I have been lurking on this listserv for about one month. I am a RN (52/6months) who is still fortunately working fulltime. My career focus for the last twelve years has been home health care. Home health is under undue constraints and numerous large agencies have closed after 100+ years of operation and many others are in jeopardy ever since Clinton signed the Balanced Budget Act 1997. I won't get into that Act specificially for my point at this time. My concern is NOT for my job, but more importantly for your and my future home health care needs. In June the Consortium for Citizens with Disabilities, a coalition of consumer and provider organizations, sent a letter to every Representative and Senator that stated, "IPS establishes payment limits that do not adequately reimburse home health providers for the level of care needed by many of the persons they serve, particularly those with significant disabilities and chronic health conditions. IPS will cause many Medicare beneficiaries, such as persons with advanced Alzheimer's disease and multiple sclerosis, to lose access to the home care that they are currently receiving and need." Two issues here: 1. Add Parkinson's to the list of those that will lose access to the home care they will need if IPS is not "reformed". 2. I did not see any Parkinson's organization as a member of the Consortium for Citizens with Disabilities--why not? Fellow USA Parkies, this is a big issue that needs your involvement so that home health care is there for you when and if you need it. The letter went on to state, "IPS emphasizes short-term savings at the expense of sound medical judgement and quality care, beneficiary health and choice, and the long-term cost benefit of services provided in the home rather than emergency rooms, hospitals, and nursing homes." Home Health Care agencies in the US and their representative organizations (National Association for Home Care, The American Federation of Home Health Agencies, etc) request your help and sincerely hope we can enlist you in the fight for a IPS moratorium. PLEASE contact your Representatives and Senators and demand that Congress the pass moratorium legislation i.e. S. 2354, H.R. 4339 , H.R. 4404. I gave you a sketchy view at best about the budget attack home health has been dealt. But, I gave you some food for thought, hopefully. I don't have all the answers but killing off home health care to save money or because ten agencies out of 10,000 across the states were fraudulent, is not the answer. Home care agencies across the nation ARE willing to do whatever makes good sense for the patients and we will cut costs, but not when the chronic care patient loses out the most! This is a serious issue and I sollicit your help. Don't hestitate to contact me personally if you have questions or concerns, but PLEASE remember that I am working fulltime and may not be able to answer everyone in a timely way (No spell checker on this software so please excuse the keyboard's "lack of knowledge" [log in to unmask] 6531 Hwy 11 Elizabeth, IN 47117.