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RELEASED EARLIER FROM HOSPITALS AND IN A WEAKER PHYSICAL

CONDITION.

IT HAS BECOME OBVIOUS THAT MANY OF THESE INDIVIDUALS WILL NEED CONTINUED CARE AT HOME. IN ORDER TO ASSURE THAT THESE OLDER AMERICANS RECEIVE THE VERY HIGHEST QUALITY OF CARE, IT IS ESSENTIAL THAT WE IMPLEMENT SOME METHOD OF MONITORING THIS

EXPANDING INDUSTRY.

I AM PLEASED TO SEE THE RECOMMENDATION ISSUED BY THE AMERICAN BAR ASSOCIATION, AND MADE PART OF THE COMMITTEE'S REPORT. THESE RECOMMENDATIONS REPRESENT A SOUND "FIRST STEP" TOWARDS ENHANCING THE SYSTEM AND INSURING THE QUALITY STANDARD THAT OLDER PERSONS ARE ENTITLED TO.

AGAIN, I CONGRATULATE CHAIRMAN ROYBAL FOR HOLDING THIS HEARING OF VITAL IMPORTANCE TO THE OLDER CONSUMER, AND I LOOK FORWARD TO HEARING FROM OUR WITNESSES THIS AFTERNOON.

The CHAIRMAN. The chair recognizes Mrs. Bentley.

Mrs. BENTLEY. Mr. Chairman, I first ask unanimous consent to include a statement of Hon. John Paul Hammerschmidt for the record.

The CHAIRMAN. All right, without objection that will be ordered. [The prepared statement of Mr. Hammerschmidt follows:]

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PREPARED STATEMENT OF REPRESENTATIVE JOHN PAUL HAMMERSCHMIDT

MR. CHAIRMAN, I WANT TO COMMEND YOU FOR YOUR FORESIGHT IN CONVENING THIS HEARING ON THE NEED TO ASSURE QUALITY IN THE PROVISION OF HOME CARE. I ALSO WANT TO COMPLIMENT THE AMERICAN

BAR ASSOCIATION COMMISSION ON LEGAL PROBLEMS OF THE ELDERLY FOR UNDERTAKING THIS EXCELLENT REPORT ON HOME CARE QUALITY.

TO THE CREDIT OF THE COMMISSION, THE REPORT DOES NOT TRY TO MAKE ITS CASE BY POINTING TO ANECDOTAL CASES. THE REPORT MAKES IT CLEAR THAT THE PROBLEM WITH HOME CARE IS THAT THERE IS NO SYSTEM IN PLACE TO PROTECT THE VERY VULNERABLE GROUP OF OLDER

PEOPLE WHO UTILIZE THESE SERVICES.

THE

THIS REPORT HELPS US TO RECOGNIZE OUR LACK OF DATA, STANDARDS, MONITORING SYSTEMS, AND ENFORCEMENT MECHANISMS. CONGRESS NOW HAS THE INFORMATION TO TAKE APPROPRIATE ACTION AND CIRCUMVENT THE KINDS OF SERIOUS PROBLEMS WE'VE SEEN IN THE PAST IN SOME INSTITUTIONAL SETTINGS.

SINCE MOST OF THE FUNDS THAT PROVIDE THESE SERVICES ARE

FEDERAL AND STATE MONIES, WE HAVE A RESPONSIBILITY TO ENSURE THAT OLDER PERSONS RECEIVE APPROPRIATE AND QUALITY CARE. IT SEEMS TO ME THAT THE OMBUDSMAN PROGRAMS THAT OPERATE IN EVERY STATE TO ASSIST PATIENTS IN NURSING HOMES COULD CERTAINLY SERVE AS A MODEL FOR HOME CARE QUALITY ASSURANCE.

