Below is the House Resolution introduced on March 19, 2009 by Rep. Alcee Hastings which calls for integrating the conversation about long-term care into the larger health care reform movement (among other things). Read below and comment with your reaction. Better yet, contact your congressmen and let them know if you support this legislation.
111TH CONGRESS 1ST SESSION H. RES. 271
Recognizing the need to support the development and enforcement of a
well-informed national long-term care strategy to solve the problems
of cost, quality, and access to long-term care in the home and community,
and the imperativeness of including long-term care in the comprehensive
health care reform agenda.
IN THE HOUSE OF REPRESENTATIVES
Mr. HASTINGS of Florida submitted the following resolution; which was
referred to Committee.
RESOLUTION
Recognizing the need to support the development and enforcement
of a well-informed national long-term care
strategy to solve the problems of cost, quality, and access
to long-term care in the home and community, and the
imperativeness of including long-term care in the comprehensive
health care reform agenda.
Whereas well over 9.4 million adults receive long-term care
in the United States;
Whereas long-term care refers to a broad range and network
of health and social services that are used by persons who
cannot care for themselves because of a physical, cognitive,
or mental disability, or a combination thereof;
Whereas long-term care may involve assisting an individual
with dressing, bathing, transportation, and medication
management or therapeutic and medical services;
Whereas 80 percent of long-term care now occurs in the
home and is accompanied by community services such as
Adult Day Care Programs, home-delivered meals programs,
mental health services, and training programs for
family caregivers;
Whereas many informal caregivers are in the ‘‘sandwich generation’’,
which are middle-age people who are simultaneously
caring for children and older family members;
Whereas family caregivers sometimes endure emotional and
physical stress, and make significant financial and career
sacrifices to provide long-term care;
Whereas the vast majority of the ‘‘sandwich generation’’ and
caregivers of all ages are women;
Whereas most long-term care health workers are also women;
Whereas home health aides are largely low-income women of
color with families, and perform a variety of medical and
personal services that are vital to long-term care;
Whereas home health aides are not subject to national standards
or covered by the Fair Labor Standards Act, which
contributes to variations in competency, education, and
staff shortages;
Whereas the number of people who are in need of long-term
care is expected to grow due to the nation’s large aging
population, longer life spans among the chronically ill and
disabled, and higher incidence of acquired disabilities
from unmanaged conditions such as heart and respiratory
disease, obesity, stroke, and diabetes;
Whereas there is a serious lack of long-term care facilities
and services for people with mental disabilities;
Whereas, although long-term homecare plays a strong role in
the way that care is received and provided, there has
never been a comprehensive national plan for long-term
care, particularly regarding homecare and community
services;
Whereas the last time that Congress comprehensively reviewed
policy options for long-term care reform was nearly
two decades ago, under the United States Bipartisan
Commission on Comprehensive Health Care;
Whereas more information is needed about the use and need
for long-term care services, especially among children and
people residing in rural areas;
Whereas the limited data on the use and need for long-term
care hinders the development of a targeted strategy to
address the disparities in routine access to quality longterm
care in the home and surrounding community;
Whereas a significant portion of formal long-term care costs
are financed with personal funds;
Whereas this method of payment potentially poses economic
burdens that can result in financial ruin, including medical
bankruptcy;
Whereas the largest public payer for long-term care is Medicaid,
which allows States to enforce strict requirements
for eligibility, and discourages some Medicaid recipients
from acquiring a higher income for fear of losing Medicaid
benefits;
Whereas although most prefer to receive long-term care in
their homes and communities, the majority of Medicaid
long-term care expenditures finance institutional care;
Whereas mentally and physically disabled persons who require
long-term care are more likely to be poor than people
who are not disabled;
Whereas income typically decreases after retirement;
Whereas people 85 and older have the highest probability of
being low income among the elderly, and the highest
probability of requiring long-term care services;
Whereas these financial realities make it difficult for patients
to pay for long-term care or purchase long-term care insurance;
Whereas persons who buy long-term care insurance are more
likely to have an above-average income;
Whereas there remains a severe lack of national standards in
quality and certification in many facets of long-term care,
particularly homecare and community services; and
Whereas there is no national standard for adult day care, a
community service that is used by people who have mental
disabilities, or who have physical disabilities from conditions
such as HIV/AIDS, respiratory disease, and
stroke:
Now, therefore, be it Resolved, That the House of Representatives—
(1) commits to integrating long-term care, particularly as
it relates to homecare and community
services, into a comprehensive health care reform
agenda because of its important role in the present
and future success of the United States’ health care system;
(2) regards preventative health and the management
of chronic disease as essential components
in decreasing the future dependence on long-term
care by preventing conditions, such as heart and respiratory
disease, diabetes, HIV/AIDS, stroke, and
obesity, from becoming permanently debilitating or disabling;
(3) recognizes the need to collaborate with local,
State, and Federal health care entities to improve
working conditions and training for home health
aides, a profession that is a crucial part of long-term
care with the intention of lowering turnover rates,
staff shortages, patient abuse, and raising the standard of care;
(4) recognizes the need to adequately fund and
support existing technologies, entities, and initiatives
that assist informal care givers, and help maintain
and improve long-term health services for the disabled
and elderly, such as the Older Americans Act
of 1965 (Public Law 89–73), Social Services Block
Grants, and the Department of Housing and Urban
Development programs;
(5) recognizes that Medicaid and out-of-pocket
spending, the dominate methods for financing longterm
care, exclude countless persons from receiving
health care service which can lead to more costly
and invasive medical interventions, and that alternative
payment options should be widely available
and more accessible; and
(6) commits to aiding relevant parties in composing,
executing, and enforcing a well-informed national
strategy for long-term care that will address
geographic and economic disparities that limit access
to care, expand long-term health services, and
streamline quality measures.
