[Senate Hearing 117-309]
[From the U.S. Government Publishing Office]


                                                     S. Hrg. 117-309

                       STRENGTHENING SUPPORT FOR
                        GRANDFAMILIES DURING THE
                      COVID-19 PANDEMIC AND BEYOND

=======================================================================

                                HEARING

                               BEFORE THE

                       SPECIAL COMMITTEE ON AGING

                          UNITED STATES SENATE

                    ONE HUNDRED SEVENTEENTH CONGRESS


                             SECOND SESSION

                               __________

                             WASHINGTON, DC

                               __________

                             JUNE 23, 2022

                               __________

                           Serial No. 117-18

         Printed for the use of the Special Committee on Aging

[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

        Available via the World Wide Web: http://www.govinfo.gov

                                __________

                    U.S. GOVERNMENT PUBLISHING OFFICE                    
48-016 PDF                 WASHINGTON : 2022                     
          
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                       SPECIAL COMMITTEE ON AGING

              ROBERT P. CASEY, JR., Pennsylvania, Chairman

KIRSTEN E. GILLIBRAND, New York      TIM SCOTT, South Carolina
RICHARD BLUMENTHAL, Connecticut      SUSAN M. COLLINS, Maine
ELIZABETH WARREN, Massachusetts      RICHARD BURR, North Carolina
JACKY ROSEN, Nevada                  MARCO RUBIO, Florida
MARK KELLY, Arizona                  MIKE BRAUN, Indiana
RAPHAEL WARNOCK, Georgia             RICK SCOTT, Florida
                                     MIKE LEE, Utah
                              ----------                              
                 Stacy Sanders, Majority Staff Director
                 Neri Martinez, Minority Staff Director
                         
                         
                         C  O  N  T  E  N  T  S

                              ----------                              

                                                                   Page

Opening Statement of Senator Robert P. Casey, Jr., Chairman......     1
Opening Statement of Senator Tim Scott, Ranking Member...........     3

                           PANEL OF WITNESSES

Donna Butts, Executive Director, Generations United, Washington, 
  D.C............................................................     5
Kim Clifton, M.S.W., Executive Director, Helping and Lending 
  Outreach Support (HALOS), North Charleston, South Carolina.....     7
Gail Engel, (accompanied by grandson Bryson Engel) Grandparent 
  Caregiver, Founder and Executive Director, Grand Family 
  Coalition, Loveland, Colorado..................................     9
Ruth Stevens, (accompanied by grandson Tamir Mills) Grandmother, 
  Philadelphia, Pennsylvania.....................................    10

                           CLOSING STATEMENTS

Closing Statement of Senator Robert P. Casey, Jr., Chairman......    25
Closing Statement of Senator Tim Scott, Ranking Member...........    25

                                APPENDIX
                      Prepared Witness Statements

Donna Butts, Executive Director, Generations United, Washington, 
  D.C............................................................    31
Kim Clifton, M.S.W., Executive Director, Helping and Lending 
  Outreach Support (HALOS), North Charleston, South Carolina.....    41
Gail Engel, (accompanied by grandson Bryson Engel) Grandparent 
  Caregiver, Founder and Executive Director, Grand Family 
  Coalition, Loveland, Colorado..................................    45
Ruth Stevens, (accompanied by grandson Tamir Mills) Grandmother, 
  Philadelphia, Pennsylvania.....................................    47

                        Questions for the Record

Kim Clifton, M.S.W., Executive Director, Helping and Lending 
  Outreach Support (HALOS), North Charleston, South Carolina.....    51
Gail Engel, (accompanied by grandson Bryson Engel) Grandparent 
  Caregiver, Founder and Executive Director, Grand Family 
  Coalition, Loveland, Colorado..................................    53

 
                       STRENGTHENING SUPPORT FOR
                        GRANDFAMILIES DURING THE
                      COVID-19 PANDEMIC AND BEYOND

                              ----------                              


                        THURSDAY, JUNE 23, 2022

                                       U.S. Senate,
                                Special Committee on Aging,
                                                    Washington, DC.
    The Committee met, pursuant to notice, at 10:01 a.m., via 
Webex, Room 562, Dirksen Senate Office Building, Hon. Robert P. 
Casey, Jr., Chairman of the Committee, presiding.
    Present: Senators Casey, Gillibrand, Blumenthal, Rosen, 
Kelly, Warnock, Tim Scott, Braun, and Rick Scott.

                 OPENING STATEMENT OF SENATOR 
                 ROBERT P. CASEY, JR., CHAIRMAN

    The Chairman. This Aging Committee hearing will come to 
order.
    I want to thank everyone for being here today, especially 
our witnesses, and to see our witnesses here in front of us 
live is something we have not been able to do every week and 
every month, so we are grateful to be in the same room together 
with you today.
    I want to start with a statistic that I think a lot of 
Americans may be familiar with, either personally or from 
having seen some of the data, but we know that more than 2.7 
million children in America are being raised by grandparents or 
next of kin. They are among our Nation's unsung heroes. They 
are, in so many ways, a light in the darkness. They have made 
sure that their grandchildren are both loved and supported even 
in the most trying of circumstances, and of course, COVID-19 
has been among the most difficult chapters in American history.
    For so many American families, this pandemic has been among 
the most darkest and trying of times. As we will hear today in 
our hearing, grandparents who are raising their grandchildren 
have become increasingly isolated throughout the pandemic. 
Grandchildren lived in fear that they might contract the virus 
and spread it to aging grandparents, and tragically, at least 
140,000 children--140,000 children--were orphaned by the 
pandemic and are now living with grandparents or next of kin as 
a result. Sadly, this staggering number is almost surely an 
undercount.
    The American Rescue Plan invested $30 million to increase 
mental health awareness among young people, including members 
of grandfamilies. Those dollars also were used to train school 
personnel to respond to these types of concerns.
    Thankfully, grandfamilies are a topic of longstanding 
bipartisan interest in this Committee, as well as action by 
this Committee, and we will continue that tradition with 
today's hearing and the policy we will talk about.
    In 2018, Senator Collins, she was then the Chair of the 
Committee. She and I worked to pass legislation to establish a 
national advisory council to support grandfamilies and kin 
caregivers. We will build on this legacy by introducing the 
Supporting the Well-Being and Mental Health of Grandfamilies 
Act to extend the advisory council for an additional four 
years. This council has been successful because it incorporates 
the voices of grandparents, grandfamilies in its membership and 
its mission.
    At today's hearing, the Committee will have an opportunity 
to hear from two grandparents: Ms. Ruth Stevens from 
Philadelphia, Pennsylvania, and also Ms. Gail Engel from the 
State of Colorado.
    Now like so many in this room and others listening, I have 
got a grandson, and I have got a grandchild on the way in July, 
so I know what I would do, and what I would do is anything to 
support him if that were--if his parents could not, and I know 
every grandparent has that same feeling of love and that same 
feeling of commitment to their grandchildren.
    Both Ruth Stevens and Gail Engel will share the blessings 
and the challenges they have experienced in raising their 
grandchildren, in this case, Tamir and Bryson, who are both 
with us today.
    Ms. Stevens fought to bring her grandson home after he was 
placed in foster care without her knowledge. Families like hers 
save taxpayers an estimated $4 billion each year in costs. 
Approximately one in five grandfamilies live at or below the 
Federal poverty line, and nearly half--half--of all grandmother 
only households are living in poverty. That is unacceptable and 
should be unacceptable to any member of the U.S. Congress.
    I have fought a lot of battles to strengthen support for 
these families. Today, I am reintroducing the Grandfamilies 
Act, which will lower costs for grandfamilies by increasing 
access to both Social Security and Temporary Assistance for 
Needy Families support. Those benefits, I should say.
    I am also reintroducing the bipartisan Informing 
Grandfamilies Act, that is, Senate Bill 4443, alongside Senator 
Young, to ensure that TANF-eligible, Temporary Assistance for 
Needy Families eligible, grandfamilies are aware of and can 
access all of the benefits for which they qualify. I want to 
thank Ranking Member Scott for his support on this bill, as 
well as Senator Kelly, a member of our Committee, for both 
supporting this bill.
    Tim, thank you for that.
    Senator Tim Scott. Certainly.
    The Chairman. I look forward to today's hearing and our 
witnesses and their stories and their experiences about what 
more Congress can do to support our Nation's grandfamilies, and 
with that, I will turn to our Ranking Member, Senator Scott.

