RAISE Family Caregivers Act

Mr. President, I rise today to discuss the epidemic of suicide--a growing crisis that has devastated millions of families across our Nation. Over the past 8 years, the rate of deaths by suicide in our country has tripled. Let me repeat that. It has tripled, and the problem is particularly severe among young adults.

According to the Centers for Disease Control, for youth between the ages of 10 and 24, suicide is now the third leading cause of death. In other words, more of America's youth die each year from suicide than cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease combined.

This crisis shows no signs of abating. Consider that each day in our Nation, there are an average of over 5,400 suicide attempts by young people in grades 7 to 12. In my home State of Utah, the statistics are particularly alarming. Every 14 hours, a Utahn commits suicide, resulting in an average of 630 deaths each year. The problem is so acute that Utah now has the fifth highest suicide rate in the Nation. This troubling trend is particularly pronounced among Utah's youth. Even though Utahns from ages 10 to 17 comprise only 13 percent of the State population, they represent nearly 23 percent of all suicide attempts. Suicide is now the leading cause of death among Utah's teenagers.

To stem the tide of teenage suicide in Utah, I convened a roundtable discussion in Salt Lake City last December that included community leaders, healthcare professionals, high school principals, and parents from across the State. There we discussed proven methods that destigmatize mental illness, a critical first step in addressing the suicide crisis. We also discussed the links between bullying and depression.

In an effort to prevent teen suicide, the effect of bullying cannot be overlooked. A recent study in the Journal of the American Medical Association finds that kids who are bullied are more than twice as likely to consider suicide. In my home State of Utah, dozens of community leaders have drawn attention to the pernicious effects of bullying. The foremost among them is Dr. Greg Hudnall, a nationally recognized expert in suicide prevention. Dr. Hudnall found that between 8 and 12 percent of all suicides are committed by young people who have been bullied. To discourage bullying and to help our teenagers who are suffering most, Dr. Hudnall led in the development of HOPE4UTAH. HOPE4UTAH is a dynamic peer-to-peer program designed to empower students in groups called Hope Squads. Hope Squads identify warning signs of depression in teenagers and offer help to those in need.

Wendy Nelson, principal of Utah's Syracuse High School, recently told me how Hope Squads have helped students at risk of suicide to connect with therapists that the school has made available on a regular basis. The high school has since partnered with a local community health center for help in addressing the need for help in this particular area and, of course, the need for mental health professionals in schools. This shortage of mental health counselors is a serious problem, not only in Utah but in schools across the Nation. It is a very, very serious problem.

In our December roundtable discussion, we learned that teen suicide is something schools, parents, and mental health professionals cannot address individually. Instead, a continuum of care must exist for each child from the first day of school to graduation. We must all work together to ensure that our children feel safe.

Educators play a vital role in maintaining an infrastructure of support for teenagers struggling with mental illness. Because educators are often the first to identify warning signs in vulnerable students, hundreds of teachers in Utah receive training in how to identify and respond to these signs. Once we know a teen is suffering, parents and mental health professionals can step in to provide ongoing care. Building community partnerships that involve everyone and that focus on evidence-based practices can save hundreds, if not thousands, of lives.

My main purpose in organizing the roundtable discussion was to find ways I could help prevent suicide on a national level. Increasing access to mental healthcare has been a fixture of my Senate service. Nearly 20 years ago, I convened the Senate Finance Committee's first hearing dedicated to mental health. More recently, I focused my legislative efforts on fighting prescription drug abuse, an epidemic that has only accelerated our Nation's mental health crisis. I played a leading role in passing the Comprehensive Addiction and Recovery Act and helped to draft the 21st Century Cures Act, which President Obama signed into law in December. Both bills take aim at the opioid epidemic that is ravaging entire communities across the Nation.

As a legislative body, we have set aside partisan differences in recent months to combat the opioid crisis as part of a broader effort to address growing rates of mental illness and death by suicide.

But there is more we can do to help. To begin, we need to provide better and more immediate access to counseling and mental health services. This is one of the main takeaways from last year's roundtable discussion. So often we hear that those seeking help are just one positive interaction away from giving life another chance. As Utah State Senator Daniel Thatcher said:

If you talk to someone, they live. If you connect them to

support, they live.

