Keep Your Holidays Happy: Be Safe!!!

Nothing ruins a great holiday or other party, celebration or vacation than the tragedy of an, accidental injury, death or other loss.

Help your employees, family and friends avoid having an avoidable accident run their holiday fun by sharing this poem from the Federal Emergency Management Association (FEMA).

Nothing ruins a great holiday or other party, celebration or vacation than the tragedy of an, accidental injury, death or other loss.

Help your employees, family and friends avoid having an avoidable accident run their holiday fun by sharing this poem from the Federal Emergency Management Association (FEMA).

The clock is ticking and we’re down to the wire. 

Everything feels like it’s just caught on fire.

But, let’s be certain that isn’t true.

Keep your real trees watered and your plants too.

 The gift list keeps growing, everyone gets a toy

Tablets, e-readers and chargers, oh boy!

There are plenty of deals out here and out there,

If you’re buying online, be secure and aware.

Plenty of people with candles alight.

Might want to keep them from becoming a fright.

The way to do that is to keep them away.

From the things that could catch on fire some way.

The big day is near, you plan to travel some place.

But a big winter storm rears its big ugly face.

It might change your plans and keep you at home

But that’s better than going out in a snow dome.

The best thing to do is sit down to a feast,

Mashed potatoes and stuffing and a big old roast beast at least.

Keep an eye on them as they sit and they stew.

That way your dinner will be sure to woo.

When the day is over, the kids all in bed.

It’s time to settle into the comfy bedspread.

Turn out the holiday lights, their job is all done.

We hope your holiday’s a big happy one!

©2016 Cynthia Marcotte Stamer.  Non-exclusive license to republish granted to Solutions Law Press, Inc.® All rights reserved.

NHI Says Coordinated Care Can Reduce Disabled’s High ER Use; System Contains Many Barriers To Providing This Care

Working-age adults with disabilities account for a disproportionately high amount of annual emergency department visitors, reports a comparison study from National Institutes of Health (NIA)researchers. As emergency department care may not be the best to address non-urgent concerns and is higher in cost, finding a way to decrease these visits is of interest to many stakeholders.

The Study & Its Findings

One of the first detailed looks at this population’s heightened use of urgent care, the NIH study published online in Health Services Research on Dec. 26, analyzed pooled data from the Medical Expenditure Panel Survey.  . Researchers found access to regular medical care, health profile complexity and disability status contributed to people with disabilities’ use of the emergency department. To address this disparity, the authors recommend enhanced communication between emergency department and primary care physicians, and tailored prevention and primary care programs.

“We want to understand what takes people to the emergency department to learn if their care could be better managed in other ways,” said Elizabeth Rasch, Ph.D., chief of the Epidemiology and Biostatistics Section in the NIH Clinical Center’s Rehabilitation Medicine Department. “While many of those visits may be necessary, it is likely that some could be avoided through better information sharing among all of the health care providers who see a particular individual.”

The study found that despite representing 17 percent of the working age U.S. population, adults with disabilities accounted for 39.2 percent of total emergency room visits. Those with a severely limiting disability visited an urgent care department more often than their peers and were more likely to visit the department more than four times per year.

Emergency visits were also associated with poor access to primary medical care, which was more prevalent among adults with disabilities.

Rasch and her coauthors identified three nationally representative comparison groups — those without any self-reported mental or physical limitations, those with a limitation but who did not need daily living assistance, and those who did need assistance with daily living. Researchers evaluated access to medical care through self-reported survey answers to questions about attainment and delay of primary care services and prescription medications. The number of emergency department visits was also self-reported.

The authors — from the NIH Clinical Center and Brandeis University, Waltham, Mass. — made recommendations for provider and policymaker actions to offset some of the need for emergency care by individuals with disabilities. Prevention and chronic condition management programs tailored for the functional limitations and service needs of people with disabilities may help avoid a crisis situation that would call for an urgent care visit, the report noted. The authors also endorsed wider adoption of coordinated care systems for the disabled that provide case management, integration of psychosocial care and 24/7 access to medical assistance, among other services.