                 OPENING STATEMENT OF SENATOR 
                   TIM SCOTT, RANKING MEMBER

    Senator Tim Scott. Thank you, Mr. Chairman, for this 
hearing and thank you to the witnesses for investing your time 
and your energy and your expertise in such an important 
subject.
    Grandparents and other relatives raising children save the 
child welfare system about $4 billion a year in costs related 
to supports and services for children. Kids raised by kin do 
better in life than those placed in foster care.
    While I was not raised by my grandparents, I certainly had 
a lot of experience with my grandparents as a youngster when my 
parents divorced when I was about seven years old. We moved 
into my grandparents' house. It was certainly one of the houses 
that Chairman Casey just described as living at the poverty 
line or slightly below the poverty line. The house was filled 
with lots of love, discipline, and encouragement, but not a lot 
of resources.
    When we think about the importance that the grandparents 
play in the lives of the kids that are in that household, it is 
undeniable that the child is infinitely better off with the 
kinfolk, so to speak, than they are in foster care. We wish we 
had more of those opportunities in this country today, to see 
those loving kids in foster care, hopefully loving homes, be in 
homes where they are related to the ones who are taking care of 
them.
    I thank you all, especially the two grandparents who have 
had that experience yourselves, for being a part of the panel 
and having that discussion with us and the important role that 
that plays in the lives of the grandchildren but also the 
important role that the grandchildren play in your lives.
    I know that one of the important lessons that I received--
most of the important lessons I received in life, some of it 
came from my academic education, but most of it came from my 
household. Most of it came from grandparents and my mother, and 
I am so thankful to have had that opportunity to move in with 
my grandfather because--and my grandmother, because he really 
taught me the value of education and the necessity of 
perseverance, the necessity of patience, the necessity of hard 
work, discipline, and frankly, being on time, though I was 
about 60 seconds late for this hearing. I am still learning the 
lessons from my grandfather. He would also agree with that.
    When we think about the households that are at that poverty 
line in today's economy, where gas is 49 percent higher than it 
was just several months ago, 100 percent higher than it was 18 
months ago, you think to yourself, what are the challenges of 
raising the second generation of kids too often on fixed 
incomes? You think and you ask yourself, clothing is up over 10 
percent, baby food, over 13 percent, the scarcity of baby 
formula. This is, without question, a serious challenge for 
those households who are already at the poverty line, trying to 
meet the needs of their loved ones.
    Grandparents raising grandchildren are absolutely a 
necessity, and we should do everything in our power to provide 
more light to the problems and more solutions as well.
    Back in 2018, I joined our former Chairman, Senator 
Collins, and our current Chairman, Senator Casey, in 
introducing legislation to establish the Supporting 
Grandparents Raising Grandchildren Advisory Council, which 
submitted its recommendations to Congress last November. I 
joined Chairman Casey, as he just said, and Senator Young in 
taking part of the important implementation through the 
Informing Grandfamilies Act.
    South Carolina is a leader in elevating the role of 
grandparents raising grandchildren. South Carolina's Department 
of Social Services employs kinship navigators to help these 
caregivers negotiates the complex web of benefits and supports 
for which they may be eligible. DSS has also implemented 
provisional licensing of kinship caregivers. Provisional 
licensing makes kinship caregivers eligible for economic 
supports otherwise only available to traditional foster 
parents. As a result, 21 percent of placements today are to kin 
caregivers, up from just five percent three years ago. That is 
really good news.
    To encourage all states to make these kinds of reforms, I 
have also introduced the Child Care Development Block Grant 
Reauthorization Act, which would make children in kinship care 
and parents 65 years or older eligible regardless of income or 
work requirements.
    I look forward to learning as much as possible from the 
witnesses today, and I thank you for sharing your stories and 
your expertise as it relates to this very important topic.
    Mr. Chairman.
    The Chairman. Thank you, Ranking Member Scott. As many of 
the witnesses know, and those listening, we will have Senators 
who will be in and out. Thursday is a busy morning in terms of 
hearings and votes, and we will have votes at 11, so we will 
have to do some juggling, but one of the Senators joining us 
already is Senator Rick Scott. We are grateful he is with us.
    Let me move to the next part of our program, which is to 
introduce our witnesses. Our first witness is Ms. Donna Butts. 
She is the Executive Director of Generations United. 
Generations United is a thought and action leader on issues 
relating to kinship care in the United States.
    For our second witness, I will turn to Ranking Member 
Scott.
    Senator Tim Scott. Thank you, Mr. Chairman. Kim Clifton 
helps South Carolinian grandparents raising grandchildren 
navigate the resources and benefits available to them. She is 
Executive Director of HALOS, which stands for Helping and 
Lending Outreach Support. The HALOS Kinship Care Program 
promotes safe and nurturing homes for children in kinship care 
through these ways: by connecting caregivers to resources and 
benefits, including legal services; helping caregivers navigate 
complicated, bureaucratic systems; and offering annual family 
respite monthly caregiving support groups and educational 
opportunities.
    Kim holds a master of social work degree from Boston 
University. Her previous experience includes working with women 
and children at risk in places as diverse as Washington State, 
Boston, and Guatemala. She is a member of the Sisters of 
Charity Foundation's statewide Kinship Advisory Council and the 
South Carolina Department of Social Services Kinship Advisory 
Panel.
    Kim's leadership has established HALOS as a model for the 
entire State of South Carolina and achieved great recognition. 
During her tenure, HALOS won the Erin Hardwick Award for 
nonprofit governance from Together SC, South Carolina's 
statewide association of over 700 charitable, nonprofit, and 
philanthropic organizations.
    We look forward to her testimony, and we thank you for your 
expertise and your investment of your energy, your time, and 
your expertise to South Carolina's most vulnerable populations. 
Thank you.
    The Chairman. Thank you, Ranking Member Scott.
    Our third witness is Ms. Gail Engel, joined by her 
grandson, Bryson. Ms. Engel is a grandparent caregiver who has 
dedicated her life to supporting her own family and 
grandfamilies in her community. She founded Grand Family 
Coalition, an organization based in Ft. Collins, Colorado, 
dedicated to providing support to grandfamilies in the 
community.
    Ms. Engel, we are grateful you are here with us.
    Our fourth and final witness, as I mentioned earlier in my 
opening, is Ms. Ruth Stevens. She is joined by her grandson, 
Tamir. She is from Philadelphia, in my home State of 
Pennsylvania, and she fought to bring her grandson out of 
foster care and to bring him home with her. She has raised her 
grandson since he was an infant and will share their story with 
us today.
    We will start with our first witness for an opening 
statement. Ms. Butts, you may begin your statement.

              STATEMENT OF DONNA BUTTS, EXECUTIVE 
         DIRECTOR, GENERATIONS UNITED, WASHINGTON, D.C.