Laura Warburton, a Utah mother who lost her daughter to suicide, said that the day her daughter died, she had attempted to make one last call to her therapist and could not get through.

While this is a complex problem with no simple, immediate answer, there are steps we can take to help. Today, we are taking those critical first steps to prevent future tragedies from taking place.

In response to what I learned during the suicide roundtable in Utah, I have joined Senator Joe Donnelly in introducing the National Suicide Hotline Improvement Act, a bipartisan proposal that will make it easier for Americans of all ages to get the help and treatment they need when they are experiencing suicidal thoughts. The current suicide prevention lifeline system and veterans crisis line are in desperate need of reform. Our bill will require the Federal Communications Commission, in consultation with the Department of Health and Human Services and the Department of Veterans Affairs, to study the current national suicide hotline system and make recommendations to Congress on how we can improve it.

Across our great Nation, there are millions of people, especially young people, who are alone and suffering in the shadows of depression. Many of them are bombarded by suicidal thoughts and have no idea where to turn for help. To make matters worse, the national suicide hotline number, 1-800-273-TALK, is not an intuitive or easy number to remember, particularly for those experiencing a mental health emergency.

Fortunately, the success of the 911 emergency system provides a model for addressing this problem. My bill will require the Federal Communications Commission to recommend an easy-to-remember, three-digit number for the national suicide prevention hotline. I believe that by making the national suicide prevention lifeline system more user- friendly and accessible, we can save thousands of lives by helping people find the help they need when they need it most.

In introducing this legislation, I wish to thank my fellow Utahn, Congressman Chris Stewart. Congressman Stewart has been an invaluable partner in offering some of the most important measures of this bill. Additionally, I would like to thank the American Foundation for Suicide Prevention. I also wish to express my appreciation for the support we have received from the Utah State Legislature, Utah's attorney general, and the Utah Department of Health Services, as well as several groups from the law enforcement community.

This proposal transcends party lines and stands to save thousands of lives.

We cannot delay this effort to prevent suicide. So I call on my colleagues in both the House and the Senate to act quickly to pass this bill. Your support for this legislation represents your commitment to preventing future tragedies. I ask all of you today, regardless of your party affiliation, to cosponsor this legislation. In doing so, you can help us help those who need our help the most. There is absolutely no time to lose.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 3759) to provide for the establishment and maintenance of a Family Caregiving Strategy, and for other purposes, as amended.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and include extraneous material on H.R. 3759.

Mr. Speaker, I yield myself such time as I may consume.

I rise today in support of H.R. 3759, the Recognize, Assist, Include, Support, and Engage Family Caregivers Act of 2017, otherwise known as the RAISE Family Caregivers Act.

Mr. Speaker, not all Americans have the luxury of complete independence. They may struggle to dress themselves, manage their retirement, or take their medications adequately. When we think of these instances, we may think mostly of seniors, but that is not always the case. Veterans, Americans

with physical and mental disabilities, wounded warriors, and even children with medical conditions rely on a family caregiver to help them live their daily lives.

Though they may have physical or functional limitations or an illness or chronic health condition that impedes their ability to fully care for themselves, many are able to remain safe and comfortable in their homes due to the important role of the family caregiver.

Nationwide, there are roughly 40 million family caregivers who provide physical and emotional care for parents, spouses, children, and other loved ones in need of assistance. These caregivers are unsung heroes who devote both their time and resources to the day-to-day activities that are necessary to provide a disabled loved one with care.

These activities may be to drive their loved ones to doctor appointments, provide them with meals, assist in the management of their finances, and administer at-home nursing and care so that their loved ones may continue to live at home.

Taking on the role of a family caregiver is a deeply personal decision, characterized by selflessness and compassion for a relative in need. It is estimated that, on average, the Nation's caregivers dedicate about 18 hours each week to carrying out their caregiver tasks, while almost a third provide over 60 hours a week of care. These activities provide an annual economic value of $470 billion each year.

About 60 percent of caregivers have full- or part-time jobs in addition to their caregiving roles, leaving them to juggle their caregiving obligations with their work hours and their personal and family time.