When a patient is admitted to the emergency department, sharing detailed medical information between emergency room and primary care staff could prevent repeat visits. Such coordination is particularly important for disabled patients as they may have limitations that interfere with medical self-advocacy and complex conditions that demand care from various providers.  “When a person has an emergency department visit, their primary care providers often don’t know or don’t get the results of that visit, and vice versa. The emergency department often doesn’t know about the complex medical history people bring with them,” Rasch said. “That’s where things tend to break down.” 

Improving Coordination Presents Big Challenges

While improved information sharing and communication between primary care and emergency room providers is a component of the answer, achieving this is not easy whether or not the patient is disabled. 

Communication and coordination issues are one of the leading challenges to the delivery of continuous care in the health care system, even where the patient isn’t disabled.  Depending on the condition of the disabled patient, cognitive, emotional, financial, home life or other conditions may further undermine the ability of the patient to mitigate these barriers through self advocacy.

In addition, the ad-hoc way in which  patients access emergency care and the possibility that patients access care based on proximity to care at the time of the emergency rather than based on affiliation with a “medical home” or other pre-planned source of care complicates establishment of reliable avenues for sharing information and records among providers. 

Furthermore, in today’s financial resource stretched health care environment, Medicare, Medicaid, Tricare, CHIP and private payers rarely make available any reimbursement to help physicians, hospitals and other health care providers defray the cost or finance resources needed to support this coordination.  Additionally, payers’ reimbursement models rarely allow for adjustment in periods of stay or other services when the disability or other conditions of the patient undermine assumptions that support early discharge to home or another environment.

Beyond these challenges, other factors also play a role.  Care coordination often is impacted by a range of other factors beyond the control of health care providers.  Disabled persons as well as other patients’ often are affected by educational, family, financial, psycho-social, cultural and other conditions beyond the ability of the health care provider to mitigate.

These and other realities create challenges to realizing the potential benefits that the NIH study suggests could be realized through proper care coordination.  Given the significance of the resources that the study reflects are consumed through the high ER use by persons with disabilities, however, payers, providers, community and government leaders and others should reconsider the appropriateness of current models and look for opportunities to adjust reimbursement and other practices to support proper care coordination and support for disabled and other individuals to mitigate the care and financial costs that result from penny-wise, pound foolish practices.

Have ideas or experiences that could help promote this goal.  Join the discussion and share your experiences in our LinkedIn group!

About Project COPE: The Coalition On Patient Empowerment & Its  Coalition on Responsible Health Policy

Sharing and promoting the use of practical practices, tools, information and ideas that patients and their families, health care providers, employers, health plans, communities and policymakers can share and offer to help patients, their families and others in their care communities to understand and work together to better help the patients, their family and their professional and private care community plan for and manage these  needs is the purpose of Project COPE:  The Coalition on Patient Empowerment, a community outreach project of theThe Coalition for Responsible Health Policy.

The Coalition for Responsible Health Care Policy and its Project Cope operate from the belief that thee best opportunities to improve access to quality, affordable health care for all Americans is for every American, and every employer, insurer, and community organization to seize the opportunity to be good Samaritans.  The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care by speaking  up, stepping up and taking the reins to control health care decisions and to help bridge the gap themselves rather than waiting for government or others to make decisions and take care of matters.  Building health care neighborhoods filled with good neighbors throughout the community is the key.

The outcome of this latest health care reform push is only a small part of a continuing process.  Whether or not the Affordable Care Act makes financing care better or worse, the same challenges exist.  The real meaning of the enacted reforms will be determined largely by the shaping and implementation of regulations and enforcement actions which generally happen outside the public eye.  Americans individually and collectively clearly should monitor and continue to provide input through this critical time to help shape constructive rather than obstructive policy. Regardless of how the policy ultimately evolves, however, Americans, American businesses, and American communities still will need to roll up their sleeves and work to deal with the realities of dealing with ill, aging and disabled people and their families.  While the reimbursement and coverage map will change and new government mandates will confine providers, payers and patients, the practical needs and challenges of patients and families will be the same and confusion about the new configuration will create new challenges as patients, providers and payers work through the changes.