*Indicates original cosponsor and date they signed on
Rep Brown, Corrine [D-FL-3] - 3/19/2009 *
Rep Castor, Kathy [D-FL-11] - 3/19/2009 *
Rep Christensen, Donna M. [D-VI] - 3/19/2009 *
Rep Conyers, John, Jr. [D-MI-14] - 3/19/2009 *
Rep Courtney, Joe [D-CT-2] - 3/19/2009 *
Rep DeLauro, Rosa L. [D-CT-3] - 3/24/2009
Rep Frank, Barney [D-MA-4] - 3/19/2009 *
Rep Grijalva, Raul M. [D-AZ-7] - 3/19/2009 *
Rep Kaptur, Marcy [D-OH-9] - 3/19/2009 *
Rep Lee, Barbara [D-CA-9] - 3/19/2009 *
Rep McGovern, James P. [D-MA-3] - 3/19/2009 *
Rep Meeks, Gregory W. [D-NY-6] - 3/19/2009*
Rep Moore, Dennis [D-KS-3] - 3/24/2009
Rep Watson, Diane E. [D-CA-33] -3/23/2009
Rep Welch, Peter [D-VT] - 3/19/2009 *
Rep Wexler, Robert [D-FL-19] - 3/19/2009 *
Rep Nadler, Jerrold [D-NY] - 3/25/2009
Rep Cleaver, Emanuel [D-MO] - 3/25/2009
Rep Eleanor Holmes Norton [D-DC] - 3/26/2009
Rep Carolyn C. Kilpatrick [D-MI] -3/26/2009
Comment Below: Is this resolution too strong? too weak? just right? Does it address the major issues that you would like addressed? What else should it include? Will you be contacting your congressmen about signing onto this resolution? Post your letters of support below.
I agree and disagree with some of what has been posted in this article. My name is Anthony Combs and I am a 36 year old C-4 quadriplegic. I became paralyzed in 1993 from a diving accident at the age of 20. I have been on both sides of this article. I have lived in one nursing home for about 10 years and while in that home I endured many abuses. To the point of losing both of my legs to the loss of my left kidney to receiving a permanently dislocated hip and multiple stage 4 decubs. After complaining to the state time and time again with out any results they kicked me out when I had hard evidence to prove my case. When I left I went to stay with a friend and all of the wounds I had for roughly 3 years in the nursing home she got them healed in less than one year. They then put my on the black list and no nursing home is willing to take me. After my friend got sick I had to find a place and after finagling my way into another facility they were trying to find was to get me out. I have always been trying to get back out on my own and away from the neglect and abuses. I have finally been able to get out on my own April 24th 2008 and have by the grace of God. However the Medicaid funded program call CAPS dropped me not even two months after being accepted on the program and being in my own apartment. They first stated safety issues then after my first hearing when they realized there were really no safety issues they then jumped to budget issues. They stated that I was going over my budget of roughly $2700 a month. I receive 39 hours a week in nursing assistant care and 2 hours of case management work. They pay for some supplies as well. Come to find out that my insurances, Medicaid and Medicare were being grossly over charged for my medical supplies. The agency Total Care Gentivia was charging Medicaid/Medicare roughly $1700 a month for my semi-electric bed. $1400 a moth for my alternating pressure mattress and roughly $1200 a month for my Hoyer lift just in rental fees. They stated that after a year the equipment would then become mine. So in rental fees alone it would have cost the tax payers roughly $50,000 for that year before the equipment would release as my own. However a new bed would cost about $2000-$3000, a mattress about $500-$1000 and a Hoyer about $1000 and be paid for unless they found used equipment. So for around $5000 I could have had everything and saved the tax payers about $45,000. What I did because that was CAPS biggest argument I search for some equipment on my own. I found a used Hoyer lift on Craig’s list for $100. I then searched online for a good deal on alternating pressure mattresses and found a great mattress on EBay, brand new and I paid including shipping and handling, $114. I then found a new never slept in semi-electric hospital bed at a thrift store and talked to the manager. I got in July 2008 a 2007 bed for $97, yes $97. So for just over $300 I purchased my own equipment and saved tax payers a lot of money. CAPS is still trying to kick me off of their program but I have filed an appeal since I did lose my first hearing. I don’t think they are used to having younger people who can stand