    Ms. Butts. Thank you. Chairman Casey, Ranking Member Scott, 
and members of the Committee, thank you for your commitment to 
families and the opportunity today to talk with you about 
grandparents and other relatives raising children, also known 
as grandfamilies or kinship families.
    My name is Donna Butts, and I have the honor of serving as 
the Executive Director of Generations United. Generations 
United's mission is to improve the lives of children, youth, 
and older adults through intergenerational collaboration, 
public policies and programs for the enduring benefit of all. 
For almost 25 years, Generations United has run the National 
Center on Grandfamilies, which has been a leading voice for 
issues affecting these families. Recently, along with national 
partners, we are also running the first ever national technical 
Assistance center on grandfamilies and kinship families, known 
as the Grandfamilies and Kinship Support Network.
    Families are the cornerstone of our neighborhoods, towns, 
and cities. Regardless of political affiliation, families and 
their well-being unites us. When parents are unable to raise 
their children, grandparents and extended family step up and 
wrap children in the cocoon, the protective cocoon, of family, 
providing roots and connection to culture, keeping siblings 
under one roof, and showering children with the one thing money 
cannot buy, love. Currently, more than 2.7 million children 
benefit from the contributions of grandparents, other 
relatives, or close family friends, and they thrive in this 
loving care.
    Caregivers may step into this role for a host of reasons, 
including most recently the COVID-19 pandemic. Whatever the 
reason, the caregivers often sacrifice dreams of their own, a 
carefree retirement, travel, dates with friends, and instead, 
invest their hope for the future in the children they never 
planned to raise. They cannot, and should not, have to do this 
alone and without our support. We are grateful for the 
important actions the Special Committee on Aging has taken to 
support the families, and thank you for understanding there is 
still more to be accomplished on their behalf.
    The vast majority of children raised by relatives are cared 
for by grandparents. These family heroes face tremendous 
challenges stepping into the role of parent. Approximately one 
in four have a disability, and 48 percent are 60 or older. 
Grandfamilies face challenges accessing necessities like health 
care, affordable housing, educational supports, and nutrition 
assistance. They often neglect their own health and mental 
health, prioritizing the children's needs.
    Despite these challenges, they play a unique and vital role 
in providing safe, stable, and permanent homes for children. 
When they cannot be raised by their parents, children do best 
with relatives. Compared to children in foster care with 
nonrelatives, children with relatives have a more stable and 
safe childhood, better behavioral and mental health outcomes, 
and are more likely to report always feeling loved. However, 
because the vast majority of children in grandfamilies are 
outside of the foster care system, these families are less 
likely to get access to services.
    The COVID-19 pandemic has had a profound impact on 
grandfamilies and is contributing to their numbers, as Senator 
Casey said, 140,000 new orphans in our country. Grandfamilies 
that formed prior to the pandemic have found that their 
challenges have been heightened and are facing struggles and 
mental health issues, stress, isolation, and from what we are 
seeing anecdotally, an increase in death by suicide.
    Thanks to the leadership of this Committee, two bold new 
Federal initiatives are beginning to make a difference in the 
lives of grandfamilies: the Federal Advisory Council to Support 
Grandparents Raising Grandchildren and the Grandfamilies 
Support Network. On behalf of the families, our partners, and 
others who care deeply about grandfamilies and kinship 
families, Generations United thanks Congress for supporting 
these initiatives.
    While progress has been made, there is much to be done. 
Generations United recommends the following: implement the 
recommendations of the Federal Advisory Council to Support 
Grandparents Raising Grandchildren, ensure legislation 
continues to promote the engagement of grandfamily voices; urge 
states to use the National Family Caregivers Support Program to 
serve grandfamilies; support quality kinship navigator 
programs; ensure adequate financial support for grandfamilies 
to meet basic needs by increasing and improving access to 
Temporary Assistance for Needy Family Child-Only Grants, family 
foster care maintenance payments, and Social Security to better 
meet the needs of grandfamilies; invest in and encourage 
greater availability and access to quality trauma-informed 
mental health providers that are familiar with grandfamilies; 
create a child only SNAP benefit and ensure automatic access to 
free and reduced school meals; facilitate the expansion of 
specially designed grandfamilies housing.
    Generations United is proud to endorse the Informing 
Grandfamilies Act, the Grandfamilies Act, and supporting the 
Well-Being and Mental Health of Grandfamilies Act. Together, 
these will help address some of the issues and recommendations 
outlined in my testimony.
    Most grandparent caregivers say they never saw themselves 
raising another generation of children. Yet, they step up, and 
despite complicated systems, hurdles, and hardships, they 
provide the loving homes in which children can thrive, but they 
cannot, and should not, have to do this alone. Collectively, 
they save our country more than $4 billion a year by keeping 
children connected to their roots and out of foster care. They 
are doing the very best they can, and they deserve our best. We 
should not expect them to fit into systems and services 
designed for other families but, instead, create connecting 
pathways that respect their unique and complex circumstances.
    Thank you for the opportunity to testify on behalf of 
Generations United and the grandfamilies we believe in and 
support.
    The Chairman. Ms. Butts, thanks for your testimony and 
bringing your experience to the hearing.
    I want to acknowledge two members of our Committee who have 
joined us, Senator Warnock and Senator Blumenthal.
    Next, we will turn to Ms. Clifton for her opening 
statement.

               STATEMENT OF KIM CLIFTON, M.S.W.,

        EXECUTIVE DIRECTOR, HELPING AND LENDING OUTREACH

       SUPPORT (HALOS), NORTH CHARLESTON, SOUTH CAROLINA

    Ms. Clifton. Chairman Casey, Ranking Member Scott, and 
members of the Committee, thank you for holding this hearing on 
the effects of the COVID-19 pandemic on grandfamilies. On 
behalf of HALOS and the grandfamilies in our program, I am 
honored to provide this testimony.
    HALOS's mission is to promote safe and nurturing homes for 
children in kinship care. We provide navigation services, 
support groups, and other programs to grandparents and other 
kinship caregivers. Currently, there are an estimated 67,000 
children living in kinship care in South Carolina, and for 
every one child in kinship foster care, there are 164 children 
who live with relatives outside of the foster care system.
    First, I want to tell you about Erika. When her daughter 
was not able to care for her own children safely, Erika, a 65-
year-old retiree welcomed her grandson and granddaughter into 
her home. She said, I prayed to God to help me provide for my 
grandchildren, and HALOS saved us. We had nowhere to go.
    Erika, like most grandparents, stepped in before her 
grandchildren were taken into custody. As a result, Erika is 
not entitled to the benefits foster parents receive, such as 
case management services, training, and financial stipends. 
Erika and other kinship caregivers do what they do selflessly, 
driven by the desire to keep their grandchildren in the family. 
They seldom have time to think of the cost to themselves 
emotionally, physically, and financially.
    ``I did not want my babies to go into foster care'' is what 
we hear time and again when grandparents explain why they are 
raising their grandchildren.
    HALOS fills the gap by connecting caregivers to essential 
resources for themselves and the children in their care. Access 
to navigation programs like HALOS varies by locale. Title IV-B 
kinship navigation funds are not adequate to meet the needs for 
services. Moreover, the funds are appropriately annually, 
making it difficult for states and service providers to develop 
long-term strategies for serving grandfamilies.
    Eight-year-old Justin experienced physical abuse, neglect, 
and abandonment before living with his great-grandmother, 
Martha. Like most kinship caregivers, Martha did not understand 
the effects of trauma on children. She loved Justin, and she 
was determined to keep him with her, but she did not know how 
to help him deal with his anger and his violent outbursts. We 
connected Martha with trauma-informed mental health and child 
advocacy services for Justin, and we referred her to the 
Trident Area Agency on Aging for respite care for herself. 
Martha and Justin were lucky. Our local Area Agency on Aging 
utilizes funds from the National Caregivers Support Program to 
support grandfamilies; not all of them do.
    During the pandemic, we saw a dramatic increase in requests 
for financial assistance because caregivers were furloughed, 
laid off, or forced to quit jobs due to lack of child care. 
Hannah, a grandmother raising three grandchildren, worked as a 
school janitor before COVID. When schools shut down, Hannah 
lost her job. When Hannah reached out to HALOS for help paying 
rent, she said, ``I have never had to ask anyone for help. I 
raised my kids and now my grandkids, and I have worked all my 
life.''
    HALOS provided Hannah with rental assistance and food 
resources. Hannah's family, like many during COVID, experienced 
food insecurity for the first time. Hannah's assistance was 
among the $450,000 in emergency financial aid we distributed 
from public and private sources. Those funds helped mitigate 
the effects of the pandemic for kinship families, but those 
funds are now drying up.
    The return to work has not solved the poverty faced by most 
grandfamilies. They need financial assistance to survive. HALOS 
has served over 900 families since 2019, and 80 percent of 
these families fall below 200 percent of the Federal poverty 
level.
    Programs meant to assist people with critical needs of 
health care, financial assistance, and food are lifelines for 
our families, but they can be challenging to navigate. As 
COVID-related Medicaid and enhanced SNAP benefits end, access 
to food and health care for many of our families are at risk. 
Additionally, affordable child care is not accessible by most 
kinship families, particularly those outside of the foster care 
system. Inclusion of kinship families in those receiving child 
care assistance would assure that caregivers can continue 
working or have much-needed respite time, knowing that the 
children in their care are safe.
    Grandparents step in because they love their grandchildren, 
but they need support. Navigation programs need to be 
consistently available throughout every State. Grandparents 
often neglect their own care to ensure that the children have 
what they need--that their grandchildren have what they need. 
They need respite and access to health and mental health 
services. Policies, services, and systems that touch kinship 
families should ensure that they remove barriers to access for 
kinship caregivers so that all children, including the nearly 
three million in kinship care across the Nation, can flourish.
    The Chairman. Thanks very much for your testimony, Ms. 
Clifton.
    We will now turn to Ms. Engel for her opening statement.

