Respite Care:

Grants and Cooperative Agreements Awarded to Implement the Lifespan Respite Care Act

GAO-11-28R: Published: Oct 22, 2010. Publicly Released: Oct 22, 2010.

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Individuals who are limited in their capacity for self-care because of a physical, cognitive, or mental disability or condition that results in a functional impairment may depend on family caregivers for assistance with routine daily activities. According to a 2009 study by the National Alliance for Caregiving and AARP, an estimated 65.7 million people, or 29 percent of the population, had served as unpaid family caregivers to an adult or child with special needs in the previous 12 months, providing an average of about 20 hours of care per week. Activities caregivers conduct can range from assistance with routine daily tasks like bathing and dressing, to carrying out more complex health-related interventions like administering medication and wound care. The responsibilities of caregiving may present physical, emotional, and financial challenges for caregivers. In December 2006, the Lifespan Respite Care Act of 2006 (LRCA) was enacted to improve the delivery and quality of respite care services available to families across age and disability groups by establishing coordinated lifespan respite systems. The LRCA authorized the Secretary of the Department of Health and Human Services (HHS) to award competitive grants or cooperative agreements to eligible state agencies7 to: (1) expand and enhance respite care services to family caregivers; (2) improve the statewide dissemination and coordination of respite care; and (3) provide, supplement, or improve access and quality of respite care services to family caregivers. The LRCA also authorized the Secretary of HHS to award a grant or cooperative agreement to a public or private nonprofit entity to establish a National Resource Center on Lifespan Respite Care to: (1) maintain a national database on lifespan respite care; (2) provide training and technical assistance to state, community, and nonprofit respite care programs; and (3) provide information, referral, and educational programs to the public on lifespan respite care. For fiscal years 2007 through 2011, over $289 million was authorized to carry out activities under the Act. Since the enactment of the LRCA, $5 million has been allocated to date to implement the federal Lifespan Respite Care Program--$2.5 million in each of fiscal years 2009 and 2010. The Administration on Aging (AOA), the agency within HHS responsible for administering the Lifespan Respite Care Program, has had two competitive grant announcements for state agencies, with funding starting in September 2009 and September 2010 respectively. Both announcements offered federal funding of up to $200,000 per award for a 3-year project period; grantees are required to provide at least a 25 percent match of total project costs. In addition, in May 2009, AOA announced the availability of funding for a public or nonprofit entity to enter into a cooperative agreement with AOA to provide caregiver and respite program development and technical assistance, including establishing the National Resource Center on Lifespan Respite Care. The LRCA required that GAO evaluate lifespan respite programs. This report describes the grants and cooperative agreements that have been awarded to implement the requirements of the LRCA.

AOA awarded a total of almost $5 million through 24 LRCA grants and one cooperative agreement in 2009 and 2010. Specifically, AOA awarded grants to agencies in 24 states--12 states in September 2009 and 12 states in September 2010. The grants, which provide funding for a 3-year project period, ranged from $110,000 to $200,000. Grants totaled $2,293,378 and $2,254,078 in 2009 and 2010, respectively. States plan to use the grant funds for a variety of activities including respite care provider training, the development of respite care provider registries, public awareness and education initiatives, and improving coordination across the various agencies that handle respite care services. In addition to the state grants, AOA awarded a 3-year cooperative agreement to the Family Caregiver Alliance (FCA) in September 2009 to provide caregiver and respite care program development and technical assistance; FCA subcontracted with ARCH for the respite care portions of the cooperative agreement. As of September 2010, ARCH had received a total of $381,622 in LRCA funds through its contract with FCA--$206,622 in September 2009 and $175,000 in September 2010. ARCH is using these funds for activities such as providing in-person and web-based training, conducting site visits of state grantees, preparing and updating fact sheets and issue briefs on respite care, preparing quarterly technical assistance newsletters, and updating an online respite care locator service.

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