There may have been no room at the inn, but California delegation members at this year’s American Association for Homecare (AAHomecare) Legislative Conference gamely shared their message with Sen Barbara Boxer’s (D-Calif) legislative assistant (LA). The meeting (see photo) took place in the Hart Senate Office Building’s lobby because no conference rooms were available in Boxer’s office.

Delegation members kindly allowed me to tag along for meetings at the offices of Senators Dianne Feinstein (D-Calif) and Boxer. In contrast to the Boxer appointment, the meeting with Feinstein’s LA, Tamar Magarik, started promptly with an eloquent summary of key issues from Lisa M. Getson, executive vice president of Apria Healthcare, Lake Forest, Calif. It quickly became clear that Magarik was not interested in touchy-feely anecdotes about seniors who may have limited access to home care if new legislation takes effect on January 1, 2005. Getson and other delegation members adjusted to this and offered up the hard facts.

As reported in our AAHomecare Conference wrap-up (page 9), the top priority was the issue of basing CMS reimbursement for certain DME items (oxygen/oxygen equipment, diabetic supplies and strips, wheelchairs, beds, and nebulizers) on the Federal Employees Health Benefits Program (FEHBP). In both meetings, members sought cosponsors and companion legislation in the Senate for HR 4491, which was recently introduced by Representatives David Hobson (R-Ohio) and Harold Ford, Jr (D-Tenn) to repeal those reimbursement cuts.

From left: Lisa M. Getson and Lynn Dondis with members of the AAHomecare California delegation.

Back in the lobby, this was all touched on in the ad hoc meeting with Lynn Dondis, Boxer’s LA. Dondis seemed sympathetic to the home care message, but it was often hard to hear the message because visiting elementary school children were chanting and clapping just a short distance away. Dondis studiously wrote notes, but I wondered how much was sinking in. For example, a delegation member informed her that there were 1.6 million chronic obstructive pulmonary disease patients in California. However, another delegate noted that Dondis ended up writing 6.1 million on her notepad. With time at a premium, the error was never corrected.

In the end, Dondis echoed the familiar lament that legislative remedies were highly unlikely in an election year. She did say that her boss might be willing to sign on to a letter supporting the concerns raised by Hobson and Ford. Magarik basically concurred.

After the scheduled meetings, I trolled the corridors of power with Vernon R. Pertelle, MBA, RRT, CCM, corporate director of respiratory/HME services for Apria, and David Corbin, a featured speaker and consultant who heads the Performance Technology Group. Pertelle and Corbin were not shy about dropping in on senators without an appointment, and at the office of Sen Mike Crapo (R-Idaho), we got lucky. Crapo’s LA, Barrett P. Thornhill, was gracious and patient as Pertelle and Corbin explained some of the issues facing home care. Pertelle pointed out the powerful fact that one full year of home oxygen costs Medicare about the same as one day in the hospital.

The following day, Thornhill’s boss spoke to attendees and truly seemed to “get it.” Crapo understands that home care is not just a product, it is a service-intensive home therapy.

Indeed, if patients need the therapy, seeking it in more costly health care settings is a loser for everyone. Senators Crapo and Blanche Lincoln (D-Ark) both understand this. Will other legislators heed the message? We’ll see.

Greg Thompson
gthompson@medpubs.com