Posts Tagged ‘Bill Nelson’

Senate Special Committee on Aging Holds a Hearing on Long-Term Care Policy

January 3, 2014

On December 18, 2013, the Senate Special Committee on Aging held a hearing entitled “The Future of Long-Term Care Policy: Continuing the Conversation.”   The hearing was attended by a handful of Senators: Chairman Bill Nelson (D-FL), Ranking Member Susan Collins (R-ME), Sheldon Whitehouse (D-RI), Jon Manchin (D-WV), Tammy Baldwin (D-WI), Elizabeth Warren (D-MA), Kelly Ayotte (R-NH), and Tim Scott (R-SC). The four witnesses during the hearing were:

  • Judy Feder, Professor, Georgetown University McCourt School of Public Policy and Fellow, Urban Institute;
  • Mark J. Warshawsky, Visiting Adjunct Scholar, American Enterprise Institute (former Chair of LTC Commission);
  • Bruce Chernof, President and Chief Executive Officer, The SCAN Foundation (former Vice Chair of LTC Commission); and
  • Anne Tumlinson, Senior Vice President, Avalere Health.

The Senators and witnesses agreed that long-term care, whether received in an individual’s home or in a nursing home, is an area that is growing in terms of individuals needing care but remains sorely underfunded and misunderstood.  The general public is unaware of the lack of coverage for long-term care offered by health insurance, Medicare and Medicaid.  How to successfully address the funding issue is where the Senators and panelists differed in their views.  Senator Scott agreed with Mr. Warshawsky, opining that the private sector holds the answers and the possibility of market-based incentives would cause individuals to seek long-term care coverage.  Senators Baldwin, Warren, and Whitehouse took greater interest in the idea of a public social insurance mechanism put forth by Judy Feder. Anne Tumlinson made the point that, regardless of a public, private or hybrid financing model, there needs to be some type of mandate in order to create a risk pool large enough to be sustainable. While the Committee reached no conclusions on the topic of how to fund long term care needs, the importance of working to develop solutions was very clear to all of the Senators.

During the question and answer session, Senator Collins brought up the homebound requirement. She noted that the requirement is outdated and forces institutionalization for patients who would prefer to receive care in their homes.  Senator Collins questioned whether the requirements for the home health benefit should be changed to remove the functionality requirement that a patient be homebound.  Dr. Chernoff agreed that the requirement should be revisited but must be balanced against inappropriately driving up utilization. HCAF agrees with and applauds Senator Collins for her understanding of the homebound requirement and its detriment to patients who prefer to receive care in their home.


As the baby boomers age, the need for quality home care will continue to grow. How to fund home care, and all types of long-term care, is a topic that cannot be avoided any longer. We must work to develop useful solutions that will provide financing for home care now and well into the future. No person should be forced into poverty in order to receive care or into a care situation that does not suit their wishes. HCAF appreciates the attention the Senate Special Committee on Aging has given to long term care needs and stands ready to assist in working toward a solution that protects our nation’s most valuable and vulnerable citizens.

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Florida Senator Bill Nelson Offers Thanksgiving Message to Family Caregivers; Co-Authors Op-Ed on the Importance of Long-Term Caregivers for the Future of Healthcare

November 27, 2013
U.S. Sen. Bill Nelson

U.S. Sen. Bill Nelson

Senator Bill Nelson (D-FL), Chairman of the Senate Select Committee on Aging, recently offered a Thanksgiving Message to family caregivers around the country, recognizing their importance and the often-overlooked work they do. Senator Nelson also coauthored an op/ed with his colleague, Senator Tammy Baldwin (D-WI) on the need for the Senate to address the challenges to, and increasing demand for, long-term care.

HCAF applauds Senator Nelson’s advocacy on behalf of these important issues. We look forward to continuing our relationship with Sen. Nelson in order to assist him with making policies that will help seniors age in place through home and community-based services.

Senator Nelson’s full remarks for the record – including the text of his op/ed – are included below:

Mr. NELSON. Mr. President, with the Thanksgiving holiday, November is a time for many of us to enjoy time with our loved ones and reflect on our futures together. With so many family gatherings, many retirement experts also encourage us to use this time to talk with family about our long-term needs.

