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Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2004

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Date:
Location: Washington, DC

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2004

AMENDMENT NO. 1558 TO AMENDMENT NO. 1542

Mr. KOHL. Madam President, this is a noncontroversial amendment I hope will be accepted later today. It addresses the tragedy of abuse and neglect in our Nation's nursing homes and other long-term care settings.

Our seniors made our country what it is today, and they have earned the right to live out their days with dignity and the best possible care.

For most seniors in long-term care, they have that opportunity. The vast majority of nursing homes, home health agencies and other long-term care providers do a good job taking care of their patients under difficult circumstances. But too often across this country, there have been and continues to be cases in which our elderly and disabled are abused, beaten, starved, or neglected.

Last year, a House Government Reform Committee report found that nearly one-third of nursing homes had been cited for an abuse violation in the past 2 years. Ten percent of nursing homes had violations that caused actual harm or placed residents in immediate jeopardy of injury or death. The Senate Aging Committee, on which I serve, has repeatedly heard from the GAO that abuse and neglect are a major problem in our Nation's nursing homes.

Tucked away in this appropriations bill is a little program that has a big impact on these problems. The State Long-Term Care Ombudsmen Program places caring people throughout each State to assist elderly and disabled patients who have been abused or neglected. The ombudsmen have the responsibility to make sure that patients' complaints are investigated and addressed. They help these vulnerable people and their families navigate the complicated system and get the help they need.

In addition, the ombudsmen work with nursing homes to improve care. They also serve a large number of patients in home health care and assisted living. In cases where a nursing home must be closed because it cannot or will not improve, the ombudsmen help patients relocate to the best possible setting.

Unfortunately, a lack of funding and staff make it difficult for the ombudsmen to serve the large number of people who need their services—leaving patients vulnerable to substandard care.

A recent Administration on Aging report found that complaints to ombudsmen increased 48 percent from 1996 to 2001.
Yet funding still lags far behind what is needed. Ombudsmen are being asked to do more and more, and Congress should make sure they have the resources to do their jobs.

I greatly appreciate the chairman and ranking member's willingness to work with me over the past several years to increase funding for the ombudsman program. Through our efforts, we have increased funding by $6 million since fiscal year 2000.

This is a great start. But I have been advised by the National Association of Ombudsman Programs that it would take a $36 million increase to adequately fund the program. I realize that such a large increase is not possible in a single
year—especially a year that has such tight fiscal constraints as this one. But I am concerned that the bill before us includes no increase at all.

This amendment would take another small but real step forward by increasing the program by $1 million this year. This increase will help ombudsmen keep up with the growing demand for their services. And it will help make sure that patients are better protected from abuse at the hands of those who are supposed to care for them.

I thank the chairman and ranking member for working with me. I know we all have the same goal of making sure our seniors are adequately protected in law term care.

I yield the floor.

The PRESIDING OFFICER. The Senator from Pennsylvania.

Mr. SPECTER. I thank the Senator from Wisconsin for offering this amendment. I share his concern about adequate care for seniors in nursing homes. That account is currently funded at $13.361 million. I note that the Senator from Wisconsin wants to add $1 million. We would like to be accommodating. However, as Everett Dirksen once said, a million here and a million there add up.

I would be interested to know if the Senator from Wisconsin would care to respond why he picks $1 million instead of $2 million or $750,000? Where does the Senator from Wisconsin see the need for an additional $1 million when there already is $13.361 million? I am searching for some rationality as to why this million should be added.

Mr. KOHL. I do appreciate that. As I say, it will take $36 million, in our judgment, to adequately fund the entire program.
I know very well that is not possible. That is not going to happen. I could pick out a figure larger or smaller than a million, and it was Senator Dirksen who did say a million or a billion added up to quite a bit of money. I do recognize $1 million is a lot of money, but considered in the context of what we are talking about and the importance of the program, which I know the Senator from Pennsylvania agrees, $1 million is a reasonable number.

I would not impose on the Senator the burden of having to make a difficult decision if that number were considerably larger. So I am asking for the support of the Senator with respect to a rather nominal number when we are considering the people we are talking about and the need for our service to them.

Mr. SPECTER. Madam President, the difficulty which I have as manager, we are now up to our 302(b) allocation. To find another $1 million, we have to take it from somewhere. It is a matter of evaluating whether $1 million means anything significant on top of $13 million which we already have.

However, I understand the interests of the Senator, the thrust of the argument by the Senator from Wisconsin. It is a worthwhile program. I will sharpen my pencil and pull down my green eyeshade and see if we can find some money to accommodate what the Senator from Wisconsin would like to have done. No commitments, but we will take a close look.

Mr. KOHL. I thank the Senator.

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