[Congressional Record Volume 140, Number 17 (Thursday, February 24, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: February 24, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                          FACES OF HEALTH CARE

  Mr. FEINGOLD. Madam President, I rise to continue my floor statements 
on the need for long-term care reform as part of the health care reform 
effort.
  I am proud to be part of an effort that we are making on the floor, 
those of us who support health care reform and universal health care, 
to portray in a very human way the faces of health care, the faces of 
those who often do not get health care.
  As I have noted in earlier statements, establishing consumer-oriented 
and consumer-directed flexible benefits, as well as making fundamental 
reforms to the linkages between the long-term care and acute care 
systems, are absolutely necessary if we are to realize the goals of 
health care reform.
  President Clinton's home- and community-based long-term care proposal 
goes further than any other in achieving this needed reform. It lays 
the groundwork for creating a system of community- and home-based 
flexible services that respond to individual consumer choice and 
preference.
  Madam President, I am proud to note that much of the basis for the 
President's long-term care reform provisions flow from a program 
established in Wisconsin in the early 1980's--the Community Options 
Program, known as COP.
  COP has been an enormous success by any measure. It has provided 
long-term care consumers with an alternative to institutional care by 
establishing a program of flexible benefits that are consumer-oriented 
and directed. It has saved State taxpayers hundreds of millions of 
dollars, and has been instrumental in actually lowering the number of 
Medicaid nursing home beds being used in the State at a time when the 
rest of the country was experiencing significant increases in Medicaid 
nursing home bed use.
  President Clinton's long-term care reform proposal can achieve the 
same success for the entire country.
  Madam President, more than any other group, advocates of long-term 
care reform like to tell stories and give examples. Part of this desire 
comes from the advocates themselves--people committed to helping 
others.

  But it also stems from the need to emphasize the uniqueness of every 
long-term care situation, and to stress the need for a system that is 
flexible enough and consumer friendly enough to respond to those unique 
situations.
  Recently I had the privilege of holding a field hearing of the Senate 
Special Committee on Aging in my home State of Wisconsin. The hearing 
was on the President's long-term care plan, and we invited a variety of 
people to testify.
  Madam President, I want to talk today about two of the witnesses that 
appeared at the field hearing. Better than any list of statistics, the 
story of these two people demonstrates both the promise of and the need 
for long-term care reform.
  First, let me tell you about a man named Robert Deist. Bob was left a 
quadriplegic as a result of a bullet wound at the age of 14. He has 
experienced just about every facet of the long-term care system. He was 
institutionalized at age 15 because there were no community services 
available to him or his family, and, at that time, his parents could 
not afford to quit their jobs and provide him care in their home.
  Eventually, though, at great financial loss to her family, Bob's 
mother quit her job to take care of Bob at home.
  Bob eventually went to college, got married, and is currently the 
director of two personal care programs at an independent living center 
in Wisconsin. He hopes to work until retirement age, but his wife is 
his only caregiver.
  Even though both Bob and his wife work, they cannot afford to pay for 
a personal care attendant to come to their home and assist Bob with his 
care needs. And because he works, Bob is not eligible for government 
funding to pay for his daily care needs.
  As Bob noted, in his testimony to our committee, his wife provides 
his care 7 days a week, 52 weeks a year, every year, whether she is ill 
or injured. If she were not able to provide Bob's personal care needs 
for some reason, even for just a few weeks, their savings would be gone 
and they would probably lose their home.
  Bob and his wife live at the edge every single day of their lives.
  As I mentioned earlier, Bob is the director of two personal care 
programs. One of those programs serves long-term care consumers who use 
Wisconsin's Community Options Program. So even though Bob actually runs 
a program that uses COP funds, Bob himself is unable to get on the 
program because it has a long waiting list. There are a lot of people 
that need these services. Because of the huge demand for services, he 
is unlikely to become eligible for years.
  With President Clinton's long-term care proposal in place, Bob would 
be eligible for services almost immediately. The very real threat to 
Bob and his wife of imminent financial disaster would begin to 
ultimately disappear, and he could begin to utilize the kinds of 
flexible services available through the very program he runs.
  Another long-term care consumer, Jettie Jones of Milwaukee also 
testified before our committee. Her husband Launcelot has been a COP 
recipient for 4 years.
  Launcelot has been an active community advocate on behalf of seniors 
for some time. Retired from the Department of Housing and Urban 
Development, he is now in frail health, having heart trouble, is 
visually and physically impaired, and is a borderline diabetic. Jettie 
is not able to provide all the care Launcelot needs.
  Launcelot was a classic candidate for a nursing home.
  But because of the Community Options Program in Wisconsin, Launcelot 
and Jettie have been able to remain together. As Jettie said, COP has 
enabled them to maintain our dignity and our love and relationship as a 
family unit.