up for themselves on their program. I have butted heads with my case manager ever since I started on the program. I have not been sick like I was in the nursing homes. I was going to the hospital several times a month and had constant urinary tract infections almost every other month. Since I’ve been in my own apartment and out of a nursing facility I have only had 1 urinary tract infection and had only two hospital stays. One was for that UTI and the other was for a surgery that was planned before I even left the nursing home. As I see it I am much better out on my own and not in a facility. However there are really no other programs for persons with disabilities to try and get them out of facilities and on there own. CAPS constantly said I needed 24 care and I couldn’t live by myself. I have proven that theory wrong. April 24th will mark my one year anniversary on my own and with only 6 hours a day of care. I’d love to talk to someone about my experiences and what I’ve had to fight for to get where I’m at now. I am still waiting for my state appeal to be able to remain on my own and free from a nursing home. However no nursing home is willing to take me. so I’m stuck between a rock and a hard place but I’m loving it because I’m free. I have so much more to say so if you’re interested in hearing please email me at [email protected]
Posted by: Anthony Combs | April 07, 2009 at 10:19 AM
Healthcare in california, being cut right an
left. What are we going to be left with? We
are due to lose a number of doctors to cuts
in a system that only has a budget in mind.
We are adults, not pregnant, an not children
so we don't matter much to a population that
believes we should just be put away into the
local nursing homes. Many of us don't meet
the requirements for nursing homes, yet we
can be kicked off our needed programs just
because we don't qualify. I am a catch-22
professional...does that mean that I work,
no, I am active, an I do volunteer, but I
am not an have not been employed, therefore
I don't get the necessary assistance that I
would qualify for if I were employed. I am
a professional catch-22, as I have been a
lifetime of falling thru all the cracks in
the systems for not nearly qualifing for the
badly needed supports. I have had IHSS for
several years, an have had just under 60hrs
per. mo., instead of giving me 60hrs, they
cut me completely off, not just reducing me
to 45hrs, but to 00hrs per mo., so as my hair,
laundry, an household doesn't get any
support, I am at odds of any assistance to
keeping my section 8 due to the lack of any
assistance to make things better.
For lack of a worker, I was cut off,when the system
that is expected to make things better doesn't work,
an badly in need of the repair, under ILC it ran a whole lot
better, as I did get the needed assistance
to hire a competent worker that was at
least prescreened, this never being the case for the
acclaimed Public Authority/IHSS workers.
Thanks, hope there is some avenue, short of
rushing into a nursing home to connect to
community resources that really are not or nolonger
exists in this good ole boy town.
Posted by: virginia rite tabled | June 12, 2009 at 12:59 AM
During the time I was a caregiver for my late parents, I realized the difficulties and indignities that many of our frail elderly and disable endure, in an effort to have the choice of remaining in one's own home with the proper care. Hence, I proposed this legislation H.RES.271, that Congressman Alcee Hastings introduced to the U.S.House of Representatives in 2002, and which now has 24 co-sponsors. It is also supported by the Florida legislature. The premise of this legislation is that the same funding be available to keep one in his own home with the proper care as is provided for nursing home care. In addition, there must be more stringent guidelines for the certification of nursing assistants and home health aids. My advocacy has led me to host and produce programs for both radio and television that serve not only as a voice for those needing care, but to bring awareness of these needs to Congress. There is no better advocate than one who has walked in the shoes. Therefore, we must continue to speak up and be heard. YOU can make a difference. I know....I was one voice that did.
Posted by: jewel littenberg | November 02, 2010 at 02:29 PM