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Purpose

• applicability of the Consumer Bill of Rights (CBR) to substance abuse and mental health settings and/or the need to modify the CBR for application in these settings;

• current status of CBR activities at the State, community, and provider levels;

• suggestions of activities that SAMHSA might undertake to help enhance CBR activities.

Discussion Questions

• What are the most important consumer rights issues that emerge in settings that provide substance abuse prevention and treatment and mental health services?

• Are you aware of any significant consumer rights efforts in your State or community?

• Would kinds of consumer rights initiatives would be most desirable?

• What activities might SAMHSA undertake that would help States, communities, and providers implement the Consumer Bill of Rights?

Consumer Bill of Rights

Box 2429

Columbia, MD 21045-1429

800-732-8200

http://www.hcqualitycommission.gov

In November 1997, the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry released the Consumer Bill of Rights and Responsibilities (Bill of Rights). In endorsing the Bill of Rights, President Clinton stressed that Commission recommendations provide an excellent framework for long-overdue national standards of consumer rights protection.

The Bill of Rights charts a course for the continued enhancement of those health systems and processes that both protect consumer rights and ensure quality. Eight areas of consumer rights and responsibilities were adopted by the Advisory Commission: information disclosure, choice of providers and plans, access to emergency services, participation in treatment decisions, respect and nondiscrimination, confidentiality of health information, complaints and appeals, and consumer responsibilities.

In accepting the Advisory Commission recommendations, the President directed certain Federal agencies, including the Department of Health and Human Services, to adopt the protections of the Bill of Rights in programs and activities. Further, he directed all Federal health plans, which include 9 million Federal employees, to come into substantial compliance with the Bill of Rights. Also, he challenged all private health plans to adopt the Bill of Rights and called on Congress to enact appropriate Federal protections.

Subsequently, Secretary of Health and Human Services Shalala asked all HHS programs that fund health services to individuals, whether directly or through block grants, to begin discussions with States and individual grantees about how the Bill of Rights can be applied.

In keeping with this philosophy and the directives of the President and Secretary, SAMHSA established a cross-agency workgroup to develop a plan to implement the Bill of Rights in SAMHSA activities. The workgroup began by contacting more than 30 external constituents, such as providers, consumers, national organizations, and State program directors, and asked them for recommendations. A workplan was prepared which SAMHSA and Center leadership reviewed.

As a result, SAMHSA is launching an initiative to implement the Consumer Bill of Rights and Responsibilities throughout all activities and programs. Early activities include: (1) sharing information about the Bill of Rights and the SAMHSA initiative with internal staff and external constituents (such as consumers, States, grantees, national and community-based organizations, and providers), and (2) soliciting recommendations on how SAMHSA can provide leadership and support to the substance abuse and mental health fields in implementing the Bill of Rights. A copy of the SAMHSA Bill of Rights workplan is attached. Lead responsibility for the Bill of Rights initiative is with the Office of Managed Care, SAMHSA. For more information, contact Carole Schauer at (301) 443-8304.

The Consumer Bill of Rights and Responsibilities in Health Care, issued today by the Commission, fully lives up to my high expectations. The members of the Commission have brought to bear their own considerable abilities and have obtained information from a wide range of sources. Ihis Bill of Rights and Responsibilities is a comprehensive and thoughtful document that wil! be an excellent guide as we move thougb this tIansition in health care delivery. We must take steps to see that the rights contained in the document become a reality for all Americans. Therefore, I hereby direct you to take the follo ing actions consistent uith the mission of your agency.

First, I direct you to determine the extent of current departmental compliance with the recommendations of the Commission.

Second, I direct you to use administrative authorities, including existing regulations, advisories, and other guidance regarding health plans under respective jurisdictions to initiate appropriate administrative actions consistent with the recommendations of the Corrunission.

Third, I direct you to identify the statutor~ impediments to compliance uith the recommendations of the Commission.

Fourth, I direct you to report back to me, through the Vice President, by February 19, 1998, v ith your findings and the a&s-suatrative actions you have already undertaken and uill undertake to effect the Commission's recommendations." (November 20, 1997)

• First, I have established a working group, comprised of every HHS component responsible for providing, monitoring, or advancing knowledge about consumer protection, that will report to me on an on-going basis about how to continue to improve the consumer protections afforded by all our programs.

• Second, I commit the Department to speedy implementation of all regulatory changes needed to bring us into fuH compliance with the Bill of Rights.

• Third, I have asked all programs that fund health services to individuals, either directly or through block grants, to begin discussions with States and with individual grantees about how they can apply the Bill of Rights in their programs. This includes working with both States and the private insurance industry to set standards for the recently enacted Children's Health Insurance Program.

• Share information with States, grantees, national and community-based organizations, providers, consumers, advocacy groups, and other SAMHSA constituents on the Bill of Rights initiative, including all relevant background and possible future actions by SAMHSA.

• Solicit SAMHSA constituents' for recommendations on how SAMHSA can provide leadership and support to the field in implementing the Bill of Rights and gather suggestions for operationalizing the Bill of Rights to be maimally responsive to the needs of consumers of mental health and substance abuse prevention and treatment services.

• Assess laws, policies, and practices currently being employed by SAMHSA constituents for safeguarding consumers' rights.

• Establish necessary knowledge base and infrastructure within SAMHSA to ensure that the Bill of Rights initiative is carried out.

• Provide technical assistance to consumers and consumer groups on implementing aspects of the Bill of Rights.

• Utilize the Protection and Advocacy system to advance the Bill of Rights. Develop and distribute model elements of the Bill of Rights, e.g. ombudsman services, complaints and appeals procedures, participation in treatment, etc.

• Collaborate with the private managed care sector to promote dialogue on compliance with the Bill of Rights.

• Utilize existing mechanisms to encourage grantees/contractors to comply with the Bill of Rights.

• Collect and analyze data regarding compliance with Bill of Rights and SA/MH community.

Special Topics Archive

Last Updated 11-7-02