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Pilot Program in Arizona Helps With Caregiver Costs

A handful of other states also test ways to aid with families' expenses

David and Fran Buss at home on Sept. 24, 2019 in Tucson, Ariz.

Caitlin O'Hara

David and Fran Buss are making modifications to their Tucson home to make it easier to navigate safely so they can continue to live independently in the house they love as they get older.

En español | At the start of 2020, Arizona began a pilot program to reimburse caregivers up to $1,000 for housing improvements such as ramps and grab bars or assistive technology like hearing aids or medical alert devices to help their loved ones age in place.

Lawmakers have allocated $1 million over two years for the Arizona Family Caregiver Reimbursement Program, and are limiting it to participants with incomes up to $75,000 for individuals and $150,000 for couples.

Arizona's new program is among only a few nationwide to help with caregiver costs, according to Boston College's Center for Retirement Research.

"The costs associated with caregiving are high, and the resources can be hard to find,” says Dana Kennedy, AARP Arizona state director.

50 percent reimbursement rate

The money allocated to the Family Caregiver Reimbursement Program is not a lot in a state with an estimated 870,000 family caregivers, almost 1 in every 8 residents. Its 50 percent reimbursement of expenses up to the $1,000 maximum for each family member who qualifies should help at least 1,000 families caring for a disabled adult who needs help with at least one activity of daily living such as bathing, being mobile, dressing, eating, moving from a bed to a chair or using the toilet.

The money can't be used for daily living costs, regular household repairs and upkeep, or expenses that insurance or other sources will reimburse. The renovations or equipment must be started or bought after Jan. 1, and the grants will be awarded to those who qualify on a first-come, first-served basis.

Steps to qualify

Arizonans can receive up to $1,000 in reimbursements for expenses that qualify.

1. Call the state's Caregiver Resource Line at 888-737-7494.

2. Answer questions from the screening specialist who answers the phone. The specialist makes an initial determination on whether a person qualifies for the program.

3. Fill out and submit a copy of the application that will be sent via mail or email as well as a medical need verification form and a Form W-9 for tax purposes.

4. Wait about 90 days for officials to review the documents. They will notify the applicant about the next steps.

After two years, the trial project will be evaluated to determine if it should continue. The Arizona Department of Economic Security's Aging and Adult Services division is overseeing the program.

In the long run, the modest grants save the state money by keeping people safe at home longer, thereby delaying or preventing the need for more expensive care in taxpayer-funded institutions such as nursing homes, supporters say.

"We will collect data on the initial use, and if it proves to be as successful as we expect, I would like to expand the program,” says state Sen. Heather Carter, a Phoenix Republican who cosponsored the bill.

Fran and David Buss have lived in their home in the desert foothills of Tucson for more than 32 years and hope never to leave. But they need to add two ramps to their single-story house so 77-year-old Fran Buss, who is partially disabled and has grown more frail, can navigate the step up to the front door and the step down to the study more easily, says David Buss, 72, a retired chaplain and his wife's caregiver.

"Fran uses a walker and manages pretty well, but it's probably not safe to have even one little step,” he says.

Hope was for Arizona tax credit

Advocates, including AARP, had backed a proposal for a state caregiver tax credit similar to New Jersey's Wounded Warrior Caregivers Credit, says Kennedy of AARP. A tax credit is an amount that can be taken directly off a tax bill; some tax credits allow residents to get a refund if their incomes are too low for them to owe taxes.

But those advocates supported the change to a caregiver grant program because they think it will reach more people in need of help, Kennedy says. If the pilot program reimburses a beneficiary $600 or more, the state considers the money taxable income.

Nationally, family caregivers spend an average of nearly $7,000 a year on related expenses, according to an AARP report. The cost rises to about $12,000 when the caregiver has to travel to help family members.

Arizona officials are working with nonprofits that have similar housing-improvement programs on options for those who can't afford the up-front costs of home modifications, Kennedy says.

Other states help with caregiver costs

Several states have enacted paid family leave lawspermit workers to earn sick leave for personal use or caregiving, or require business to allow caregivers to use their sick leave benefits to attend to a family member. But few offer financial assistance to help with the estimated 34 billion hours of care that family caregivers provide without compensation.

• In 2018, Hawaii launched its Kupuna Caregivers Program, which allows family caregivers who work outside the home for at least 30 hours a week to qualify for money — paid directly to authorized contractors — to cover the cost of services including adult day care, home help and meal delivery.

In the Native Hawaiian language, kupuna means grandparent or elder. Last year, Hawaii lawmakers increased financing for the program and set a $210-a-week limit for beneficiaries. County aging offices in the state administer the program.

• In 2017, New Jersey passed its Wounded Warrior Caregivers Relief Act, which allows for a maximum state income tax credit of $675 to family caregivers who are assisting a veteran disabled in any armed conflict after Sept. 11, 2001.

• In 2018, Virginia revived and revised an earlier grant program to provide up to $400 reimbursement of respite care per family. The hope is that financing for the Virginia Lifespan Respite Voucher Program will last through July 31, 2021.

The state program has close to $195,000 in federal money to disburse over 35 months. Families that received previous benefits from the program are not eligible.

As of October 2019, 20 states are receiving State Lifespan Respite grants from the federal government. Each state's aging agency officials determine how the money will be used.

• In 2022, Washington state residents will begin paying a 0.58 percent payroll tax that will allow individuals to tap into benefits they've accumulated, starting in 2025, to finance myriad services designed to keep seniors and people disabled as adults in their own homes. People who are self-employed can opt in, and those with long-term care insurance can opt out.

To qualify for the yearlong benefit, those who have paid into the program must show that they need help with at least three activities of daily living. The bill was signed into law in May 2019, and many details of the program still are being worked out.

Washington is one of nine states without a state income tax. The others are Alaska, Florida, Nevada, New Hampshire, South Dakota, Tennessee, Texas and Wyoming.

Contributing: Linda Dono, AARP. Miriam Davidson is a writer living in Tucson, Arizona. This story, which originally appeared in some October editions of the AARP Bulletin, has been updated to reflect the start of Arizona's program and information about other states’ programs.

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