Supporting Family Caregivers: Key Insights from the HHS Progress Report on the National Strategy

Family caregivers — some men, but overwhelmingly women — are the unsung heroes of our healthcare system, providing critical support for loved ones with chronic illnesses, disabilities, or age-related conditions.

Here’s a historical perspective: During World War II, the need for women to contribute to the national defense effort was identified. However, women had no substitutes to take their place for the jobs they were already doing: caring for the children, the sick and the elderly, running scrap drives, scrimping and saving to preserve supplies for the troops, as well as planting victory gardens to feed their families. 

The Lanham Act of 1940, also known as the Defense Housing and Community Facilities and Services Act, was an infrastructure law that funded the first and only universal childcare program in the United States during World War II. The purpose was to allow mothers to enter the workforce and increase war production. 

Congress allocated $20 million in 1943 to fund the program, and state and private companies established hundreds of “war nurseries” that provided care for children from birth to age 12. The centers offered a variety of services, including low student-teacher ratios, free meals and snacks, arts and educational activities, and before- and after-school care. Mothers received up to 6 days a week of full-time childcare, for the equivalent of less than $10/day in today’s dollars. Most were open 12 hours/day, and some even ran round the clock to accommodate factory production hours. The program was an important milestone in recognizing childcare as critical infrastructure; however, the was temporary and did not reach every family in need. Besides, Congress never meant to build a permanent national childcare program, and when the war was over, the funds for the program were pulled. 

“While the post-war boom left the US with plenty of money to build a national childcare system, and a national healthcare system, and offer more support to families in need. But we chose short-term profits were prioritized over long-term prosperity, forcing women to stand in for the social safety net — and caregiving duties remain a huge stumbling block on the path to equality between women and men,” writes Jessica Calarco in the book Holding It Together: How Women Became America’s Safety Net. 

Eighty years have passed since the national childcare system folded, and caregiving duties have increased and impacted far more than only women. Family caregivers are the backbone of the nation’s system of long-term care — replacing the support they provide with paid services would cost an estimated $600 billion each year. But when they do not have training, support, and opportunities for rest and self-care, their health, well-being, and quality of life often suffer. Their financial future can also be put at risk; lost income due to family caregiving is estimated to be a staggering $522 billion each year. (HHS.gov).

Recognizing caregivers’ vital economic role, the U.S. Department of Health and Human Services (HHS) has taken a significant step toward improving support for caregivers with the release of its *Progress Report on Federal Implementation of the National Strategy to Support Family Caregivers*. This update highlights the advancements made in policies, programs, and initiatives designed to uplift and assist family caregivers across the nation.

What follows is a breakdown of the key findings of the report, an examination of the improvements made in caregiver support, and explore what these changes mean for the millions of caregivers in the U.S.

What is the National Strategy to Support Family Caregivers?
The *National Strategy to Support Family Caregivers* was launched in 2022 to create a unified approach to supporting family caregivers through federal collaboration. This comprehensive strategy was born out of recognition that caregivers are integral to the health and well-being of their loved ones, yet they often face physical, emotional, and financial challenges with little formal support.

The strategy is built on five key goals:

1. **Increase awareness of family caregiving** 

2. **Incorporate family caregivers into care delivery teams**

3. **Support financial and workplace protections for caregivers**

4. **Increase access to respite services and other forms of support**

5. **Enhance data collection and research to inform policies**

Key Findings from the HHS Progress Report

The report provides an encouraging update on the federal implementation of this strategy. Here are some notable achievements and areas of focus:

1. **Increased Federal Collaboration**

One of the biggest takeaways from the report is the successful coordination between various federal agencies. Agencies like the Centers for Medicare & Medicaid Services (CMS), the Department of Veterans Affairs (VA), and the Administration for Community Living (ACL) have been actively working together to create more cohesive support systems for caregivers. This collaboration has led to new guidelines and programs designed to ease the burden on caregivers and ensure their concerns are integrated into policy discussions.

2. **Expanded Access to Respite Care**

Respite care gives caregivers temporary relief by providing professional care for their loved ones, allowing them time to rest, manage their own health, or take care of personal responsibilities. The progress report highlights efforts to expand access to respite services, which have been notoriously difficult to obtain. Federal grants and programs are helping more states implement respite services, with a particular focus on improving access in rural areas, where caregivers often face the most isolation.

3. **Workplace Protections and Financial Support**

Caregivers frequently struggle to balance employment with their caregiving duties, and many face financial strain as a result. In response, the federal government has been working on strengthening workplace protections for caregivers, including advocating for paid family leave and flexible work schedules. The report highlights new initiatives and legislative efforts that aim to address the financial challenges caregivers face, such as tax credits and stipends.

4. **Enhanced Caregiver Health and Well-being**

Family caregivers are more prone to experiencing stress, anxiety, and burnout, which can have serious health consequences. To mitigate these risks, the report outlines several federal programs aimed at improving caregiver well-being. Mental health resources, peer support programs, and caregiver counseling are becoming more readily available through federally funded programs. These initiatives recognize the importance of the caregiver’s health in the overall care equation.

5. **Data Collection and Research**

To create more effective policies and programs, it’s crucial to understand the specific needs of caregivers. The HHS progress report underscores the ongoing commitment to gathering comprehensive data on family caregivers through surveys, studies, and collaborative research initiatives. This data will inform future caregiver policies and allow for more targeted support.

What This Means for Family Caregivers

The federal government’s implementation of the *National Strategy to Support Family Caregivers* is a promising sign for the millions of caregivers across the U.S. The report reflects a growing acknowledgment of caregivers’ needs and the importance of providing them with the necessary resources, financial assistance, and mental health support.

Family caregivers should expect to see improvements in access to respite services, workplace accommodations, and financial aid, thanks to ongoing legislative efforts and federal programs. The focus on caregiver well-being is a critical advancement, as it emphasizes the importance of supporting the individuals behind the caregiving roles. More reliable data on caregiver experiences will also mean future policies and resources are better tailored to their needs.

Moving Forward

While the progress report is encouraging, it also highlights areas where more work is needed. Some programs are still in their early stages, and there remains a need for broader state-level adoption of federal initiatives. Moreover, ensuring that underserved communities, such as rural areas and minority populations, have equitable access to caregiver resources is a priority moving forward

As the implementation of the *National Strategy to Support Family Caregivers* continues, the hope is that caregiving in America will become more sustainable. Family caregivers are invaluable to the well-being of millions of people across the country, and with greater federal support, their journeys will hopefully become less burdensome and more fulfilling.

Conclusion

The HHS progress report on the National Strategy marks a significant step forward in recognizing and supporting family caregivers. With expanded respite care, workplace protections, financial assistance, and greater attention to caregivers' well-being, the federal government is making strides in improving the lives of caregivers. As these initiatives grow, we can expect to see a more robust system of support, ensuring that family caregivers receive the help they deserve while they continue to care for those they love.