We also encourage you and others to help develop real meaningful improvements by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. The Coalition For Responsible Health Care Policy provides a resource that concerned Americans can use to share, monitor and discuss the Health Care Reform law and other health care, insurance and related laws, regulations, policies and practices and options for promoting access to quality, affordable healthcare through the design, administration and enforcement of these regulations.

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources.

Some examples of recent publications that may be of interest include:

For important information concerning this communication click here

©2012 Solutions Law Press, Inc.  All rights reserved.

Look At Mental Health Care For Part Of The Solution To Prevent A Future Newtown Tragedy

As American’s struggle in the wake of the heartbreaking massacre of 20 children and 6 teachers at Sandy Hook Elementary School in Connecticut last week to understand and find effective ways to prevent tragedies like those in Newtown, Connecticut, Aurora and Columbine Colorado, Virginia Tech and so many others, one area that definitely merits close attention is the role of mental illness and the opportunity to mitigate these risks through more effective mental health diagnosis and treatment of individuals with mental health conditions that raise the risk of this or other violent behavior.

The purpose of this discussion is not to demonize the mental health profession or system, but merely to highlight the need to look to the diagnostic and treatment capabilities and the availability and quality of mental health care as part of the solution to the challenge of preventing other similar tragedies.

While the circumstances that lead Adam Lanza to kill his mother and the 26 other victims in Newtown last week remain under investigation, acute mental health events or other mental health conditions often are credited with playing a significant driver behind these horrible episodes. In Newtown, Aurora, Columbine, Virginia Tech and so many other mass shootings, the shooters all exhibited some signs of emotional instability or mental illness prior to the shootings.  Often, reports about these shootings also reflect that the patient or his family sought psychiatric or other mental health care for the shooter before the shooting.  Indeed, defense attorneys for Aurora, Colorado shooter James Holmes have reported that Holes reportedly tried unsuccessfully to call his university psychiatrist nine minutes before he opened fire during the movie premiere of the Batman movie, “The Dark Knight Rises,” killing 12 people and injuring 58 others.  The silent and not so silent struggles of individuals suffering mental illness with explosive, antisocial or other violent manifestations and their famlies typically are littered with a lengthy timeline of these and other desperate cries for help.  Unfortunately, in these and all too many other tragic situations, this care has been unavailable or otherwise ineffective with too often tragic outcomes ranging from destroyed property, to attacks against an individual family member or other person, to more public mass acts of violence like the Newtown massacre last week.

The intractability of mental illness, limited dollars and a host of other reasons often undermine the effectiveness of mental health treatment.  In the case acute mental health episodes leading to violence, however, the inability of a mental health patient or his caregiver to self-stabilize or readily access care from a mental health professional with an established relationship with the patient can be critical. Unfortunately, while scheduled sessions have long been the backbone of treatment of patients suffering nonacute psychiatric conditions, like cardiac patients suffering heart attacks, mental health patients suffering acute episodes rarely enjoy the luxury of the ability to reschedule their nervous breakdown until their next scheduled or some other appointment time convenient for their existing psychiatrist, psychologist, counselor or other mental health professional. That is why the growing tendency of many (but not all) psychiatrists and other mental health professionals to practice their own version of “9-5” medicine is concerning when looking for interventions or other solutions that could effectively stabilize a mentally unstable individual with a potential for mass or other violence.

Although the likelihood that patients may experience acute periods of mental instability or crisis requiring immediate care is foreseeable for virtually all patients suffering any significant mental illness at some point, a distressing number of mental health professionals and practices do not adequately recognize or make themselves available to provide care in accordance with their professional responsibility for when a psychiatric patient experiences an acute episode or other psychiatric crisis outside their scheduled appointment time.  While mental health treatment historically has focused heavily on the periodic scheduling of patient visits largely around the appointment availability of the provider rather than the acuity of the patient’s condition, this trend has accelerated in recent decades. 

