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"Never doubt that a small group thoughtfil, committed people ca change the world. Indeed, it is th

State Council only thing that ever has. Conference - p.2 - Margaret Mead

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CONSUMER PROTECTION NEEDE New Legislation Proposed -

Patient Protection Act by Charlie Smith, Editor

The bill establishes basic con- any incentives that affect the I . has a life threatening phys- sumer protections for all availability of services or re- ical condition, or mental ill- Minnesotans regardless ofthe ferrals. ness, or a chronic health ' care

t=Z, -2 health care company in which condition; or

- they participate. Provisions Health care providers who are - 1 include: licensed, credentialed or 2. has adegenerative disease, registered by a licensing board physical disability, mental re-

Health Care Consumer As- must be correctly identified. tardation or otherrelatedcon- sistance Program and Over- ditions; or - - .- r _ - . & - 3 M t - . U S-tb-. d.33-- - - -:

.. - --. has-the E n d Establishes a one-stop shop sumers with acopy ofan item- trimester of pregnancy at the and advocacy program for ized and intelligible bill when- effective date of enrollment, consumer information on the ever the consumer must pay in which case the enrollee shall health care system, one's for any portion of the bill. be allowed to receive health rights as a health plan enroll- services throu

Alan Reick presen air of ;MinneapolG Advisov ee, any app~als available to Health care providers, upon care directly ., on People with Disabilities, Joan Willshire, for the Committee's winning of a nationalfirst them, triage to the appropri- request, must provide a sum- delivery. prize for Commuttity Involtlement. (Pictured lefl to right) Mike Opal, Hennepin County ate ombudsmen offices and ofany surveys or results Commissioner; Sharon Sayles Belton, Mayor of Minneapolis; Alan Reich, President of the advocacy during the appeal surveys in which it ~ ~ ~ ~ iof care: National Organization on Disability; Uri C m e ~ a , Public Relations Manager of Ut~ited process for consumers that do participated, Parcel Service; and Joan H'illslrire. . .- . . . by Dawn Doering not traditionally have an ad- A new health plan company

vocate available to them.

Foreclosure: Woman 1 Establishes a board of con-

May Lose Her Home by Jeff Nygaard

Kathy, a middle-aged Twin took out a $10,000 loan from Predictably, she soon got be- Cities woman with a mild de- TCFtoreplace her oil furnace hind again. After a few velopmental disability, may and to pay off credit carddebt. months, she went back to TCF lose the home she's lived in As the story will show, this and asked for another loan. for40 years. Her story, which is by no means over, contains some lessons for all people with disabilities and their friends.

In 1987, after Kathy's father died, the family house was put into Kathy's name so that she would always have a home. Now, after approving an im- possibly large loan to Kathy - with payments so burdensome that Kathy was never able to make a single one - Twin Cit- ies Federal (TCF) Bank is try- ing to foreclose her mortgage and leave her with nowhere to live. Would TCF do this to a person with no disability? Let's look at the fact..

was a dificblt debt to handle for awoman withUdirninished intellectual capacity and . . . certain learning disabilities" which "restrict her ability to know and understand" the meaning of a loan like this (as her current lawsuit against TCF states).

After making acouple of small payments on this loan, Kathy began to use her credit card to try to pay it off. The credit card debt grew, and nine months later she applied to Associated Bank in So. St. Paul for a loan of $18,358 to pay off the TCF loan.

Kathy was in over her head, as anyone with banking (or bor- rowing) experience could see.

Remarkably, TCF approved her request and loaned her $4 1,000.

Atthis point, Kathy's "friend" AM came to live with her. Soon Ann began to take ad- vantage of Kathy's trusting nature. Kathy loaned her friend thousands of dollars, based on false promises of repayment. After AM moved out last May, Kathy's family found never-before-seen bills stuffed into drawers, andmore would soon anive - forjewel- ry, furniture, cellular phones, andthousands of dollarsworth of calls.

A little bit about Kathy: She has had a steady job for about

sumer representatives to de- sign and oversee the advoca- cy program and to monitor trends in patient complaints and resolutions to those com- plaints.

Consumer Complaint Pro- cess:

Establishes a quicker, faster timeframe for internal health care company appeals pro- cesses; including 48 hour turn around for medically urgent complaints, 15 business days for referrals, and 30 days for all other complaints.

Establishes an independent appeals process for consurn- ers to directly access either mediation or arbitration.

Disclosure of Health Care Provider Information to Consumers:

Health plan companies and providers must disclose to the public the provider payment plans that they use including

Health plan companies must disclose to consumers a sum- mary of any incentive plan that transfers "substantial fi- nancial risk" to a health care provider.

Access to Emergency Care:

Requires a health plan com- pany to establish a toll-free number for enrollee's to call for information about emer- gency services.

Defines emergency service as what an average person would consider as an "emergency".

Procedure for Specialty Referrals:

Health plan companies must have a procedure by which an enrollee who needs ongoing care from a specialist may receive a standing referral.

Health plan companies must have a procedure for a referral to a specialist who will be responsible for coordinating the enrollee's primary and specialty care if the enrollee:

enrollee, whose current health care provider is not part ofthe enrollee's new health plan network, will be allowed to .finish a course of treatment with hisher current provider if the enrollee:

1. has a life threatening phys- ical condition, or mental ill- ness, or a chronic health care condition; or

2. has a degenerative disease, physical disability, mental re- tardation or otherrelated con- ditions; or

3. has entered the second trimester of pregnancy at the effective date of enrollnlent, in whichcasetheenrollee shall be allowed to receive health services through postpartum care directly related to the delivery.

4. does not speak English or is receiving culturally appro- priate services (this language mirrors protections provided to recipients of PMAP).

An enrollee, whose health care Protection - cont. on p.3 [n October of 1994, Kathy Foreclosure - cont. on b.5 I