The Home Health Planning and Improvement Act of 2011 would allow advanced practice registered nurses (APRNs), which includes nurse practitioners, clinical nurse specialists, certified nurse midwives, and physician assistants, to order home health services under Medicare in accorance with state law (Conant, 2011). APRNs now provide the majority of care to home health patients. However, Medicare law has kept APRNs from signing home health plan of care and from certifying Medicare patients for home health benefit. This greatly limits the care that these healthcare workers can provide. In rural areas where physicians are often limited, these regulations have led to delays in health care delivery, inconvenience for patients and their families, and increased costs to the Medicare system when patients are required to make otherwise unnecessary visits to more expensive institutional settings. Currently, only physicians can sign home health care plans and authorize Medicare patients for home health care. Seniors and disabled citizens who see APRNs must make extra visits to physician offices because Medicare will not certify payment for the services provided by APRNs until a physician signs the order ("Congressional legislation", 2011). In support of the act, ANA President Karen Daley, RN, PhD, MPH, FAAN, stated, "In order to meet our nation's healthcare needs, an integrated, national healthcare workforce that optimizes utilization of all qualified providers must be put into action." ("ANA endorses home", 2011).
On January 31, 2011, the Home Health Planning and Improvement Act was read twice in Congress. It was then sent to the Senate Finance Committee ("Congressional legislation", 2011).
The original sponsor is Susan Collins (R-ME), who introduced the proposed legislation to the Senate. Collins is a businesswoman and congressional aide with a BA from St. Lawrence University (1975). She currently serves on the Appropriations Committee, Armed Services Committee, and is a member of the Special Committee on Aging. Collins also served six years on the Committee on Health, Education, Labor, and Pensions, where she supported programs to expand access and improvement to healthcare, especially in rural areas. Collins helped restore funding to Medicare for home health so that elderly citizens are able to receive care in their own homes ("Susan Collins", 2011). Co-sponsors in the Senate include: Sen. Daniel Akaka (D-HI), Sen. Kent Conrad (D-ND), Sen. Daniel Inouye (D-HI), Sen. Tim Johnson (D-SD), Sen. Jeff Merkley (D-OR), Sen. John Reed (D-RI), Sen. Ron Wyden (D-OR), and Sen. Chris Coons (D-DE). Representatives Allyson Schwartz (D-PA) and Greg Walden (R-OR) introduced the Home Health Care Planning and Improvement Act of 2011 to the House of Representatives. There are approximately 30 representatives in support of the act.
