Caregiver Act: CARE, RAISE, FMLA, and State Leave Rights

There is no single federal statute called the Caregiver Act. When people use that phrase, they usually mean one of two different laws: the CARE Act, a state-level model law that protects family caregivers when a loved one is discharged from the hospital, or the RAISE Family Caregivers Act, a 2018 federal law that directed the government to build a national caregiving strategy. Separate from both, the Family and Medical Leave Act (FMLA) is what actually gives working caregivers job-protected time off. Which law helps you depends on what you are trying to do.

The CARE Act at the Hospital

The Caregiver Advise, Record, Enable Act is a model law enacted in some form by 44 states and territories. The details vary by state, but the framework puts three duties on hospitals.

When a patient is admitted, the hospital must give the patient or their legal guardian the chance to formally name a caregiver. The facility records that person’s name, contact information, and relationship in the medical record, and the patient consents to sharing medical information with them so the hospital can communicate about the care plan.

Before the patient goes home or is transferred, the hospital must notify the designated caregiver. How much advance notice is required depends on the state.

The hospital must also give the caregiver hands-on instruction in the after-care tasks the patient will need at home. That can mean showing you how to change a wound dressing, administer medication through a feeding tube, or operate medical equipment. The training happens before discharge, not after.

One point worth flagging: being named as a caregiver under the CARE Act does not legally obligate you to perform any of those tasks. The designation triggers the hospital’s duty to inform and train you. Whether you take on the role remains your choice.

Who qualifies is patient-driven and broad. The patient picks. That can be a spouse, adult child, sibling, partner, friend, or neighbor. No blood relationship is required, only the patient’s consent to share medical information with you.

The RAISE Family Caregivers Act

The Recognize, Assist, Include, Support, and Engage Family Caregivers Act is a separate federal law enacted in 2018. It directed the Department of Health and Human Services to develop a national strategy for supporting family caregivers and established an advisory council of caregivers, healthcare providers, and policy experts to help shape it.

The RAISE Act does not create individual rights you can enforce in court. Its role is structural: it put family caregiving on the federal policy agenda and produced recommendations that continue to shape program funding and service delivery. If you are looking for enforceable protections, look to the CARE Act and the FMLA.

FMLA: Job-Protected Leave for Working Caregivers

The Family and Medical Leave Act is the primary federal law that protects a working caregiver’s job. Eligible employees can take up to 12 workweeks of unpaid, job-protected leave in a 12-month period to care for a spouse, child, or parent with a serious health condition.¹ Your employer must maintain your group health benefits while you are out and restore you to the same job or an equivalent position when you return.²

Two thresholds have to be met before those rights kick in:

Your employer must have had 50 or more employees on the payroll during at least 20 workweeks in the current or previous calendar year.³
You must have worked for that employer for at least 12 months, logged at least 1,250 hours in the preceding year, and work at a location where the employer has 50 or more employees within a 75-mile radius.¹

The 75-mile rule catches a lot of people off guard. You might work for a large company, but if your specific office is in a rural area without 50 coworkers nearby, you may not be eligible.

Who You Can Take Leave For

The FMLA is far more restrictive than the CARE Act about relationships. Job-protected caregiving leave covers only three: your spouse, your child, or your parent.² You cannot use FMLA leave to care for a sibling, grandparent, in-law, or close friend, no matter how serious the illness. An adult child qualifies only if incapable of self-care because of a disability.

“Parent” does extend beyond biology. It includes adoptive, step, and foster parents, and anyone who stood in the role of a parent to you when you were a child (the “in loco parentis” concept). A child can have more than one qualifying parent under this standard. If your employer asks for documentation, a simple written statement asserting the relationship is enough.⁴

One limit to keep in mind: in loco parentis applies to the FMLA’s definition of a child. It does not stretch to cover caring for an elderly person who is not your parent.

Military Caregiver Leave

Military families get a more generous entitlement. If you are the spouse, child, parent, or next of kin of a covered servicemember with a serious injury or illness, you can take up to 26 workweeks of leave in a single 12-month period.⁵ That is more than double the standard entitlement.

“Next of kin” is broader here than most people expect. It means the nearest blood relative, prioritized in this order: someone granted legal custody, siblings, grandparents, aunts and uncles, and first cousins. A servicemember can also designate a specific blood relative in writing. This expanded definition applies only to military caregiver leave; it does not carry over to standard FMLA leave for civilian family members.⁵

The 26-week entitlement is per servicemember and per injury. Unused leave at the end of the single 12-month period is forfeited for that particular injury, but a new 26-week period can begin if the same servicemember sustains a different qualifying injury or if you need to care for a different covered servicemember.⁵

What Counts as a Serious Health Condition

The FMLA does not cover every illness. A “serious health condition” means an illness, injury, or physical or mental condition involving either inpatient care (an overnight hospital stay) or continuing treatment by a healthcare provider.⁶

Common short-term problems like colds, the flu, earaches, upset stomachs, minor ulcers, and routine dental issues typically do not qualify on their own. Conditions such as cancer, stroke, severe injuries requiring surgery, chronic conditions like asthma or diabetes needing periodic treatment, and Alzheimer’s disease generally do. Mental illness and severe allergies can qualify if they meet the threshold of continuing treatment or incapacity.⁶

The practical test is whether the condition involves a period of incapacity along with ongoing medical treatment.

