On Target

 Informing Indiana About Disability Issues

On Target is a monthly publication of the Indiana Governor's Council for People with Disabilities.

We welcome your suggestions for newsletter content and ideas concerning the actions of the Council. On Target is made available in accessible formats upon request.

Suellen Jackson-Boner
Executive Director

Christine Dahlberg
Associate Director

Paul Shankland
Grants Manager

Patients’ Bill of Rights makes progress in Congress

Managed health care providers are feeling the sting of a backlash as customers tire of limited access to services and providers’ control of treatment options. The Patients’ Protections Act of 2001, or the "Patients’ Bill of Rights," might give power back to patients’ doctors. The Patients’ Bill of Rights would cover about 190 million Americans who obtain health insurance through their employers. The bill would provide:

Guidelines for treatment, Greater flexibility for patients, and The ability to appeal when treatment is denied and sue when patients are harmed.

The Senate passed its version (S. 1052) on Fri., June 29. The House was expected to address amendments to its version (H.R. 526) in July, before a conference committee to reconcile the two versions. This information was not yet available at press time. If the House and Senate can agree on a version, the bill will go to President George W. Bush, who has already threatened to veto the bill if it costs employers too much or grants too generous a right to sue.

Supporters of the Patients’ Bill of Rights say that while HMOs have made improvements, they need to go further. "Their conduct has not changed sufficiently enough to give people a sense of security that they will get the health care that they need," said Ron Pollack, president of Families USA. "Allowing patients to sue will make them accountable," he said.

For this bill to be meaningful, it must provide affordable, quality health care to all Americans. Hoosiers should contact their legislators to let them know they are concerned about obtaining affordable, quality health care in this country.

Let your voice be heard by contacting your senator or house representative. Contact information can be found by visiting www.house.gov, www.senate.gov or by calling the Council at (317) 232-7770 (voice) or (317) 232-7771 (TT). For updated information on the status of the House version of the bill, visit http://thomas.loc.gov and search for bill number H.R. 526, www.familiesusa.org, or contact the Council at the numbers above.

Highlights of the bill

• Allows patients to appeal with an agency independent of the insurance company when treatment is denied.
• Bars the prohibition of doctors discussing different treatment options with patients.
• Requires insurance plans to cover emergency room care and pediatric care.
• Permits patients, in particular instances, to sue for damages in state and federal court.
• Allows access to clinical or experimental trials.
• Prohibits giving "bonuses" to doctors who limit their number of referrals.

Indiana Olmstead hearings in August

• East Chicago – Mon. morning
• Merrillville – Mon. evening
• South Bend – Tues. morning
• Warsaw – Fri. morning
• Ft. Wayne – Fri. afternoon
• Muncie – Thurs. evening
• Lafayette – Tues. evening
• Vincennes – Wed. morning
• Evansville – Wed. evening
• New Albany – Thurs. morning

Bush order is latest in Olmstead news

"The United States is committed to community-based alternatives for individuals with disabilities and recognizes that such services advance the best interests of Americans," the order stated. In the Olmstead decision, the Supreme Court states that unjustified institutionalization of people with disabilities amounts to discrimination under Title II of the Americans with Disabilities Act (ADA). It suggests community-based services as a possible alternative.

"I interpret the president’s executive order as a call for all states to increase their efforts, with the support and assistance of the federal government, to comply with the Olmstead decision through the development and implementation of comprehensive community integration plans," said Tom Gallagher, executive director of the Indiana Protection and Advocacy Services Commission and a Governor’s Planning Council member.

The secretary of Health and Human Services (HHS) will take the lead in working with states to help them assess their ADA and Olmstead compliance. Another goal is to ensure that federal resources are used effectively to advance ADA objectives.

Six federal agencies also must evaluate their policies, programs, statutes and regulations to ensure they support community-based services for people with disabilities. This could include improving the flow of information from the agency or removing barriers to community-based services. In addition, the order requires the attorney general and the secretary of HHS to investigate all complaints of unjustified institutionalization.

"This administration has made it a top priority to tear down the barriers to equality facing people of all ages with disabilities," HHS Secretary Tommy G. Thompson said. In response to Bush’s executive order, HHS will provide $70 million in grants to help states improve their community-based services. The agency also is providing grants to task forces and public-private partnerships that will advise on the use of federal grants that improve services for people with disabilities.

"As a result of Gov. O’Bannon’s executive order, the secretary of the (Indiana) Family and Social Services Administration has submitted an initial community integration plan," Gallagher said. "I expect that in light of both of these important executive orders, Indiana will continue to build on the current momentum to develop and implement a community integration plan – a plan that is comprehensive, detailed, measurable and that ultimately brings Indiana into full compliance with the ADA."

For the full text of the president’s executive order, see www.whitehouse.gov/news/releases/2001/06/20010619.html. For more information about Indiana’s Olmstead decision process, see www.in.gov/fssa/servicedisabl/olmstead/index.html.

Phone service aids people with speech disabilities

"Sometimes people have trouble understanding me, and that’s difficult," said Pam Gavin, a person with a speech disability. The phone interview with Gavin was conducted via an STS call placed through Sprint Relay Indiana, the contractor hired by Relay Indiana to offer services to the state. Gavin has never used a relay service before, but was pleased with the STS call. "I can see where I might use this service again. I don’t have the [TT machine] for any other type of relay call." Relay Indiana does not have information about how many people have used the STS services since March, but the U.S. Census Bureau estimates about 2.5 million Americans have a speech disability that might require the use of STS services.

States have offered relay services with TT since 1993, but some people found that the typing was inconvenient, difficult or even impossible. Dr. Bob Segelman, who has a cerebral palsy-related speech disability, implemented STS in the United States as a solution to this problem. STS allows people with speech disabilities to communicate simply by speaking through a CA, and it doesn’t require the special equipment TT does.

CAs are highly trained to recognize a variety of speech patterns, and they revoice the speaker’s words in a three-way call. CAs are required by law to keep the content of any conversation confidential, and they are allowed only to record the length of the call. They are also forbidden to alter a conversation.

Just like relay calling in general, STS is available 24 hours a day, 365 days a year for both Spanish-to-Spanish and English-to-English calls. Translation services are not available in Indiana. For more information about STS and other Sprint Relay Indiana services, contact customer service at (800) 676-3777 (TT/voice). To place a relay call using STS, contact an operator at (877) 743-8231 (TT/voice).

New CMS puts priority on quality

Health and Human Services Secretary Tommy G. Thompson made the announcement in June. "We’re making quality service the number one priority in this agency," Thompson said. "These sweeping reforms will strengthen our programs and enable our dedicated employees to better serve Medicare and Medicaid beneficiaries, as well as health care providers."

Three new business centers will be established as a part of the reform, including the Center for Beneficiary Choices, Center for Medicare Management, and Center for Medicaid and State Operations. CMS will launch a national media campaign to educate seniors and other Medicare beneficiaries about their options, allowing them to make better decisions.

In addition, CMS is enhancing the 1-800-MEDICARE number [(800) 633-4227 (voice)] to serve beneficiaries 24 hours a day, seven days a week.

For all the details, visit CMA’s Web site at www.hcfa.gov or www.medicare.gov.

Web site of note

Conference update