SPECIAL ARTICLE
Creating A Nationwide Nonpartisan Initiative for Family
Caregivers in Political Party Platforms
Ben Scribner, MSN,* Joanne Lynn, MD,* Victoria Walker, MD,† Les Morgan,*
Anne Montgomery, MS,* Elizabeth Blair, MPP,* Davis Baird, MSG,*‡ Barbara Goldschmidt, BA,§
and Naomi Kirschenbaum, MPH¶
Policymakers have been slow to support family caregivers,
and political agendas mostly fail to address the cost burdens, impact on employment and productivity, and other
challenges in taking on long-term care tasks. This project
set out to raise policymakers’ awareness of family caregivers through proposals to Republican and Democratic
party platforms during the 2016 political season. The Family Caregiver Platform Project (FCPP) reviewed the state
party platform submission process for Democratic and
Republican parties in all 50 states and the District of
Columbia. We built a website to make each process understandable by caregiver advocates. We designed model submissions to help volunteers tailor a proposal and recruited
caregiver advocates participating in their state process.
Finally, we mobilized a ground operation in many states
and followed the progress of submissions in each state, as
well as the formation of the national platforms. In 39
states, at least one party, Republican or Democrat, hosted
a state party platform process. As of September 2016
FCPP volunteers submitted proposals to 29 state parties in
22 states. Family caregiver language was added to eight
state party platforms, one state party resolution, two
bipartisan legislative resolutions, and one national party
platform. The FCPP generated a non-partisan grassroots
effort to educate and motivate policymakers to address
caregiving issues and solutions. Democratic party leaders
provided more opportunities to connect with political leaders, with seven Democratic parties and one Republican
party, addressing family caregiver issues in their party platforms. J Am Geriatr Soc 2017.
From the *Center for Elder Care and Advanced Illness, Altarum Institute,
Washington, District of Columbia; †The Evangelical Lutheran Good
Samaritan Society, Sioux Falls, SD, District of Columbia; ‡National
Association of Area Agencies on Aging, Washington, District of
Columbia; §Volunteer, Teaneck, New Jersey; and ¶Volunteer, Watsonville,
California.
Address correspondence to Ben Scribner, Center for Elder Care and
Advanced Illness, Altarum Institute, 625 Scott St. Apt. #403 San
Francisco, CA 94117. E-mail: [email protected]
DOI: 10.1111/jgs.14814
JAGS 2017
© 2017, Copyright the Authors
Journal compilation © 2017, The American Geriatrics Society
Key words: caregiving;
policy
political
platforms;
aging;
I
n 2014, Americans relied on 43.5 million family caregivers to provide the daily personal care needed by those
who are ill, disabled, elderly, or frail.1 A 2016 report estimated that at least 17.7 million individuals in the United
States are family caregivers of someone 65 years or older
that has a significant impairment.2 These women and men
are called on to help with tasks of daily living; to manage
medications and medical appointments; and to perform
increasingly sophisticated medical tasks that used to be
done only by nurses and physicians in hospitals. Family
caregivers are essential to providing care for our frail
elders, but the demographic shift caused by the aging of
the large baby boomer population has challenged the sustainability of adequate care for the aging population. By
2060, the number of adults over 65 will more than double
from 46 million to over 98 million, and the number of
adults over 85 will more than triple, increasing from about
6 million currently to 19 million.3 AARP estimates that
the unpaid help family caregivers provide is worth $470
billion a year, assuming a near-minimum wage.4 The ratio
of available family caregivers to older adults who will need
care is projected to decrease rapidly as members of the
Boomer generation reach their 80s, the years when they
are likely to become frail.5
Federal policy has dodged the issue of long-term care
for decades. The Community Living Assistance Services and
Supports Act (CLASS Act) was originally enacted as a voluntary, public long-term care insurance option in the
Affordable Care Act. In 2013 it was repealed as not being
feasible. Funding for community-based services like homedelivered meals and disability-adapted transportation has
not risen with the increasing numbers of older people.6 The
2016 presidential election created an opportunity for Democratic and Republican candidates to address critical issues
like this that our nation will face in the coming years.
