At a time when the economy is bad, Chicago plans to close some of the city's neighborhood mental health clinics. Below is a link to a WGN interview of Bechar Choucair of the Chicago Department of Public Health trying to rationalize the closings. Cook County Sheriff Dart has said this will result in making Cook County Jail the largest mental health care "provider" in the state, because if the mentally ill cannot receive treatment, they will ultimately be arrested and incarcerated at a greater expense to the city. Dart is right.
http://www.wgntv.com/videogallery/68433606/News/chicago-dept.-of-public-health-talks-the-closing-of-mental-health-clinics#pl-62864487
Sherrif Dart's prediction:
http://www.chicagonewscoop.org/county-jail-a-large-mental-ward-dart/
Tuesday, February 28, 2012
Friday, August 20, 2010
New Illinois Insurance Plan for Those with Pre-existing Medical Conditions is Now Accepting Applications Effective August 20, 2010
The federal health reform law, known as the "Patient Protection and Affordable Care Act", establishes a federally-funded temporary high risk pool to provide affordable health insurance coverage to people who have been denied insurance because of pre-existing conditions. In Illinois, this plan is call the Illinois Pre-Existing Condition Insurance Plan (IPXP). Urbana-based Health Alliance Medical Plans Inc. was awarded the contract for this plan. The plan began accepting applications at 10:00 am August 20, 2010.
To qualify for the plan you must be a U.S. Citizen, national, or legal resident, be uninsured for at least 6 months, and have a pre-existing condition.
You can establish that you have a pre-existing condition by: 1.) providing documentation from a health insurance company stating that you are ineligible for comprehensive coverage due to a medical condition; 2.) providing documentation from a health insurance company offering you health coverage with a rider that excludes coverage for your medical condition; or 3.) provide a written statement from a physician stating that you have an existing medical condition that may result in denial of comprehensive coverage by a health insurance company. The plan has provided me with a "Qualifying Pre-existing Medical Condition Certification Form" that you may provide to your doctor to certify your current health status.
You can find out more information at htt://www.insurance.illinois.gov/HealthInsurance/highriskpools.asp.
I would recommend that any interested persons apply asap because the project has limited funding.
Steve
To qualify for the plan you must be a U.S. Citizen, national, or legal resident, be uninsured for at least 6 months, and have a pre-existing condition.
You can establish that you have a pre-existing condition by: 1.) providing documentation from a health insurance company stating that you are ineligible for comprehensive coverage due to a medical condition; 2.) providing documentation from a health insurance company offering you health coverage with a rider that excludes coverage for your medical condition; or 3.) provide a written statement from a physician stating that you have an existing medical condition that may result in denial of comprehensive coverage by a health insurance company. The plan has provided me with a "Qualifying Pre-existing Medical Condition Certification Form" that you may provide to your doctor to certify your current health status.
You can find out more information at htt://www.insurance.illinois.gov/HealthInsurance/highriskpools.asp.
I would recommend that any interested persons apply asap because the project has limited funding.
Steve
Monday, May 24, 2010
Urgent: New Government Funding For Biomedical Research
On May 21, 1010, the U.S. Treasury Department announced the procedures for requesting a tax credit of up to $5 million per firm to be utilized for the development of new biomedical therapies (Therapeutic Discovery Credit). The purpose of the credit is to provide an immediate boost to U.S. biomedical research and the small businesses that conduct it. The credit is effective for investments made in 2009 and 2010. Only smaller firms with 250 employees or less can participate.
The application period for the credit opens on June 21, 2010 and closes on July 21, 2010. The Department of Health and Human Services (HHS) will evaluate each project for its potential to produce new therapies, address unmet medical needs, reduce health care costs or advance the goal of curing cancer. Meeting any one of the pre-stated criteria could result in qualification. Applicants will receive a determination no later than October 29, 2010.
The credit can apply to up to 50% of a company's "qualified investment" which is defined as the "aggregate amount of the costs paid or incurred in the taxable year for expenses necessary for and directly related to the conduct of a qualify therapeutic discovery project". The credit can be applied to the taxable years of 2009 and 2010. The qualfied investment does not include costs for remuneration for executives, interest expenses or facility maintenance expenses during those taxable years. Qualified investments may include expenses for wages, supplies and lab costs, depreciable property, contractor costs, etc.
There are three types of projects that can qualify for the credit: 1.) those to treat or prevent diseases or conditions by conducting pre-clinical activities, clinical trials, and clinical studies, or carrying out research protocols, for the purpose of securing FDA approval; 2.) those to diagnose diseases or conditions or to determine molecular factors related to diseases or conditions by developing molecular diagnostics to guide therapeutic decisions; and 3.) those to develop a product, process, or technology to further the delivery or administration of therapeutics.