              STATEMENT OF GAIL ENGEL, GRANDPARENT

           CAREGIVER, FOUNDER AND EXECUTIVE DIRECTOR,

           GRAND FAMILY COALITION, LOVELAND, COLORADO

    Ms. Engel. Chairman Casey, Ranking Member Scott, and 
members of the Senate Special Committee on Aging, thank you for 
allowing me to share my story and my perspective. It is an 
honor to be here.
    My name is Gail Engel. My husband and I raised our grandson 
since he was a year old. We later adopted him, now 15, and are 
co-parenting our 14-year-old granddaughter.
    Our daughter experienced trauma as a child by a father who 
suffered from his own mental health issues. I did not place 
trauma on my child. We experienced it together. Yet, the guilt, 
shame, stigma kept me from seeking help.
    Our daughter suffered from physical and mental health 
problems that she was not able to overcome, just a single 
mother of two children, one of whom had challenging behaviors 
and has lived in poverty, her ability to adequately care for 
the children and fear of child welfare involvement. We stepped 
in.
    Raising a child a second time around has many challenges: 
physical, social, emotional, and financial. At the age of 52, I 
was already caring for my aging mother. We felt alone and lost 
contact with friends. The physical demands, such as being able 
to teach a child how to ride a bike, with two knee 
replacements, was impossible. Many times we asked ourselves, 
can we do this?
    The cost of raising a child not only has not allowed us to 
retire; the funds put aside for retirement may not sustain us 
through the age of 82, a mere 15 years away. With a diagnosis 
of autism, IDD, cognitive function disorder, after adopting 
him, we were able to collect Social Security Supplemental 
Income to help us financially.
    Children with trauma and developmental delays are often 
unable to access the part of the brain needed to learn and 
often with a fight-or-flight response to the disciplinary 
actions. Schools are most often ill prepared with specialized 
training to support these youth. My grandson has suffered 
unnecessarily due to the continuous punitive punishment and 
being labeled as a behavior child. Having to pay out of pocket 
to get a medical diagnosis, we were finally able to advocate 
for an IEP, Individualized Education Plan. Even at that, the 
inadequate trained staff, services, and supports--his emotional 
well-being and education has suffered traumatically.
    Having to educate myself to seek out resources that were 
mostly nonexistent, I discovered in my own small community that 
there were over 3,000 grandparents raising grandchildren. I 
found myself struggling just as they were and now serve over 
140 families. Building upon my own experience, I built a 
community of grandparents and other kin raising kin by creating 
a place where grandfamilies and services connect. Grand Family 
Coalition was created out of my own need to survive.
    It should not be ignored that aging has its own challenges, 
and grandparents are taking on an additional role. Often taking 
on grandchildren with little warning and often returning to the 
workforce to maintain stability for the long haul of raising 
children to adulthood, often winding up in significant legal 
expenses to retain legal responsibility of the children, they 
often isolate and avoid judgment, guilt, and shame, and 
experience a secondary trauma. They must navigate a complex 
system and find resources that are often lacking and 
inadequate. Grandfamilies are stepping up while the world is 
unaware of their complexities or even their existence.
    Grand Family Coalition relies on grants, donations, and 
volunteer staff to support our mission. We also know the need 
for our support is in every community. Other small nonprofits, 
such as Grand Family Coalition, have the experience and 
knowledge to support grandfamilies. However, due to limited 
funding, they struggle to take root. We need funding to expand 
our work and reach and compensate for their efforts.
    My ask would be to encourage collaboration among the many 
systems that are responsible for assisting children and 
families so that more dollars can be put in the hands of small 
nonprofits so that they can do the beneficial work for grand 
and kinship families. Thank you.
    The Chairman. Ms. Engel, thanks for your testimony.
    We will now turn to our fourth and final witness, Ms. 
Stevens.

