[Congressional Record Volume 144, Number 108 (Tuesday, August 4, 1998)]
[House]
[Pages H7004-H7005]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          HOME HEALTH CARE SYSTEM SUFFERING STATE OF EMERGENCY

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 21, 1997, the gentlewoman from Michigan (Ms. Stabenow) is 
recognized during morning hour debates for 5 minutes.
  Ms. STABENOW. Madam Speaker, I rise today to declare a state of 
emergency. Our home health care industry is suffering from drastic cuts 
to the Medicare reimbursement system that was done in last year's 
balanced budget agreement. Cuts were made to reduce fraud and abuse, 
but these cuts unfortunately have had unintended consequences.
  To date, over 1,200 home health agencies have gone out of business, 
and that number is expected to triple by the end of September, and 
these are not the high-cost agencies. Families are suffering. The new 
payment system for home health is so restrictive that patients who 
require the most expensive care will be the first to lose their care. 
The sickest and most feeble will be left in the cold.
  I have visited many families and have made many home visits over the 
years. I know how important it is for individuals to receive care in 
their own home whenever possible where they can be surrounded by family 
and friends who love them. We are not just talking about the elderly, 
we are talking about children, we are talking about the disabled, 
anyone who needs to be in their home and receive home health care.
  Home health care is a critical element of our Nation's health care 
safety net and that safety net is quickly unraveling as more and more 
patients are unable to receive care and more and more home health care 
agencies shut their doors.

[[Page H7005]]

  Madam Speaker, I would like to put a human face on this issue and 
share one of the many constituent letters I have received from families 
who are afraid that a loved one will lose their home health care.

       Dear Ms. Stabenow:
       Suppose you were 84 years old, living on a Social Security 
     monthly check of $650 in a small town. Suppose further that 
     approximately one-and-a-half years ago you were declared 
     legally blind because of complications from diabetes, and 
     then one year ago you fell and broke your hip, but most 
     importantly, through all of this you kept a sound mind and 
     you owned your own home and had lived alone since your 
     husband died 25 years earlier.
       Now suppose also that when you broke your hip you had to be 
     put in a nursing home, and the only one with available beds 
     was 45 minutes from your home, family and friends. Now, 
     further suppose that thanks to a home health care program, 
     you were able to return home where you could live in your own 
     home, talk to your friends on the telephone, attend senior 
     citizen functions, keep your dog, and live somewhat of a 
     normal life. All of this is possible because home health care 
     provided:
       A nurse to oversee administering of daily insulin, which 
     you could not give yourself because you could not see, and an 
     aid to come in twice a day for an hour to make sure you were 
     well, got your bath, had breakfast and dinner, and had 
     regular contact with the outside world.
       I do not have to suppose any of this, because that 84 year 
     old woman is my mother. I am not a great supporter of 
     government programs, but taking care of our elderly so they 
     can live with dignity has got to be a valid issue for 
     government.
       After such a long introduction, why am I writing this, my 
     first-ever letter to a Congresswoman? Why, because the 
     Balanced Budget Act has endangered my mother's home health 
     care. She is in danger of losing her home and really, her 
     life. The spending limits will cause the Health Department to 
     drop her from the program. The only alternative is a nursing 
     home. My mother cannot continue to live alone without the 
     assistance that she has been receiving. Please help to 
     restore the budget cuts in Medicare.

  I urge my colleagues today to act quickly. There are many initiatives 
that have been introduced by the gentleman from Massachusetts (Mr. 
McGovern); the gentleman from Oklahoma (Mr. Coburn); the gentleman from 
West Virginia (Mr. Rahall); the gentleman from New Jersey (Mr. Pappas); 
the gentleman from Rhode Island (Mr. Weygand), to name just a few, and 
there are several bills. Unfortunately, we must act now if we are going 
to solve this issue in time for too many families.
  First, I am pleased to join with the gentleman from Oklahoma (Mr. 
Coburn); the gentleman from Massachusetts (Mr. McGovern); and the 
gentleman from Rhode Island (Mr. Weygand) today in urging the immediate 
adoption of the Home Health Access Preservation Act, a bill that will 
correct many of these problems, and I urge immediate consideration by 
this House.
  If this does not happen quickly, then I would secondarily urge that 
the bill introduced by the gentleman from West Virginia (Mr. Rahall) 
and myself and others that would place a 3-year moratorium on the 
interim perspective payment system for home health care benefits be 
passed immediately. We must act either to fix the problem or put a 
moratorium on the current payment system until it is fixed, or we are 
going to see more and more serious repercussions for our families.
  Madam Speaker, after a serious examination of the data, I believe 
that either of these approaches are budget-neutral. The Balanced Budget 
Agreement has targeted $16.1 billion in savings to home health care. 
But the new CBO baseline now projects Medicare savings will exceed $26 
billion.
  This is $9.9 billion more than the expected savings from the Balanced 
Budget Agreement. Unfortunately this savings has been achieved on the 
backs of efficient, quality home care providers and the people who need 
care.
  In the next few days I will be asking my colleagues to join me in a 
letter to President Clinton and to Speaker Gingrich. The letter will 
urge them to recognize the crisis in the home health care industry and 
implore them to make the resolution of this crisis a national priority. 
Congress should not let one more family or one more senior citizen 
suffer. Madam Speaker, I urge my colleagues to sign these letters and 
to get involved in finding an immediate solution to this home health 
care crisis. Thank you.

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