0002-8614/17/$15.00
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Clearly, the millions of Americans, past, present, and
future, who will be providing care for frail and disabled
adults could be a sizeable constituency with political influence if its members mobilized. State political party platforms are declarations of what matters to people in that
state party, letting voters know what general policies the
party supports. State platforms are often developed using
an inclusive and open process, providing family caregivers
an opportunity to introduce caregiving needs into policy
discussions. Whether or not a new platform position is created, the process draws attention to a topic that is salient
for our nation’s long-term care system. Discussions and
platform issues at the state level go forward to the national
level during the build-up to the national elections. This
project aimed to push eldercare issues onto policymakers’
agendas by helping family caregivers generate discussions
in the state party platform process in both parties in as
many states as possible. With this project, we aimed to
draw substantially more policymaker attention to the issue
of family caregiving.
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(http://www.caregivercorps.org) to make each platform
process understandable to caregiver advocates who wanted
to participate. We created a web page for each state which
outlined the key dates and contacts for both Democratic
and Republican state parties. While some parties actively
sought public input, other parties did not welcome public
contributions. For the parties that accepted public input,
we provided details of what we had learned about the
platform submission process.
Construct Model Caregiver Submission Language
In order to assist volunteers with a submission, we created
examples of possible planks. We provided a menu of nonpartisan policy options and encouraged volunteers to place
emphasis on issues they felt would resonate in their state
and to speak from their personal caregiving experience.
The planks were housed as downloadable content on the
website. The templates included a master list of suggested
platform planks, model language for a state resolution,
and model language for a state platform committee memo.
METHODS
Outreach to Recruit Volunteers
Describe the Platform Process for Each State and Party
We searched the Internet to find basic contact information
for state parties. We followed this initial search with a
phone call to states’ Republican and Democratic party headquarters to inquire about participation in the platform process. Most often, party staff members were unable to give
specifics about participation but did connect us with wellinformed party leaders who could provide better assistance.
The construction of a state party platform mostly follows two processes. Many state parties form “platform
committees,” which are in charge of drafting the state
party platform. In these states, the project contacted members of the platform committee who could provide the
most reliable information regarding the construction of the
state party platform. If a party did not convene a platform
committee, a high-ranking party official (party chair, executive director, or communications director) provided us
with more detail on the process.
Our research found that, in addition to forming platforms, state parties also adopt resolutions, which are onetime statements of position, often beginning with a list of
crucial facts calling attention to the problem and concluding with a policy response that the party supports. In contrast, a platform plank is usually only a few sentences
communicating the support from the party, but lacking the
context and justification for the issue. Party resolutions
can happen on a yearly or ad hoc basis, rather than tied to
an election season. In addition to party resolutions, state
legislatures may adopt legislative resolutions, which can
have bipartisan support. Resolutions may or may not be
presented and adopted by the party in similar fashion to a
platform plank. In some cases, any state citizen can initiate
work on a resolution and the fate of the proposal is determined by platform or resolution committee vote. This procedure became another opportunity to get political leaders
to discuss family caregiving.
After compiling information about the platform process for both parties in every state, we built a website
State party leaders want to address issues that are important to the residents of the state. Thus, a submission from
a state resident can be considerably more powerful than a
submission from an advocacy organization. Though we
identified the platform submission process for each state
party, we needed to rally caregiver advocates from each
state to present submissions and encourage state political
leaders to include that language in the platform.
The project used several methods to develop a network of volunteers to submit proposals. We formed partnerships with fourteen national caregiving and aging
advocacy organizations, and each used their communication devices to contact their members. The partnerships
gave credibility to our project, provided technical consulting, provided a membership audience, and delivered volunteers on the ground to influence state party platforms. The
partners wrote articles in their newsletters and tweeted
about our project, creating awareness for our project with
their membership. Some national partners had policy staff
in place to share expertise and provide us with advice. In
addition, we sent out a monthly newsletter by electronic
mail to followers who signed up through our website,
summarizing our work from the prior month and updating
subscribers on the action items for the upcoming month.
We contacted colleagues in states where parties formed
platforms and used opportunities at conferences and meetings to network and promote the project. Finally, we used
a Twitter account for social media interaction. A paid
Twitter advertising campaign to find specific state residents
who could be interested in participating in the platform
process sent state-specific tweets making 388,000 impressions and 2,640 engagements. Interested advocates connected with the project through direct Twitter messaging
or email to learn how to submit a platform suggestion to
political parties in their state.
The project used several low-cost cloud-based information systems to organize our outreach and to prioritize
tasks between staff members within the team. The
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2017
project’s core staff was led by a national coordinator
(VW) who oversaw the project’s daily operations. In addition, a ground operations coordinator (LM) provided
political direction and implemented several low-cost technologies that the ground team used to keep track of our
progress within each state. We used WordPress for website
management, Zoho CRM for contact management, Constant Contact for mailing list management, Google Fusion
Tables for project data management, and Google Hangouts for team videoconferencing. The project team also
included two staff members (AM, JL), two volunteers (BG,
NK), and two summer interns (BS, DB). The team aggregated roughly 500 paid hours in this project.