The trend is the profession increasingly is to limit or deny access to the provider outside scheduled appointment times, and in doing so, to force patients and their caregivers either to struggle to cope until the mental health professional makes themselves available or to seek emergency care from an emergency room or other health care provider unfamiliar to or with the patient and the patients needs.  Meanwhile, inpatient facilities and other acute care providers increasingly primarily provide only stabilization care or other relatively short term intensive treatment designed to stabilize the patient sufficiently to send the patient home to resume a series of outpatient periodic care.  Long term care for more intractable conditions has become extremely rare, and made more inaccessible for all except the most financially secure by the unavailability of any realistic level of adequate insurance or other source of payment.  The reimbursement system is not the only problem, however. A troubling change in the professional commitment of many mental health providers also plays a role.

While professional law and ethics do not require that a psychiatrist, psychologist, licensed professional counselor or other mental health provider to impose unlimited patient access, the practice increasingly accepted among mental health care providers of restricting patient’s ability to access care from the provider to hours convenient for the provider often runs crosswise with both the needs of the patient and the legal and professional responsibilities of the mental health provider.

As with other physicians or other medical professionals, when a psychiatrist, psychologist, licensed professional counselor or other licensed mental health professional has agreed to treat a patient, that agreement to treat creates a relationship with corresponding duties to and rights of the patient. See, e.g. Oja v. Kin (1998).   Once the psychiatrist agrees to treat the patient, a psychiatrist-patient relationship is formed with the duty to provide treatment as long as is necessary.  The courts and licensing bodies generally recognize that a psychiatrist or other mental health professional may breach his legal and professional responsibilities to an existing patient by failing appropriately to attend, monitor, observe or provide care to a patient.  Furthermore, when delay or inattention in providing care causes a patient injury, tort laws and professional licensing or other disciplining bodies generally stand ready to hold a mental health professional accountable for wrongful abandonment of the patient.  See, Mains (1985). For example, as early as 1928 in Bolles v. Kinton (1928)  stated that a physician may violate his professional obligations by simply not attending the patient without sufficient notice. Others courts have found abandonment when psychiatrists or other mental health professionals make themselves inaccessible to patients, particularly if a crisis is occurring or foreseeable.  Thus, for instance, courts have construed as negligent acts amounting to abandonment by a psychiatrist, psychologist or other licensed mental health professional the professional’s:

  • Failure to provide patients with a way to contact the psychiatrist between sessions;
  • Failure to maintain reasonable contact with a patient hospitalized or otherwise in known crisis; or
  • Failure to provide adequate clinical coverage when away from practice.

Shrinking mental health dollars, the desire to further the provider’s desire for a more controlled lifestyle, the desire to enhance practice profitability and other provider goals often leads many psychiatrists, psychologists or other mental health professionals to  mistakenly underestimate their responsibility to patients suffering acute or other mental health care emergencies when deciding to make themselves unavailable outside scheduled appointment times, not to provide emergency care, or to use “spit care” or other “consultative” treatment arrangements under existing law and ethical standards

Courts typically recognize that a psychiatrist or other mental health professional may be liable for abandonment he fails to respond when an emergency exists or under other circumstances when the provider fails to provide care when the patient still needs care without seeing the patient adequately through the crisis or making suitable arrangements to the attendance of another qualified medical professional with adequate skills and understanding of the patient’s needs. See, e.g. Grant v. Douglas Women’s Clinic P.C. (2003); Johnson v. Vaughn (1963).

Taking into account these traditional legal and ethical principles, the increasingly common practice of sending a patient requiring care to be treated at an emergency room, an acute psychiatric care facility unfamiliar with the patient or other care source may not necessarily fulfill the patient’s needs or the psychiatrists or other mental health professional’s professional responsibility.