In addition to thinking about financial needs for retirement, it is important to also address our health as we age. According to the Department of Health and Human Services, an individual turning 65 today has almost a 70 percent chance of needing long-term care in the future, and 1 in 5 will need long-term care for more than 5 years. Conversations about long-term care and advance care planning can be understandably difficult, but they are necessary to ensure our loved ones receive the care they want if they are no longer able to speak for themselves.

Thinking about long-term care means recognizing the invaluable—but too often unrecognized—contributions made daily by family caregivers. Over 65 million Americans provide $450 billion worth of unpaid care every year, twice as much as homecare and nursing home services combined, and these numbers are increasing. More than one-half of family caregivers perform intensive activities such as bathing, feeding, and medication management. However, these services often come with a cost to the caregiver, such as financial burdens and a toll on physical and mental health.

As the chairman of the Special Committee on Aging, I want to help middleclass families struggling to provide necessary care for their loved ones. This year, the committee has examined the importance of advance care planning as well as why a majority of Americans have done little to no planning for future long-term care needs.

Next month, we will continue this series of hearings by looking at expert recommendations for reforming our long-term care system. Lastly, Senator BALDWIN and I penned a column in recognition of the critical need to address the long-term care inadequacies in this country, and I ask unanimous consent that a copy be printed in the RECORD following my remarks.

I urge my colleagues to join me in this effort. As our Nation continues to grow older, this problem will continue to grow worse, and the current system must change to meet these needs.

There being no objection, the material was ordered to be printed in the RECORD, as follows:

[From The Hill, Oct. 29, 2013]

(By Sens. Bill Nelson and Tammy Baldwin)

As Congress embarks on a new venture to create a bipartisan budget that would strengthen the economic security of families and reduce the deficit without shortchanging our future, it’s our hope that both parties will also work together to find viable ways to help families pay for long-term care.

With the aging of the baby boomers, our country finds itself in the midst of one of the most dramatic demographic shifts in our history. And, as the aging population grows, so too will the long-term-care needs of many in our society.

Providing assistance to family members who can no longer care for themselves can be taxing for all involved.

In fact, the Senate Special Committee on Aging held a hearing last month to examine a myriad of challenges facing seniors today, and found many were unprepared.

So, later this year, we’re going to hold another hearing to see what we can do to help. Some of the things we’re going to look at include the possibility of expanding Medicare to cover long-term care, and other various ways to possibly make private long-term care coverage more affordable for those who need it.

Currently, about 12 million Americans have long-term-care needs—a number that’s rising rapidly. While most receive care from family and friends, an increasing number depend on costly in-home care or end up in assisted living facilities or nursing homes, where the median annual costs range from $40,000 to $80,000, respectively.

Most middle-class families in this country simply can’t afford the expense of providing long-term care for a loved one. And there are few viable options available to help them pay for the services they would need. Medicare and most traditional health insurance plans don’t cover long-term-care expenses. And while private long-term-care insurance is available, most people don’t have it because they see long-term care as something they’ll never need.

In fact, according to a recent study from the SCAN Foundation, most Americans have done little or nothing to prepare for their future long-term-care needs. This is despite research that shows that 70 percent of people 65 or older will eventually need some form of assistance.

Clearly, our current system of providing long-term care is unsustainable. And, that’s why we shouldn’t wait much longer to address it.



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Sen. Bill Nelson Named to Congressional Budget Conference Committee

November 1, 2013

As part of the agreement reached by Senators Reid (D-NV) and McConnell (R-KY) to reopen the government and raise the debt ceiling, a bipartisan, bicameral Conference Committee was named to negotiate a budget for 2015.

U.S. Sen. Bill Nelson

U.S. Sen. Bill Nelson

The Conference Committee – co-chaired by Senate Budget Committee Chairwoman Patty Murray (D-WA) and House Budget Chairman Paul Ryan (R-WI) – begins work this week to reach a consensus between Mr. Ryan’s budget proposal and Ms. Murray’s.