A separate application for certification must be submitted to each project for which an eligible taxpaying entity is seeking certification of a qualified investment. An application consists of the following:
1. New Tax Form 8942 (this new tax form will be released no later than June 21, 2010)
2. Penalty of Perjuries Statement
3. Project Information Memorandum
4. Consent to Public Disclosure of Certain Qualifying Therapeutic Discovery Project Program Application Information (optional).
Brochures and other presentations are not permitted as part of the application and will not be considered.
The application must disclose the number of full-time and part-time employees whose work is directly billed to the project and their average salaries. It must also disclose the number of contractors in the US that were paid for work on the project.
The application must also disclose whether the project is active, terminated, or suspended. If the project has been terminated or suspended because the project failed a clinical trial, failed a pre-clinical research milestone, or failed to secure FDA licensure, it would be ineligible for the credit. Termination or suspension of the project due to lack of funds does not disqualify the project for consideration.
The application must assert whether the project will produce new or significantly improved technology as compared to commercial technologies currently in service and whether the project is expected to lead to the construction or use of a contract production facility in the US within the next five years.
The Project Information Memorandum, to be included in the application, must meet a specified format and meet certain stated number of word limitations in response to the required questions. The applicant can take certain steps to protect confidential trade secrets and information. The memorandum will describe the scientific rationale, research and developent plan, and the scientific evidence relied upon by the applicant, including citations. The memorandum will address the FDA regulatory status of the project. The memorandum will also explain the resources, management experience and organizational capacity of the applicant. The memorandum will finally address in 250 words or less per item the likelihood that the project will: 1.) produce new therapies; 2.) address unmet medical needs; 3.) reduce health care costs; or 4.) advance the goal of curing cancer.
I recommend that interested applicants start preparing their Project Information Memorandum immediately so they can stand at the beginning of the line when their application is filed on June 21, 2010.
Steve
Steve Schurr
Friday, April 9, 2010
Immediate Benefits to Health Care Reform
According to President Obama, below are some of the immediate effects of the new health care bill:
Beginning this year, small businesses can receive tax credits to help cover the cost of employee health insurance, if they choose to do so. Eligible employers will receive credits worth up to 35% of employees' premiums.
This year, a high risk pool provides access to affordable coverage to individuals who are uninsured because of a pre-existing condition.
This year, the law begins to close the Medicare Prescription Drug "Donut Hole" by providing a $250 rebate for seniors who fall in the coverage gap.
This year, the law helps early retirees by creating a temporary re-insurance program to help offset the expensive costs of premiums for those aged 55 to 64.
Next year, seniors will have access to free preventive care under Medicare, such as annual check-ups, mammograms and colonoscopies.
Next year, seniors will receive a 50% discount on proscription drugs in the Medicare "Donut Hole."
This year, health insureres are banned from discrimination against children with pre-existing conditions.
This year, insurers are required to give parents enrolled in new plans the ability to select their child's pediatrician from among any participating provider.
Steve
Beginning this year, small businesses can receive tax credits to help cover the cost of employee health insurance, if they choose to do so. Eligible employers will receive credits worth up to 35% of employees' premiums.
This year, a high risk pool provides access to affordable coverage to individuals who are uninsured because of a pre-existing condition.
This year, the law begins to close the Medicare Prescription Drug "Donut Hole" by providing a $250 rebate for seniors who fall in the coverage gap.
This year, the law helps early retirees by creating a temporary re-insurance program to help offset the expensive costs of premiums for those aged 55 to 64.
Next year, seniors will have access to free preventive care under Medicare, such as annual check-ups, mammograms and colonoscopies.
Next year, seniors will receive a 50% discount on proscription drugs in the Medicare "Donut Hole."
This year, health insureres are banned from discrimination against children with pre-existing conditions.
This year, insurers are required to give parents enrolled in new plans the ability to select their child's pediatrician from among any participating provider.
Steve
Thursday, December 17, 2009
COBRA Extension to 15 Months
House Lawmakers Approve COBRA Subsidy Extension
December 16, 2009 (PLANSPONSOR.com) – The U.S. House of Representatives on Wednesday approved a bill that would extend federal COBRA health coverage cost subsidies for involuntarily terminated employees.
http://www.plansponsor.com/House_Lawmakers_Approve_COBRA_Subsidy_Extension.aspx
December 16, 2009 (PLANSPONSOR.com) – The U.S. House of Representatives on Wednesday approved a bill that would extend federal COBRA health coverage cost subsidies for involuntarily terminated employees.
http://www.plansponsor.com/House_Lawmakers_Approve_COBRA_Subsidy_Extension.aspx
Sunday, December 13, 2009
The Illinois Mental Health Treatment Preference Declaration Act
In Illinois, an individual of sound mind may make an advance declaration of preferences or instructions regarding mental health treatment. See the Mental Health Treatment Preference Declaration Act, 755 ILCS 43. If you suffer from a recurring mental illness, I recommend that you implement such a directive on your behalf when you are of sound mind. This will help you maintain control over your situation if you later become incapacitated.
