• Abstract and Figures
• Public Full-text

THE RIGHTS OF THE UNINSURED IN NEW YORK CITY TRAINING MANUAL 2002 By New York Lawyers for the Public Interest, with input from the Commission on the Public’s Health System. Special thanks to the Commonwealth Fund for its support of this project. TABLE OF CONTENTS Preface . iv I. Emergency Medical Services: Getting to the Hospital . .1 Supplement I-A New York City Trauma Centers Supplement I-B List of Permanent Hospital Diversion II. Access at Private and Public Facilities: Patients’ Rights to Emergency Care . 13 Supplement II-A Sample Statement of Deficiencies and Plan of Correction for St. Lukes- Roosevelt Hospital III. Health and Hospitals Corporation: Patients’ Rights at New York City’s Public Hospitals and Clinics . 45 Supplement III-A HHC Facility Addresses and Phone Numbers Supplement III-B HHC Patient Relations Offices Supplement III-C New HHC Plus Program Supplement III-D Adult Fee Scale for Outpatient Services Supplement III-E Fee Scale for Ambulatory Surgery Supplement III-F Fee Scale for Inpatient Services Supplement III-G NYS Patients’ Bill of Rights Supplement III-H HHC Executive Order No 29 Supplement III-I Basic Collection Advice for Low-Income People IV. Hill-Burton Facilities: Patients Rights at Facilities in Receipt of Hill-Burton Funding . 87 Supplement IV-A NYC Uncompensated Care Facilities (20 years) Supplement IV-B NYC Uncompensated Care Facilities (Forever) Supplement IV-C Where to Send Complaints Supplement IV-D NYC Community Services Facilities V. Civil Rights at Public and Private Health Care Facilities . .109 VI. Appendices . 115 - ii - A. New York City District Attorney’s Offices B. HHS Poverty Guidelines (2002) C. Medicaid Financial Eligibility Levels for New York (2001) D. Office of Civil Rights Discrimination Complaint Form E. Community Health Centers F. Federally Qualified Health Centers G. Child Health Plus H. Facilitated Enrollers I. Family Health Plus J. Medicaid K. Medicaid Managed Care L. Medicare M. Medicare Buy-In N. School-Based Health Centers O. COBRA P. EPIC Q. HIV Uninsured Care Programs R. NYS Partnership for Long-Term Care S. Immigrant and Refugee Eligibility for Public Benefits in New York State VII. Glossary . .179 VIII. Endnotes . .187 - iii - PREFACE Despite its incredible human and financial resources, New York City’s health care system does not adequately provide health services to a large and growing number of its residents. Indeed, the percentage of New Yorkers who are uninsured is significantly higher than the numbers for the state and the nation as a whole, and study after study reveals that the “system” is unprepared or unwilling to deal with them. Recent changes in the way that governmental agencies are providing benefits to low-income Americans compound the health care problems facing New York City’s most vulnerable residents. Now more than ever New Yorkers must have information about how to access services and the rights of the uninsured. New York Lawyers for the Public Interest, Inc. (NYLPI) and the Commission on the Public’s Health System in New York City (CPHS) launched a collaborative effort to create a manual and training program for community- based advocates on how to overcome obstacles to access in order to help meet this need. The training manual is intended to provide advocates with information about the laws governing health care, as well as practical ideas on how to overcome obstacles to access. The first five chapters (I-V) provide questions and answers about the laws, rules and regulations governing New York City’s health care delivery system. We focus on the rights of the uninsured to ambulance service, emergency care, and inpatient and outpatient services at both private and public hospitals, paying particular attention to patients’ rights at public hospitals and clinics because it is their mission to provide care regardless of a patient’s ability to pay. While the emphasis of this manual is on the rights of the uninsured, we note here that the laws, rules and regulations also apply to all individuals, regardless of their race, color, national origin, disability or immigration status. The final chapter (VI) is devoted to a series of appendices that provide information on additional resources, including the eligibility criteria for Medicaid and other programs that offer coverage to otherwise uninsured individuals and families, such as Child Health Plus and Family Health Plus. This is the first revision of the manual and it incorporates the comments and suggestions of many people who have used it since it was first published. The manual is intended for use in conjunction with training to be led by CPHS, and it is to CPHS’s Judy Wessler that NYLPI is indebted first and foremost. Judy is a tireless advocate who has shared her knowledge and experience, provided material for the manual, and given detailed feedback on drafts, and we complete this text with confidence that any errors or omissions will be addressed in the training sessions by our extraordinarily knowledgeable partner in this effort. - iv - A number of key individuals contributed