Senator Susan Collins (R-ME)

Issues Affecting Home and Community-Based Care Are “At the Top of My Agenda”

United States Senator Susan Collins (R-ME) spoke at the National Association for Home Care & Hospice’s (NAHC) 2016 March on Washington Senate Breakfast. Sen. Collins, who chairs the Special Committee on Aging and serves on the Health, Education, Labor, and Pensions Committee, is a passionate advocate of home care and hospice. As NAHC President Val J. Halamandaris said prior to her remarks, “She is the absolute best that there is.” This was Sen. Collins’s 18th consecutive time speaking at the Home Care & Hospice March on Washington Senate Breakfast.

Lisa Harvey-McPherson, Vice President of Government Relations at Eastern Maine Healthcare Systems in Waterville, Maine, introduced Sen. Collins. “We are honored each and every day by her service,” Ms. Harvey-McPherson said. “Home care and hospice is a passion for her, and she has persevered to ensure that citizens across the United States have access to these critical services. In fact, she is a leader among leaders, placing home and community-based care at the heart of America’s health care system. Sen. Collins is a tireless advocate for older adults and individuals suffering from chronic illness.”

Ms. Harvey-McPherson also highlighted that Sen. Collins founded the Senate Diabetes Caucus and has led efforts to more than double funding for diabetes research. In addition, she has sponsored priority legislation on behalf of the home care and hospice community, including: the Home Health Care Access Protection Act, to reform the process of evaluating home health case-mix changes; legislation to extend the rural add-on; and the Home Health Care Planning Improvement Act to allow Nurse Practitioners, Advanced Practice Nurses, and physician assistants to sign home health plans of care.

“I’ve worked hard to modernize and promote fairness in the Medicare home health and hospice benefit,” Sen. Collins said. “As the chairman of the Senate Aging Committee, I am all too aware of the challenges facing our nation due to our changing demographics. In fact, the cohort in our population that is age 85 and older is the fastest growing part of our population. Our health care system stands directly in the path of a tidal wave of aging baby boomers who will be retiring at a rate of 10,000 a day for the next 20 years, and the tsunami of Alzheimer’s disease in that generation, my generation, will require the system to adopt and change if it is to survive the impact and if federal programs are not to go bankrupt. One of the most important actions that we can take is to shift our orientation from institutional to community and home-based care.”

Sen. Collins continued, “Advances in technology and medical practice have made it possible for older adults who previously would have been forced to move to a hospital setting or a skilled nursing home to stay just where they want to be and that’s in the privacy, comfort and security of their own homes. Who among us, if it’s possible to stay home, doesn’t want to be home rather than in an institutional setting? That is why I am concerned that Medicare beneficiaries continue to face unnecessary barriers to getting needed home health services.”

Among the necessary changes to remove barriers to access for Medicare beneficiaries, Sen. Collins highlighted the Home Health Care Planning Improvement Act. “To ensure that they get the home care they need when they need it, we simply must allow Advanced Practice Nurses and physician assistants to order home care for all. Talk about a policy that makes no sense whatsoever, it’s our current policy… Why in the world do we erect this barrier on their ability to order up needed home care?”

Sen. Collins also spoke about the importance of the rural add-on for Medicare home health services. “We must also realize the increased costs, as much as 12 to 15 percent higher, of delivering home health care in rural areas.” In rural areas of Maine, she said, providers “can see fewer people in a day” and travel costs are higher. “We should acknowledge that,” she said. “If not, those seniors will be hospitalized more frequently and forced into nursing homes. That is only going to cost our health care system more. I don’t know why this is such a difficult concept for CMS to understand.”

Providing home care and hospice advocates with some closing advice, Sen. Collins reminded the audience that she became a passionate advocate herself only after going on a home care visit. “I encourage each and every one of you to invite your Senators and your members of the House, when they are back home during the recess, to come with you on a home health care visit. I can assure that you will gain converts every step of the way,” she said.