President Calls for Compliance with Patient Bill of Rights

President Clinton has directed major federal agencies, including the Departments of Health and Human Services, Veterans Affairs, Defense and Labor, as well as the Office of Personnel Management to take all appropriate administrative actions to bring the agencies into compliance with the Patient Bill of Rights. Developed by the Advisory Commission on Consumer Protection and Quality in the Health Care Industry (known as the “Quality Commission”), the Patient Bill of Rights addresses a wide range of health plan issues including appeals and grievance processes, access to consultants, full discussion of treatment options, access to women's health professionals and ensurance that emergency care decisions are resolved within 72 hours. The action is significant because of the huge numbers of patients affected by these federal agencies. The agencies will implement the changes through administrative and regulatory actions; no legislation is necessary.

States Are Expanding Children's Access to Health Coverage

On January 30, Department of Health and Human Services (HHS) Secretary Donna Shalala announced that Alabama became the first state to receive approval of its program to provide health insurance coverage for thousands of uninsured children under the federal-state Children's Health Insurance Program (CHIP), created under the new Title XXI of the Social Security Act. CHIP will expand health coverage to uninsured children whose families earn too much to qualify for Medicaid but too little to afford private coverage. It builds on the Medicaid program, which already covers 18 million children. Under the new law, states are eligible to receive an enhanced federal matching rate for state programs approved by the HHS that expand access to targeted, low-income children. As of February 11, plans have been submitted by 15 additional states: Colorado, Missouri, Pennsylvania, New York, California, Florida, South Carolina, Ohio, Michigan, Tennessee, Illinois, Rhode Island, Massachusetts, Connecticut and Oklahoma. States have until September 30, 1998, to have their CHIP plans approved.

AHCPR Announces Topics for First Evidence-Based Reports

The Agency for Health Care Policy and Research (AHCPR) has announced the first set of topics assigned to the AHCPR's 12 Evidence-Based Practice Centers (EPCs). The centers will review the relevant scientific literature about these topics and conduct additional analyses, if necessary. The findings will be published as evidence reports or technology assessments. The topics and the centers to which they were assigned follow: pharmacotherapy for alcohol dependence, Research Triangle Institute and University of North Carolina, Chapel Hill; management of stable angina, University of California, San Francisco, and Stanford University, Stanford, Calif.; diagnosis of sleep apnea, MetaWorks, Inc., Boston; treatment of attention deficit/hyperactivity disorder, McMaster University, Hamilton, Ontario, Canada; rehabilitation of persons with traumatic brain injury, Oregon Health Sciences University, Portland; testosterone suppression treatment for prostate cancer, Blue Cross/Blue Shield Technical Evaluation Center, Chicago; evaluation of cervical cytology, Duke University, Durham, N.C.; depression treatment with new drugs, University of Texas, San Antonio; evaluation and treatment of new onset of atrial fibrillation in the elderly, Johns Hopkins University, Baltimore; prevention and management of urinary complications in paralyzed persons, Southern California EPC, Santa Monica; diagnosis and treatment of acute sinusitis, New England Medical Center, Boston; and diagnosis and treatment of dysphagia/swallowing problems in the elderly, ECRI, Plymouth Meeting, Penn.

AMA Recommends Voluntary Moratorium on Human Cloning

The Board of Trustees of the American Medical Association (AMA) has called for a voluntary five-year moratorium by the medical and research community on cloning a human being. The Board does support research that is important to the health of patients, and urges Congress to write no legislation that would interfere with current human, animal or cellular cloning-related research that is not directed at producing a human being.

“This decision comes as a consequence of the Board's belief that the scientific and ethical issues dealing with human cloning require careful and deliberate consideration. We stand with our many other research colleagues who urge a voluntary ban so as to permit the opportunity for careful and reasoned protections to be developed while not adversely affecting important research and medical intervention,” said Thomas R. Reardon, M.D., chair of the AMA's Board of Trustees.

A New Smoking Cessation Initiative Is Available

The Agency for Health Care Policy and Research (AHCPR) has made available a new Smoking Cessation Two-Three Initiative to clinicians to help them get their patients who smoke to quit. The initiative highlights the AHCPR-sponsored smoking cessation clinical practice guideline released last year recommending the questions “Do you smoke?” and “Do you want to quit?” be part of every medical assessment by clinicians. This should be followed by an intervention as brief as three minutes recommending smoking cessation treatments. To aid clinicians in the intervention, AHCPR has developed a Smoking Cessation Consumer Tools Kit. A free copy of the kit can be obtained through the AHCPR by calling 800-358-9295 or writing Smoking Cessation, AHCPR Publications Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907-8547. The kit is also available on the newly redesigned Web site of the AHCPR at http://www.ahcpr.gov/ and on the Office on Smoking and Health Web site at http://www.cdc.gov/tobacco.