to the manual, including NYLPI’s Pauline Yoo, Jyothi Desai, Rose Cuison-Villazor, Denise White, Michael Silverman and Liana Harper and our wondrous interns Jill Lebwohl, Erin Barton, Dimple Abichandani, Josephine Yeh and Aly Stang, as well as CPHS’s Allison Harriott. Special thanks to the many others at NYLPI and CPHS who also worked on this project, adding materials and insight. Thanks are also due to the individuals at the New York City Health and Hospitals Corporation (HHS), New York City Fire Department, the Health Resources and Services Administration (HRSA), and other government agencies that provided information on their programs and activities. Thanks to Advocates for Children and the Children’s Defense Fund, which were among the many agencies that provided assistance in tracking down forms, numbers and program information. Much appreciation is due the law firm of Shearman & Sterling for publication of the manual and, especially, to Shearman & Sterling’s Karen Flynn and Bernie Wein, who guided the manual through their able production department. Of course, we are indebted to all for their contributions, but we feel particular gratitude toward the Commonwealth Fund for its support of this project. We hope that this manual, together with the training program, will provide needed information on the rights of the uninsured to communities across New York City. Though this is truly a collaborative effort, all responsibility for errors and omissions rests with NYLPI. Marianne Engelman Lado NYLPI Contact Information: Access to Health Care Program Commission on the Public’s New York Lawyers for the Public Health System for New York City Interest, Inc. c/o Ryan Health Center 151 West 30th Street 110 West 97th Street 11th Floor New York, NY 10025 New York, NY 10001 (212) 749-1227 (212) 244-4664 Fax: (212) 749-1189 Fax: (212) 244-4570 E-mail: [email protected] E-mail: [email protected] - v - CHAPTER I Emergency Medical Services: Getting to the Hospital All persons, without regard to ability to pay, are entitled to emergency medical care. This chapter outlines the rights of patients in need of emergency medical treatment and ambulance service. The statement of policy introducing New York State’s Emergency Medical Services (EMS) law states that “prehospital emergency medical care, the provision of prompt and effective communication among hospitals and safe and effective care and transportation of the sick and injured are essential public health services.”1 Nevertheless, uninsured persons often face obstacles in trying to access these essential public health services. In particular, uninsured patients may face two barriers to emergency care: · steering — being taken to particular hospitals based on their ability to pay, rather than based on which hospital is closest and has the most appropriate services; and · diversion — being refused and rerouted inappropriately at the emergency room because a hospital does not want to take on an uninsured patient. The New York statutes and Fire Department of New York policies are designed to ensure access to at least minimum levels of service to which all people are entitled. What rights do patients have to pre-hospital emergency medical care? The Fire Department of New York, which operates the EMS/911 system in New York City, has EMS operating policies that set forth guidelines for EMS operations in New York City. These guidelines apply to both city and private ambulances. According to these policies, ambulance staff shall:2 • Render pre-hospital emergency care as necessary to resuscitate, stabilize, extricate, remove and/or transport the patient. • Render pre-hospital emergency care if flagged down except when transporting a patient whose status is critical or unstable. • Take to the patient all equipment necessary to render appropriate care. - 1 - • Be responsible for moving and transporting the patient to an appropriate designated receiving hospital with a maximum of safety while continuing all required patient care. • While transporting individuals with disabilities, ensure that any prostheses, appliances, equipment devices (e.g., wheelchairs) or other aids that the patient requires for mobility are transported to the medical facility along with the patient. Who operates EMS in New York City? The Fire Department of New York (FDNY) operates the EMS/911 system in New York City. The Fire Department orders the dispatch of an ambulance when 911 receives an emergency call. According to EMS policy, the dispatcher will send the ambulance that is closest to the scene of the emergency. The ambulance that is dispatched may be either a municipal ambulance or a “voluntary” ambulance. The City operates municipal ambulances. Private hospitals such as St. Vincent’s, Beekman and Beth Israel operate “voluntary” ambulances. These voluntary ambulances are required to follow all rules and procedures that govern municipal ambulances. How many ambulances serve New York City? According to preliminary statistics from the Fire Department for 2000, approximately 289 municipal ambulances serve the City each day.

Load more

  202

Copy Link