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REPORTS |
| Resolution
in Support of Home Care
and Seeking Changes in the Balanced Budget Act |
Whereas, health related services provided to ill, frail, elderly, and disabled persons in their own homes by registered nurses, certified nurse aides, physical, occupational and speech therapists, positively affect a person’s quality of life, improves outcomes, saves money, is an integral component of the continuum of care, and in most cases is the patient’s choice;
Whereas, these vital services provided by health care professionals are made possible by a network of highly regulated home care agencies in the state of Colorado and across the country;
Whereas, in Colorado in 1998, home care agencies provided more than 5 to 6 million visits to some 104,000 Coloradans and employed more than 9,000 health care professionals;
Whereas, in Colorado in 1997, home care services saved the state more than $34 million due to nursing home and hospital avoidance;
Whereas, the Balanced Budget Act of 1997 contains an Interim Payment System which has reduced reimbursement for home care agencies by about 33 percent by setting per-beneficiary limits at a very low level and reducing per-visit cost limits;
Whereas, the Interim Payment System has damaged the health care delivery system by making it virtually impossible for home care agencies to deliver complex, medically necessary services to their sickest, most vulnerable home care patients;
Whereas, the Interim Payment System discriminates against the most frail, elderly and disabled patient; creates reimbursement inequities between home care agencies; and penalizes the most cost efficient home care agencies while rewarding the most high cost agencies;
Whereas, the Interim Payment System requires a further 15 percent cut in reimbursement in October 2000 and mandates the completion of a 17-page OASIS outcomes measurement tool at admission and periodically during the home care episode;
Whereas, subsequent to the Balanced Budget Act of 1997, the Health Care Financing Administration has promulgated numerous onerous regulations such as 15 minute increment reporting and home health advanced beneficiary notices that add to the administrative burden of providing home care services and has resulted in a mass exodus of health care professionals from the home care delivery system;
Whereas, these new laws and regulations have forced home care providers to reduce costs of providing services by reducing clinical and supervisory staff, curbing services to patients with expensive medical problems, and sometimes even being forced to decline to admit the most frail, elderly and disabled patient;
Whereas, since the passage of the Balanced Budget Act of 1997, as of November 1, 1999, 59 home care agencies have closed in Colorado and nearly 3,000 home care agencies have closed across the nation resulting in greatly diminished consumer access and choice and placement of many persons in more expensive institutional settings;
Whereas, the Balanced Budget Act of 1997 which sought to save
some $16 billion from home care cuts is now projected to actually save
nearly $50 billion;
Whereas, responsibility of government health insurance programs
continues to be shifted from the federal to the state and local level which
puts a grave burden on these local entities;
THEREFORE BE IT RESOLVED,
The below signed elected officials request the Colorado Congressional delegation to support legislative remedies to the Balanced Budget Act during this congressional session by
- ~ eliminating the additional 15 percent cut in Medicare home care
reimbursement scheduled for October 2000;
~ increasing payments for high-cost, medically complex patients;
~ recognizing and paying for costs related to collection of OASIS data and other new regulatory mandates.
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