
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Barriers to RespiteConfusing and
Restrictive Eligibility Criteria
Affordability IssuesLimited ProvidersReluctance to identify
as caregiver or ask for help
Bureaucratic Maze of Funding Streams and Services
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Medicaid Waivers
New Health Care Reform and VA Provisions
National Family Caregiver Support Program
Block Grants (TANF, Maternal and Child Health, Social Services, Children’s Mental Health)
Federal Categorical Funding Streams, such as CAPTA, Family Support, Alzheimer’s Demos
State Respite or Family Caregiver Support Programs
Building Blocks forLifespan Respite
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Lifespan Respite is like a QuiltIt weaves together these extremely
important, but fragmented funding streams, disparate and duplicative programs, and silos to form a seamless system that
make barriers invisible to families.
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Characteristics of Lifespan Respite Programs
Identify and coordinate existing respite resources/funding/programs at state level
Identify service gaps to help create and monitor new respite services
Connect families to respite services, providers, and payment resources
Recruit and train respite providersPromote public awareness about respite
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Best Practices in State Lifespan Respite Systems
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Oregon’s Lifespan ProgramState Agency: In 1997, Oregon
Department of Human Services (DHS) charged by state law to develop statewide respite coordination
Relies Heavily on Local Structures to Build Resources: DHS worked directly with 22 local respite networks (LRNs) serving all 36 counties in Oregon
Diverse State Advisory Council brings Lifespan Perspective
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Nebraska’s Lifespan Program
Nebraska Lifespan Respite Services Program created by legislation in 1999Lifespan Respite Network Also has Lifespan Respite Subsidy (respite
payments up to 312% of poverty for families who do not qualify for any existing funding stream)
State Agency: Implemented by Nebraska Department of Health & Human Services (DHHS)
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NE Respite Network More Regional than Local (like in OR)Regional Structure: HHSS contracts
with six (6) regional entities to form the Lifespan Network.
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Oklahoma’s Lifespan Program
Oklahoma Respite Resource Network (ORRN) is a statewide partnership of public and private agencies
Partnering State Agencies include: developmental disabilities, mental health, aging, maternal and child health and others
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Oklahoma Structure
No local/regional structure
ORRN relies on a statewide resource and referral system (OASIS) through an 800 toll-free number and the web to link families to the program, to respite providers and to training opportunities.
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Oklahoma’s Lifespan Program:Consumer-Directed
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Family Caregivers eligible for respite vouchers of $200-400 every three months as long as funds are available.
Encouraged to choose own providers from community/family support network.
By using OASIS, caregivers receive information on other services and supports besides respite.
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Moving to National ScaleLifespan Respite Law Signed in 2006Funded for the First Time in 2009 at $2.5 million and again in 2010
Administered by the US Administration on Aging
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Federal Lifespan Respite Care ProgramUS Administration on Aging administers competitive state grants for these mandatory uses of the funds:
Development or enhancement of State and local Lifespan Respite systems
Provision of planned or emergency respite for all ages
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Lifespan Respite Care Program (con’t)
Training and recruitment of providers/volunteers
Provision of information to caregivers about available respite and support services, and assistance in gaining access to such services
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State Lead AgencyEligible State Lead Entities
State Units on AgingState Medicaid AgenciesOther State Agencies
In concert with…Aging and Disability Resource
CentersState Lifespan Respite Coalition
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Mandated Collaboration: What does it Mean for Your State?ADRC and State Respite Coalitions must
be a partner in program implementation.The State’s Application must include:
Memorandum of agreement regarding the Joint responsibility for the eligible State agency's Lifespan Respite program between the eligible State agency and a public or private nonprofit statewide respite coalition or organization.