Likewise, limited involvement by a psychiatrist or other caregiver by participating in a collaborative or split care arrangement with the acute care facility or other covering provider also may not be adequate to fulfill the provider’s responsibility to the patient.  When a patient is cared for in a collaborative relationship, responsibility for the patient’s care is shared according to the qualifications and limitations of each discipline so that the responsibilities of one discipline generally do not diminish those of the other discipline.  See, e.g., American Psychiatric Association (1980). Rather, when patient’s clinical illness cannot be easily placed into the domain of the other clinician or the other, psychiatrists, psychologists and other mental health professionals generally continue to bear responsibility to ensure adequate psychiatric care as well as to adequately coordinate and communicate with their nonphysician mental health colleagues and other health care providers caring for the patient.  As a consequence, physiatrists, psychologists and other mental health professionals relying upon collaborative or split relationships with other mental health providers or other health care professionals risk running afoul of their legal and professional responsibilities by among other things:

  • Failing to establish and observe clear and appropriate lines of communication and clinical responsibility when providing coverage for emergencies, hospitalizations, absences or other consultative, cover or split treatment relationships
  • Delegating care of their patient without adequate oversight or supervision when the other provider has insufficient clinical knowledge of the patient
  • Failing to obtain and maintain adequate knowledge of the patient and his condition necessary to provide for appropriate, professional consultation and management of care by the psychiatrist during periods of consultation or other split care;
  • Failure to provide careful monitoring of the patient’s clinical condition;
  • Failure to maintain ongoing communication with the nonmedical therapist regarding the patient’s treatment.

While the legal and professional rules concerning abandonment are not new, changes in reimbursement, changing attitudes within the profession, and other factors leading increasing numbers of mental health providers to cut corners in their availability and treatment of patients experiencing violent or other acute mental health conditions outside scheduled office hours.  While the intervention of a qualified, responsible psychiatrist or other mental health professional alone cannot guarantee that a patient won’t become violent, the ability of a patient or his family to timely access care or input from a mental health professional familiar with and committed to the treatment of the patient clearly is a key factor that may help head off or mitigate a crisis.  Consequently, Americans should look to the mental health system, the adequacy of its financial and other resources, and the professionalism and quality of its providers as a key part of the potential answer to the question all Americans are asking:  “What can we do to reduce the likelihood of another tragedy like Newtown, Conn?”  Meanwhile, as we pray for those suffering the loss of friends and family in Connecticut, let’s not forget the a family member is probably begging for help or treatment for the next shooter while we debate the causes and solutions.

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources.

Some examples of recent publications that may be of interest include:

For important information concerning this communication click here

©2012 Solutions Law Press, Inc.  All rights reserved.

NIH “Weight of the Nation” and Other NIH Resources To Help Employees, Families Fight Obesity

Coincident with annual Hurricane Season, the Federal Emergency Management Agency (FEMA) is encouraging all Americans to mark National Preparedness Month during September by preparing a family emergency plan during September.  While important for all Americans, this planning is particularly important for aging, disabled or other individuals with illnesses or other conditions that require ongoing treatment.

Through its Ready Campaign, in partnership with Citizen Corps and The Ad Council, FEMA asks all Americans to make the pledge to prepare this month. To learn more about creating a family emergency plan, emergency kits and supplies and planning for people with disabilities and others with access and functional needs.

About Project COPE: The Coalition On Patient Empowerment & Its  Coalition on Responsible Health Policy

Sharing and promoting the use of practical practices, tools, information and ideas that patients and their families, health care providers, employers, health plans, communities and policymakers can share and offer to help patients, their families and others in their care communities to understand and work together to better help the patients, their family and their professional and private care community plan for and manage these  needs is the purpose of Project COPE:  The Coalition on Patient Empowerment, a community outreach project of theThe Coalition for Responsible Health Policy.

The Coalition for Responsible Health Care Policy and its Project Cope are founded and operated based on the belief that thee best opportunities to improve access to quality, affordable health care for all Americans is for every American, and every employer, insurer, and community organization to seize the opportunity to be good Samaritans.  The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care by speaking  up, stepping up and taking the reins to control health care decisions and to help bridge the gap themselves rather than waiting for government or others to make decisions and take care of matters.  Building health care neighborhoods filled with good neighbors throughout the community is the key.