                  STATEMENT OF RUTH STEVENS, 
            GRANDMOTHER, PHILADELPHIA, PENNSYLVANIA

    Ms. Stevens. Good morning, Chairman Casey----
    The Chairman. Ms. Stevens, maybe we will just check to make 
sure your mike is on. Is it on?
    Ms. Stevens. My name is Ruth Stevens. I am 75 years old. I 
was born in north Philadelphia, and I grew up in the same 
community I live in now. I have two biological children, a 
daughter and a son. My grandson, Tamir, is here with me today.
    I have always loved taking care of children, and I hate to 
see them unhappy. I raised more than 10 children who were not 
my own. It is very dangerous on the streets of north 
Philadelphia, and every child that I have taken care of 
graduated school, stayed off drugs while they lived with me. I 
taught the children how to ride a bicycle, read, take care of 
themselves. I went with them on trips. No matter what I had to 
do, I made sure I was with them to their activities and that 
they knew they had someone who cared.
    When my grandson, Tamir, was born, I found out that he was 
placed in foster care with a white family in Northumberland, 
PA, who I keep in touch with today, and they wanted to adopt 
him. Tamir is my grandson, and he needed to be with me. I took 
the train, which was about three and a half hours from 
Philadelphia, to see the family a few times, trying to get him 
through legal support.
    A community member told me about the Senior Law Center and 
shared that they may be able to help me. It took about a month, 
and I was eventually able to bring Tamir home with me. He was 
about eight weeks ago. I had to do what I had to do to get my 
grandchild out of foster care. It was not easy. Tamir was on a 
breathing machine, an oxygen machine, an asthma machine, and he 
needed a lot of support.
    I was 50 years old when I got him, and it was not easy. I 
did not drive. I brought him to all his medical appointments on 
the bus or train. I got help from different programs in the 
community. I was on public assistance. I received a small check 
to take care of him. We struggled for a while. He was able to 
get on--until he was able to get on disability insurance.
    A community member told me about Temple University Family 
Friends program, where I connected with other grandparents. 
Family Friends is a program based at Temple University that 
provides support to grandfamilies and kinship families in 
Philadelphia who have taken on the role of primary caregiver 
for related children with special needs. The program serves 160 
families and children annually.
    With the Temple program, I received a lot of support. We 
met once a month before COVID as a support group to help 
address issues of stress and isolation of grandparents and 
kinship members. We went on trips. They connected us to 
resources in the city. I always had somewhere to take Tamir.
    During COVID, we were not able to get together or have the 
activities. It was difficult. We do have a trip coming up at an 
amusement park, and Tamir and I will go on that trip. Tamir's 
mentor from the Temple program took him to play basketball, and 
they went to games together. His mentor often calls and checks 
on me and Tamir to make sure we are okay. The Family Friends 
program is my support system. I have been in the program since 
Tamir was eight years old.
    Tamir is doing okay, I guess. He just graduated from high 
school. He has asthma but has not had an asthma attack in a 
while. Tamir still faces challenges with hearing, and he has 
hearing aids. His hearing aids cost about $2,000. He just got a 
small job at Walmart, which is good, but I am working with 
Community Legal Services to make sure that he can keep his 
disability benefits.
    He still has challenges even though as a teenager he thinks 
he is okay. He does not get sick as often anymore, which is a 
good thing. Sometimes he acts like he cares about me, but 
sometimes he acts like I am his worst enemy. It can be 
isolating. I am able to go to therapy once a week, meet other 
older ladies. We talk and laugh together. That is my fun.
    During the pandemic, my iPad was the only way I 
communicated. There was nothing else I could do. I went from 
iPad to laptop to cleaning my house and kept myself busy. Now I 
am starting to go outside and do other activities.
    Taking care of kids makes me feel loved. I feel somebody 
loves me. It gives me a sense of purpose. Even though it is 
very hard, I enjoy it. It is very dangerous for kids out there 
on the streets. I do my best. I do the best that I can to keep 
Tamir safe, and I am proud of myself for raising him.
    The Chairman. Ms. Stevens, thanks for your testimony, and I 
think what you have testified to today is emblematic of the 
sacrifices so many families have undertaken for their 
grandchildren but also for all of us, and we are grateful you 
are willing to share that story with us.
    I wanted to start my questions with you. If you do not 
mind, I will either call you Ms. Stevens or Ruth, but I hope 
either is appropriate.
    I am grateful for the story, and I also am grateful you are 
willing to share the reality of it, the challenges that you 
faced. I cannot even imagine when I was 50, a long time ago, 
but when I was 50, just beginning to raise a child who I guess 
you said was eight weeks old or even being part of that as a 
team with my wife. I cannot imagine the challenge that alone 
presented to you.
    We are grateful that you talked about the Temple University 
Intergenerational Center's programming to support you and to 
support other families. You also noted the pandemic brought all 
programs online, as we all experienced, and that you have not 
had the opportunity to connect with other grandparents who are 
caregivers in a personal way over the course of the pandemic.
    Could you share with us why it is important for you to be 
connected to other grandfamilies, other grandparent caregivers, 
and programs that support grandfamilies as you age and as Tamir 
progresses?
    Ms. Stevens. Well, it is helpful because, first place, I do 
not know what to do any more than what I am doing, and I feel 
that with help he could get something that he is not getting. 
He does not have a male role model or anything, and there is 
not too much that I can actually tell him, so it would be 
helpful to have resources where he could connect even so more 
than me, so that would help.
    The Chairman. Well, I was noting in your testimony when you 
talked about raising him gave you a sense of purpose.
    Ms. Stevens. Yes.
    The Chairman. It is remarkable when you consider what you 
and so many others as part of this panel have either 
experienced personally or know a lot about. The idea that one 
person can provide love and care and support to one child, or 
more than one as the case may be, that alone is a substantial 
contribution to American life, but when you combine that with 
the benefit to the rest of us, because you out of an act of 
love and responsibility, really duty, took on this 
responsibility, you saved a lot of us from having to expend 
other dollars that we would have to spend, so it is pretty rare 
in life when you can help one person but also help a lot of 
other people by extension, so we are grateful you are willing 
to share that.
    I wanted to turn next to Donna Butts and ask about the 
impact of the pandemic. We keep referring to that, obviously, 
the devastation that that caused and so many, so many people 
lost in the pandemic. We also know that caregivers and their 
loved ones are, as I mentioned to Ruth Stevens, isolated, 
dealing with trauma without adequate support or services. I 
think Congress has a responsibility to respond to this part of 
the larger tragedy of the pandemic, to make sure that no family 
goes without the mental health care they need in addition to 
other supports. That includes, obviously, grandfamilies, both 
those who were struggling before the pandemic and those 
grandfamilies that formed because of the COVID-19 pandemic.
    I would ask you, Ms. Butts, how can Congress better support 
the mental health of grandfamilies, both the caregivers as well 
as the children?
    Ms. Butts. Thank you, Senator Casey, and as I think you 
learned from Ms. Stevens and Ms. Engel, one of the things that 
is really important to grandparents raising grandchildren is to 
know that they are not alone, so those support groups, access 
to mental health services provided by people who are informed 
by trauma and know what the special needs are of the family are 
really, really important, so supporting services that are 
community-based and informed by the caregivers themselves to 
make sure they are relevant; making sure that we are using 
Federal resources that are available, like the National Family 
Caregivers Support Program, to provide support groups, respite, 
counseling, things that are there and that can be used; it is 
also making sure that mental health services are accessible to 
families using Medicaid and CHIP.
    I think one thing that we are very excited and supportive 
of is the Supporting Well-Being and Mental Health of 
Grandfamilies Act, which includes extending the Federal 
Advisory Council Supporting Grandparents Raising Grandchildren 
and realizes that one of the things that has changed since that 
panel was first established is COVID and the impact of COVID-
19, so we need to be able to dig deeper into the impact because 
we are only skimming the surface at this point, and we need 
that council to be able to look and make recommendations and be 
informed by the impact of COVID-19.
    Thank you.
    The Chairman. Thanks very much.
    Ranking Member Scott.
    Senator Tim Scott. Thank you, Mr. Chairman, and thank you 
all for your testimony this morning, and certainly, Ms. 
Stevens, thank you to your commitment to Tamir, who I believe 
is behind you.
    I will say as the kid who moved into my grandparents' house 
at seven that I did not always appreciate the sacrifice of my 
grandparents. The truth is that it takes time and age before 
you can look back with 20/20 vision and say, my, gosh, how 
blessed was I, so sometimes you love them; sometimes you do not 
love them, talking about your grandparents, but the truth of 
the matter is you always love them; you do not always express 
it well.
    I am sure that Tamir and I have that in common, and I am 
sure that he loves you beyond recognition and appreciates your 
sacrifice and, frankly, the fact that you have 10 other kids 
that were not your kids that you were able to help, not only 
help along the way, but you helped them graduate from school as 
well, which is a testament to your sacrificial love and support 
of your community, and we need more examples like that. If each 
one would reach just one, not 10 but just one, our country 
would be certainly better off, so thank you for your sacrifice.
    You did touch on the topic of resources and the importance 
of finding support groups and support systems, and I would love 
to talk for one second with Ms. Clifton about the importance of 
legislation that may provide more resources, certainly the 
CCDBG grants that come through the reauthorization act, that 
for the first time makes kinship care families and children 
with parents over 65 eligible for support regardless of work or 
income requirements.
    Kim, I would love to just have you talk with us about the 
child care experiences in South Carolina from a grandparent's 
perspective and explain how this bill could provide more 
resources.
    Ms. Clifton. I think it is really important. One of the 
biggest challenges that kinship caregivers and grandfamilies 
face is finding child care. Often, it is associated with the 
need to work, and caregivers are forced to quit jobs because 
they have to--they do not have child care. They do not have 
affordable, accessible child care.
    Of course, that was really exacerbated by the pandemic 
because even when caregivers can access child care right now 
there are so few places open that have room, but because 
vouchers, child care vouchers, have not been accessible by most 
kinship families and they have a time limit of 52 weeks, it has 
been really hard.
    We have certainly worked with grandparents who have quit 
jobs because it makes more sense to be home with the kids 
because they do not have child care and they need to know that 
the children in their care are safe, and it puts enormous 
financial pressure on these families when they cannot work and 
do not have the alternative to keep a job because they do not 
have child care, so I think the enhancement adding kinship 
families and the grandfamilies over 65 would be an enormous 
benefit to families.
    Senator Tim Scott. Excellent. Thank you very much.