ONE ISSUE RAISED IN THE REPORT WAS THAT ACCOUNTABILITY TO THE CONSUMER WAS AN IMPORTANT FEATURE IN ANY MODEL USED TO ACHIEVE QUALITY HOME CARE. I WOULD LIKE TO PLACE IN THE RECORD AN ARTICLE FROM THE ST. PETERSBURG TIMES WHICH PROVIDES SOME EXCELLENT GUIDELINES FOR ANY CONSUMER INTERESTED IN UTILIZING THESE SERVICES. I HAD THIS ARTICLE REVIEWED BY THE ARKANSAS ASSOCIATION OF HOME HEALTH AGENCIES AND THEY FELT IT WOULD BE OF

GREAT USE TO ANYONE INTERESTED IN OBTAINING HOME HEALTH CARE.

1 LOOK FORWARD TO HEARING THE TESTIMONY OF THE WITNESSES AND

I HOPE THIS HEARING WILL LEAD TO SOUND LEGISLATION TO ADDRESS
THIS ISSUE.

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nursing supervisor to monitor the perfor-
mance of personnel. Inform the agency
administrator and your doctor if this sched-
ule is not met.

If the person receiving home care
lives alone, ask your Neighborhood Crime
Watch to be alert for any suspicious behav-
ior involving workers sent to the home. Also
encourage friends, neighbors and relatives
to visit the homebound person regularly.

Make an inventory of valuables.
Don't leave jewelry, cash or bank receipts in
the open. Don't ask home health personnel
to handle a patient's finances or pay bills.

If you suspect theft, contact the
police immediately. There is nothing scary
about filling out a police report, and the
sooner it gets done the better.

If you are being abused or suspect
abuse of an older person, call the state
Abuse Registry at 1-800-342-9152.

Know in advance what each employ-
ee is paid to do for the patient. Remember
that home health personnel are hired
hands, not substitute relatives or miracle
workers. They must do their jobs while
treating the patient with dignity and re-
spect. Don't expect more or less.

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STATEMENT OF REPRESENTATIVE HELEN DELICH BENTLEY Mrs. BENTLEY. Mr. Chairman, health care is an area of great interest to me, and because the elderly are quickly becoming a larger percentage of the population, we must take our responsibility as committee members seriously by exploring alternative health care methods for elderly, and I commend you, Mr. Chairman, for calling this hearing so that we may further study the development of health care and its weaknesses and its strengths.

Although the availability of home care agencies have markedly increased over the past year, from 1,275 in 1966 to 6,005 in 1986, there is still a need for additional home health care providers. Evidence of this is seen in the exorbitant denial rate of 133 percent, which was measured from the first quarter of 1984 to the first quarter of 1986. Both of these issues mark the dilemma faced by both the home health agencies and the Government, how to regulate the deluge of operations while simultaneously increasing the availability of services.

The benefits of home care seem to outweigh the long-run costs. There is evidence of patients cared for in the home recover more quickly than those placed in nursing homes and hospitals. In addition, the successes of the Rhode Island Home Care Agencies in collaboration with Blue Cross and Blue Shield are said to be working wonderfully. As we see more and more elderly patients and their families opting for home care as opposed to nursing home and hospital services, regulation of these organizations will demand intense scrutiny.

I welcome the witnesses here today, and I am anxious to hear their testimony. Thank you.

The CHAIRMAN. Thank you, Mrs. Bentley.

Mr. Stallings.

STATEMENT OF REPRESENTATIVE RICHARD H. STALLINGS Mr. STALLINGS. Thank you, Mr. Chairman, and I commend you for holding this hearing and encouraging this dialog on the quality of care that is provided to persons in the home. Throughout our lives, we work to insure that our later years will be comfortable, productive, and most importantly, independent. Home health care and home support service providers have made it possible for many people to live in their own homes years after they would otherwise have been forced to seek institutional care.

There can be no doubt that physical and psychological recuperation from an illness can best be achieved in the home setting, allowing a person to benefit from loving and individualized care. Home care services have generally enjoyed a good reputation over the years. I have had the opportunity to visit with home health care professionals in Idaho and their clients, and I am truly impressed with the services being rendered and the substantial reduction in health care costs cannot be ignored.

However, because of the very nature of home care, little information is available to assess the type and, most importantly, the quality of home care. Today's hearing provides an opportunity to address the needs for appropriate standards and monitoring to assure the availability of quality home care services. Thank you, Mr. Chairman.

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