RESULTS
State Submissions
In 2016, there were 12 states in which neither the Democratic nor Republican parties formed platforms, and 32
state parties that adopted the national platform rather than
forming their own. We focused our efforts on the 38 states
in which at least one of the parties formed a state platform. By July 2016 when the national parties held their
conventions, the project had submitted proposals to 29
state parties in 22 states (Table 1).
We identified three specific methods by which state
parties accept new proposals for their platform: (1) “Bubble-Up” Process, (2) Direct Submission, or (3) Live Testimony (Table 2). Eighteen state parties received input via
direct submission, four state parties received input via live
testimony at formal party hearings, and seven state parties
received input via the “bubble-up” process.
Twenty-three submissions were made for state party
platforms, four submissions were made for state party resolutions, and two legislative bipartisan resolutions were
developed within state legislatures (Figure 1). The project
succeeded in getting caregiving language adopted as an
official state resolution or in state party platforms in eleven states: Arizona Democratic Platform, California
Democratic Platform, Indiana Democratic Platform, Iowa
Democratic Platform, Maine Democratic Platform, Michigan Democratic Platform, South Carolina Republican Platform, Mississippi Bi-Partisan Resolution, Oregon
Democratic Resolution, South Dakota Bi-Partisan Resolution, and Washington Democratic Platform. In Mississippi
and South Dakota, caregiving language was submitted to
the state legislatures and passed with unanimous bipartisan
support, showing the broad appeal of the issue when
framed in a collaborative manner. The Oregon Democrats
passed a family caregiving resolution.
Some submissions may have been made by volunteers
directly to state parties without our knowledge. Most of
our proposals (18/29) were submitted directly by volunteers, while (11/29) were submitted as part of testimony or
during local meetings. Six of the 11 live testimony or
“bubble-up” submissions resulted in the party adding family caregiving language to their party’s resolution or platform, while only five of the 17 direct submissions resulted
in language added to their party’s resolution or platform.
Roughly one-third (10/29) of the submissions were
made to state Republican parties. Recruited volunteers
FAMILY CAREGIVERS IN PARTY PLATFORMS
3
Table 1. Submissions by State
2016 Platform and
Resolution
Submissions
Submission
Type
Arizona Democrats
Arkansas Republicans
California Democrats
California Republicans
Colorado Democrats
Illinois Republicans
Indiana Democrats
Platform
Platform
Platform
Platform
Platform
Platform
Platform
Iowa Democrats
Iowa Republicans
Maine Democrats
Maine Republicans
Michigan Democrats
Platform
Platform
Platform
Platform
Platform
Minnesota Democrats
Minnesota Republicans
Mississippi Bi-Partisan
Policy Development
Process (and if
adopted)
Platform
Platform
Platform
Platform
Testimony (adopted)
Direct Submission
Testimony (adopted)
Direct Submission
Direct Submission
Direct Submission
Direct Submission
(adopted)
Bubble – Up (adopted)
Bubble – Up
Testimony (adopted)
Direct Submission
Direct Submission
(adopted)
Bubble – Up
Bubble – Up
Direct Submission
(adopted)
Direct Submission
Direct Submission
Direct Submission
Testimony
Resolution
Platform
Resolution
Platform
Direct Submission
Bubble – Up
Bubble – Up (adopted)
Bubble – Up (adopted)
Resolution
Direct Submission
(adopted)
Direct Submission
Direct Submission
Direct Submission
Direct Submission
Direct Submission
(adopted)
Resolution
Resolution
Resolution
Mississippi Democrats
Nebraska Democrats
Nebraska Republicans
New Hampshire
Democrats
New Mexico Democrats
Nevada Democrats
Oregon Democrats
South Carolina
Republicans
South Dakota Bi-Partisan
South Dakota Democrats
Texas Democrats
Vermont Democrats
Virginia Democrats
Washington Democrats
Platform
Platform
Platform
Platform
Platform
had better connections to state Democratic parties, and
fewer state Republican parties offered opportunities for
volunteers to participate in their platform process. Of
the 51 state Republican party possibilities (including the
District of Columbia), Republicans offered a way for
state citizens to engage in the platform process in 31
states, while Democrats offered this in 37 states. The 21
Republican jurisdictions that did not undertake a state
party platform process in the run-up to the 2016 election referred volunteers to the Republican party’s
national platform, suggesting that state Republican
parties may place greater emphasis on the national
platform.