  COP provides Launcelot adult day care at Village Church in Milwaukee, 
where he receives meals and socializes with others. COP also provides 
transportation to and from the day care as well as transportation to 
and from the doctor.
  COP provides a personal care attendant who comes to the Jones home 4 
hours per week, and a homemaker who helps Jettie maintain the home.
  Jettie and Launcelot Jones are an example of what can be achieved 
with a flexible, consumer oriented long-term care program. Without COP, 
Launcelot and Jettie would not be able to live together.
  Madam President, thousands of elderly couples like the Joneses are 
forced to separate and impoverish themselves in order to get needed 
long-term care services in the only setting available to them-a nursing 
home.
  Thousands of disabled consumers who could live and work productively 
in a home or community setting are forced to live out their days 
without that opportunity.
  And thousands more like Bob Deist, who is able to live and work in 
the community only while his wife is able to provide him care, live 
with the daily threat that the least disturbance or misfortune could 
bankrupt them in days or weeks.
  In some of the most eloquent testimony I have heard on long-term 
care, Chuck McGlaughlin, a county long-term care administrator, 
testified at our hearing that prior to the Community Options Program, 
elderly and disabled people had few choices. Unless they were wealthy 
enough and had a sufficient natural support system to remain in their 
home, they had no alternative but to enter a nursing home.
  McGlaughlin noted that these people were torn from familiar places 
and familiar people, an lost the continuity of their lives. While some 
eventually adjusted to leaving their homes and communities, others 
never did.
  And some he saw simply willed their own death because they saw no 
reason to continue living.
  In contrast to the grim lack of choice for the elderly and disabled, 
McGlaughlin recalled thinking that when he went to the grocery store, 
there was an incredible choice available to consumers, even an entire 
aisle for various types of pet food.
  It seemed a sad reality to McGlaughlin that society has been doing a 
much better job at providing meal diversity to cats and dogs than they 
were doing at offering choices to humans facing frailty.
  Madam President, I can and have made arguments on this floor about 
the need for long-term care as a part of health care reform as a way to 
control costs, as a way to ensure that our acute care reforms can work, 
and as a guarantee that we can realize the goal of a reduced Federal 
budget deficit. And I believe all of that is the case.
  But, Madam President, to me the most persuasive argument for long-
term care reform is a human one.
  We must provide our seniors and others with mental and physical 
disabilities with real choice. They are entitled to the opportunity to 
continue to live and contribute in the homes and communities they have 
helped build and sustain.
  Madam President, to conclude, I am very glad to have the opportunity 
to join with other Senators in trying to show the faces of health care 
and, in particular, that many of those faces are ones who need long-
term care.
  I yield the floor.
  Madam President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The absence of a quorum has been suggested. 
The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mrs. FEINSTEIN. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  Mrs. FEINSTEIN. Mr. President, I ask unanimous consent that I be 
recognized to speak in morning business.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered. The Senator from California is recognized to speak for up to 
20 minutes.
  Mrs. FEINSTEIN. Thank you very much, Mr. President. I would like to 
speak this morning on two subjects. The first involves a piece of 
legislation I would like to introduce and the second an update on 
legislation which the Senate passed and is now before the House.
   (The remarks of Mrs. Feinstein, Ms. Moseley-Braun, and Mr. Simon 
pertaining to the introduction of S. 1864 are located in today's Record 
under ``Statements on Introduced Bills and Joint Resolutions.'')

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