Two Pa. bills would remove barriers to home caregiving

Support program is showing its age

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Two decades ago, Pennsylvania was a pioneer in providing support for family caregivers through a lottery-funded initiative to reimburse some of the costs of keeping a loved one at home.

Today, advocates for the elderly say the state program has fallen out of date and become too restrictive to do the good that it should.

AARP Pennsylvania, the Pennsylvania Homecare Association, Pennsylvania Association of Area Agencies on Aging and other groups will join lawmakers at a news conference at the state Capitol today calling for passage of legislation that would remove some of the barriers to helping home caregiving.

The similar bills introduced in the state Senate and House would also increase the amount of monthly reimbursements -- for the first time in two decades -- for purchase of medical supplies, respite care services and home modifications that help keep older members of low- to moderate-income households out of nursing homes.

"It's important to keep people at home for as long as you can, and it's less expensive," said Sen. Kim Ward, R-Hempfield, sponsor of one of the bills and chairwoman of the Senate Aging and Youth Committee, which sent her measure to the full Senate for consideration.

In the current fiscal year, $12.1 million in state lottery funds and $10 million from the federal government provide help for caregivers in Pennsylvania, but the state money is more restrictive. Under the state's Family Caregiver Support Act, caregiving-related costs are reimbursed only in a household where the volunteer caregiver and physically or mentally dependent person are related and living under the same roof.

The federal program allows help in the cases of a non-family member who becomes the primary caregiver for someone else, even if they live apart. In such cases, for instance, a trip to adult day care for a person who needs assistance can be covered on a day when the volunteer caregiver is unable to visit to provide usual supervision.

In addition to allowing similar flexibility with state dollars, the legislative proposals would increase maximum funding assistance, up from $200 to $600 monthly for basic costs, and up from $2,000 to $6,000 total for home modifications such as grab bars or a wheelchair ramp. The program, run through Area Agencies on Aging, primarily serves care recipients with incomes less than 200 percent of poverty level.

Ray Landis, Pennsylvania AARP advocacy manager, said the state has not been expending all of the money allocated for caregiving assistance in recent years because of the restrictions on who qualifies for help. He said $1 million was returned to the lottery fund last year instead of being used for the people for whom it was designed.

Christina Reese, a spokeswoman for the Pennsylvania Department of Aging, said the Corbett administration has not taken a position on the proposed changes to a program that actually started as a pilot project in 1987, before being expanded statewide in 1991.

"We have experienced (since then) that nuclear families aren't as close together as they used to be, and it's been more of a challenge for relatives to maybe be the caregiver in some instances for their loved ones," Ms. Reese acknowledged, while saying the legislation is being evaluated for its potential impact on seniors.

While Pennsylvania has been recognized for some time as a leader in services to the elderly, due to the funding dedicated to them through its lottery, it was given much lower grades in long-term care support in a recent scorecard from the national AARP and other groups. One of the things it was faulted for was its level of assistance to caregivers.

Lynn Friss Feinberg, senior strategic policy adviser for independent living/long-term care for the AARP Public Policy Institute, said Pennsylvania, to its credit, was ahead of both the federal government and other states in reimbursing costs for family caregivers. She said it has not gone beyond that in the time since, however, with steps taken by other states such as expanding upon the federal Family and Medical Leave Act to assist caregivers who have to give up paid employment temporarily.

In the State Long-Term Services and Supports Scorecard that came out this month, Pennsylvania ranked 36th among the 50 states and District of Columbia in how caregivers interviewed in a broad national survey evaluated the level of government support they received. In a broader scorecard ranking aimed at assessing long-term care supports overall, the state was 39th, due in part to a relatively high cost for either institutional or in-home long-term care when government subsidies aren't involved.

Gary Rotstein: or 412-263-1255.


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