[Congressional Record (Bound Edition), Volume 147 (2001), Part 11]
[Extensions of Remarks]
[Page 16245]
[From the U.S. Government Publishing Office, www.gpo.gov]



              CURRENT CRISIS IN HOME HEALTH CARE SERVICES

                                 ______
                                 

                        HON. WILLIAM D. DELAHUNT

                            of massachusetts

                    in the house of representatives

                        Thursday, August 2, 2001

  Mr. DELAHUNT. Mr. Speaker, I rise today to call to your attention an 
issue of great concern to me and the constituents throughout my 
southeastern Massachusetts congressional district--the current crisis 
in home health care services.
  As you are well aware, in 1997 Congress approved the ``Balanced 
Budget'' Act (BBA). This legislation sought to slash Medicare benefits 
by $115 billion--the largest reduction in Medicare payment rates in the 
program's 35 year history.
  I opposed this ``reform'' bill because I thought it recklessly 
threatened the quality and dependability of health care for Medicare 
recipients. Regrettably, it has fulfilled these fears--resulting in 
$240 billion of cuts, $124 billion more than originally intended.
  The BBA has resulted in a 53% drop in federal reimbursements for home 
health services in Massachusetts--well over $350 million in lost 
Medicare revenue. 31 Massachusetts home care agencies have closed--and 
other on the South Shore and the Cape & Islands have limited services 
to homebound patients.
  It is clear that the ``unintended'' consequences of BBA has had and 
continues to have a devastating impact on our health care system. And 
now Congress is backpedaling, trying to address the immediate 
consequences of the BBA, while searching for comprehensive approaches 
to the long-term solvency of the overall Medicare program.
  In this light, I would like to share with my colleagues an editorial 
from the Cape Codder newspaper that followed a month-long series of 
articles outlining critical steps in addressing the challenges in home 
health care. And I hope this will serve as a useful source of guidance 
as we continue these deliberations.

                  [From the Cape Codder, July 6, 2001]

                       Assuring Home Health Care

       For a month, Jennifer Brockway has been reporting on one of 
     the more frightening prospects facing an increasingly older 
     Cape Cod population: the specter of rising health needs and 
     the drastic decrease in home health care aides.
       This gap between supply and demand will threaten thousands 
     of us who want to grow old in as independent a fashion as 
     possible. We want to avoid hospitals, nursing homes and 
     assisted living facilities. That's why so many retirees are 
     moving here in the first place.
       Those struggling to right a sinking ship offer a wide array 
     of solutions. But, as Brockway reported, remedies will 
     require action by both state and federal governments, as well 
     as the health care industry itself.
       Our month-long series identified the following steps as 
     crucial:
       The long-term community--home health care and nursing and 
     rehabilitation homes--must form a united front.
       Medicare and Medicaid reimbursement rates must be increased 
     to reverse damage caused by the 1997 Balanced Budget Act and 
     compensate for rising health care delivery costs.
       Home health aides must be paid a wage allowing economic 
     self-sufficiency. They currently earn about $10 an hour, $7 
     less than what's needed to afford a median-priced home on the 
     Cape.
       Family health insurance must be made affordable for all 
     direct-care workers.
       Training programs for direct-care workers must be increased 
     and expanded to the home care industry.
       An active recruitment program must be instituted to capture 
     the high school students, immigrants, and older adults re-
     entering the workforce.
       Opportunities for career advancement in direct care must be 
     encouraged.
       Home health agencies must allow greater involvement of home 
     health aides in agency operations and patient care decisions. 
     Aides should be made to feel like respected stakeholders 
     through acknowledgment of their skills and contributions.
       As with most complex issues, there is no magic bullet. 
     Solutions require crossing many jurisdictional and geographic 
     boundaries. It means forming unique alliances.
       And unless other problems facing Cape Codders--inadequate 
     housing, childcare and transportation--are addressed 
     simultaneously, the current challenges facing home health 
     care indeed will become a crisis.

     

                          ____________________