Applicability
In the declaration, the individual may designate a competent individual to be an agent to make decisions about mental health treatment if the principal is incapable. The individual may also designate an alternative mental health care agent. 755 ILCS 43/15. Under the law, the treating physician must continue to obtain the individual’s informed consent to all mental health treatment decisions if the individual is capable of providing informed consent or refusal. 755 ILCS 43/25. The designated agent has no authority to make mental health treatment decisions unless the individual is incapable. 755 ILCS 43/30(a). In addition, the treating physician or health care provider and the owner, operator or employee of the health care facility cannot act as the designated agent. 755 ILCS 43/60.
Issues Addressed
In the declaration, the individual may address the following issues:
1.) Consent or refusal to the administration of psychotropic medications;
2.) Consent or refusal to electroconvulsive therapy;
3.) Consent or refusal to admission and retention in a mental health facility;
4.) Selection of a treating physician; and
5.) Any other pertinent matters (for example, medications that you react more favorably to versus others, who may visit you while you are institutionalized, etc.)
Duration of Effectiveness
Such a declaration remains valid for three years, and continues past the three-year period if the individual is mentally incapacitated at the time of expiration of the three year period. 755 ILCS 43/10(2). Under the statute, a person is “incapable” if, in the opinion of two physicians or a court, the individual’s ability to receive and evaluate information effectively or communicate decisions is impaired to such an extent that the individual currently lacks the capacity to make mental health treatment decisions. 755 ILCS 43/5(5). The individual may revoke the declaration in writing, but only if he/she is capable. 755 ILCS 43/50.
Duties of Treating Provider
Once a declaration is implemented, the physician or health care provider must comply with the declaration unless: 1.) a court order contradicts the declaration or 2.) an emergency endangering life or health arises. The declaration does not limit the provider’s rights to implement commitment proceedings under Illinois law. 755 ILCS 43/45.
Confidentiality of Mental Health Records
The agent may obtain and consent to disclosure of mental health records, but this right of access does not waive any pre-existing legal privilege regarding the confidentiality of the mental health records. 755 ILCS 43/30(3).
Liability of Designated Agent
The designated agent is not personally liable for the resulting costs of the mental health treatment that he/she directs. 755 ILCS 43/30(2).
Proper Execution
A declaration is effective only if it is signed by the individual and witnessed by two competent adults who must attest that the principal is known to them, signed the declaration in their presence and appears to be of sound mind and not under duress, fraud or undue influence. 755 ILCS 43/20. The following people may not serve as witnesses: 1.) a family member related to the individual by blood, marriage or adoption, 2.) the treating physician or health care provider, and 3.) the owner, operator or employee of the health care facility.
Contact the Schurr Health Care Legal Clinic at 312-560-4202 if you desire such a directive.
Thanks.
Steve
Applicability
In the declaration, the individual may designate a competent individual to be an agent to make decisions about mental health treatment if the principal is incapable. The individual may also designate an alternative mental health care agent. 755 ILCS 43/15. Under the law, the treating physician must continue to obtain the individual’s informed consent to all mental health treatment decisions if the individual is capable of providing informed consent or refusal. 755 ILCS 43/25. The designated agent has no authority to make mental health treatment decisions unless the individual is incapable. 755 ILCS 43/30(a). In addition, the treating physician or health care provider and the owner, operator or employee of the health care facility cannot act as the designated agent. 755 ILCS 43/60.
Issues Addressed
In the declaration, the individual may address the following issues:
1.) Consent or refusal to the administration of psychotropic medications;
2.) Consent or refusal to electroconvulsive therapy;
3.) Consent or refusal to admission and retention in a mental health facility;
4.) Selection of a treating physician; and
5.) Any other pertinent matters (for example, medications that you react more favorably to versus others, who may visit you while you are institutionalized, etc.)
Duration of Effectiveness
Such a declaration remains valid for three years, and continues past the three-year period if the individual is mentally incapacitated at the time of expiration of the three year period. 755 ILCS 43/10(2). Under the statute, a person is “incapable” if, in the opinion of two physicians or a court, the individual’s ability to receive and evaluate information effectively or communicate decisions is impaired to such an extent that the individual currently lacks the capacity to make mental health treatment decisions. 755 ILCS 43/5(5). The individual may revoke the declaration in writing, but only if he/she is capable. 755 ILCS 43/50.
