[Congressional Record Volume 149, Number 34 (Tuesday, March 4, 2003)]
[House]
[Pages H1481-H1484]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
ESTABLISHING AN ANNUAL VISITING NURSE ASSOCIATION WEEK
Mrs. MILLER of Michigan. Mr. Speaker, I move to suspend the rules and
agree to the concurrent resolution (H. Con. Res. 54) expressing the
sense of the Congress that there should be established an annual
National Visiting Nurse Association Week.
The Clerk read as follows:
H. Con. Res. 54
Whereas visiting nurse associations (VNAs) are nonprofit
home health agencies that, for over 120 years, have been
united in their mission to provide cost-effective and
compassionate home and community-based health care to
individuals, regardless of the individuals' condition or
ability to pay for services;
Whereas there are more than 500 visiting nurse
associations, which employ more than 90,000 clinicians,
provide health care to more than 4,000,000 people each year,
and provide a critical safety net in communities by
developing a network of community support services that
enable individuals to live independently at home;
Whereas visiting nurse associations have historically
served as primary public health care providers in their
communities, and are today one of the largest providers of
mass immunizations in the medicare program (delivering over
2,500,000 influenza immunizations annually);
Whereas visiting nurse associations are often the home
health providers of last resort, serving the most chronic of
conditions (such as congestive heart failure, chronic
obstructive pulmonary disease, AIDS, and quadriplegia) and
individuals with the least ability to pay for services (more
than 50 percent of all medicaid home health admissions are by
visiting nurse associations);
Whereas any visiting nurse association budget surplus is
reinvested in supporting the association's mission through
services, including charity care, adult day care centers,
wellness clinics, Meals-on-Wheels, and immunization programs;
Whereas visiting nurse associations and other nonprofit
home health agencies care for the highest percentage of
terminally ill and bedridden patients;
Whereas thousands of visiting nurse association volunteers
across the Nation devote time serving as individual agency
board members, raising funds, visiting patients in their
homes, assisting in wellness clinics, and delivering meals to
patients;
Whereas the establishment of an annual National Visiting
Nurse Association Week would increase public awareness of the
charity-based missions of visiting nurse associations and of
their ability to meet the needs of chronically ill and
disabled individuals who prefer to live at home rather than
in a nursing home, and would spotlight preventive health
clinics, adult day care programs, and other customized
wellness programs that meet local community need; and
Whereas the second week in May is an appropriate week to
establish as National Visiting Nurse Association Week: Now,
therefore, be it
Resolved by the House of Representatives (the Senate
concurring), That it is the sense of the Congress that there
should be established an annual National Visiting Nurse
Association Week.
The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from
Michigan (Mrs. Miller) and the gentleman from Illinois (Mr. Davis) each
will control 20 minutes.
The Chair recognizes the gentlewoman from Michigan (Mrs. Miller).
General Leave
Mrs. MILLER of Michigan. Mr. Speaker, I ask unanimous consent that
all Members may have 5 legislative days within which to revise and
extend their remarks on the concurrent resolution under consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentlewoman from Michigan?
There was no objection.
Mrs. MILLER of Michigan. Mr. Speaker, House Concurrent Resolution 54,
introduced by my distinguished colleague, the gentleman from
Massachusetts (Mr. Markey), expresses the sense of the Congress that
there should be established an annual National Visiting Nurse
Association Week.
Mr. Speaker, visiting nurses provide an invaluable medical service to
countless people across our great country. For more than 120 years,
these admirable citizens have helped to promote health and to prevent
disease by providing skilled nursing care in the homes of millions of
sick Americans each and every year. These caring nurses treat illnesses
of all varieties, from the initial symptoms of the common cold and flu
to the gravest stages of heart disease, of AIDS, and of cancer.
I would like to just give an example of one such person. Her name is
Marcia Nowc, and she lives in my district, the Tenth Congressional
District of Michigan; and she truly epitomizes the hard work and
selflessness demonstrated by visiting nurses across our great country.
Her profession is nursing, and while she makes her living doing this,
she also volunteers for an organization called Neighbors Caring for
Neighbors Outreach Clinic. This clinic provides medical services,
laboratory tests and x-rays to some of our most vulnerable families and
individuals, often free of charge, thanks to the volunteer efforts of
visiting nurses, like Mrs. Nowc. Nurse Nowc's volunteer activities are
supported by 16 churches in Macomb County, Michigan; and oftentimes
visiting nurses, just in their everyday work, truly demonstrate how
faith-based initiatives can provide an essential support system within
our communities.