The outcome of this latest health care reform push is only a small part of a continuing process.  Whether or not the Affordable Care Act makes financing care better or worse, the same challenges exist.  The real meaning of the enacted reforms will be determined largely by the shaping and implementation of regulations and enforcement actions which generally are conducted outside the public eye.  Americans individually and collectively clearly should monitor and continue to provide input through this critical time to help shape constructive rather than obstructive policy. Regardless of how the policy ultimately evolves, however, Americans, American businesses, and American communities still will need to roll up their sleeves and work to deal with the realities of dealing with ill, aging and disabled people and their families.  While the reimbursement and coverage map will change and new government mandates will confine providers, payers and patients, the practical needs and challenges of patients and families will be the same and confusion about the new configuration will create new challenges as patients, providers and payers work through the changes.

We also encourage you and others to help develop real meaningful improvements by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. The Coalition For Responsible Health Care Policy provides a resource that concerned Americans can use to share, monitor and discuss the Health Care Reform law and other health care, insurance and related laws, regulations, policies and practices and options for promoting access to quality, affordable healthcare through the design, administration and enforcement of these regulations.

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources.

Some examples of recent publications that may be of interest include:

For important information concerning this communication click here

©2012 Solutions Law Press, Inc.  All rights reserved.

NIH “Weight of the Nation” and Other NIH Resources To Help Employees, Families Fight Obesity

While tight budgets may require employers, families and communities to cut back on a broad range of expenditures, limited budge Employers, communities and families struggling to find affordable resources to promote and manage obesity and other wellness challenges should check out the wealth of free and other cost-effective resources available from the National Institutes on Health (NIH).   See NIH Health Information: Obesity

Using these and other free or governmentsubsidized resources from NIH or other government agencies, as well as the broad range of reputable resources available from non-profits like the National Kidney Foundation, the American Diabetes Association, the American Heart Association and others can help employers, communities and families stretch their wellness dollars and support efforts to promote wellness.

Obesity & Weight Control Film Series

NIH has developed an extensive video library that provide resources and education to fight obesity and other health challenges.   The HBO Documentary Films series on obesity, “The Weight of the Nation,” that originally premiered in May 2012 provides a four-part series—Consequences, Choices, Children in Crisis, and Challenges—highlighting several NIH research advances and addressed the factors contributing to the country’s obesity problem.  You can view “The Weight of the Nation” at HBO.com  The “Weight of the Nation” HMO film series is the centerpiece to a public awareness campaign, which also includes a three-part HBO Family series for kids, 12 short films, a website and social media, and a nationwide community-based outreach effort using free film discussion guides and other tools. To get a film screening kit, visit hbo.com/theweightofthenation.

NIH Weight Control Research & Health Information

In addition to its video resources, NIH also has an extensive library of other resources on weight control and obesity.  Examples of these resources include: 

With budgets tight, using these and  other free or government subsidized resources from NIH or other government agencies, as well as the broad range of reputable resources available from non-profitscan help employers, communities and families continue and support their ongoing wellness efforts.

About Project COPE: The Coalition On Patient Empowerment & Its  Coalition on Responsible Health Policy

Sharing and promoting the use of practical practices, tools, information and ideas that patients and their families, health care providers, employers, health plans, communities and policymakers can share and offer to help patients, their families and others in their care communities to understand and work together to better help the patients, their family and their professional and private care community plan for and manage these  needs is the purpose of Project COPE:  The Coalition on Patient Empowerment, a community outreach project of theThe Coalition for Responsible Health Policy.

The Coalition for Responsible Health Care Policy and its Project Cope are founded and operated based on the belief that thee best opportunities to improve access to quality, affordable health care for all Americans is for every American, and every employer, insurer, and community organization to seize the opportunity to be good Samaritans.  The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care by speaking  up, stepping up and taking the reins to control health care decisions and to help bridge the gap themselves rather than waiting for government or others to make decisions and take care of matters.  Building health care neighborhoods filled with good neighbors throughout the community is the key.

The outcome of this latest health care reform push is only a small part of a continuing process.  Whether or not the Affordable Care Act makes financing care better or worse, the same challenges exist.  The real meaning of the enacted reforms will be determined largely by the shaping and implementation of regulations and enforcement actions which generally are conducted outside the public eye.  Americans individually and collectively clearly should monitor and continue to provide input through this critical time to help shape constructive rather than obstructive policy. Regardless of how the policy ultimately evolves, however, Americans, American businesses, and American communities still will need to roll up their sleeves and work to deal with the realities of dealing with ill, aging and disabled people and their families.  While the reimbursement and coverage map will change and new government mandates will confine providers, payers and patients, the practical needs and challenges of patients and families will be the same and confusion about the new configuration will create new challenges as patients, providers and payers work through the changes.

