National Family Caregiver Support Program

In November 2000, through reauthorization of the Older Americans Act (OAA), the National Family Caregiver Support Program became law. The U.S. Department of Health and Human Services, Administration on Aging administers the program and provides funds to the states. They in turn fund Area Agencies on Aging (AAAs) to provide five categories of supportive services to grandparents and other relatives aged 55 and older who are raising children, in addition to family caregivers of older individuals. 


INTRODUCTION

In November 2000, through reauthorization of the Older Americans Act (OAA), the National Family Caregiver Support Program (NFCSP) became law. [1] The U.S. Department of Health and Human Services, Administration on Aging (AoA) administers the program and provides funds to the states. They in turn fund Area Agencies on Aging (AAAs) to provide five categories of supportive services to grandparents and other relatives aged 55 and older who are raising children, in addition to family caregivers of older individuals. See below for the five categories of services available.

 

A paralled program exists for tribes, which is known as the Native American Family Caregiver Support Program.  The funding mechanism is different for that program, but the services that can be provided are the same.
 

The NFCSP has been a very successful program. Acknowledging its usefulness, the age of eligible relative caregivers was lowered to 55 as part of the 2006 reauthorization of the OAA, thereby increasing the percentage of caregivers who can be served by the program by almost 20 percent. [2] The budget for this program has also increased since its inception.
 

According to the law, the AoA releases the appropriation for the NFCSP to the states based on each state’s percentage of the population aged 70 and older. The money is then allocated to the AAAs based on intrastate funding formulas. AAAs use these funds, often in conjunction with other funding sources, to provide or contract for the provision of any or all of the five categories of supportive services to relative caregivers.
 
In 2020, Congress removed the NFCSP cap of ten percent that states were allowed to spend to provide support services to grandparents or older relatives who are raising relatives’ children. This reform allows communities to respond to their unique needs.

PROVISIONS IN THE FEDERAL LAW

Definition of a Grandparent or Older Individual Who is a Relative Caregiver

The NFCSP defines “grandparent or older individual who is a relative caregiver” as follows: 

 

…a grandparent or stepgrandparent of a child, or a relative of a child by blood, marriage or adoption, who is 55 years of age or older and –

(A) lives with the child;

(B) is the primary caregiver of the child because the biological or adoptive parents are unable or unwilling to serve as the primary caregiver of the child; and

(C) has a legal relationship to the child, such as legal custody or guardianship, or is raising the child informally.

 

Although there are few formal national studies on the issue, ample anecdotal evidence suggests that the majority of relative caregivers are raising children “informally,” which means that they are raising children without a legal relationship such as guardianship or legal custody. It is therefore very useful to grandfamilies that the law specifically mentions informal caregivers.  Generations United educated Members of Congress to include them, and they eventually were.


Support Services

The following are the five categories of support services delineated in the NFCSP:

 

(1) information to caregivers about available services;

(2) assistance to caregivers in gaining access to the services;

(3) individual counseling, organization of support groups, and caregiver training to assist the caregivers in the areas of health, nutrition, and financial literacy and in making decisions and solving problems relating to their caregiving roles;

(4) respite care to enable caregivers to be temporarily relieved from their caregiving responsibilities; and

(5) supplemental services, on a limited basis, to complement the care provided by caregivers.

 

These categories are written to be flexible and respond to the needs of the caregivers in the area being served. The fifth category, supplemental services, is particularly broad.
 

The NFCSP requires the AAAs, or the agency it contracts with, to coordinate the provision of support services with community agencies and voluntary organizations that are providing similar supportive services. Some of the most successful AAAs that serve these families are those that have collaborations with a broad range of community based organizations, including institutions and organizations associated with serving children, such as schools and Head Start programs.


Priority Language

The NFCSP includes a provision stating that states must give priority for services to older individuals with the greatest social and economic need. Furthermore, specifically for grandparents or older individuals who are relative caregivers, states must give priority to those caregivers who provide care for children with severe disabilities.


Matching and Maintenance of Effort Requirements

The NFCSP has a requirement that each state match 25 percent of its federal allocation. Additionally, the NFCSP includes a maintenance of effort requirement, which provides that funds made available through the NFCSP must supplement, not replace, any federal, state or local funds spent by a state or local government to provide similar services.


PROGRAM EXAMPLES

Thanks to the NFCSP, many AAAs around the country have either started or expanded services to grandparents and other relatives raising children. These successful programs provide models to other AAAs that want to support the families.
 
For example, the largest AAA in Michigan -- AAA 1-B -- has been working to help these families since 1993. Among the supports it helps provide, it has published and disseminated resource guides that are specially targeted towards relatives raising children for each of the six counties it serves. Other AAAs, including ones in Idaho, Illinois, Maryland, Minnesota, Ohio, Texas, and Washington have provided supportive services such as information and referral, counseling, support groups, and/or respite. The AAA in Big Stone Gap, Virginia provides extensive assessment and referral services to grandparents and other relatives raising children through its KinCare Program.
 

Supplemental services, the NFCSP’s fifth category, are also being provided to grandparents and other relatives raising children. For example, six of the thirteen AAAs in Illinois have used NFCSP funds to provide legal services to relatives raising children. Several of these AAAs use NFCSP funds in conjunction with other state, federal, and private funds, because the NFCSP funds alone are often not enough to cover grandfamilies' needs.

If you have any comments concerning this analysis, please contact its author: Ana Beltran, Co-Director, Generations United's National Center on Grandfamilies, at abeltran@gu.org.

 


 

[1] 42 U.S.C. 3030s-1

[2] Public Law 109-365, sections 320 and 321


Pearlie, aged 59, lives with her two grandchildren, aged 10 and 6, in her East Baltimore, Maryland home. Five years ago, Pearlie took the full time care of the children after domestic violence disrupted their home life.

Pearlie knows well the emotional and physical struggles grandparents face when raising their grandchildren. She has high blood pressure and arthritis. Additionally, she struggles with depression and often can’t get to the doctor to address her medical issues because she puts her grandchildren’s health needs first. Her granddaughter and grandson are both diagnosed with ADHD, are dealing with a variety of grief and loss issues, and need behavioral and educational support.

Some organizations have lent Pearlie their support. For example, Grandparent-Family Connections, a local program that provides up to 6 months of intensive services, gave her short term supportive case management. It helped Pearlie connect with some basic medical care and educational care, but she knows her family needs for ongoing support once these services end. Pearlie recently learned about supports available to grandparents raising grandchildren through her local Area Agency on Aging. Thanks to federal funding for the National Family Caregiver Support Program, the agency offers support groups, respite care, and ongoing information and referral services, all of which would be important resources for her. Unfortunately, at 59 years old, Pearlie did not qualify because only individuals 60 years and older could receive services at the time she sought help from the program. Congress recently changed the law, allowing people age 55 and older to qualify. Now Pearlie is eligible to receive a wide range of support to assist her family as needs arise.

Many other caregivers face similar struggles and are younger than 55. Some states have helped ensure younger caregivers of children get services they need by supplementing the National Caregiver Support Program with state funds or other federal sources like the Social Services Block Grant or Temporary Assistance for Needy Families.


Promising Practices in Encouraging and Supporting Grandparents and Relatives Raising Children

Examines the various Relatives As Parents Programs operated by Area Agencies on Aging across the country from The Brookdale Foundation Group and The National Association of Area Agencies on Aging, (2007). 

U.S. Administration on Aging
Information from the government agency that administers the National Family Caregiver Support Program.