Many of these visiting nurses literally work miracles every day
because they give so generously of their time and of their spirit and
because they recognize the dignity of every citizen and the
possibilities of every life. Many times visiting nurses provide care to
those that might be considered on the outer fringe. Perhaps they are
underinsured; they may be the working poor or may even be homeless.
Visiting nurse associations are nonprofit home health agencies
located throughout the United States that aim to enhance the quality of
life of all through comprehensive home and community health services.
Often, these organizations provide in-home services that are available
24 hours a day, 7 days a week to Americans in need. It is truly
worthwhile for this House to honor the compassion and the sense of
obligation exhibited by visiting nurses for well over a century.
It is not an exaggeration to say that America's visiting nurses are
some of our Nation's greatest treasures and greatest traditions.
Therefore, Mr. Speaker, I urge all Members to support the adoption of
House Concurrent Resolution 54.
Mr. Speaker, I reserve the balance of my time.
[[Page H1482]]
{time} 1430
Mr. DAVIS of Illinois. Mr. Speaker, I yield such time as he may
consume to the gentleman from Massachusetts (Mr. Markey), the sponsor
of this legislation.
Mr. MARKEY. Mr. Speaker, I thank the gentleman for yielding me this
time, and I thank the gentleman from Pennsylvania (Mr. Peterson) for
all of the gentleman's excellent work on this legislation.
This is the kind of thing that kind of mystifies the American public
sometimes, they do not understand that 80 percent of everything that we
do, we agree. Most of the time they only focus on the 20 percent where
we disagree. For the vast majority of issues, there is a consensus in
terms of what our country should be doing and where we agree. Today I
am proud, with these other great Members, to offer this resolution to
establish an annual National Visiting Nurse Association Week in honor
of the army of health care heroes, who every day comfort, care for and
assist our loved ones.
I appreciate the support and the dedication of the Visiting Nurse
Associations. Every Member of Congress does, as does every American.
Visiting Nurse Associations of today are founded on the principle that
the sick, the disabled and the elderly benefit most from health care
when it is offered in their own homes.
They are nonprofit home health agencies that provide cost-effective
and compassionate home and community-based health care to individuals,
regardless of their condition or ability to pay for services.
Through these exceptional organizations, 90,000 clinicians dedicate
their lives to bringing health care into the homes of over 4 million
Americans every year.
In the face of rising costs and drastic changes in our health care
system, visiting nurse associations have continued to deliver high
quality health services for over 120 years.
When Henry Wadsworth Longfellow read of the work of Florence
Nightingale, he penned a poem, Santa Filomena, that spoke of the keep
appreciation owed by all of us to those dedicated to service in the
ultimate caring profession, the visiting nurse. He wrote of her as he
could have written of every other visiting nurse. ``Whene'er a noble
deed is wrought, whe'ever is spoken a noble thought, our hearts, in
glad surprise, to higher levels rise.
``The tidal wave of deeper souls into our inmost being rolls, and
lifts us unawares out of all meaner cares.''
Mr. Speaker, today I would like to say my own thank you to our
Visiting Nurse Associations. Through their work and their philosophy of
nursing, they teach us every day about human kindness, the strength of
human character, and the true definition of what it means to care. I
thank them for their sharp minds, their watchful eyes, their nerves of
steel; and, of course, their hearts of gold.
In recognition of their hard work and dedication that visiting nurses
bring to the nursing profession, and the comfort and quality care that
they provide to patients, I ask Congress to please support this
resolution to set aside one week each year to recognize and honor
visiting nurses across the country. Democratic, Republican, liberal,
conservative, each of us owes them an enduring debt.
Mrs. MILLER of Michigan. Mr. Speaker, I yield such time as he may
consume to the gentleman from Pennsylvania (Mr. Peterson).
Mr. PETERSON of Pennsylvania. Mr. Speaker, I thank the gentlewoman
for yielding me this time.
Mr. Speaker, I am delighted to join the gentleman from Massachusetts
(Mr. Markey) and the gentlewoman from Michigan (Mrs. Miller) today on
this resolution establishing a national Visiting Nurse Associations
Week.
