|
| |
NCD Releases Report on Health Care and People with Disabilities
Mark Quigley of the National Council on Disability
<mquigley@ncd.gov> shares the following
NCD press release about its report released on July 26, 2002.
NEWS FEATURE
NCD #02-376
August 7, 2002
Contact: Mark S. Quigley
202-272-2004
202-272-2074 TTY
National Council on Disability Feature:
Health Care and People with Disabilities
WASHINGTON-The National Council on Disability released its 2001 annual National
Disability Policy: A Progress Report, on July 26, 2002. The report addresses
several important issues related to people with disabilities. This feature
highlights issues related to health care for people with disabilities, including
barriers to adequate health care and the status of issues designed to advance
access and equity in the nation's health care systems.
The report points out that as Congress continues its work on a number of issues
related to the costs and availability of health insurance and health care
"Americans with disabilities face a number of distinct barriers in obtaining,
maintaining, and using health insurance and in accessing and using health care
services. At the same time, Americans with disabilities also confront the
barriers, problems, and frustrations with which most Americans routinely
struggle in the insurance and health care systems."
The report identifies six health related issues of particular significance to
individuals with disabilities and makes a number of recommendations to remove
barriers and create equity in our nation's health care system.
Patients' Bill of Rights
As Congress continues to grapple with the Patients' Bill of Rights legislation,
the NCD report reminds lawmakers that the legislation must apply to all health
plans as well as all privately insured persons, including individuals with
disabilities. The report points out that if individuals with disabilities are
denied access to affordable health insurance, the costs of their care will fall
on the public sector. The law must establish a system of open referrals to
specialists to accommodate the need for regular and predictable specialty care
often required by individuals with disabilities. The Act should contain
requirements for effective communication with purchasers, beneficiaries, and
practitioners, including provisions for written materials in accessible formats,
sign language interpreters, and assistive listening technology. Should the Act
provide for access to clinical trials, it must include instructions to the
researchers to develop procedures for registering such non-pharmaceutical
trials.
To determine strategies for encouraging a broader standard for medical
necessity, NCD recommends the following two parallel research projects to be
included in the Act: (1) a five-year demonstration project aimed at assessing
the costs and benefits associated with assistive technology devices; and, (2) an
examination of how medical necessity decisions are made and how functional
considerations might be included in these decisions.
Mental Health Parity
NCD not only recommends the elimination of the discrepancy between treatment of
health care coverage for individuals with physical and mental diseases, the
report also emphasizes the fact that the distinction between the two is
"increasingly called into question", given the increased recognition of the
interconnection between mental, emotional, and underlying somatic factors.
Parity for mental health treatment in the nation's health care system must be
established in the Patients' Bill of Rights or separate legislation.
America's Law Enforcement and Mental Health Project
Public Law 106-515 authorized the attorney general to make grants to state and
local governments to establish demonstration programs addressing issues relevant
to non-violent offenders with mental illness, mental retardation, and substance
abuse. These programs would include specialized training of law enforcement and
judicial personnel, voluntary outpatient or inpatient treatment, case
management, treatment plans, and service coordination. NCD recommends that the
Department of Justice issue an overview and update on the implementation and
early results of this program, including coordination between the criminal
justice and mental health systems.
Pain Relief Promotion v. Assisted Suicide
The report emphasizes that responsible and compassionate pain relief should be
the right of all people, but provisions to guarantee this right must be
implemented in a manner that protects people with disabilities, who may be more
vulnerable than others to the risks and dangers of assisted suicide.
Appropriately regulated alternative pain management therapies, including
medications-controlled or non-controlled, biofeedback, acupuncture, support
groups, visualizations, etc. constitute a humane and essential component of
medical care. NCD recommends the creation of a national commission of leading
experts in the fields of law, medicine and bioethics, along with representatives
from the disability community, to develop a framework for legislative solutions
to this thorny issue.
Medicare
The current Medicare system includes a large number of rules and regulations
that are potentially outmoded and far too limiting in their range of
reimbursable services for individuals with disabilities. Thorough examination of
this program with an eye towards identifying and removing unnecessary barriers
is badly needed. NCD recommends that CMS convene a panel of experts, health care
practitioners, and beneficiaries, including individuals with disabilities who
are SSDI and Medicare beneficiaries. The panel would review existing policies,
including national and regional coverage decisions, regulations, manuals and all
other sources of administrative limitations on coverage and recommend changes to
eliminate any undue and arbitrary limitations on coverage for individuals with
disabilities.
Telemedicine
For many people with disabilities who do not travel with ease, telemedicine is a
particularly appealing solution to their inability to access essential health
care. Few, if any, reimbursement systems or funding streams have undertaken a
comprehensive assessment of changes that will be necessary in order to make
telemedicine work in their system. NCD recommends that Congress hold hearings on
the changes to the insurance system, particularly to Medicare and Medicaid, that
would be required to make telemedicine work, as well as on accessible design
requirements needed to ensure that technology of telemedicine can be effectively
utilized.
 | NCD continues to advise lawmakers on issues of importance to individuals
with disabilities on health related legislation under active consideration in
the 107th Congress-Patients' Bill of Rights and Mental Health Parity.
|
| To more thoroughly understand the utilization issues for individuals with
disabilities in Medicare, NCD will conduct this year an in-depth study of the
system, with accompanying recommendations for legislative and/or regulatory
changes to ease the barriers that currently exist.
|
| For a number of years, NCD has recognized the harmful effects of
discrimination based on individuals' genetic information and supported the
need for federal legislation prohibiting genetic discrimination as well as the
enforcement of existing legislation that may prohibit certain types of genetic
discrimination. In March 2002, NCD issued a Position Paper on Genetic
Discrimination Legislation and Principles for Genetic Discrimination
Legislation, which are being used as advisory tools for lawmakers with an
interest in this issue.
|
| NCD is currently conducting an inquiry into effective systems of community
supports, including health care, for American Indian and Alaskan Native tribal
members with disabilities. From that inquiry, NCD will develop recommendations
for sovereign tribal governments. |
For more information, contact Mark Quigley at 202-272-2004.
* * *
Source: National Disability Policy: A Progress Report,
December 2000-December 2001
www.ncd.gov/newsroom/publications/progressreport_07-26-02.html
# # #
|
