A study of 10 states since passage of the national family caregiver support program: policies, perceptions, and program development.
OBJECTIVE
This study describes the preliminary experiences of 10 states in providing support services to family or informal caregivers of elderly adults and adults with disabilities; it focuses on the newly created National Family Caregiver Support Program, state general funds, Medicaid-waiver programs, and other state-funding streams.


METHODS
Case studies were conducted, between March and July 2002, through in-person interviews with state officials and stakeholders in Alabama, California, Florida, Hawaii, Indiana, Iowa, Maine, Pennsylvania, Texas, and Washington.


RESULTS
States were in the start-up phase of implementing the National Family Caregiver Support Program and varied greatly in program design and integration of caregiver support into their home- and community-based care system. Viewing family caregivers as a client population was a paradigm shift for many state officials.


CONCLUSIONS
Heavy reliance is currently placed on family and informal caregivers in home- and community-based care, without adequate support services. Family support should be an explicit goal of long-term-care system reform.
Feinberg
Lynn Friss
LF
National Center on Caregiving, Family Caregiver Alliance, 180 Montgomery St., Suite 1100, San Francisco, CA 94104, USA. lfeinberg@caregiver.org
Newman
Sandra L
SL
D000368:Aged; D001294:Attitude to Health; D017028:Caregivers / Q000191:economics*; D005190:Family; D005380:Financing, Government; D006291:Health Policy; D006299:Health Services for the Aged / Q000191:economics*; D006701:Home Nursing / Q000191:economics*; D006801:Humans; D008134:Long-Term Care / Q000191:economics; D019982:Organizational Case Studies; D016730:Program Development; D012944:Social Support; D012947:Social Work / Q000191:economics*; D013221:State Health Plans / Q000458:organization & administration*; D014481:United States