As we were growing up, doctors visited homes and nurses visited
homes. Today it is seldom that a doctor visits a home unless it is a
personal friend; but the visiting nurses just keep right on trucking.
Serving communities around the country for over 120 years,
congressional recognizing and gratitude for these nonprofit health
agencies is long overdue. The nearly 500 VNAs across the country
collectively provide home and community-based services to over 4
million Americans each year. Founded in the 1890s, VNAs have
continuously served as charitable providers in their local communities,
creating a safety net for the poorest and most chronically ill and
functionally disabled individuals. VNAs serve the majority of Medicaid
home health beneficiaries and represent nearly one-half of all
nonprofit home health agencies in the United States. On average,
Medicare and Medicaid represent approximately 82 percent of VNAs'
revenue, and this percentage is even greater in rural areas such as my
rural congressional district.
Mr. Speaker, this fact is significant because rural America has
always been shortchanged in the Medicare payment system. My rural
providers are asked to provide the same level of care with less Federal
dollars, even though wage rates have largely equalized between rural
and urban areas due to the current workforce shortage. The Medicare
home health reimbursement was slashed by 15 percent last October, and
the 10 percent rural add-on is set to expire this April. Home health
providers, including VNAs, are being crippled by these cuts and I will
continue to fight as co-chairman of the Home Health Working Group to
resist them. In the meantime, I am pleased to introduce this resolution
with my colleague from Massachusetts to demonstrate our continued
support for these under-recognized heroes.
In a country struggling with staggering health care costs, the
Visiting Nurse Association continually and successfully works to
achieve its mission of cost-effective and compassionate home and
community-based health care to individuals, regardless of the
individuals' condition or ability to pay for those services. They are a
leading provider of mass immunizations in the Medicare program and
constitute over 50 percent of all Medicaid home health admissions. The
association relies heavily upon volunteer nurses and reinvests any
budget surplus into charity care, adult day care centers, wellness
clinics, Meals-on-Wheels, and immunization programs.
This resolution will establish an annual National Visiting Nurse
Associations Week in order to increase public awareness of the charity-
based organization. They unquestionably deserve recognizing for their
noble services; and by establishing this resolution, Congress would
support the continuation of their mission.
I want to particularly mention, too, Ruth Ann Nerlich, who has been a
part of VNA in Venango County as long as I have been aware. When I
served in the State legislature, she was the go-to person State-wide.
She was the person that best understood and best sold the message of
home health care delivered by the VNA. And also Betsy Roberts of Elk
County, who for decades has been a leader in providing home health
care.
I want to conclude my comments with when the Balanced Budget Act was
passed, there were problems in this country, mainly with for-profit
home health care agencies which were really taking advantage of the
system. Unfortunately, Congress, at that time, squeezed the system
equally, and the Visiting Nurse Associations, scattered around much of
this country, were not fat and wasteful. They raised millions of
dollars to give free care to those who could not pay. They were made up
of boards of local people, in health care and out of health care, who
cared about and helped deliver the services that they provided.
So when the Balanced Budget Act cut them and squeezed them about 30
percent, it squeezed some of them out of business. Some of the VNAs in
my district today, the only reason they stayed in business, they
borrowed money to continue providing those services. They have debt to
service today.
Mr. Speaker, it is vital that this 15 percent cut is taken away, and
it is vital that the 10 percent add-on that was proven was needed for
home health care is continued on past April.
With that, I am proud to recognize these individuals and the
invaluable contributions of our VNAs by cosponsoring this legislation,
and urge the support of my colleagues.
Mr. DAVIS of Illinois. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, the National Visiting Nurse Association of America,
VNAA, is the official association for not-for-
[[Page H1483]]
profit, community-based home health organizations known as Visiting
Nurse Associations. VNAs care for patients of all ages, from infants to
the elderly, and offer comprehensive services that begin with maternal-
child health programs and end with hospice care. VNAs provide a broad
range of essential home health care and support services to patients in
the security and comfort of their homes. These services include skilled
nursing, rehabilitation, physical and occupational therapies, speech-
language pathology, home medical equipment, and behavioral and mental
health counseling, to name just a few.
Many VNAs provide homemaker services that help patients remain
independent in their home while reducing the burden on family members.
These services can include cooking, housekeeping, shopping,
transportation, personal care, and a variety of other essential
nonmedical services.