The RAISE Family Caregivers Act will direct the Secretary of Health and Human Services to develop a Family Caregiving Advisory Council to make recommendations regarding best practices on recognizing and supporting family caregivers. The council will include members from the public and private sectors, family caregivers, elderly Americans and people living with disabilities, State and local officials, and healthcare providers. The Secretary will then publish the council's findings so that the family caregivers may be equipped with the information that they need to be successful in their roles.

The council will provide information about streamlining Federal and State activities to maximize efficiency, and it will preserve the integrity of family rights and person-centered care. This is an opportunity to help improve the quality of life of millions of Americans who both provide and receive familial care.

One important provision of the RAISE Family Caregivers Act ensures that the Secretary of Health and Human Services is prohibited from mandating best practices or expanding the Federal authority in any way.

Additionally, the bill does not authorize any additional funds for the formation of the council and, after 3 years, the council and its related activities will sunset.

The RAISE Family Caregivers Act is an important step we can take to recognize the essential role of family caregivers and share important information so that they can better care for others. This legislation fulfills a bipartisan recommendation of the Federal Commission on Long- Term Care. The Senate passed this bill earlier this year by unanimous consent, and the House of Representatives now has the opportunity to have this bill signed into law.

I urge my colleagues to support this bipartisan legislation so that family caregivers are recognized for the important role they play in our communities.

I reserve the balance of my time.

Mr. Speaker, I yield 3 minutes to the gentleman from Mississippi (Mr. Harper).

Mr. Speaker, I yield myself the remainder of my time.

Mr. Speaker, before I came to Congress in April, I served as the Kansas State treasurer. In that role, I had the opportunity to implement the ABLE Act, which was legislation that was passed here in the last few years.

Talking with a lot of parents, as they were abled and concerned about how do they care for their disabled children, led to the creation of the ABLE Act. During that process, we also talked with a lot of other caregivers who cared for maybe senior citizens, maybe adult children who were in their home, and wanted to make sure that that burden that they faced in providing that family care was ameliorated and supported in any way that it could be.

The RAISE Family Caregivers Act will help recognize the essential role of family caregivers and share important information so that they may better care for others.

This legislation fulfills a bipartisanship recommendation from the Commission on Long-Term Care, and I urge my colleagues to vote in favor of H.R. 3759.

Mr. Speaker, I yield back the balance of my time.

Mr. President, I rise today to introduce legislation with my colleague from Wisconsin, Senator Baldwin, that would require the Secretary of Health and Human Services to convene a panel to develop a national strategy to recognize and support the more than forty million family caregivers in the United States. I am pleased that Senators Murkowski and Bennet have joined us as cosponsors.

The United States' population is aging. Every day, 10,000 baby boomers turn 65 years old. Americans 85 and older--our oldest old--are the fastest growing segment of our population. This is the population that is most at risk of multiple and interacting health problems that can lead to disability and the need for round-the-clock care.

At the very time that our population is aging, birth rates are declining. While the need for care and support is increasing, the numbers of professional and informal caregivers is shrinking. In the future, more people will have to rely on fewer caregivers.

Families will likely continue to be the most important source of support for people with long-term care needs. We must do more to support the more than 43 million family caregivers in the United States who make remarkable sacrifices to care for their loved ones. While it is impossible to put a dollar amount to the value of the devotion, time, and services that these caregivers provide, it is estimated that in 2013 family caregivers provided $470 billion in uncompensated long- term care. This figure nearly equals the annual sales of the four largest United States tech companies combined.

Family caregivers provide tremendous value, and they also face many challenges. Caregivers experience high levels of stress and have a greater incidence of chronic conditions like heart disease, diabetes, and depression. Caregiving can be an isolating experience. Last week, the Aging Committee held a hearing highlighting that social isolation is a serious risk factor for depression, anxiety, dementia, functional decline, and even death.

The average caregiver is a 49-year-old woman. She is caring for a 69- year-old relative living with a long-term physical condition. That relative is often a parent. She has been providing care for four years on average, spending 24.4 hours a week. She may be raising her own children and working full time.

Other caregivers are seniors. One third of family caregivers are age 65 or older, and even more susceptible to putting their own health at risk.

I am, therefore, introducing legislation with my colleague from Wisconsin that would lead to the development of a national strategy to recognize and support family caregivers. Titled the Recognize, Assist, Include, Support, and Engage, or RAISE Family Caregivers Act, the legislation is based on a recommendation of the bipartisan Commission on Long Term Care. It is modeled after a law that I co-authored in 2010 with then-Senator Evan Bayh that created a coordinated strategic national plan to combat Alzheimer's disease.