We also encourage you and others to help develop real meaningful improvements by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. The Coalition For Responsible Health Care Policy provides a resource that concerned Americans can use to share, monitor and discuss the Health Care Reform law and other health care, insurance and related laws, regulations, policies and practices and options for promoting access to quality, affordable healthcare through the design, administration and enforcement of these regulations.

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can access information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can access other recent updates and other informative publications and resources.

Some examples of recent publications that may be of interest include:

For important information concerning this communication click here

©2012 Solutions Law Press, Inc.  All rights reserved.

COBRA Subsidy Extension Enactment Requires Quick Action, Shows Subtle Reform Enactment While Health Care Reform Debate Continues

Congress’ quiet extension of the COBRA subsidy rules for involuntarily terminated employees and their dependents beyond their scheduled 12/31/09 expiration date and lengthening of the required subsidy period from 9 to 15 months shows that the big health care reform debate is not the only legislation Americans and American business needs to watch. (You can learn more about the COBRA Subsidy extension mandates at http/ /slphrbenefitsupdate.wordpress.com ).

Congress’ quiet extension of the COBRA subsidy rules for involuntarily terminated employees and their dependents beyond their scheduled 12/31/09 expiration date and lengthening of the required subsidy period from 9 to 15 months shows that the big health care reform debate is not the only legislation Americans and American business needs to watch. (You can learn more about the COBRA Subsidy extension mandates at http/ /slphrbenefitsupdate.wordpress.com ).

Through enactment of this legislation and other recently enacted and proposed employment leave and health plan continuation rules, Congress already is expanding the groups of individuals that employers are required to cover and thereby broadening the reach of the mandates to come in larger health care reform legislation. Since the 35% premium limit often is substantially less than currently enrolled employees pay for coverage, it comes as no surprise that data shows that as a result of the COBRA Subsidy Rules, COBRA enrollment is higher than ever before.

In the meantime, employer and union sponsored group health plans, their sponsors and administrators must act quickly to provide required notifications and implement other plan document and procedural changes required to comply with the extension and expansion of temporary “COBRA Subsidy Rules” for “assistance eligible individuals” signed into law as part of the Department of Defense Appropriations Act (H.R. 3326).

The COBRA Subsidy Rules originally were added to the group health plan medical coverage continuation requirements of the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended (“COBRA”) by the American Recovery and Reinvestment Act of 2009 (“AARA”) last February.
H.R. 3326 extended the period that employer and union-sponsored group health plans must allow employees and members of their family that lose group health plan coverage due to an involuntary employment loss to continue their group medical coverage under the reduced premium and other temporary ARRA COBRA Subsidy Rules and lengthened the period during which an involuntary employment loss can qualify an otherwise COBRA-eligible employee or dependent as an assistance eligible individual. Health plan administrators must provide notifications to assistance eligible individuals and restore COBRA eligibility and coverage at reduced premiums for certain assistance eligible individuals who allowed their coverage to lapse before the extension.

Even as this extension takes effect, Congress is considering legislation that would further reduce the premiums health plans are allowed to charge and extend the COBRA Premium rules to June, 2010.

Like the already-enacted school leave mandates for dependent children requiring school medical leaves, military services related expansions to the Family Medical Leave Act and the host of other proposed mandated leave laws that also would mandate continued health coverage, few anticipate that these eligibility mandates, once enacted will go away when the bigger health care reforms come to pass.

Bottom line: Americans have to keep their eye on a bigger game than just the big health care reform debate.  In the meantime, the law increasingly requires that U.S. businesses already struggling to pay health care costs and keep businesses afloat to treat the terminated employees – including those fired for poor performance –  better than the hard working employees that show up every day to help fight the fight.

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©2009 Cynthia Marcotte Stamer. All rights reserved.