Long-term care

“ I propose a tax credit of $1,000 for the aged, ailing or disabled and the families who care for them. Long-term care will become a bigger and bigger challenge with the aging of America--and we must do more to help our families deal with it. ”

“ Nearly 2 decades have passed since Congress seriously considered long-term care reform. The United States Bipartisan Commission on Comprehensive Health Care, also know as the `Pepper Commission', released its `Call for Action' blueprint for health reform in September 1990. ”

“ We must also enact my Administration's long-term care initiative, which, among other important measures, provides tax relief and support services to the millions of family caregivers who devote countless hours to helping older loved ones remain in their homes and communities. ”

“ Good adequate health requires more than just the treatment of sickness and injury, though providing treatment is vital. Good health care must also include proper nutrition, preventive and health maintenance services, as well as provision for long-term care.
In older persons the interrelationship between physical and mental health is especially important. Mental health services for the elderly have been sadly lacking in this country. Active and satisfying lives are both dependent upon and necessary to maintaining the health of older Americans. ”

“ Family caregivers embody the finest of American values. With compassion and a deep sense of responsibility, they devote their time and energy and often their own financial resources to care for family members in need. In many ways, family caregivers are mainstays in the provision of long-term care in our country. Today, more than 7 million Americans are informal caregivers who provide unpaid help to older persons, and 95 percent of older Americans with limitations on their daily living activities depend on family members for some portion of their care. ”

“ Medicare must be available in a variety of forms, and older Americans must have the opportunity to choose the healthcare plan that best fits their needs. My Administration will continue its efforts to improve programs that support older Americans and to offer innovative options for long-term care. ”

“ Scientists at the NIH and the Department of Veterans Affairs are continuing their research to help improve patient care and ease the burdens of caregivers at home and in nursing facilities. The Administration on Aging is working to develop best practices for serving persons with Alzheimer's disease and assisting States as they attempt to improve their responsiveness and the accessibility of home and community-based long-term care services and other support resources. ”

“ ENHANCE COMMUNICATION ON PROMOTING QUALITY OF, AND PREVENTING ABUSE, NEGLECT, AND EXPLOITATION IN, LONG-TERM CARE- The Advisory Board shall develop collaborative and innovative approaches to improve the quality of, including preventing abuse, neglect, and exploitation in, long-term care. ”

“ An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary) , or a hospice program. ”

“ Only 6 states spent 50 percent or more of their Medicaid long-term care dollars on home and community-based services for elderly individuals and adults with physical disabilities while 1/2 of the States spent less than 25 percent. This disparity continues even though, on average, it is estimated that Medicaid dollars can support nearly 3 elderly individuals and adults with physical disabilities in home and community-based services for every individual in a nursing home. ”

“ Of course it's too early to predict what will work best, but the important point is that our proposal calls on the Government to start working. I'm confident that, working with Congress and private insurers, we can find a new and innovative way to ease the financial burden of long-term care. ”

“ LONG-TERM CARE FACILITY- The term `long-term care facility' means a residential care provider that arranges for, or directly provides, long-term care. (16) NEGLECT- The term `neglect' means-- (A) the failure of a caregiver or fiduciary to provide the goods or services that are necessary to maintain the health or safety of an elder; or (B) self-neglect. (17) NURSING FACILITY- (A) IN GENERAL- The term `nursing facility' has the meaning given such term under section 1919 (a) . ”

“ DIRECT CARE- The term `direct care' means care by an employee or contractor who provides assistance or long-term care services to a recipient. (5) ELDER- The term `elder' means an individual age 60 or older. (6) ELDER JUSTICE- The term `elder justice' means-- (A) from a societal perspective, efforts to-- (i) prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation; and (ii) protect elders with diminished capacity while maximizing their autonomy ”

“ Such term does not include a volunteer unless the volunteer has duties that are equivalent to the duties of a direct patient access employee and those duties involve (or may involve) one-on-one contact with a patient or resident of the long-term care facility or provider. ”

“ Such procedures shall ensure that a long-term care hospital has the opportunity to review the data that is to be made public with respect to the hospital prior to such data being made public. The Secretary shall report quality measures that relate to services furnished in inpatient settings in long-term care hospitals on the Internet website of the Centers for Medicare & Medicaid Services.'. ”

“ CAREER LADDERS AND WAGE OR BENEFIT INCREASES TO INCREASE STAFFING IN LONG-TERM CARE- (i) IN GENERAL- The Secretary shall make grants to eligible entities to carry out programs through which the entities-- (I) offer, to employees who provide direct care to residents of an eligible entity or individuals receiving community-based long-term care from an eligible entity, continuing training and varying levels of certification, based on observed clinical care practices and the amount of time the employees spend providing direct care ”

“ As a result, more people are living to an old age than ever before.
The corollary to this achievement is an increase in the incidence of chronic illnesses affecting people as they age. Those who suffer these illnesses may require care over a long period of time, a fact which tests our Nation's ability to provide older Americans the kind of care that will allow them to continue to live independently in their communities.
The rapid growth of adult day care centers is a reflection of increasing community interest in developing long-term alternatives in community settings. ”

“ HEALTH-RELATED TASKS- The term `health-related tasks' means specific tasks related to the needs of an individual, which can be delegated or assigned by licensed health-care professionals under State law to be performed by an attendant. ”