In 2016, 75 of the 102 state parties (including District
of Columbia) approved platforms prior to the Democratic
and Republican national conventions. The FCPP project
concluded the 2016 political season with submissions to
Democratic and Republican national platforms. The Leadership Council of Aging Organizations, unifying a joint
effort of 72 non-profit national organizations, including
the FCPP, made these submissions. In the final version of
their national platform, the Republicans highlighted
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Table 2. Submission Process
Direct Submission
Bubble – Up
This process starts with a written proposal,
submitted as directed by the party Platform
Committee. Often, the party does not have a
published protocol for making a written
submission, but most frequently done by a web
form or via email. If the party only accepts
input via a web form, the details of the
submission are determined by the web form.
The platform suggestions are submitted directly
to the party by a specific date. The party
collects proposals, reviews them, and the
platform committee votes on approval at the
state convention.
Residents participate by appearing at local
caucuses and party meetings to submit
platform suggestions through public comment
or by handing in written proposals. Platform
proposals are discussed and voted for approval
at local (precinct, district or county) meetings.
If passed, proposals are forwarded to higher
levels in the state party for final consideration.
Testimony
Participants attend platform committee
meetings or other public input sessions to
present a platform proposal. This is an
opportunity for platform committee members
to ask questions about the proposal and
engage with state citizens in forming the
platform.
Figure 1. Submission map.
“homecare as a priority in public policy,”7 while the
Democrats included a sub-section titled Supporting Working Families, specifically calling for various policies to support family caregivers.8
Effective Caregiver Submission Language
Tailoring the language of a submission to match a particular volunteer’s experience to their party’s beliefs and values
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was instrumental in having a proposal accepted by a party.
Because most state parties only accepted submissions from
state citizens registered in that party, the project encouraged local volunteers to make submissions. This dynamic
underscored the importance of empowering advocates with
information on how to make a submission and versatile
platform language that readily fit a variety of platform formats. Below are some of the planks volunteers selected
most often. A full list of recommended planks can be
found online (https://www.caregivercorps.org/planks).
• Recognize and address the financial burden of caregiving and work to protect families and adult children
from impoverishment at all levels of care.
• Encourage employers to establish policies that recognize
the impact that caregiving can have on workers, and
encourage employers to find ways to support their
workers during difficult family times.
• Support recognizing the economic value of family caregiving and, as appropriate, compensation of that value
through tax credits or other means.
Volunteers
Once we attracted a volunteer, we needed to assist volunteers to connect with state leaders who were influential in
forming the platform. We urged volunteers to join our
Google Hangouts, the platform used for team meetings, or
to connect with us through email to help craft a platform
proposal. Roughly 100 volunteers were able to commit
personal time to work with political leaders to determine
the additional details of the state platform process and
make a submission. The volunteers became part of the
team as we built relationships and learned about the personal stories of caregiver advocates and they made submissions to state parties.
DISCUSSION
The FCPP was able to recruit and train caregiver advocates
throughout the country to connect with their state political
leaders and help raise awareness about policy actions that
can aid family caregivers. The project managed 29 submissions that contributed to eight state party platforms, one
state party resolution, and two state legislative resolutions.
The national party platforms took up the issues, with the
Democrats giving substantial policy attention.
Several limitations circumscribed our ability to connect with political leaders from all states. Republican
and Democratic parties in eleven states do not form
state party platforms: Alabama, Connecticut, Florida,
Kentucky, Louisiana, Maryland, New Jersey, New York,
Ohio, Pennsylvania, and Tennessee. Some state parties
form platforms in non-presidential election years: Massachusetts Democratic Party (2017), Massachusetts
Republican Party (2018), Connecticut Democratic Party
(2018), and Oklahoma Democratic Party (2018). Some
additional submissions may have been made without our
help and some submissions may have been made after
September 20, 2016, the cut-off date for this article.
Some of the rise in attention to caregiving is from other
sources, so this project is not the sole force that led to
FAMILY CAREGIVERS IN PARTY PLATFORMS
5
these results. The project was also limited in relying
solely on state volunteers to control and motivate the
process. Recruited volunteers were variably effective, and
we were sometimes challenged to maintain consistent
communication with volunteers on the status of their
work within a given state.
