[Congressional Record Volume 149, Number 87 (Friday, June 13, 2003)]
[Extensions of Remarks]
[Page E1239]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




MEDICARE SHOULD OFFER COMMUNITY HEALTH CARE CHOICES FOR SENIOR CITIZENS 
                             JUNE 12, 2003

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                         HON. GERALD D. KLECZKA

                              of wisconsin

                    in the house of representatives

                        Thursday, June 12, 2003

  Mr. KLECZKA. Mr. Speaker, today I am reintroducing the Medicare 
Substitute Adult Day Care Services Act. This important bill would 
provide new rehabilitative care choices for Medicare beneficiaries 
while simultaneously assisting family caregivers with the difficulties 
in caring for a homebound family member.
  Specifically, this bill would update the Medicare home health benefit 
by allowing beneficiaries the option of substituting some, or all, of 
their Medicare home health services for care in an adult day care 
center (ADC).
  The ADC would be paid the same rate that would have been paid for the 
service had it been delivered in the patient's home. In addition, the 
ADC would be required, with that one payment, to provide a full day of 
care to the patient at no additional cost to the Medicare program. That 
care would include the home health benefit as well as transportation, 
meals, medication management, and a program of supervised activities.
  The ADC is able to provide these extra services at the same payment 
rate as home health care because there are inherent cost savings in the 
adult day care setting. In the home care arena, a skilled nurse, a 
physical therapist, or other home health provider must travel from home 
to home providing services to one patient per site. There are 
significant transportation and time costs associated with this method 
of care. In an adult day facility, the patients are brought to the 
providers, who see a larger number of patients in a shorter period of 
time.
  I would like to point out that the bill would not expand the Medicare 
home health benefit. It does not make any new people eligible for the 
home health benefit nor would it expand the definition of what 
qualifies for reimbursement by Medicare for home health services. To be 
eligible for this new option, a patient would still need to qualify for 
Medicare home health benefits just like they do today. They would need 
to be homebound and have certification from a doctor for skilled 
therapy in the home.
  The Medicare Substitute Adult Day Care Services Act simply recognizes 
that adult day care facilities can provide the same health services 
with the added benefits of social interaction, activities and meals. 
They also offer a therapeutic environment, in which a group of trained 
professionals can treat, monitor and support Medicare beneficiaries who 
would otherwise be monitored at home by a single caregiver.
  Not only does ADC aid in the rehabilitation of the patient, it 
provides a tremendous benefit to the family caregiver. Many frail 
beneficiaries cannot be left alone; therefore, caregivers are unable to 
have a respite or maintain employment. If senior citizens could utilize 
ADC services, they would receive supervised care for an entire day and 
the caregiver would have the opportunity to work outside the home and/
or leave the house for longer periods of time.
  Adult day care centers offer high-quality, safe, and often preferable 
alternatives to senior citizens who face complete confinement in the 
home. I urge my colleagues to cosponsor and support this important 
legislation.




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