Page 15 - 2018PHAVoterGuide

different lens. While there is more than enough room for the reduction of waste, fraud, abuse and limiting
overregulation, we must utilize innovation and technology to promote better outcomes and in turn create
savings for the Medicare program, so it will remain viable well into the future. Second to innovation and
better case management of the most costly chronic conditions, we must find ways to expand the scope
of benefits to allow individuals to age in place and receive care in the dignity of their own homes. This
starts with expanding in-home personal care.

Susan Boser (D)
I am aware of the need for in-home health care, in part because one of my campaign
workers told me about her husband who was diagnosed with Alzheimer’s Disease.
She needed to work full-time. She couldn’t stay at home during working hours to care
for her husband. Although Medicare does cover some in-home skilled care, it did not
cover her husband’s in-home personal care. Neither did Medicaid. She was able to pay
for his in-home care even though it put a strain on their finances. When her husband’s
condition worsened, he was admitted to a nursing home and near the end, had Hospice
services. Medicaid paid for both. She was relatively lucky. Many folks, even though they
have fulltime jobs, can’t afford to pay for in-home personal care for a family member. In
fact, the majority of care givers are unpaid family members, many who have had to leave their jobs.

Our aging population will increasingly strain Medicare and Medicaid. Currently, the average cost for
nursing home care is over $95,000 a year, while at-home care is half the cost at a bit over $45,000 a
year. In order to keep costs under control, states like Alabama are increasing coverage of in-home skilled
and personal care as a less expensive way to provide quality services. Other benefits of in-home services
include allowing individuals to be more in control of their daily schedule, be closer to family and friends,
and receive more personalized care. By having Medicare cover in-home personal care service, fewer folks
would need to apply for Medicaid to cover the cost of nursing home care.

I went on your website and reviewed the federal bills that impact PHA members. I too support the
bills that were listed. One in particular addressed setting quality standards and improving services:
Creating High Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017.
I think it important to improve and set quality standards for home-based services. Based on outcome
measures, education and training for providers would help ensure services are cost-effective. This could
make Medicaid home-based care a sustainable option for years to come. Even more crucially, Congress
is planning on cutting funding for Medicare and Medicaid that will result in less coverage and fewer
services. Yet at the same time, Congress is planning on cutting capital gains taxes for the very wealthy. I
will oppose such budget cuts and fight to reform the Federal tax code to ensure wealthy individuals and
corporations pay their fair share in taxes to help sustain Medicare and Medicaid.

District 16 – Butler (part), Crawford, Erie, Lawrence, Mercer

Mike Kelly (R) (Incumbent)
Rep. Kelly believes home health care is an important key in improving quality of care
and lowering costs in the Medicare and Medicaid program. Improvements in medicine
and technology have made it easier for patients to stay in the comfort of their homes
when sick or in rehab. As the founder of the Health Care Innovation Caucus, Rep. Kelly
believes that Medicare needs to take a more holistic and value-based approach to
health care. In-home personal care has the potential to reduce hospitalizations and
improve medication adherence especially in patients with multiple chronic conditions.
The caucus, under Rep. Kelly’s leadership, aims to look at ways to incentivize better
care for seniors in the setting they prefer. Rep. Kelly is a proud sponsor of H.R. 1825 and
H.R. 2663 which would ease burdensome red tape in home health. One of the biggest concerns in home
health is workforce shortages. He supported H.R. 959 to extend funding for nursing workforce programs. 15