To the editor;

I have recently discovered that Congress will soon be voting on a proposed $50 billion cut to the Medicare Home Health benefit. I am currently serving as the director of nurses to one of the largest home health agencies in the state of Texas that services this area. I have been a nurse for over nine years and have been in the home care field for eight. I have personally seen the benefits that home health provides to homebound patients and reaped the rewards of helping patients stay home — where they want to be. I have been an admitting nurse that initiates home care with a patient that has had a recent decline in health or recent surgery, etc. Often due to cuts previously made in health care, these patients are sent home from the hospital too soon and feel overwhelmed. Home care offers these patients peace of mind by providing support with therapy, personal care, and nurses to teach them about their medications and disease processes.

We currently serve an extensive elderly population that is confined to their home and might otherwise not be able to participate in any type of medical care without home care services. I feel that these cuts would do a great injustice to our senior population; they deserve our honor and care, not more cuts to the benefits that they worked hard to enjoy in their golden years. We often provide them with skills to manage their disease processes that will ultimately help them decrease hospitalizations (which equals a significant amount of Medicare dollars saved). Per day, the average Medicare charges for hospitals are close to $6000; the home care average is under $150!

We are also facing a growing population of citizens from the “Baby Boomer” generation that will need home care in very near future. Of the 12 million individuals who rely on home care, 3.4 million are Medicare home health users. Cutting the Medicare home health benefit would devastate our community, cost people their jobs, and cost patients access to quality care at home, forcing them in to the emergency rooms and nursing homes.

We agree that the health care budget needs some fine-tuning, but making cuts in this manner will only impede our elders' care and could possibly cause the loss of employment for a vast industry in health care. The home care community directly employs almost one million people. Of that, Medicare directly funds over 250,000 of those jobs. In a struggling economy, Medicare cuts would put tens of thousands of valuable health care professionals out of work. This will put half of all home care providers out of business.

In summary, home care is an asset to our communities. It is cost-efficient for all taxpayers, it provides a significant number of jobs for members of our community, and it offers patients an alternative to nursing home placement or longer hospitalizations, all of which equals more taxpayer dollars spent! Please call, e-mail, fax, and mail letters to our representatives. Congressman Ralph Hall needs to hear our voices in this matter!


Analisa Worley, RN


To the editor:

I am a co-owner of a home healthcare agency in Kaufman and would like to address the current pending legislation for healthcare reform. As President Obama and Congress push forward with a plan this year, I think it is important for everyone to realize what is at stake for Medicare home health beneficiaries.

Yesterday the House of Representatives officially made public their health reform legislation, running in excess of 1000 pages. This plan is estimated to cost in excess of $1 trillion over 10 years. Half of the financing, between $500 and $600 billion over 10 years, would come from cuts to healthcare providers under Medicare and Medicaid. Home healthcare providers, which make up 3.5 percent of the Medicare program, would see deep cuts of about $56.8 billion over 10 years.

The “National Association of Home Care and Hospice (NAHC)” estimates that 37.23 percent of home healthcare agencies in 2010 will have negative margins and be forced out of business if these cuts go through. I have serious concerns that under the banner of “cost containment” and “stopping fraud and abuse” we are rationing healthcare for our seniors. Sure, we can easily save some money by cutting provider payments, but we will be left with no providers willing or able to participate in the Medicare program — and what does that do for our senior citizens? If there is a homecare agency that has engaged in fraud, the right response is to prosecute that agency, not penalize the entire industry.

While I understand that healthcare reform must be paid for, it should not be at the expense of providing care to chronically ill and homebound patients. Once again it appears that this portion of our population has been cast adrift on a sea of good intentions which will threaten access to needed care by millions of Americans. Many of our patients live in rural areas 50 miles or more from their doctors and cannot remain in their homes without home healthcare intervention. Home health and hospice services preserve patients' independence, keeps families together, and saves Medicare millions of dollars by keeping beneficiaries out of hospitals, nursing homes and other institutionalized care. Because of our efforts, people are able to live a life of dignity and spend their final days in the most comfortable environment possible — home. Home healthcare is not the problem with the healthcare system; it is part of the solution!

Our agency, as well as other agencies, has been active in contacting Congress and the president regarding this issue. We have personally faxed/e-mailed over 1000 letters from our staff, patients, family members and concerned citizens since January; but we need everyone's help. We owe it to our elderly and homebound citizens to show them the respect and dignity they deserve. I have been blessed to serve in a profession that is truly a labor of kindness and love. Everyone in our industry should be commended for the difference they make in people's lives every day. Whether home healthcare has personally touched your life or not, you probably know someone that it has, and chances are you will need it for yourself or a loved one in the future. It will take all of us to get the attention in Washington we need. I urge everyone to stay informed on these issues and contact President Obama, our Senators John Cornyn and Kay Bailey Hutchinson, as well as the representatives in your area. It is easy to e-mail each of them through their Web sites or through NAHC's Web site. My office is always available for questions or comments and will be happy to assist you in contacting your elected officials. I urge you to be the voice for those who often cannot speak for themselves.

Donna Onstott

Your Health Team


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