Health

Homebound Clarification Act of 2001

Since the 1970's Medicare beneficiaries have had a need for skilled care and be certified as being "confined to home" in order receive home health services. This second criterion, known as the homebound rule, is increasingly coming under attack as forcing Medicare beneficiaries with disabilities and chronic health conditions to become prisoners in their own homes.

Representative Edward Markey (MA) and about 30 other Members of Congress are sponsoring HR 1490, the Homebound Clarification Act of 2001, which is intended to address this anachronism in current law. It would do this by requiring that beneficiaries still have a need for skilled care and experience significant difficulty in leaving their home due to a disability or medical condition but would drop the current requirement that such individuals only can leave their homes on a short and infrequent basis to go to a medical appointment, religious service or adult day care.

The week of May 14, UCP joined with the National Coalition to Amend the Homebound Restriction to sponsor a briefing on this legislation. The following is a recent letter sent to David Jayne:

April 17, 2001

David Jayne, Founder
The National Coalition to Amend the Homebound Restriction

Dear Mr. Jayne:

On behalf of United Cerebral Palsy Associations ("UCP") -- our 133 member affiliate family of consumers, families and volunteers - we would like to express our deep appreciation and strong support for the leadership and vital work of the NCAHB.

The mission of UCP is to advance the independence of all people with disabilities in every facet of life. NCAHB's efforts to amend the requirement that Medicare beneficiaries be homebound to receive home health services to live in their own homes and communities are crucial to realizing this vision. When Medicare was first enacted in 1965, the homebound rule provided a clear cut, fair and efficient way to administer the home health benefit. This rule reflected the harsh realities of the times - at that time, most individuals with significant disabilities were, in fact, institutionalized or "confined to home" by barriers to health care, education, employment and community living that were far more rampant in society nearly 40 years ago.

Fortunately, we live in a far more inclusive and barrier free America than we did in the 1960's. Thanks in large part to the enactment of legislation such as the Americans with Disabilities Act, as well as advances in health care and technology, those with significant disabilities and chronic illnesses should no longer have to be shut in, left out or left behind in our great nation. Your personal example and that of countless others provides ample testimony as to why the Medicare homebound policy must be amended and updated to reflect the vital strides we continue to make in affording full, first class citizenship to all Americans with disabilities. No one should be forced to choose between receiving the vital home health care they need to continue to survive and their right to leave their homes and freely move about their communities.

UCP believes that the Medicare homebound rule must be amended to ensure that those who rely on home health services for their very lives do not have to forfeit their most fundamental freedoms to do so. Furthermore, we believe these changes can be made in a manner that does not harm the integrity of the Medicare program or create unmanageable new costs for the Trust Fund. We, therefore, look forward to working with you, NCAHB, the Congress, the Administration and others to achieve these critical policy aims. If you have any questions, please contact Bob Williams or me.

Sincerely,

Kirsten A. Nyrop
Executive Director

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