•HRES 271 IH 
population, longer life spans among the chronically ill and 
disabled, and higher incidence of acquired disabilities 
from unmanaged conditions such as heart and respiratory 
disease, obesity, stroke, and diabetes; 
Whereas there is a serious lack of long-term care facilities 
and services for people with mental disabilities; 
Whereas, although long-term homecare plays a strong role in 
the way that care is received and provided, there has 
never been a comprehensive national plan for long-term 
care, particularly regarding homecare and community 
services; 
Whereas the last time that Congress comprehensively re-
viewed policy options for long-term care reform was near-
ly two decades ago, under the United States Bipartisan 
Commission on Comprehensive Health Care; 
Whereas more information is needed about the use and need 
for long-term care services, especially among children and 
people residing in rural areas; 
Whereas the limited data on the use and need for long-term 
care hinders the development of a targeted strategy to 
address the disparities in routine access to quality long- 
term care in the home and surrounding community; 
Whereas a significant portion of formal long-term care costs 
are financed with personal funds; 
Whereas this method of payment potentially poses economic 
burdens that can result in financial ruin, including med-
ical bankruptcy; 
Whereas the largest public payer for long-term care is Med-
icaid, which allows States to enforce strict requirements 
for eligibility, and discourages some Medicaid recipients 
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•HRES 271 IH 
from acquiring a higher income for fear of losing Med-
icaid benefits; 
Whereas although most prefer to receive long-term care in 
their homes and communities, the majority of Medicaid 
long-term care expenditures finance institutional care; 
Whereas mentally and physically disabled persons who re-
quire long-term care are more likely to be poor than peo-
ple who are not disabled; 
Whereas income typically decreases after retirement; 
Whereas people 85 and older have the highest probability of 
being low income among the elderly, and the highest 
probability of requiring long-term care services; 
Whereas these financial realities make it difficult for patients 
to pay for long-term care or purchase long-term care in-
surance; 
Whereas persons who buy long-term care insurance are more 
likely to have an above-average income; 
Whereas there remains a severe lack of national standards in 
quality and certification in many facets of long-term care, 
particularly homecare and community services; and 
Whereas there is no national standard for adult day care, a 
community service that is used by people who have men-
tal disabilities, or who have physical disabilities from con-
ditions such as HIV/AIDS, respiratory disease, and 
stroke: Now, therefore, be it 
Resolved, That the House of Representatives— 
(1) commits to integrating long-term care, par-
ticularly as it relates to homecare and community 
services, into a comprehensive health care reform 
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•HRES 271 IH 
agenda because of its important role in the present 
and future success of the United States health care 
system; 
(2) regards preventative health and the man-
agement of chronic disease as essential components 
in decreasing the future dependence on long-term 
care by preventing conditions, such as heart and res-
piratory disease, diabetes, HIV/AIDS, stroke, and 
obesity, from becoming permanently debilitating or 
disabling; 
(3) recognizes the need to collaborate with local, 
State, and Federal health care entities to improve 
working conditions and training for home health 
aides, a profession that is a crucial part of long-term 
care with the intention of lowering turnover rates, 
staff shortages, patient abuse, and raising the stand-
ard of care; 
(4) recognizes the need to adequately fund and 
support existing technologies, entities, and initiatives 
that assist informal care givers, and help maintain 
and improve long-term health services for the dis-
abled and elderly, such as the Older Americans Act 
of 1965 (Public Law 89–73), Social Services Block 
Grants, and the Department of Housing and Urban 
Development programs; 
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•HRES 271 IH 
(5) recognizes that Medicaid and out-of-pocket- 
spending, the dominate methods for financing long- 
term care, exclude countless persons from receiving 
health care service which can lead to more costly 
and invasive medical interventions, and that alter-
native payment options should be widely available 
and more accessible; and 
(6) commits to aiding relevant parties in com-
posing, executing, and enforcing a well-informed na-
tional strategy for long-term care that will address 
geographic and economic disparities that limit access 
to care, expand long-term health services, and 
streamline quality measures. 
Æ 
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