“ CONSULTATION- In conducting the review under subparagraph (A) (i) , the Secretary shall consult with-- (i) State long-term care ombudsman programs; (ii) consumer advocacy groups; (iii) provider stakeholder groups; (iv) skilled nursing facility employees and their representatives ”

“ SOCIAL- The term `social', when used with respect to a service, includes adult protective services. (21) STATE LEGAL ASSISTANCE DEVELOPER- The term `State legal assistance developer' means an individual described in section 731 of the Older Americans Act of 1965. (22) STATE LONG-TERM CARE OMBUDSMAN- The term `State Long-Term Care Ombudsman' means the State Long-Term Care Ombudsman described in section 712 (a) (2) of the Older Americans Act of 1965. ”

“ We will take proactive measures to tackle population aging, including developing at-home, community-based, and mutual-aid elderly care, promoting integrated medical and elderly care services, and improving the quality of services at senior care facilities. ”

“ For these older Americans, however, the blessing of longevity also brings with it an increased likelihood of disability and chronic disease, reduced physical and mental agility, and higher risk of injury or illness-all of which create a greater need for care. ”

“ As these individuals continue to work on our behalf, our Nation is working to fulfill our obligations to older Americans by providing them with good health care and other services to enhance their lives. ”

“ Through the United States Administration on Aging, and through the vast network of State and regional agencies on aging, our Nation is working to provide senior citizens with the opportunities and services that they need and deserve. Many of our efforts are designed to assist elderly Americans who do not have a family member to help care for them. We are also working to provide support to older Americans who serve as primary caregivers for an ill or disabled spouse, parent, or other elderly relative. ”

“ We must raise awareness of the unique needs of older Americans and ensure that caregivers and health professionals are specially trained to treat the elderly. We must expand our research efforts into chronic conditions that affect older Americans. And we must improve health care financing, delivery, and administrative structures so that health plans and providers have the flexibility they need to reduce the prevalence of chronic diseases, slow the rate of disability progression, and ensure the continuity and quality of care. ”

“ It’s about a promise this country made to our seniors that says if you put in a lifetime of hard work, you shouldn’t lose your home or your life savings just because you get sick.
Over the last 47 years, millions of Americans have worked for that promise. They’ve earned it. And for many seniors, the care they’ve gotten through Medicare has made all the difference in the world. ”

“ Our Nation can benefit greatly from the experience and hard work of our older Americans, and I am committed to providing service opportunities to achieve this end. We owe older Americans a debt of gratitude and must work to help them age with dignity. Through home- and community-based services, including health promotion and preventive care programs, many older Americans are able to live more independent and healthier lives. ”

“ The dedication of these organizations and their thousands of employees and volunteers has eased the path to recovery for countless Americans.
The high-quality services of home health care providers give aged and disabled citizens an exceptional opportunity to take advantage of this Medicare-covered benefit and recuperate in their own homes, where they can most effectively draw upon the constant support and concern of their families. ”

“ The health of older Americans varies from individual to individual and can depend on many factors, but we all recognize the critical importance of quality medical care, financial security, and a caring support system to sustaining a high quality of life. As our Nation's population ages, let us work together to ensure that these essential components of good health are available to every American. ”

“ The public and private sectors have forged a unique partnership in the development of high standards and new programs for hospice care. These and other changes to be brought about by health care reform hold the promise for even greater accomplishments as we try to improve the quality of life of those most in need. Thus, my Administration is deeply committed to maintaining and strengthening these efforts in our health care system. ”

“ Home care provides the assistance needed to help older Americans to maintain independence despite such illness. All Americans should commend those individuals who provide personal and health care in the home. ”

“ This year's theme, "Choices for Independence," reflects the importance of our citizens making retirement, lifestyle, and health choices that enhance their quality of life as they grow older. My Administration is committed to strengthening senior programs and ensuring the health and retirement security of older Americans. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 provides for the biggest improvement in health care for our seniors in nearly 40 years. ”

“ But I'm confident if we come together and work together, we will finally achieve what generations of Americans have fought for and fulfill the promise of health care in our time. And what a remarkable achievement that would be -- something that Democrats and Republicans, business and labor, consumer groups and providers, all of us could share extraordinary pride in finally dealing with something that has been vexing us for so long. ”

“ What is true is that every month, another 250,000 Americans turn 65 years old, and become eligible for Medicare. And we all deserve a health care system that delivers efficient, high-quality care. So to keep these programs strong, we’ll have to make smart changes over time, just like we always have. ”

“ When we help those who hurt and those in pain, we become part of our Nation's armies of compassion. Hospice programs provide an option for individuals with terminal illnesses to be cared for as they choose in their final days, often in their own homes and surrounded by the love of their families. The doctors, nurses, counselors, volunteers, and others who provide hospice care throughout our country bring comfort to those most in need every day, treating terminally ill patients with the dignity and respect they deserve. ”

“ Third, our initiative will expand services for older Americans with serious illnesses or disabilities. Today, about 75 percent of elderly Americans with serious illness receive care from their families. But often these families can't afford the services they really need. Now, for the first time, all older Americans with serious impair-ments will be eligible for care in their homes or in community-based settings that they choose. ”