WHEREAS:

AFSCME represents approximately 10,000 home health care workers and 15,000 nursing home workers in the public, private and non-profit sectors; and

WHEREAS:

As potential purchasers of long-term care services, AFSCME retirees and members are justifiably concerned with the future of long-term care funding and services in this country; and

WHEREAS:

Federal changes in the Medicare program — specifically the introduction of DRGs in 1983 — have caused patients to be discharged from the hospital "quicker and sicker" causing a greater need for long-term care services; and

WHEREAS:

Today, 12% of the population is 65 years and older. Older Americans spend a higher proportion of their incomes on health care than when Medicare was first enacted in 1965. For millions of elderly, out-of-pocket medical costs range from 1/4 to 1/3 of their incomes, with 81% of the out-of-pocket costs going to long-term care; and

WHEREAS:

Medicare fails to cover a broad range of the elderly's health care needs, such as long-term care, prescription drugs, dental care, basic preventive services, eyeglasses and hearing aids; and

WHEREAS:

Millions of Americans suffer from chronic conditions that limit their ability to function on their own, requiring services ranging from nursing home care to assistance in their homes. The average cost of a year in a nursing home is over $25,000 and most is not covered by Medicare. An estimated I million Americans become impoverished each year due to costs of long-term illness; and

WHEREAS:

Medicaid provides significant assistance for nursing home and other long-term care expenses. However, restricted eligibility rules make benefits available to less than half of those with income below $11,000. Medicaid reimbursement is inadequate for publicly run nursing homes, who care for the most seriously ill and disabled patients and have fewer private paying patients; and

WHEREAS:

The nursing home market continues to be a lucrative area for non-union, for-profit chain corporations. Small community nursing homes and public nursing homes are particularly threatened by corporate takeovers; and

WHEREAS:

In recent years, there's been a tremendous growth in the home health care industry. Home health care is one of the fastest growing services used by Medicare recipients, with expenditures increasing from $60 million in 1968 to $2.3 billion in 1985; and

WHEREAS:

The number of home care agencies has more than doubled in the past ten years, with the most significant change being the emergence of the for-profit sector; and

WHEREAS:

Employment in the home care industry is characterized by low wages, minimal benefits and high turnover.

THEREFORE BE IT RESOLVED:

That AFSCME actively participate in the national Long-Term Care '88 campaign to promote long-term care in the presidential campaign; and

BE IT FURTHER RESOLVED:

That AFSCME shall support current federal legislation expanding Medicare coverage of home care for the chronically ill, and protections against the cost of catastrophic acute care costs and prescription drugs; and

BE IT FURTHER RESOLVED:

That the International Union continue to devote appropriate resources to fight nursing home contracting out schemes, under-funded reimbursement systems, deregulation, wage or benefit cuts and other threats to quality care; and

BE IT FURTHER RESOLVED:

That AFSCME work to implement the "Nursing Home Reform Act of 1987," which includes many of the recommendations set forth in the Institute of Medicine study "Improving the Quality of Care in Nursing Homes;" and

BE IT FURTHER RESOLVED:

That AFSCME shall support long-term care policies which encourage the growth of home care while ensuring that workers' rights are respected. Development of the home health care industry should emphasize the expertise and cost effectiveness of a public system; and

BE IT FURTHER RESOLVED:

That AFSCME maintain its vigilant efforts to improve nursing home wage and benefit levels, opportunities for career advancement, and quality care; and

BE IT FINALLY RESOLVED:

That every effort be made to organize unrepresented nursing home and home care workers thereby demonstrating that through collective bargaining both patient conditions and working conditions will be improved.

SUBMITTED BY:

International Executive Board