The RAISE Family Caregivers Act directs the Secretary of Health and Human Services to establish a National Family Caregiving Project to develop and sustain a national strategy to support family caregivers. The bill would create a Family Caregiving Advisory Council comprised of relevant Federal agencies and non-federal members. It would include representatives of family caregivers, older adults with long-term care needs, individuals with disabilities, employers, health and social service providers, advocates for family caregivers, state and local officials, and others with expertise in family caregiving.

The Advisory Council would be charged with making recommendations to the Secretary. The strategy and plan would be updated to reflect new developments. The plan would include an initial inventory and assessment of federally funded caregiver efforts. It would then identify specific actions that government and communities could take to support family caregivers.

The Project would be funded from existing funding appropriated for the Department of Health and Human Services. No new funding is authorized and it would sunset in five years.

Family caregivers are an invaluable resource to our aging society. Chances are that, sooner or later, we will all either be family caregivers or someone who needs one. The RAISE Family Caregivers Act will launch a coordinated, national strategic plan that will help us to leverage our resources, promote innovation and promising practices, and provide our nation's family caregivers with much-needed recognition and support. Our bipartisan legislation is widely endorsed by aging and disability organizations. I urge all of our colleagues to join as cosponsors.

Mr. President, I rise today to introduce legislation with my colleague from Wisconsin, Senator Baldwin, that would require the Secretary of Health and Human Services to convene a panel to develop a national strategy to recognize and support the more than forty million family caregivers in the United States. I am pleased that Senators Murkowski and Bennet have joined us as cosponsors.

The United States' population is aging. Every day, 10,000 baby boomers turn 65 years old. Americans 85 and older--our oldest old--are the fastest growing segment of our population. This is the population that is most at risk of multiple and interacting health problems that can lead to disability and the need for round-the-clock care.

At the very time that our population is aging, birth rates are declining. While the need for care and support is increasing, the numbers of professional and informal caregivers is shrinking. In the future, more people will have to rely on fewer caregivers.

Families will likely continue to be the most important source of support for people with long-term care needs. We must do more to support the more than 43 million family caregivers in the United States who make remarkable sacrifices to care for their loved ones. While it is impossible to put a dollar amount to the value of the devotion, time, and services that these caregivers provide, it is estimated that in 2013 family caregivers provided $470 billion in uncompensated long- term care. This figure nearly equals the annual sales of the four largest United States tech companies combined.

Family caregivers provide tremendous value, and they also face many challenges. Caregivers experience high levels of stress and have a greater incidence of chronic conditions like heart disease, diabetes, and depression. Caregiving can be an isolating experience. Last week, the Aging Committee held a hearing highlighting that social isolation is a serious risk factor for depression, anxiety, dementia, functional decline, and even death.

The average caregiver is a 49-year-old woman. She is caring for a 69- year-old relative living with a long-term physical condition. That relative is often a parent. She has been providing care for four years on average, spending 24.4 hours a week. She may be raising her own children and working full time.

Other caregivers are seniors. One third of family caregivers are age 65 or older, and even more susceptible to putting their own health at risk.

I am, therefore, introducing legislation with my colleague from Wisconsin that would lead to the development of a national strategy to recognize and support family caregivers. Titled the Recognize, Assist, Include, Support, and Engage, or RAISE Family Caregivers Act, the legislation is based on a recommendation of the bipartisan Commission on Long Term Care. It is modeled after a law that I co-authored in 2010 with then-Senator Evan Bayh that created a coordinated strategic national plan to combat Alzheimer's disease.

The RAISE Family Caregivers Act directs the Secretary of Health and Human Services to establish a National Family Caregiving Project to develop and sustain a national strategy to support family caregivers. The bill would create a Family Caregiving Advisory Council comprised of relevant Federal agencies and non-federal members. It would include representatives of family caregivers, older adults with long-term care needs, individuals with disabilities, employers, health and social service providers, advocates for family caregivers, state and local officials, and others with expertise in family caregiving.

