Hearings, Reports and Prints of the Senate Committee on Human Resources

Tear Sheet

implementation of various provisions of the
1972 Amendments to the Social Security Act,
and by better provider understanding, gained
through experience, of Medicare's home health
care requirements. (See p. 32.) However, offi-
cials of Federal, State, and private agencies
stated that many physicians were unaware of
the types of services being provided by home
health agencies. (See p. 36.) States still
have different requirements concerning the
number of visits allowed under Medicaid.
Florida has given unequal treatment to certain
Medicaid recipients also eligible for Medicare
coverage, which is contrary to HEW regulations
and the State's approved Medicaid plan. (See p.
39.)

DIFFICULTIES IN COORDINATION

Under current legislation the various Federal home health programs defy coordination according to HEW. (See p. 50.) An overall Federal policy for home health care would have to be developed and legislative changes enacted before the programs could be consolidated.

The Administration on Aging is the designated
focal point within the Federal Government in
matters pertaining to problems of aged and
aging. Additionally, the Public Health Serv-
ice has responsibility for coordinating
HEW's short-term initiatives to improve home
health care. However, a working agreement
between the two agencies has not resulted in
effective coordination. (See p. 49.)

State and local officials acknowledge that
home health care and other related home de-
livered services for the elderly are not being
effectively coordinated. They generally agreed
that there is such a vast number of services
available through so many different programs
that effective coordination and delivery
of all home health care is difficult. (See
p. 51.)

Although interagency or intra-agency agreements between State and local agencies exist, they have not provided coordinated services to the beneficiaries. (See p. 50.)

One study prepared by the Health Systems Agency of South Florida concluded that better coordination is needed. The study in part

indicated that

--there is no unified system providing an integrated comprehensive and coordinated package of health related and supportive services in the home,

--existing programs providing services in the home result in fragmented provision of services at the local level, and

--the lack of a local coordinated mechanism among providers of health related and supportive social services in the home and between providers of health services creates community problems. (See o. 50.)

RECOMMENDATIONS

HEW should:

--Have intermediaries and carriers publicize the use of home health care and provide information concerning the availability of home health services to physicians and institutional providers.

--Identify State Medicaid programs which do not provide equal treatment to eligible individuals and take steps to correct such inequities.

--Develop a comprehensive national home health policy for consideration by the Congress.

The Congress, in deliberations on the Administration's welfare reform proposal should consider focusing the jobs created to assist the sick and elderly to those elderly who live alone and are without family support.