S. 2848 Homebound Legislation
"ACTION ALERT!! Contact Senators to Support Homebound Legislation"
David Jayne <djayne23@aol.com> urges
advocates to contact their Senators in support of legislation introduced in the
Senate, S. 2848, to amend the Medicare Homebound restriction:
Dear friends of NCAHB,
THE FINANCE COMMITTEE HAS ALREADY DRAFTED THE MEDICARE PROVIDER BILL and I have
heard (from conversations with Finance staff) that the homebound language
included in this bill is much more conservative than what's in S. 2848. The only
way to change this now is through a STRONG grassroots effort so that Senator
Daschle and Finance Committee Senators are motivated to make sure that the
Finance bill includes S. 2848 in its bill (rather than what's currently included
in the bill).
PLEASE CALL, EMAIL AND IF POSSIBLE VISIT THE SENATORS ON THE FINANCE
COMMITTEE BELOW.
THE MESSAGE IS SIMPLE:
"COSPONSOR S.2848 AND INCLUDE IT IN THE SENATE FINANCE COMMITTEE'S MEDICARE
BILL.
PEOPLE WITH SEVERE AND PERMANENT DISABILITIES AND ILLNESSES RECEIVING HOME
HEALTH SERVICES SHOULD NOT BE IMPRISONED IN THEIR OWN HOMES FOR THEIR ENTIRE
LIVES. S. 2848 WILL REMOVE THE MEDICARE HOMEBOUND RULE FOR THESE INDIVIDUALS SO
THAT THEY CAN WORK, PARTICIPATE IN THEIR COMMUNITIES, AND/OR ENJOY FAMILY
ACTIVITIES OUTSIDE THE HOME WITHOUT LOSING THEIR LIFE-SUSTAINING HOME HEALTH
SERVICES.
Democrats:
MAX BAUCUS, MT
JOHN D. ROCKEFELLER IV, WV
TOM DASCHLE, SD
JOHN BREAUX, LA
KENT CONRAD, ND
BOB GRAHAM, FL
JAMES M. JEFFORDS, VT
JEFF BINGAMAN, NM
JOHN F. KERRY, MA -- a cosponsor of S2848
ROBERT G. TORRICELLI, NJ
BLANCHE L. LINCOLN, AR
Republicans:
CHARLES E. GRASSLEY, IA
ORRIN G. HATCH, UT
FRANK H. MURKOWSKI, AK
DON NICKLES, OK
PHIL GRAMM, TX
TRENT LOTT, MS
FRED THOMPSON, TN
OLYMPIA J. SNOWE, ME -- a cosponsor of S2848
JON KYL, AZ
CRAIG THOMAS, WY
This is truly our last opportunity for real homebound reform in this Congress.
Selfishly, I do not know if my health will allow me to start all over next
Congress. A summary and talking points to S2848 is below. Please help make this
bill a reality. Many heartfelt thanks in advance.
Best regards,
David Jayne
NCAHB Founder
http://www.amendhomeboundpolicy.homestead.com
115 Hayes Circle
Rex, Georgia 30273
djayne23@aol.com
Support the "David Jayne Medicare Homebound Modernization Act of 2002" (S.
2848)
Sponsored by Senator Susan Collins (R-ME), Senator Max Cleland (D-GA), Senator
John Kerry (D-MA), Senator Olympia Snowe (R-ME), Senator Tim Hutchinson (R-AR),
and Senator Zell Miller (D-GA).
We urge the United States Senate to take action on behalf of thousands of
individuals with permanent and severe disabilities and illnesses -- whose
freedom has been robbed by the Medicare homebound rule -- by passing S. 2848
before adjourning this year.
Summary
S. 2848 would amend the Medicare home health statute that currently requires
that an individual be "confined to the home" in order to receive vital and life
sustaining home health services. (Permission to leave the home is currently
allowed only for absences that are "infrequent and of short duration," or to
attend medical appointments, adult day care or religious services.)
S. 2848 would change current law by providing an exception to the Medicare
homebound rule to individuals who have been certified by a physician:
as an individual who has a permanent and severe condition that will not
improve and requires the individual to receive assistance from another
individual with at least 3 out of the 5 activities of daily living (i.e.
eating, dressing, bathing, transferring and toileting), and
as an individual who requires home health services to achieve a functional
condition that gives the individual the ability to leave home, and
as an individual who requires technological assistance or the assistance of
another person to leave the home, and
as an individual who has received home health services during the previous
12-month period and is expected to require such services for at least the next
12 months.
The cost of the legislation is expected to be budget neutral because it would
be specifically limited to Medicare home health beneficiaries whose clinical and
functional conditions are so severe that it would be virtually impossible for
them to survive in the world without currently receiving skilled nursing care
under the home health benefit. Therefore, there would be no "woodwork effect"
(i.e. new beneficiaries eligible for the home health benefit). The legislation
simply gives these individuals their freedom.
Background
The "homebound rule" was put in effect in the 1960s when home health care was
viewed primarily as a post-acute care Medicare benefit. For example, a person
discharged from the hospital for hip surgery is considered to be "confined to
the home" because the trauma to the hip and post-surgery healing make leaving
the home physically difficult and often medically contraindicated. Therefore,
the person's physician prescribes home health care for post-surgery healing
and/or rehabilitation until the person is able to access medical care outside
the home.
From 1965 through today, "confinement to the home" has been the proxy for
determining the severity of a person's clinical and functional condition. When a
person is considered "homebound" by a physician, Medicare will cover home health
care until the person is no longer considered to be "homebound."
During the past 37 years, access to home health care for individuals with
long-term chronic illnesses and disabilities has increased and, accordingly, the
Medicare home health benefit has evolved to serve beneficiaries with both
post-acute and long-term care needs. As long as a person meets all of the
following home health eligibility criteria:
- the individual has a skilled care need (i.e. skilled nursing, physical
therapy and/or speech therapy);
- the individual is under a physician's plan of care, and
- the individual is considered by the physician to be "confined to the
home;" then home health care is covered by Medicare.
However, while the Medicare home health benefit has evolved over 37 years to
become a cost-effective alternative to institutional care, the "confined to the
home" eligibility criterion has not kept pace with our times and is now
punishing those who receive home health care over a long period of time.
Individuals with severe long-term illnesses and disabilities who otherwise would
be "confined to the home" if it were not for advanced technology (e.g., portable
ventilators and intravenous feeding equipment) that allows them to survive
outside the home, have become prisoners in their homes.
Americans all across the nation, who paid into Medicare and now rely on it for
their very lives, are serving life sentences in their homes. Like David Jayne
who is dying of ALS - Lou Gehrig's disease, they know if they leave their home
at almost anytime, they can lose their eligibility for Medicare home health
services - their lifeline.
S. 2848 is targeted to those individuals who inarguably by the severity of their
conditions would be "confined to their homes" for the rest of their lives if
were not for technological and personal assistance and the provision of home
health care that make it possible for them to leave their homes.
For more information, please call Kathy Thompson at the Visiting Nurse
Associations of America at 202-737-3707, ext. 114.
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