When caregiver advocates personally connected with
state party leaders, the likelihood that the party would
include family caregiver language in a state party platform
or resolution improved substantially. Live testimony and
“bubble-up” submissions allowed state advocates to
appear at local party meetings to introduce issues that are
important to the community. In contrast, a written direct
submission did not allow advocates to meet state political
leaders in person. As a result, the percentage of accepted
direct submission proposals was very low. State volunteers
who could commit significant time to the project (i.e.,
showing up at party meetings) were highly valuable and,
when given the opportunity, were very successful in highlighting the importance of family caregivers to the care of
aged and disabled family members.
Party platforms represent a useful avenue for advocates
to highlight the need to support care for frail and ill loved
ones. While the FCPP is a solid start in shining a light on the
need to build out a much more robust agenda for support in
an aging society, further action is needed for large-scale
political change. Getting issues into policy discussions raises
public awareness, but only legislation and regulation can
actually change the policies that determine how adequately
family caregivers will be supported to continue, in turn,
playing an effective role in long-term support of tens of millions of Americans who need frequent or daily assistance.
The FCPP did not aim for legislation; rather, we
aimed to get a large number of political leaders aware of
the facts and considering these issues as suitable for policy
approaches. Political platforms are a leading indicator of
issues that might see implementation in legislation, but the
movement from general ideas to specific laws can be quite
indirect. Political party platforms have different ways to
define the party’s values, using a variety of formats, levels
of detail, and time horizons. Due to the lack of consistency
within state party platform processes, the FCPP aimed to
raise general awareness of family caregiving issues rather
than lobbying for specific legislative positions.
This largely volunteer project shows that citizens,
when given the opportunity to personally introduce family
caregiving issues to state politicians, are effective in creating political awareness and a baseline of support. The project demonstrated that, with careful organization, a
nationwide ground operation could use volunteer advocacy
to bring elder care issues to the attention of policymakers.
ACKNOWLEDGMENTS
Conflict of Interest: The authors declare that there is no
conflict of interest.
Author’s Contribution: BS contributed to acquisition
of data, analysis, and interpretation of data; and drafting
and revising the manuscript for critically important intellectual content. JL contributed to the concept and design,
analysis and interpretation of data, and revising the manuscript for critically important intellectual content. VW
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SCRIBNER ET AL.
contributed to acquisition of data, analysis and interpretation of data, and revising the manuscript for critically
important intellectual content. LM contributed to concept
and design, acquisition of data, analysis and interpretation
of data, and revising the manuscript for critically important intellectual content. AM contributed to the concept
and design and revising the manuscript for critically
important intellectual content. EB contributed to acquisition of data and revising the manuscript for critically
important intellectual content. DB contributed to acquisition of data, analysis and interpretation of data, and revising the manuscript for critically important intellectual
content. BG contributed to acquisition of data, analysis
and interpretation of data, and revising the manuscript for
critically important intellectual content. NK contributed to
acquisition of data and revising the manuscript for critically important intellectual content. All authors approve
the final version to be published.
Funding Sources: The Family Caregiver Platform Project was supported by a grant by the Stern Family Foundation to the Center for Elder Care and Advanced Illness at
the Altarum Institute. This project was also made possible
through the Health and Aging Policy Fellows program,
through the generous support of Atlantic Philanthropies
and the John A. Hartford Foundation.
Sponsor’s Role: This project was made possible by the
collective efforts of volunteers from all walks of life across
the United States. The work at Altarum Institute was generously supported by the Lawrence and Rebecca Stern
Family Foundation who believed that family caregivers
could be effective in the public policy domain through the
power of connecting everyday people with practical tools.
The project lead, Victoria Walker, was a Health and Aging
Policy Fellow, in the program sponsored by Atlantic Philanthropies, under the direction of Harold Pincus, MD.
The graduate student interns, Ben Scribner and Davis
Baird, started this work as part of their National Academy
of Social Insurance Summer Internship Program. The Project had fourteen national partner organizations that were
immensely helpful in connecting the project with caregiver
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advocates across the county. AMDA – The Society for
Post-Acute and Long-Term Care Medicine. ARCH
National Respite Coalition. Caregiver Voices United, a
501c4 allied with Caregiver Action Network. Caring
Across Generations. Community Catalyst. The Evangelical
Lutheran Good Samaritan Society. Family Caregiver Alliance. The John A. Hartford Foundation. Justice in Aging.
LeadingAge. National Alliance for Caregiving. National
Coalition on Care Coordination. National Council on
Aging.
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~/media/Files/Report%20Files/2016/Caregiving-RiB.pdf. Accessed November
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7. The Republican Party (online). Republican Platform 2016. 2016. Available
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