As a member of the powerful Senate Budget Committee, Senator Bill Nelson (D-FL) has been named as a member of the conference committee. HCAF is proud to have Senator Nelson serving Florida’s interests on this committee that will be incredibly important to the home health industry.

Of biggest concern to home care are provisions that have been floated for consideration that would reintroduce a home health copayment and further cut Medicare home health spending – both of which HCAF continues to vehemently oppose. Senator Murray and Congressman Ryan continue to emphasize that all options are on the table with respect to reaching a compromise budget that is acceptable to both parties.

Congress eliminated the home health copayment in 1972 for the very reasons it should not be resurrected now. The home health copayment in the 1960s and 1970s deterred Medicare beneficiaries from accessing home health care and instead created an incentive for more expensive institutional care.  Reinstating the home health copay today would undo the progress made in efforts to reduce unnecessary hospitalizations and nursing home stays. The 20 percent copay would mean an average copay of $600 for a 60-day episode of home health care.

HCAF is urging our members to contact Senator Nelson and ask him to oppose reinstating the home health copayment. It takes all of us to be engaged in order to prevent this measure from going through!

There are 29 members named to the Conference Committee in total – including the entire Senate Budget Committee, four House Republicans and three House Democrats. Below is a list of all 29 Conferees:

House Republicans: 
Rep. Paul Ryan (WI)
Rep. Tom Cole (OK)
Rep. Tom Price (GA)
Rep. Diane Black (TN)

House Democrats:
Rep. James Clyburn (SC)
Rep. Chris Van Hollen (MD)
Rep. Nita Lowey (NY)

Senate Republicans:

Sen. Jeff Sessions (AL)
Sen. Charles Grassley (IW)
Sen. Mike Enzi (WY)
Sen. Mike Crapo (ID)
Sen. Lindsey Graham (SC)
Sen. Rob Portman (OH)
Sen. Pat Toomey (PA)
Sen. Ron Johnson (WI)
Sen. Kelly Ayotte (NH)
Sen. Roger Wicker (MS)

Senate Democrats: 

Sen. Patty Murray (WA)
Sen. Ron Wyden (OR)
Sen. Bill Nelson (FL)
Sen. Debbie Stabenow (MI)
Sen. Bernie Sanders (VT)
Sen. Sheldon Whitehouse (RI)
Sen. Mark Warner (VA)
Sen. Jeff Merkley (OR)
Sen. Chris Coons (DE)
Sen. Tammy Baldwin (WI)
Sen. Tim Kaine (VA)
Sen. Angus King (ME)

Source: NAHC

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Home Health Line: Florida Association Seeks Congressional Relief From MA Pain

June 24, 2013

By Burt Schorr, Home Health Line

The visit authorization delays and denials home health agencies long have experienced in serving Medicare Advantage (MA) enrollees show no signs of going away. But a new letter from the Home Care Association of Florida (HCAF) to a key senator aims to provide relief for the ever-worsening situation.

Home health executives are finding themselves forced to invest more and more hours in getting the information and authorizations plans require. Indeed, plans’ coverage reductions and delayed authorizations effectively have restricted beneficiary access to quality home care, the HCAF noted in its recent letter to Sen. Bill Nelson, D-Fla., chairman of the Senate Aging Committee. (more…)

Senators Circulate Dear Colleague Letter Urging Support of the FITT Act

June 17, 2013

Senators John Thune (R-SD) and Amy Klobuchar (D-MN), recently circulated a Dear Colleague letter asking their colleagues to support the Fostering Independence Through Technology (FITT) Act, S. 596. Senators Thune and Klobuchar are the FITT Act’s lead sponsors.