    I know Ms. Engel also is living the reality and the truth 
of each one reaches one, so often we talk about the sacrifices 
of the grandparents when they are taking the grandkids, and 
that is certainly one perspective and a real perspective.
    I would also suggest that it is an investment, not just a 
sacrifice, but an investment of the most important currency we 
have, the currency of love, and sometimes as I read scripture, 
it says love is not just the emotion; it is the commandment. It 
is a commitment to do something, and certainly I think you have 
demonstrated that commitment to do something good on behalf of 
those you love.
    I hope that when we walk away from this hearing today we do 
not think of it just from a sacrificial perspective, but 
sacrifice and investment leads to a healthier human being who 
happens to be related to you, and that is all good news, so I 
really do appreciate and respect your affinity for doing the 
right thing and for investing your life, your time, and your 
energy and your resources into your grandson's life, and to 
that end, I am going to turn right back because I do like South 
Carolina. I have an affinity for my home State and the 
expertise that HALOS brings to the table as it relates to 
resourcing. In the legislation introduced by Chairman Casey, 
myself, and Senator Young, the Informing Grandfamilies Act, it 
would require states to communicate with grandparents who 
receive or are applying for TANF, provide more information 
about additional supports.
    Sometimes we live in vacuums, and when we are busy taking 
care of our loved ones, we do not necessarily have the margin 
in our schedules to figure out how this complex web of 
resources actually works on our behalf, so to the extent that 
you could help us understand how South Carolina, through things 
like the Informing Grandfamilies Act, could provide more 
support to raising your grandchildren.
    Ms. Clifton. I think that would be an enormous benefit. 
Right now, often grandparents do not even know they can access 
TANF, and that can be very cumbersome trying to apply. We deal 
with many families that get rejected, and then we help them 
navigate the system and advocate because they are eligible 
regardless of income through child-only grants, but if they 
were given more knowledge about community resources, any 
resources, any benefits they may be eligible for, it would be 
great because what we know is kinship caregivers and 
grandfamilies, grandparents raising grandchildren, are less 
likely to know about resources even when they exist. They are 
less likely to have knowledge of them or be able to access 
them, so utilizing TANF is a way to provide resources for 
families because many of them do access them, access TANF. It 
would be a huge benefit.
    Senator Tim Scott. Excellent.
    Ms. Clifton. Yes.
    Senator Tim Scott. Thank you, ma'am. I know I am basically 
out of time, so I will not ask another question, but I will 
prepare you for another question. I oftentimes think to myself 
that there is a system of social services for our seniors or 
for our grandparents and then we have a separate system of 
social services for our grandchildren, who are the younger 
folks, and the chasm between the two might be problematic, so 
if we could figure out how to have a one-stop approach, that 
might be helpful as well. I will give you a chance to talk 
about that in just a minute.
    Ms. Clifton. Okay.
    Senator Tim Scott. Thank you.
    The Chairman. Thank you, Ranking Member Scott.
    We will next turn to Senator Gillibrand who is appearing 
virtually.
    Senator Gillibrand. Thank you so much, Mr. Chairman. During 
today's hearing, we have heard and learned about many programs 
and services aimed at helping families that are not set up to 
accommodate grandfamilies or kinship families. These resources 
involve access to programs such as SNAP, Social Security, and 
others that can be life-changing for many grandparents across 
the country who have to navigate the challenges of child care. 
Additionally, the complex nature of legal guardianship laws can 
lead to difficulties for grandparents looking to access these 
programs and to provide for their grandkids.
    Ms. Stevens, thank you so much for sharing your journey of 
becoming the primary caregiver for your grandson, Tamir, and 
for bringing him here today.
    Ms. Stevens. Thank you.
    Senator Gillibrand. While navigating this journey, what are 
some of the biggest challenges you have had to overcome and 
what resources did you wish you had access to, to ease taking 
care of the role of caregiver for your grandson?
    Ms. Stevens. Well, some of the challenges that I had to 
overcome was getting to these places and finding the help that 
I needed. Can you repeat that again because I am having a hard 
time?
    Senator Gillibrand. Just if there are any other challenges 
that really speak to this hearing about things you wish were 
different.
    Ms. Stevens. Okay. Well, I wish that I could have had more 
resources. I wish that I could have had a mentor or somebody to 
help him, you know, because I could not do but so much and 
still cannot do but so much.
    Senator Gillibrand. Yes. Yes, that makes sense, very much 
so.
    Ms. Butts, through your work with Generations United, you 
have seen how the COVID-19 pandemic has exacerbated the 
challenges that grandfamilies endure. In what ways can these 
proposals, proposed changes, provide the support that is needed 
by grandfamilies, especially emerging from the pandemic?
    Ms. Butts. Thank you, Senator. The Grandfamilies Act will 
do a host of things to make the supports more available and 
stronger for the families. That includes financial supports, 
like access to TANF and Social Security, addressing legal 
barriers by promoting guardianship laws to help grandfamilies 
have the legal authority to make decisions and secure supports, 
promote collaboration by facilitating cross-sector 
partnerships, and investing in peer supports.
    I want to emphasize the promoting collaboration because, as 
Senator Scott said, sometimes we have systems that do not speak 
to each other and the new Grandfamilies and Kinship Families 
Support Network, the National Technical Assistance Center, is 
designed to facilitate those kinds of conversations, and we are 
seeing some beginnings of some blossoming relationships, some 
communication that we have not seen before, so the 
Grandfamilies Act is going to really help the families as well 
as some of the things that this Committee has supported in the 
past.
    Thank you.
    Senator Gillibrand. Based on what we just heard from Ruth, 
she said that she wanted more mentorship for her son, more 
technical assistance so she knows which programs have resources 
for her. Will those challenges be addressed?
    Ms. Butts. Yes, in terms of promoting collaboration and 
also in making sure that we are investing in peer supports 
because what we have learned--we are very fortunate to get to 
work with a number of grandparents around the country--is that 
being able to support each other, to talk with other people 
that are also walking the walk as you are makes a real 
difference, to have that voice. It helps inform policy, it 
helps inform practice, and it makes our community stronger, so 
that peer support is very important.
    Senator Gillibrand. Thank you.
    Ms. Engel, given your experience as a grandparent caregiver 
and as the founder of the Grand Family Coalition, to what 
degree do you believe the community-based organizations have 
been able to provide families with complex structures the tools 
and services they need to overcome the challenges that they are 
met with?
    Ms. Engel. Coming into being a grandparent raising a 
grandchild is rarely expected or planned. It does not come with 
a guidebook because, like many families, the needs are all 
different and situations are very different.
    What is really different is that we are unique in the fact 
that we have an advanced knowledge of relationships to the 
parent and usually the children. The needs are never going to 
be the same, but because we are unique, being inclusive when 
referring to an aging population, it is considered that they 
may have children which are not traditional things. When 
referring to a grandfamily or kinship, we may also refer to a 
sibling raising sibling or an aunt or an uncle.
    Most importantly, the situation often leaves us without 
many services, and it depends, and many other factors. When 
raising someone else's children, services should go to the 
children as they are the ones who are having the abandonment, 
and yes, we are--yes, we would have been navigating a peer to 
walk with me through what the ``what if'' and ``what depends,'' 
I could have managed so much better.
    Senator Gillibrand. Well, thank you, ma'am, and thank you, 
Mr. Chairman.
    The Chairman. Senator Gillibrand, thanks very much.
    We will turn next to Senator Kelly.
    Senator Kelly. Thank you, Mr. Chairman.
    Ms. Engel and Ms. Stevens, I want to start off by thanking 
both of you for being here today and sharing your experiences. 
I became a grandfather just last year, and I think it is very 
special that your grandchildren are able to be here with both 
of you today.
    I am glad we are having this hearing today. This is an 
important topic. In my State of Arizona, there are about 62,000 
grandparents who, like the two of you, are the primary 
responsible caregivers for their grandchildren. More than half 
of foster children in Arizona are placed with their 
grandparents or other family members, which is higher than the 
national average. This is encouraging because we know that kids 
do best with their families, but we also know that most of 
these caregivers are unlicensed and thus are not getting all 
the support and services that a licensed foster parent might be 
eligible for.
    That is why today I am joining Chairman Casey, Senator 
Young, and Ranking Member Scott to introduce the Informing 
Grandfamilies Act, and this bill will ensure that states are 
communicating to kinship caregivers and grandfamilies what 
additional supports and relief programs that may be available 
to them. You know, things like nutrition assistance or home 
energy assistance, so for the two of you, Ms. Engel and Ms. 
Stevens, thinking back to when you initially became a 
grandparent caregiver, would having this information readily 
available have been helpful to you?
    Ms. Engel. I think some of it would have been useful to us 
except for the barriers that I ran into is that I am not low 
income, and so many of those resources did not fit my needs. I 
did not have access to them because I was not involved with the 
child welfare system. I did not get services through them 
because I did not qualify for Medicaid. I made too much money 
to get housing assistance or anything like that.
    I did not--I could have used some mentor myself. My 
grandson could have used a mentor. I could have managed to have 
someone navigate the system for me, the legal system. None of 
those things were available to me at all, none of the 
resources, and so it was a challenge and something that was 
very difficult for me to overcome.
    Senator Kelly. It sounds like legal help and mentorship 
would have been helpful.
    Ms. Engel. Absolutely.
    Senator Kelly. Right. Ms. Stevens?
    Ms. Stevens. Well, I agree that both legal--I mean, 
mentorship for myself and my grandson would have been helpful 
to me because I was really struggling. I knew about all the 
TANF or Social Security, but I did not know how to get it, and 
I could not get help to get it, so I did not really get a lot 
of help until he got about eight, when I joined Family Friends 
and they started giving me information and telling me where to 
go and what to do, so that is how I got the help, and right 
now, any resource that I could get can still help me. It would 
have helped me back then.
    Senator Kelly. Sometimes navigating these Federal programs 
are a challenge, you know, of itself.
    Ms. Stevens. Yes.
    Senator Kelly. Well, thank you, Ms. Stevens and Ms. Engel.
    I want to switch to a different topic here with Ms. 
Clifton. Rising costs, it is an issue that is impacting seniors 
across the board. The cost for gas and groceries, they keep 
rising. Rent is going up. In the Phoenix metropolitan area, 
rent has increased 30 percent in 2021, and that is not 
sustainable for families, let alone families led by 
grandparents who may be on a fixed income.
    That is why one of my top priorities is to bring down the 
cost of prescription drugs. That would help the budget, you 
know, because we know that so many grandparents would do 