Duties of Treating Provider
Once a declaration is implemented, the physician or health care provider must comply with the declaration unless: 1.) a court order contradicts the declaration or 2.) an emergency endangering life or health arises. The declaration does not limit the provider’s rights to implement commitment proceedings under Illinois law. 755 ILCS 43/45.
Confidentiality of Mental Health Records
The agent may obtain and consent to disclosure of mental health records, but this right of access does not waive any pre-existing legal privilege regarding the confidentiality of the mental health records. 755 ILCS 43/30(3).
Liability of Designated Agent
The designated agent is not personally liable for the resulting costs of the mental health treatment that he/she directs. 755 ILCS 43/30(2).
Proper Execution
A declaration is effective only if it is signed by the individual and witnessed by two competent adults who must attest that the principal is known to them, signed the declaration in their presence and appears to be of sound mind and not under duress, fraud or undue influence. 755 ILCS 43/20. The following people may not serve as witnesses: 1.) a family member related to the individual by blood, marriage or adoption, 2.) the treating physician or health care provider, and 3.) the owner, operator or employee of the health care facility.
Contact the Schurr Health Care Legal Clinic at 312-560-4202 if you desire such a directive.
Thanks.
Steve
Friday, December 4, 2009
Mental Health Parity Law Effective 2010
Because I've had some questions, I thought I would repost a blog that I posted previously in 2008 in regards to the Mental Health Parity Law.
Steve
Previously posted:
At least one good thing came out of the recent financial troubles that our country has been experiencing. After more than 10 years of trying, Congress has passed a law that requires employer-sponsored health care plans to treat mental health disorders to the same level and degree as they do physical ailments.
The new requirements are included in the Emergency Economic Stabilization Act (H.R. 1424), which is the "economic bailout" bill that President Bush signed into law on October 3, 2008. For years, plans have generally been less generous in their coverage of treatment for mental illness. The new law becomes effective in 2010 and generally applies to employers with more than 50 workers, with certain exceptions.
Under the new law, plan participants cannot be required to pay more in deductibles, copayments, coinsurance and out-of-pocket expenses for mental health and substance use disorder benefits than they are required to pay for the plan's most common or frequent types of medical/surgical benefit. The new law prevents plans from limiting the frequency of treatment, the number of visits, the days of coverage, etc. for mental health/substance use treatment moreso than they do for medical/surgical benefits. In addition, "out-of-network" mental health services must be covered under the law if they are covered for medical/surgical benefits.
A plan must provide a legally acceptable definition of "mental health" and "substance use disorder" and is permitted to use utilization review and/or pre-authorization to determine medical necessity and appropriateness. The plan administrator must disclose any medical necessity determination criteria to any participant upon request. Also, the reason for any denial of reimbursement or payment also must be provided.
The law provides a penalty of up to $100/day for non-compliance and allows plan participants to file civil lawsuits to obtain inappropriately denied benefits. Steve
Steve
Previously posted:
At least one good thing came out of the recent financial troubles that our country has been experiencing. After more than 10 years of trying, Congress has passed a law that requires employer-sponsored health care plans to treat mental health disorders to the same level and degree as they do physical ailments.
The new requirements are included in the Emergency Economic Stabilization Act (H.R. 1424), which is the "economic bailout" bill that President Bush signed into law on October 3, 2008. For years, plans have generally been less generous in their coverage of treatment for mental illness. The new law becomes effective in 2010 and generally applies to employers with more than 50 workers, with certain exceptions.
Under the new law, plan participants cannot be required to pay more in deductibles, copayments, coinsurance and out-of-pocket expenses for mental health and substance use disorder benefits than they are required to pay for the plan's most common or frequent types of medical/surgical benefit. The new law prevents plans from limiting the frequency of treatment, the number of visits, the days of coverage, etc. for mental health/substance use treatment moreso than they do for medical/surgical benefits. In addition, "out-of-network" mental health services must be covered under the law if they are covered for medical/surgical benefits.
A plan must provide a legally acceptable definition of "mental health" and "substance use disorder" and is permitted to use utilization review and/or pre-authorization to determine medical necessity and appropriateness. The plan administrator must disclose any medical necessity determination criteria to any participant upon request. Also, the reason for any denial of reimbursement or payment also must be provided.
The law provides a penalty of up to $100/day for non-compliance and allows plan participants to file civil lawsuits to obtain inappropriately denied benefits. Steve
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