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Neurology Today:
doi: 10.1097/01.NT.0000360719.28518.f6
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New Bill Proposes Extended Medicare Coverage of Adult Day Care

STUMP, ELIZABETH

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Proposed legislation moving through the Congress would extend and expand Medicare coverage for home care for patients with dementia or other disabilities, enabling them to live at home, while receiving nursing services, therapy, meals, fellowship, learning, and recreation at a nearby adult day center.

The Medicare Adult Day Care Services Act (HR 3043), introduced to the House of Representatives on June 25 by Rep. Linda Sanchez (D-CA), would pay adult day care providers at 98 percent of the home health care rate.

The bill helps protect the income of family members and caregivers, who take unpaid leave to provide care and coordination of services and typically lose an average of $659,139 in wages, pension benefits, and Social Security benefits over a lifetime, said Rep. Sanchez. Additionally, it does not add to the cost of Medicare and it provides patients with more services and longer hours of care for a lower, all-inclusive rate.

Fifty-two percent of the people using adult day care center services nationwide have some cognitive impairment, said Beth Meyer-Arnold, chair of the National Adult Day Services Association. She added that currently, Medicare beneficiaries have few options — they receive skilled rehabilitation services at home (using a Medicare Certified Home Health Agency), or move into a skilled nursing facility for rehab.

The AAN Government Relations Committee and AAN President Robert C. Griggs, MD, sent a letter to the House of Representatives in support of the bill, said Daniel C. Potts, MD, a neurologist at Alabama Neurology and Sleep Medicine, P.C., who is an assistant professor of neurology at the University of Alabama School of Medicine in Tuscaloosa. Dr. Potts, who was named the 2008 Palatucci Advocacy Leadership Forum Advocate of the Year, brought the bill to the attention of the AAN.

“The AAN realizes that this bill has the potential to provide great benefits to our patients and their caregivers at a time when the aging of the population looms as a huge challenge,” said Dr. Potts.

“In addition, because this bill will create greater choice under Medicare, and will result in overall cost savings for the health care system by keeping patients in the home longer and giving caregivers the option to remain in the workplace, I think the AAN sees this as an important aspect of the overall healthcare reform effort.”

“My father had a life-changing experience at Caring Days, a dementia daycare center in Tuscaloosa like the ones alluded to in the bill. Its program of cognitive stimulation, including art and music therapy, helped stabilize my dad's condition, preserve human dignity and sense of self worth, and gave my mother respite,” he said.

Dr. Potts encouraged AAN members to contact their members of Congress and ask for them to cosponsor or support HR 3043, write letters of support to Ways and Means Chairman Charles B. Rangel, and raise awareness in the community and among patients for the bill.

At press time, HR 3043 has six bipartisan cosponsors: Rep. Charles A. Gonzalez (D-TX), Rep. Sheila Jackson-Lee (D-TX), Rep. James P. McGovern (D - MA), Rep. Ron Paul (R - TX), Rep. Albio Sires (D-NJ), and Rep. Donald M. Payne (D-NJ).

Similar versions of this legislation have been introduced in prior sessions of Congress, said Rep. Sanchez. But she said that she is hopeful that the major health care overhaul Congress is working on this year will be the “right time” for the adoption of the adult day care legislation.

The bill will not be in the House health reform bill and most likely will also not be in the Senate health reform bill. It will be offered as a stand-alone or attached to another health-related vehicle later in the year.

“I plan to continue to advocate for the bill's passage because it is good for patients, their families, and American taxpayers,” said Rep. Sanchez.

Visit the National Adult Day Services Association at www.nadsa.org/advocacy/default.asp for links to the bill and sample letters for e-mailing your representatives in Congress in support of HR 3043.

©2009 American Academy of Neurology

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