Start: November 2018

Funder: The John A. Hartford Foundation, the Milbank Memorial Fund, the May and Stanley Smith Charitable Trust, and the Gordon and Betty Moore Foundation


More than 17 million individuals in the United States provide care and support to an older parent, spouse, friend, or neighbor. 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 caregivers.

Through the Helping States Support Families Caring for an Aging America initiative, the Center for Health Care Strategies (CHCS) is working with five states — Alabama, Iowa, New Hampshire, South Carolina, and Virginia — 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, the Milbank Memorial Fund, the May and Stanley Smith Charitable Trust, and the Gordon and Betty Moore Foundation, these states will develop strategies to assist family caregivers. Potential approaches include:

  • Creating uniform policies to govern complicated networks of family caregivers and health and social service agencies, which often have competing guidelines.
  • Rethinking how to identify and track family caregivers, both to accurately measure community needs, and simplify patient/provider communication and medical decision-making.
  • Providing critical training opportunities to family caregivers on topics such as chronic disease, managing medication regimens, and how to access community resources.
  • Expanding access to respite and adult day care, services that allow caregivers to take a much-needed break from the 24/7 nature of caring for someone with complex medical needs, thereby reducing stress and preventing caregiver burnout.

Over 18 months, the state teams, which include staff from Medicaid as well as the Governor’s Office, Departments of Aging and Health and Human Services, state legislatures, and other local organizations, will participate in individual technical assistance calls, peer-to-peer “learning lab” webinars, and in-person meetings to learn from peers and other experts. An additional state participant will be added to the initiative in the future.

CHCS will distill lessons from the states’ efforts, which will be shared broadly with stakeholders across the country.