These services are critical at a time when the latest projections
from the U.S. Bureau of Labor Statistics, published in the November
2001 Monthly Labor Review, estimated that more than 1 million new and
replacement nurses will be needed by the year 2010. The U.S. Department
of Labor projects a 21 percent increase in the need for nurses
nationwide from 1998 to 2008, compared with a 14 percent increase for
all other occupations.
Furthermore, according to a July 2001 report released by the General
Accounting Office titled Nursing Workforce: Emerging Nurse Shortages
Due to Multiple Factors (GAO-01-944), ``a serious shortages of nurses
is expected in the future as democratic pressures influence both supply
and demand. The future demand for nurses is expected to increase
dramatically as the baby boomers reach their sixties, seventies and
beyond.''
As baby boomers age, the role of visiting nurses is more important,
as patients spend less time in the hospital and demand the same quality
of services at home. VNAs contribute to the well-being of the Nation,
and I urge my colleagues to support this resolution as we pay special
tribute to those who come into our homes, into our places of being, and
bring not only their technical and professional services, but also
bring the individuality of their care.
Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise in support of H. Con.
Res. 54, expressing the sense of the Congress that there should be
established an annual National Visiting Nurse Association Week.
Our health care system is in a state of crisis. Our health care costs
are rising exponentially, but it seems that these added expenses are
not translating into rising access to quality compassionate care for
the American people. Instead, it seems that too often, profits are
driving our health care system--rather than the needs of the sick, our
children, and the elderly.
Pharmaceutical companies are making record profits, while people in
America are choosing between food and the prescription drugs their
doctors have prescribed. Reimbursements for Medicare and Medicaid
treatments are so low that many health providers are turning away sick
patients. Due to massive tax cuts for the wealthy, the Administration
has not left adequate funds to help financially-strapped State and
local governments to continue health care programs for the poor and
underserved. For example, this has led to the recent closure in my
District of two mental health clinics, that serve 1,400 adults and 240
children. Yes, this is a crisis.
But in the midst of that crisis, there are some shining examples of
groups that truly seem to embody what health care can and should be.
The Visiting Nurse Associations (VNAs) fall into that noble category.
Visiting Nurse Associations are non-profit agencies that, for over 120
years, have been working toward their mission of providing cost-
effective and compassionate health care to millions of individuals per
year, regardless of their condition or ability to pay.
Nurses from VNAs go into communities and individual homes, providing
primary care of all sorts, and prevention such as immunizations. Such
care dramatically improves quality of life for seniors and the disabled
who would prefer to live in their own homes, in their own
neighborhoods, but need a bit of help from a visiting professional.
Besides providing comfort and dignity to those in need, VNAs also save
us millions of dollars in hospital and long-term care costs.
I am very pleased with the excellent work of the VNA of Houston.
Their 50 nurses partner with social workers, physical therapists, home
health aids, occupational therapists and speech therapists, in order to
provide services to some 1,600 to 1,700 hundred patients per day in the
area of Harris and the surrounding counties. This kind of care is the
way of the future--helping people stay in the comfort of their homes,
where they want to be.
I am sometimes frustrated when I ask members of the medical
community, why they do not spend more time pushing prevention and
education. They often reply that doctors don't have the time to talk to
their patients for that long, or that a doctor's time is too expensive
to spend on education. I am bothered by this, because as most people
know, nurses and physician's assistants and auxiliary health
professionals, are often much better communicators than their physician
colleagues anyway. Expanding our utilization of nurses is a cost-
effective way of improving American health.
The problem is that we have a nursing shortage. Our clinics and
hospitals are being forced to squeeze too much out of the nursing
staffs they have. The added workloads are driving many qualified nurses
out of the field, and may be jeopardizing treatment for some patients.
We need to find ways to recruit more nurses and to maintain the one we
have.
For example, I have introduced HR 87, which would alter H-1C non-
immigrant visa requirements, in order to make it easier to bring in
qualified foreign nurses to fill in some of the gaps in our own nursing
workforce. I would like to see some action on that bill soon.
Today's bill, H. Con. Res. 54, represents another way of improving
our pool of nurses. By establishing an annual National Visiting Nurse
Association Week, not only will we be honoring an excellent and
deserving group of health care professionals, but we will also be
raising awareness of the important role they serve in our communities.