Intermittent Leave

You do not have to take all 12 weeks at once. When medically necessary, the FMLA allows intermittent leave in separate blocks or a reduced weekly schedule. This matters for caregivers managing chronic conditions with recurring appointments or unpredictable flare-ups. For planned treatments, you have to make a reasonable effort to schedule them so they do not unduly disrupt your employer’s operations, and your employer can temporarily transfer you to an alternative position with equivalent pay and benefits that better accommodates recurring absences.⁷

How to Actually Invoke These Rights

At the Hospital

Act early. Ask about caregiver designation as soon as your family member is admitted so the facility records your information. That designation triggers the hospital’s duty to notify you before discharge and train you on any medical tasks you will handle at home. The patient also has to consent to the release of their medical information to you; without that, the hospital cannot legally share discharge details, regardless of your relationship. Once designated, be proactive about requesting the hands-on training. Discharge can happen faster than expected.

At Work

The notice clock starts with you. If the need for leave is foreseeable, such as a scheduled surgery or planned treatment, you must give your employer at least 30 days’ advance notice.⁸ When that is not possible because of a medical emergency, you must notify your employer as soon as practicable.

Your employer will then give you FMLA paperwork, including a medical certification form. Your family member’s healthcare provider completes it to confirm the serious health condition. The employer must allow at least 15 calendar days for you to return it, and additional time if the provider needs it.²

Keep copies of every notice you give and every form you submit. If a dispute later comes up about whether you followed proper procedures, documentation is what separates a protected absence from an unexcused one.

State Paid Leave Programs

The biggest gap in the FMLA is that the leave is unpaid. Twelve weeks without a paycheck is not financially survivable for many caregivers. A growing number of states have stepped in with mandatory paid family leave programs that cover caregiving. As of 2026, roughly 15 states and the District of Columbia have enacted some form of paid family and medical leave, funded through payroll contributions from employees, employers, or both. Several programs are still phasing in, with benefit payments beginning on staggered timelines through 2028.

Maximum weekly benefits, eligibility rules, and the length of paid leave vary considerably. If you live in a state with a paid leave program, it usually runs alongside the FMLA rather than replacing it. You may be able to use paid state leave and FMLA protections at the same time, which gives you income and the guarantee of getting your job back. Check your state’s labor department website for the specifics that apply to you.

If Your Employer Breaks the Rules

Federal law makes it illegal for your employer to interfere with, restrain, or deny your right to take FMLA leave. It is also illegal to fire or discriminate against you for using leave, filing a complaint, or participating in any FMLA-related proceeding.⁹

The remedies are substantial. You can recover lost wages, salary, and employment benefits, plus interest. The law also provides for liquidated damages equal to the total of your lost compensation and interest, effectively doubling your recovery.¹⁰ Even if you did not lose wages, you can recover actual monetary losses tied to the violation, such as out-of-pocket costs for hiring replacement care.

Courts can also order equitable relief like reinstatement or a promotion you were denied. Your employer is responsible for your reasonable attorney’s fees and court costs on top of any damages.¹⁰ An employer can reduce the liquidated damages portion only by proving both that the violation was in good faith and that there were reasonable grounds for believing no violation occurred. That is a difficult standard to meet, so doubled damages are the norm rather than the exception.

The CARE Act, by contrast, generally does not include an individual right to sue a hospital for noncompliance. Enforcement varies by state, but most schemes rely on hospital licensing and regulatory oversight rather than private lawsuits. If a hospital fails to follow CARE Act requirements, reporting the issue to your state’s health department or hospital licensing authority is typically the correct path.

1
U.S. Department of Labor. Family and Medical Leave Act
2
U.S. Department of Labor. Fact Sheet 28 – The Family and Medical Leave Act
3
eCFR. 29 CFR 825.105 – Counting Employees for Determining Coverage
4
U.S. Department of Labor. Fact Sheet 28B – Using FMLA Leave When You Are in the Role of a Parent to a Child
5
eCFR. 29 CFR 825.127 – Leave to Care for a Covered Servicemember
6
eCFR. 29 CFR 825.113 – Serious Health Condition
7
U.S. Department of Labor. FMLA Frequently Asked Questions
8
eCFR. 29 CFR 825.302 – Employee Notice Requirements for Foreseeable FMLA Leave
9
Office of the Law Revision Counsel. 29 USC 2615 – Prohibited Acts
10
Office of the Law Revision Counsel. 29 USC 2617 – Enforcement