In their letter, Senators Thune and Klobuchar state that:

“Remote monitoring, a form of telehealth, uses non-invasive sensors to monitor the health and well-being of seniors in their home and can prevent the premature or unnecessary placements in more expensive types of long term care facilities…This bipartisan, budget neutral legislation would establish a pilot program under the Medicare program to provide incentives for home health agencies to utilize remote monitoring technology. We believe that using this type of technology in the home would reduce the number of visits by home health aides and allow individuals to remain in their homes longer while still providing quality care.” (more…)

Home Health Patient Monitoring Bill Gaining Steam in Congress

April 23, 2013

The bipartisan Fostering Independence Through Technology (FITT) Act – S. 596 – which was introduced by Senators John Thune (R-SD) and Amy Klobuchar (D-MN) last month now has two additional cosponsors. Senators Mike Enzi (R-WY) and Al Franken (D-MN) are now also supporting the bill. The legislation would expand the use of telehealth technology under Medicare to reduce hospital re-admissions in rural and underserved communities across the country. (more…)

Bobby Lolley: The Future of Healthcare is Right At Home

April 8, 2013

InOurOpinion_12HCAF Executive Director Bobby Lolley submitted the following op-ed to the South Florida Sun-Sentinel following its March 11, 2013 article ‘Home Care, Tele-Medicine Cut Health Costs‘.

In Washington, D.C. and in communities across the nation – like in Southeast Florida – it would be impossible to deny that times are tight when it comes to healthcare dollars. As Congress continues to grapple with various budget plans and proposals, and with the sequester beginning to take a serious bite out of Medicare reimbursement, healthcare providers are turning over every stone to try and stretch the precious dollars allotted for care of America’s seniors. We’re also trying to do what’s best for patients – giving them quality, choice and the best value possible. (more…)

HCAF Calling for Input on Medicare Advantage & Home Health

April 1, 2013

HCAF representatives met recently with the U.S. Senate Special Committee on Aging staff, which is now chaired by Florida Senator Bill Nelson, to discuss issues impacting Medicare providers and beneficiaries. A major topic of discussion was Medicare Advantage and the concerns expressed my multiple providers related to authorization of care, specifically reduced and delayed authorizations. (more…)

Home Care Industry Marches on Washington

March 20, 2013

lobbyforhomecareMore than a dozen Florida home care professionals descended on the U.S. Capitol in Washington, D.C. this week to lobby Congress on home care industry issues, including Medicare reimbursement rates and cuts, copays, the companionship services exemption and the employer mandate. In addition to meeting with Florida’s members of Congress, attendees also met with the U.S. Senate Special Committee on Aging, which addresses Medicare, Medicaid and senior issues, and is chaired by Florida Senator Bill Nelson.

Before meeting with lawmakers, attendees participated in a preparation meeting to discuss the industry’s message. Attendees also heard from members of the U.S. Senate who have been champions for the home care industry, including: Senators Amy Klobuchar (D-MN), Al Franken (D-MN), Susan Collins (R-ME), Mark Warner (D-VA), Pat Roberts (R-KS), Jerry Moran (R-KS), Ben Cardin (D-MD) and Mary Landrieu (D-LA). (more…)

Home Care, Tele-Medicine Cut Health Costs

March 11, 2013

By William E. Gibson, South Florida Sun-Sentinel

To understand how the health-care system sometimes fails patients and often wastes money, consider the case of a South Florida nursing-home patient who developed a cough and slight fever.

“The nurse notifies the doctor, who doesn’t get much information and says, ‘Send her to the emergency room,'” recounts Joseph Ouslander, associate dean for geriatric programs at Florida Atlantic University. “She has tests in the emergency room, some of which are falsely positive, and is admitted unnecessarily to the hospital, where she gets acute confusion and breaks her hip.

“It happens every day: An episode that could have cost Medicare a couple hundred bucks turns into one that costs closer to $20,000. So you are creating human misery, and you’re spending money.”

Striving to avoid such calamities, Ouslander and other health-care leaders in Florida are developing innovative methods to care for many patients in the comfort of their homes or in nursing homes instead of sending them on costly and risky trips to the hospital.

An FAU program trains nurses and advises thousands of nursing homes across the country about ways to detect problems and treat patients without always resorting to the emergency room. Farther north, Orlando Health is using physician interventions, “tele-medicine” and even old-fashioned house calls to keep people out of hospitals.

These Florida initiatives are tackling one of the biggest problems facing Congress and the nation: how to provide quality care at lower cost without raising taxes or cutting benefits. (more…)