anything for their grandchildren and that includes skipping the 
medicine they need to put food on the table, so we cannot let 
that happen, so that is just another reason why ensuring that 
folks can take advantage of their programs that do exist, like 
yours, is so important.
    Ms. Clifton, as someone who works directly with members of 
your community, I am sure you hear so many stories about this. 
Could you share some of those with us and some of your 
successes, when you have been able to connect with folks, 
connect folks with the services they need?
    Ms. Clifton. Sure. In particular with the prescription 
drugs, what we are seeing is grandparents continue to push 
their own needs aside, mental health, physical health, when 
their grandchildren are in need, so with rising prices, 
prescription drugs that are not paid for by Medicare become a 
real problem, so what we are seeing is grandparents will just 
stop taking their own medicine to make sure that they can fill 
prescriptions for the children in their care.
    One of our family advocates and I were discussing this 
yesterday, and she said it takes--speaking of cumbersome 
bureaucracies, trying to access Medicaid for the kids is often 
a real barrier, so before they are able to access Medicaid, 
they are trying to pay for prescriptions for their 
grandchildren and for themselves, and again, if they are going 
to lose one of those, it is going to be for themselves even if 
we know grandparents raising grandchildren tend to be in poorer 
health. They are not going to access really vital drugs, 
prescription medicines, I am sorry, for themselves to treat 
chronic disease.
    Senator Kelly. Well, thank you. You know, regardless of 
where I travel across the State of Arizona, one thing I hear 
over and over again is that the price of prescription 
medication is too high. I mean, it goes up faster than 
inflation, faster than the price of gasoline lately. It is just 
too expensive, and it is up to Congress to do something about 
it, so thank you.
    The Chairman. Senator Kelly, thanks very much.
    As I mentioned earlier, everyone is juggling hearings. 
Senator Scott had at least two this morning and might have a 
third I am not aware of, but Senator Braun joined us this 
morning as part of the hearing.
    I will now turn to Ranking Member Scott for a followup 
question from before.
    Senator Tim Scott. Certainly one of the things I would like 
to point out that Ms. Stevens has, I think, said very well is 
that when you are taking care of your grandchild who has 
special needs the transportation conundrum is incredibly 
important, and that is something that as we think through the 
future of our acts that we want to pass perhaps we take a 
serious look at the transportation conundrum that you have 
talked so clearly about.
    I want to give Ms. Clifton an opportunity to answer the 
question that I was starting to ask as it relates to the silos 
of consciousness, streams of consciousness. One is for our 
seniors from a social service delivery system; one is for those 
grandkids or for younger folks. There is a bridge that needs to 
be built between the two, and perhaps you might illuminate how 
we get there, perhaps.
    Ms. Clifton. I completely agree with you and enjoyed 
hearing what Ms. Butts said earlier about collaboration. I 
think that in general there is a lack of collaboration between 
systems, but you are absolutely right; the child welfare system 
does not really speak to the systems that help the aging.
    I would even say, again, we are very fortunate to have our 
local Area Agency on Aging that does support grandparents 
raising grandchildren, but even so, we do not always think 
about when we are working with grandparents the other ways that 
AAA could help them. We are focused on the family unit and them 
raising their grandchildren.
    I think that there are a lot of ways to build bridges 
between these two that would really illuminate and help because 
I think, in general, the child welfare system does not do a 
good job of addressing the needs grandparents have that are 
specific to an aging population and it would be a great benefit 
to see more collaboration.
    Senator Tim Scott. Thank you very much.
    The Chairman. Ranking Member Scott, thanks very much.
    I know we are awaiting another Senator for questioning, but 
I wanted to pose a question to Ms. Engel on the subject of 
grandchildren with disabilities. Obviously, there is so much 
work we have got to do in the disability space generally, but 
in the context of grandchildren and coming through the pandemic 
and so much else.
    You said in your opening that--and made reference to the 
educational needs of your grandson, who has multiple 
disabilities, and you said, ``Our school systems are most often 
ill-prepared with specialized training in support of these 
youth.'' You also talked about the challenges of securing 
services for him from his school. As you assumed responsibility 
for your grandson, what information would have been available 
for you regarding school services?
    Ms. Engel. I had the smarts to get my daughter to sign a 
delegation of power, I was able to get my grandson enrolled 
into school, to visit the doctors, to get vaccinations, so I 
was good there.
    It was after being told that my grandchild, through the 
kindergarten teacher, that I needed to educate him in order for 
her to teach him, I was a little overwhelmed, so after---excuse 
me. I am sorry. Teaching him and being able to--having him 
kicked out of school many times, over and over, I did not learn 
about an education plan. It was then that I learned how I was 
ill prepared, how ill prepared our schools are, for handling 
children with trauma and mental disorders.
    There is trauma-informed, and there is trauma-respective. 
Our school systems do not have the latter. Grandparents are ill 
prepared to even understand the trauma and how to parent them, 
no more than the school system does. The school did not 
understand it, know how to identify it, let alone how to deal 
with it. There are very little programs for children with 
mental disorders.
    It took me nine years to find the programs for our grandson 
that works, and it was in the deep, dark--it was a deep, dark 
secret, and it was understaffed and unsupported. Our school 
systems are not prepared to handle children with mental 
disabilities.
    The Chairman. Ms. Engel, thanks very much for your answer.
    We will now turn to Senator Rosen.
    Senator Rosen. Well, thank you, Chairman Casey. I 
appreciate you, Ranking Member Scott as well, and I really want 
to extend a special thanks to the witnesses for being here 
today.
    You know, in the United States, over a quarter of Latinos 
and nearly a third of Asian Americans live in multigenerational 
households. Such households are particularly common in Nevada, 
where Latinos make up nearly 30 percent of our State's 
population, and we have one of the fastest growing AAPI 
populations in the country, so more than half of lower-income 
adults and 45 percent of middle-income adults report that 
caregiving is one of the reasons for living in a 
multigenerational household, so as the cost of child care and 
other kinds of caregiving continue to increase, the number of 
multigenerational households will likely to continue to 
increase as well.
    Ms. Butts, what trends can you tell me that you are 
observing among grandparents living in multigenerational 
households in diverse states like Nevada, and how do you think 
the pandemic impacted the grandparent caregivers living in 
those households more specifically?
    Ms. Butts. Multigenerational households are on the rise in 
our country, and they are on the rise to stay for a number of 
reasons, as you just pointed out, whether it be need to provide 
care for children or for older adults, to pool resources, and 
to strengthen our families. With grandparents living in 
multigenerational households, oftentimes those are skip 
generations households, and they do not have the combined 
access to resources or the combined resources that other 
households have.
    The grandparents have been isolated because of COVID-19, 
when we were told as older adults to stay away from children. 
They could not stay away from children. They needed to provide 
that care. There was the children that were afraid because they 
did not want to infect their grandparents. There was all of a 
sudden everybody needed to be able to go online, and they may 
not have had access to internet or equipment, so the pandemic 
has had a tremendous influence, which is why we also are 
supporting extending the life of the advisory council and 
taking a deeper dive into the impact of COVID and what can be 
done to support families, grandfamilies, that have been 
impacted especially hard by COVID. Thank you.
    Senator Rosen. Thank you. I look forward to that report 
because we want to see Congress can do to continue to provide 
resources for these core caregiving duties, and you touched a 
little bit upon mental health concerns, particularly for the 
pandemic but for children living with their grandparents. We 
know we are in the midst of a youth mental health crisis 
worsened by the pandemic. Two-thirds of children and teens, 
they have expressed feeling down, hopeless, depressed during 
the pandemic, and more than 200,000 children have lost a parent 
or primary caregiver to COVID-19 because, sadly, they passed 
away, and so these children may be living with grandparents or 
other family caregivers. They are just going to require 
additional mental health resources, not just now but most 
likely into the future.
    Ms. Engel, could you speak to some of the challenges that 
children who are part of grandfamilies may face in losing a 
parent or primary caregiver, whether it is due to the pandemic 
or something else, and how that trauma can affect the children 
and their grandparent caregivers?
    Ms. Engel. Well, I will tell you that I support over 100 
and some grandparents in my organization. Every one of them 
struggles. The pandemic was just an added situation.
    When a child loses his parent, him or her loses a parent, 
that is a connection that is made at birth, and once that 
connection is lost it becomes a trauma because they do not know 
where they belong. They do not know how, why they are in the 
situation. They take blame for themselves. The COVID just added 
onto that because they are isolated and they do not understand 
the situation.
    Most of the kids that I know that are being raised by 
grandparents also come with trauma due to some kind of fetal 
exposure. The trauma of losing a parent, it is impacting the 
mental health of these kids dramatically, and then again, with 
the schools systems not being able to understand that, not 
being able to support them, these children are struggling.
    It will also perpetuate onto the next generation, as it has 
with my family. My daughter did not receive the support she 
needed when she was in need of mental health. It perpetuated to 
my grandson, and now it will continue on if we do not do 
something about it.
    Senator Rosen. Yes. Well, thank you for that.
    I see my time is up, but I do want to say that particularly 
an impact of the pandemic or the loss of a parent, grandparents 
have lost a child, the child has lost a parent, so there is 
family trauma going forward a grieving family has to deal with 
while trying to take on all these new roles, and we need to 
really address this with our mental health workers and their 
capacity to work on these types of issues.
    Thank you, Mr. Chair.
    The Chairman. Senator Rosen, thanks very much.
    I wanted to say to our witnesses we are having something we 
usually do not have, which is an expedited wrap-up today 
because of the votes. One vote was called about 10 minutes ago, 
so Senator Scott and I, the Ranking Member, will submit 
statements, closing statements for the record, but we want to 
thank each of you for your testimony today, for your presence 
here, and for your own personal experience and expertise you 
bring to these issues, and the word that kept coming to mind 
for me was sacrifice, the sacrifice of so many grandparents, 
grandfamilies, to give love and support to their children and 
help the rest of us along the way, so we are grateful for that 
commitment and that sacrifice.
    The record for this hearing will be open for seven days 
until next Thursday, June 30th, for Senators who might have 
additional questions or statements for the witnesses, but 
again, thank you for your presence here today. Thank you for 
your testimony.
    The hearing is adjourned.
    [Whereupon, at 11:14 a.m., the Committee was adjourned.]

