Start: May 2018

Funder: The John A. Hartford Foundation


Over the last five years, the number of adults in the United States caring for a family member or friend age 50 or older has increased to more than 40 million individuals. While states are the primary payers for long-term services and supports (LTSS), in many cases their health care and social service systems are not prepared to meet the needs of an aging population or their family caregivers.

Through the Helping States Support Families Caring for an Aging America initiative, the Center for Health Care Strategies (CHCS) is working with states committed to developing policies or programs to support family caregivers and address the challenges of an aging population. Through the initiative, cross-sector state teams — comprised of state and private organizations, including Medicaid, Departments of Aging and Health and Human Services, Area Agencies on Aging, and community organizations — are partnering in new ways to prioritize and strengthen family caregiving programs.

During Phase I (2018-2020), CHCS worked with six states — Alabama, Idaho, Iowa, New Hampshire, South Carolina, and Virginia — in advancing family caregiving policy and program changes through support from The John A. Hartford Foundation, the Milbank Memorial Fund, the May & Stanley Smith Charitable Trust, and the Gordon and Betty Moore Foundation. Participating states received tailored one-on-one technical assistance, as well as peer-to-peer information sharing, convening, and learning opportunities. Over two years, participating states focused on strengthening strategies to identify family caregivers, collecting data through new statewide family caregiver assessments, determining how to assess and streamline existing programs and supports, and improving access to respite care.

In Phase II (October 2020-September 2022), CHCS will recruit up to six additional states committed to developing policies or programs to support family caregivers and address the challenges of an aging population. With support from The John A. Hartford Foundation, states will develop and/or enhance existing strategies to assist family caregivers. Potential areas of focus include:

  • Strengthening family caregivers’ capacity, including, for example, through use of new technologies, technology, increased access to respite care, and formalized training for family caregivers;
  • Establishing robust data collection strategies to enhance programs or inform policies to support family caregivers (e.g., family caregiver needs assessments, surveys of program effectiveness);
  • Building cross-sector partnerships (e.g., aging, housing, transportation, health plans, etc.) to better support family caregivers’ needs; and
  • Connecting aging initiatives and family caregiving programs in more formal ways to prioritize family caregiving.

Over the next two years, the state teams will participate in individual technical assistance calls, peer-to-peer “learning lab” webinars, and virtual “hang outs” to learn from peers and other experts and implement new strategies to support family caregivers. CHCS will distill lessons from the states’ efforts, which will be shared broadly with stakeholders across the country.