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State Match Requirement
25% Match Required
Can be Cash or In-Kind
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Lifespan Respite Programs Must…Advance State’s Ability to Meet Respite
NeedsServe all Population/Disability Groups,
especially gap populationsCoordinate With, and on Behalf of,
Existing Respite Programs and Infrastructures
Have a Consumer FocusDemonstrate Stakeholder Collaboration
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Current Status
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Grantee Activities: Examples
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South Carolina: Expanding Volunteer Training and Provider Opportunities using faith-based and Senior Companion programs; Tennessee using University-based volunteer training program
Arizona: Developing partnership with Adult Protective Services to provide respite to high risk families; Illinois: set aside grant funds to pay for some emergency respite•North Carolina: “Just One More”: 100 NC
counties will be challenged to develop at least one new respite service
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New Grantees: Roles of State Respite Coalitions and ADRCs
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What are these entities and what do they do?
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Role of State AgenciesAll must engage in Program Administration/Implementation/ Oversight/ Leadership.
May undertake themselves toCoordinate Respite InformationCoordinate Statewide Respite Databases orContract to Local Entities To Complete
Required Tasks
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State Respite CoalitionNo definition of coalition in law or PANo standardized requirements for structure or
missionMost respite coalitions predate Lifespan Respite;
others developed because of it.Respite Coalitions have a history of advocacy and
networking; some progressed to service/voucher delivery and training.
As far as Lifespan Respite is concerned, coalition’s role and activities are completely determined by decisions jointly made between state lead agency and the coalition.
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State Respite Coalition Examples in Grantee StatesSouth Carolina Respite Coalition:
Co-facilitate State Advisory CommitteePull together information on funding
streams, respite barriers, identifying respite gaps.
North Carolina: Serve on State Advisory Board Responsible for New Training and Program
Material Development (e.g. cultural diversity, volunteer respite guide)
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State Respite Coalition Examples in Grantee StatesIllinois Respite Coalition will:
Establish 800 numberResponsible for provider training
Texas Respite Coalition: Distribute productsIdentify ongoing barriers and best
practicesAttract media attention and raise
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Aging and Disability Resource Center
Serve as “one stop shops” or "no wrong door” entry into long-term supports and services system for older adults and people with disabilities;
Over 200 ADRCs funded in 49 states and territories;
Jointly funded by CMS and AoA;
Lifespan Respite Law has a specific definition of ADRC, but the law does not mandate what the specific role of the ADRC should be in program implementation.
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State Examples of ADRC RoleConnecticut: ADRC will be single point of entry; CT
Lifespan Respite Coalition as “respite portal.”South Carolina: Bridging Family to Family Health
Centers with ADRCs through electronic resources.Tennessee: ADRC and Coalition working side-by-side
to form “no-wrong door” approach. Alabama: Alabama Connect, virtual ADRC, will house
Alabama Lifespan Respite Network website, but Respite Network will be point of contact.
Texas: With state funding, ADRCs given priority to receive grants to serve as Lifespan Respite local points of entry
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State Role: Getting Ready to Implement Lifespan Respite
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FY 2011 Timeline
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Lessons From First Round of Federal Funding
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Questions to Consider
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How do we build or strengthen our State Respite Coalition? What role will it play?
Respite Coalitions Can:
Advocate with a Respite Focus
Conduct Program Oversight
Provide Guidance and Expertise to Lead Agency
Serve as Respite “Portal” for Access to Lifespan System
Develop and Offer Respite Recruitment/Training
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What will be the role of the ADRC?Outreach, public awareness and information dissemination
Serve on State Advisory Teams or Task Forces
Expand Caregiver TrainingEmbed Respite Hotlines
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What are the short and long term goals we need to reach to become a Lifespan Respite state?Develop a Timeline to Prepare for Funding
and Application WritingDevelop relationships, enhance
collaborations between ADRCs, Respite Coalition, Governor’s office, State and Local Agencies
Research and Identify Current State Respite Needs/Barriers/Funding Sources
Collaborate to Design Your State’s Program – What should it look like??
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For More InformationARCH National Respite Network and Resource Center http://www.archrespite.org/
Caregiver Programs& Lifespan Respite:Technical Assistance Centers
This project is supported, in part, under a grant from the U.S. Department of Health and Human Services, Administration on Aging. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. These contents, however, do not necessarily represent the policy of the U.S. Department of Health and Human Services and endorsement by the Federal government should not be assumed.
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