ABCD Exchange : February - March 2000 : Lunch Bunch - Continuity of Care

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Continuity of Care Becomes an Issue on the Hill
by Kate de Medeiros

A few short weeks before Congress reconvened, the ABCD Lunch Bunch on End-of-Life issues met to discuss two recent pieces of patient protection legislation, H.R. 2990 and S. 1344. Although the bills include language that addresses continuity of care and access for special needs patients - both issues of great concern for chronically ill and end-of-life patients - they differ greatly in definition and scope.

Meeting Moderator Al Guida, Vice President, Government Affairs, National Mental Health Association, introduced speakers: Karen Folk, Minority Professional Staff Member, House Commerce Committee; Cybele Bjorklund, Minority Deputy Staff Director, Senate Health, Education, Pensions and Labor Committee; and Kathy McGinley, Assistant Director of Government Affairs, ARC, and co-chair of the Consortium for Citizens with Disability (CCD).

Folk gave an overview of H.R. 2990, which would provide coverage for people in a special course of treatment (e.g. chronically ill, disabled, or with a degenerative condition) enrolled in an HMO should their health plan or physician change. The bill would also provide special needs patients with continuous and ongoing access to a specialist, eliminating the need for repeated referrals in some instances.

Bjorklund discussed S. 1344, a bill similar to H.R. 2900 but which is more limited in scope because it applies only to individuals enrolled in self-insured health plans. McGinley then raised the issue of access to health care for developmentally disabled adults and children. Since these groups tend to have greater need for medical and allied services (e.g. occupational and physical therapies), their needs must be considered in the context of legislation. Joanne Lynn added that the Medicare definition of “terminally ill” currently included in the bills would be better if it were changed to “serious and complex illness” because approximately 70% of dying patients have a serious illness with an unpredictable course.

Currently, both bills have been passed in their respective chambers and are being addressed in conference committee. At the meeting’s conclusion, Sue Emmer, who represents ABCD on Capitol Hill, presented a draft letter for attendees to review. The letter urged congressional conferees to adopt the continuity of care provisions described in the House bill rather than those in the Senate bill.

For updates on legislation, visit the Library of Congress website, “Thomas,” which tracks all legislation at thomas.loc.gov.

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This content is provided by Americans for Better Care of the Dying. For more information, visit www.abcd-caring.org.