The Advisory Council would be charged with making recommendations to the Secretary. The strategy and plan would be updated to reflect new developments. The plan would include an initial inventory and assessment of federally funded caregiver efforts. It would then identify specific actions that government and communities could take to support family caregivers.

The Project would be funded from existing funding appropriated for the Department of Health and Human Services. No new funding is authorized and it would sunset in five years.

Family caregivers are an invaluable resource to our aging society. Chances are that, sooner or later, we will all either be family caregivers or someone who needs one. The RAISE Family Caregivers Act will launch a coordinated, national strategic plan that will help us to leverage our resources, promote innovation and promising practices, and provide our nation's family caregivers with much-needed recognition and support. Our bipartisan legislation is widely endorsed by aging and disability organizations. I urge all of our colleagues to join as cosponsors.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I join my colleague from Kansas (Mr. Estes) today and rise in support of H.R. 3759, the Recognize, Assist, Include, Support, and Engage Family Caregivers Act. I want to congratulate all the cosponsors of this bill for their good work in terms of bringing this forward, and, again, it looks very promising that it will be passed and signed into law shortly.

Mr. Speaker, the number of Americans over the age of 65 is expected to reach 70 million by 2030, roughly doubling the number that existed in 2005. As those Americans age and require assistance with their daily routines--taking medication, getting dressed, cooking, and attending medical appointments--family caregivers will step in to make sure that their loved ones are safe and cared for.

This is difficult work. For an adult child, caring for an aging parent can quickly become a full-time job. Between juggling appointments, understanding medications, helping make informed medical decisions, a caregiver's own priorities can take a backseat. Most caregivers have jobs of their own, and many care simultaneously for an aging parent as well as their own children.

But caregivers are not only providing care for older Americans or even younger Americans with developmental disabilities. They also serve those who have served our country.

I recently met with a caregiver from my district, Jessica, who cares for her husband, a veteran who suffered serious traumatic brain injury during the battle of Fallujah. Her experience managing her husband's complex medical needs while also raising their children goes to show that ensuring caregivers are supported is a national priority.

The bill under consideration today would recognize the contribution that family caregivers make toward the safety and health of older Americans. It would require the Secretary of Health and Human Services to develop and maintain a strategy to support family caregivers by establishing an advisory body to bring together caregivers, older adults, persons with disabilities, veterans, employers, and State and local officials. This advisory council would make recommendations for how to support, assist, and engage family caregivers.

Caregivers are needed to help Americans live independently in their homes and communities for as long as possible. In my home State of Connecticut, there are 459,000 family caregivers who provide an estimated $5.9 billion in unpaid care, annually. Supporting older and disabled Americans through caregiving and ensuring caregivers are equipped to take on this important role benefits all Americans. Evidence has shown that, when caregivers are supported, patients delay placement in a nursing home, continuing with lower-cost, long-term support in the home for much longer periods of time.

Caregiving is foundational to our long-term care system in the United States. This legislation is an important step to ensure this work is recognized and supported.

Again, as the gentleman pointed out, the Commission on Long-Term Care, which was actually created by this body in 2012 as part of one of the budget bills that passed that year, was a group of stakeholders from all across the country, in various sectors, that came together and issued a report that, unfortunately, I don't think has gotten the focus and attention it needs with the demographics that our country is experiencing right now: the aging of our society.

However, this is one of those recommendations for which signs of intelligent life appeared in Congress, and we are taking up their call for passing legislation like the RAISE Act.

So again, I want to congratulate all the sponsors for coming together, and I am looking forward to sending this bill to the President for his signature.

I reserve the balance of my time.

Mr. Speaker, I yield such time as she may consume to the gentlewoman from Florida (Ms. Castor), a cosponsor of the bill, a former member of the Education and the Workforce Committee; and even though she has migrated to other committees, her heart still is with the mission of the Education and the Workforce Committee, which is obviously shown by her cosponsorship of this legislation.

Mr. Speaker, I want to congratulate the sponsors of this legislation and also just note that the Elizabeth Dole Foundation is a strong supporter. This is a group that has been formed to help wounded warriors in terms of getting the caregiving help that they need from other family members who are sometimes overlooked in terms of our country's appreciation for those who wear the uniform of this country.

Mr. Speaker, I call for support for the bill, and I yield back the balance of my time.