[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H. Res. 271 Introduced in House (IH)]

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

                             March 19, 2009

  Mr. Hastings of Florida (for himself, Mrs. Christensen, Ms. Lee of 
California, Mr. Wexler, Mr. McGovern, Ms. Corrine Brown of Florida, Mr. 
Conyers, Mr. Courtney, Ms. Castor of Florida, Mr. Grijalva, Ms. Kaptur, 
   Mr. Meeks of New York, Mr. Welch, and Mr. Frank of Massachusetts) 
submitted the following resolution; which was referred to the Committee 
on Energy and Commerce, and in addition to the Committees on Financial 
 Services, Ways and Means, and Education and Labor, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                               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 long-term 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 long-term 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.
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