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                           CLOSING STATEMENTS

=======================================================================
    
                 CLOSING STATEMENT OF SENATOR 
                 ROBERT P. CASEY, JR., CHAIRMAN

    In today's hearing, we heard powerful testimony from 
grandparents who are fighting for their grandchildren's 
futures.
    We learned about the many barriers that they face. We 
cannot let any grandfamily fall through the cracks. We must 
ensure that every grandparent and kinship caregiver across the 
country has the resources and support they need to care for 
their children, regardless of their background.
    That's why Democrats are committed to addressing the long-
term impact of systemic racism and health inequities on all 
Americans, including grandfamilies.
    Today's hearing highlighted the critical role that 
grandparents play in supporting our Nation's children.
    Ms. Stevens shared in her testimony that she is proud of 
her role as a grandparent caregiver. Her heroic efforts to 
support her grandson have not gone unnoticed.
    It's time that Congress fights to support these families 
the way they deserve.
    I want to once again thank all the witnesses for 
contributing their time and expertise today.
    If any Senators have additional questions for the witnesses 
or statements to be added, the hearing record will be kept open 
for seven days, until next Thursday, June 30.
    Thank you all for participating and this concludes today's 
hearing.

                 CLOSING STATEMENT OF SENATOR 
                   TIM SCOTT, RANKING MEMBER

    Thank you, Chairman Casey, for today's hearing, and thank 
you to each and every witness for providing your expertise and 
stories.
    Today's hearing has highlighted how important it is for us 
to recognize and value grandparents raising grandchildren. 
Since the Aging Committee identified the need for Congress to 
establish an Advisory Council to support grandparents raising 
grandchildren back in 2017, we have made great progress.
    Kinship caregiving is increasingly recognized in federal 
laws, including the Families First Prevention Service Act, and 
the National Family Caregiver Program authorized through the 
Older Americans Act.
    States have responded, adopting a "kin first" approach to 
placing kids whose parents cannot raise them. Congress can help 
by passing the Informing Grandfamilies Act, which will ensure 
grandparents raising grandchildren are fully informed about all 
the resources available to them. Congress must ensure funds 
appropriated for states' child-welfare agencies go to 
grandparents raising grandchildren, too. The Child Care and 
Development Block Grant Reauthorization Act, which I introduced 
with Senator Burr takes an important step in that direction.
    Thanks to the testimony of the witnesses at today's 
hearing, we are even better informed and prepared to take 
further steps to support grandparents raising grandchildren, 
like how my grandparents helped raise me.
    Thank you all for your testimony today.
    
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                                APPENDIX  
      
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                      Prepared Witness Statements

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                        Questions for the Record

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