I hope that by focusing Congressional and public attention on Visiting
Nurse Associations, we will inspire more bright young people to go into
that noble profession.
I commend our nation's visiting nurses, and my colleague from
Massachusetts for seeking to honor them. I support H. Con. Res. 54.
Mr. BACA. Mr. Speaker, our nation is facing a catastrophic nursing
shortage. The average age of nurses in America is 43 years of age.
Nurses are leaving the profession in droves, and fewer people are
choosing to enter the profession. We have to do more to not only retain
the nurses that we have but also to increase their numbers. We need to
send the message that nursing is a rewarding and much needed
profession. We need to do our best to make sure that nurses get the
recognition that they deserve so that we can turn around the shortage.
Nurses need to know that they are needed. I support H. Con. Res. 54
because it helps bring more recognition, not only to the individualized
profession of visiting nurses, but also to the profession as a whole.
Visting nurses deserve all of the recognition that can be afforded.
They are a valuable group of professionals that travel to the homes of
some of the sickest individuals to ensure that they are receiving much-
needed health care in the comfort and privacy of their own home. By
supporting Visiting Nurses Associations we are supporting a system of
health care that is compassionate and that allows patients to receive
care while maintaining their dignity. In my district, The Visiting
Nurses Association of the Inland Counties works hard to bring care to
patients all over the area. I know that they are working to obtain the
necessary grant money to implement essential technology so that they
could treat more patients while offering the individualized care that
every patient deserves. I applaud the effort of the nurses and I
applaud the Congress for bringing recognition to their noble work.
Mrs. TUBBS JONES of Ohio. Mr. Speaker, I rise in support of Housing
Concurrent Resolution 54, honoring the Visiting Nurse Association.
In 1902, 13 young women met in Cleveland to form a local organization
that would become one of the earliest pioneers of a new concept called
community health nursing. From those women the Visiting Nurse
Association of Cleveland was born.
These nurses understand that most people prefer the comfort and
security of their home to recover and rehabilitate from an illness or
injury. Making home health care an essential part of health care today.
The Visiting Nurse Association touches the lives of nearly every
American in some way.
While the size of the Visiting Nurse Association has grown
tremendously, the quality of health care that they provide to people
regardless of their ability to pay, continues to be superb. The
organization serves over 15,000 people a year in Ohio. I would like to
honor the visiting Nurse Association for the hard work and dedication
they continue to provide to those in need.
Mr. FOLEY. Mr. Speaker, I rise today in support of H. Con. Res. 54, a
bill expressing the sense of the Congress that we should establish an
annual National Visiting Nurse Association Week.
[[Page H1484]]
As you know, Mr. Speaker, the visiting nurse associations are
nonprofit home health agencies that, for over 120 years, have been
united in their mission to provide cost-effective and compassionate
home and community-based health care to individuals, regardless of the
individuals' condition or ability to pay for services. There are more
than 500 visiting nurse associations, which employ more than 90,000
clinicians, provide health care to more than 4,000,000 people each
year--with 95,000 visits in Florida alone--and provide a critical
safety net in communities by developing a network of community support
services that enable individuals to live independently at home.
In my home state, the Visiting Nurse Association of Florida serves 13
counties with a complete array of home health services. With
headquarters in Stuart since 1976, VNA last year provided more than
$346,000 in charitable care to the most vulnerable in our communities.
The establishment of an annual National Visiting Nurse Association
Week would increase public awareness of the charity-based missions of
visiting nurse associations and of their ability to meet the needs of
chronically ill and disabled individuals who prefer to live at home
rather than in nursing homes, and would spotlight preventive health
clinics, adult day care programs, and other customized wellness
programs that meet local community needs. I encourage all of my
colleagues to join me today in support of this important resolution.
Mr. DAVIS of Illinois. Mr. Speaker, I yield back the balance of my
time.
Mrs. MILLER of Michigan. Mr. Speaker, I have no further requests for
time, and I yield back the balance of my time.
The SPEAKER pro tempore (Mr. Culberson). The question is on the
motion offered by the gentlewoman from Michigan (Mrs. Miller) that the
House suspend the rules and agree to the concurrent resolution, H. Con.
Res. 54.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds of
those present have voted in the affirmative.
Mrs. MILLER of Michigan. Mr. Speaker, on that I demand the yeas and
nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the
Chair's prior announcement, further proceedings on this motion will be
postponed.
____________________