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Access PrEss Volume 3. Number5




HealthRight Passes - T:-.2 Sponsors Tell Us All About It The initial flurry of pub- not widely understood. Ogren,and both of theiropinion articles follow on pages 6 licity a b u t bdiawwta's rtebvm&icalpbbs& The real experts on & 7. n t . ..,



sided and an amazing amounrof misinformation has surfaced in the form of rumors and speculation on timetables, costs and availability of the insurance. "The Gang of



A lot of us watched the Minnesota legislature shut down







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Diagnostic, rehabilitation, out-patient lab and x-rayi home health and mental health services

How It Wonks Who's Eligible and When

-1,1992 &WtStwkd siblings with a child in the Children's Health Plan may

Immunizations Vision care Eyeglassesf~rkidsand~~;~

by William A. Smith, Jr.

January 1,1994: Shgkdml~ TtK hllowing co-payments ~ required: ~ ~ and while conducting a se- by the chairman (and the be changed to act as a safety and households w i l h 0 ~ tk ries of sham public hearings, board members) at the legis- net that supplements acces- I dren may enroll. Unless 10 &cent for inpatient

their own agenda called "VISION FOR TRANSIT" whichdoesnot includeMetro Mobility as a primary source of transportation. Instead, it is listedas aL'safetynet". The very term "safety net" has fallen into such disrepute after (RTB). administration'sabuseofthe term, I regard it asan insult to Wehdnorhing. the public. And, of course, people don't ride "safety aftter the fact,it wasapparent nets" to work each day or to that there was no discussion. amoviein the evening. They Our representatives in the need buses and taxis andvans. legislature and the senate accepted the governor's pro- Reading the latest publicaposal to add $1,500,000 to tions of the RTB, however, the Metro Mobility budget clarify thesituation. Theonly without a whimper. This unanswered question seems amount almostcoversa defi- to be the timing of thechange cit created in 1991 when the in plans. Whendid"V1SION program wasprovidingclose FORTRANSIT'becomethe to full service and optimisti- mission of the Board? Apcally predicting improve- parently,wellbeforethepublic hearings in late 1991. So ments. the die was cast, the hearings The support promised last were for show, and the i&tGovernorCarlson tention of the chairman and ever materialized leading board members at the heare agency into a deficit. ings makes more sense. The gparently by the end of the lack of support for future ear, the RTB had given up, funding of Metro Mobilit abandonment of Metro Mobility and were, frankly, shocked that there was no visible concern over the issue. We expected at least to hear some response to the pleas by those affected and the demands made by the Regional Transit Board

HealthRight are the original sponsors?and tireless advocam) who kept the process moving until it became law. So, ACCESS PRESS asked Senator Linda brglin and


Thejust published 1991An- lation -rather than serve as a nual Report of the RTB starts comprehensive public tranwith amessage from Michael sit service for those with Ehrlichmann, chairman, in mobility limitations. New which he notes that the main criteria willbe in placeby the missionof theRTB istomove summer of f 992. people where they want to -

a subsidy are eligible to buy into the Health Right plan. People over income guidelines should be able to buy affordable insurance in the private market.


and subject to $10,000 an- && nual benefit limit - July 1,1993 50 Percent for preventive dental; kids are fully covered $3.00 per prescription for


of the statement makes no mention of Metro Mobility cutbacks, but touts the new Vision for Transit, which he says benefits every resident in the region. Gregory Andrews, the Executive Director of the RTB, notesthattheboardincreased fares for Metro Mobility in 1991but says the changes in eligibility and certification will help bring the program within its available budget. There is a brief mention of the fare increase which was ruled discriminatory by the Minnesota ~i~h deparunentand thus lowered to the maximum permitted.

urna an

Finally, there is the state-



issue of the RTB MESSENGER, an official publication:

uninsured for at least 4 ered months to be eligible. The $25.00foradulteyegli~~ses; plan targets the uninsuredby kids are fully covered Here's what Val Higgins, a requiring employees to wait -m new board member has to say 18 months for eligibility. A on the subject: "Right now How is it Financed people with disabilities de- How Do You Enroll Cigarette tax is increased ] pend on Metro Mobility be- Health Right will be adminby 5 cents per pack for j I cause it's convenient and isteredprincipallythrough the start-up money quite often, is the only option Departments of Health and January 1,1993: 2percent ' they have available. Unfor- HumanServices. Enrollment tax on hospital gros? revtunately, some people think information will be widely enues wearegoing to changeMetro publicized. The telephone January 1,1994: 2 percent Mobility in a way that will numbersare 1-800-657-3672 grossrevenuetax expanded limit their travel patterns. and 612-287-3862. to includeother healthcare i Instead, we are working to providers and wholesale h make all transit more acces- What Benefits are Covered drug distributors -.X & ' sible so that people will have in the HealthRight Plan January 1,1996: 1percent many choices in addition to insurance premium tax on hF> t~s e &Mobility." o The plan builds on the non-profi~payerslike~lue Children's Health Plan which Cross, Michael Ehrlichmann's col- covers: Out-patient hospital, phyumn is headed "Momenulm for Transit Funding Growsician and clinic services NOTE: The 2 percent k'




H O W IT W 0 R K . C Cnnt nn n 7

May 10,1992


Access Press


Building Community Across Disabilitv Lines

N ~ W State Trust Law Could Effect Perso'ns With Disabilities I




Date: May 29,1992 by Arnie Gruetzmacher .. Time: 8:30 - 4:00 prn avoidingpaying nursing home to talk to a lawyer or Place: Minneapolis Society for the Blind costs, however it also effects a financial planner to see how anybody that is using a trust as tbis will affect your particular a planning device t~ protect situation. It may be possible Come join us for a one day assets for a person with a dis- to change the form of the trust workshop designed to inability. to offset the effect of this new crease understanding and law, but professional advice communication between disability groups, Issues will be Many persons with disabili- ,will be required. addressedin areas of Employties are depending on a trust that will be created from an- There is currently an effort other persons wiil, such as underway to attempt to amend their ~arents.called a testa- or clarifv this new change so

This will elim hate a very importantplanningtoo1that is used extensively for financial planning for a person with a disability. Theoriginal intent of the law was to prevent wealthy senior citizens from

comes effectivewhen the par- wal nbt:@iniluded. ent or other interested person dies, which more than likely (Arnie Gruetzmacher is Regional Director of Estate will be after July 1, 1992. PlanningfirPersons withDisFor people who are relying on abilities) a testamentary trust it will be

A new trust provision will go into effect July 1,1992. This new provision states "A provision in a trust created after July 1, 1992, purporting to make assets or income unavailable to a beneficiary, if the beneficiary applies for or is determinedeligiblefor public assistanceorapublichealth care -program, is unenforce-




Washington County Home Modification Program Starts May 4 Washington County Housing md Redevelopment Authorty (HRA) has developed -.a lewprogram forpersons with jhysical disabilities and senlory impairments. Called the 'Home Mod" program, it can

provideasmuchasa~grant to a home owner living in Washington County for adaptive housing modification.

may not be available until tt middle of June. Intereste parties should contact tt Washington County HRA ; 321 Broadway Ave., St. Pal Applications are being taken Park, MN 55071. Telephor now, although final funding 458-0936.



YOUR COMPLETE MEDICAL SUPPLY VENDOR Wheelchairs Commode chairs (with complete repair service) Walkers Canes, crutches Bathroom safety aids Blood pressureequipment Incontinent supplies

ment, Transportation,Education and Recreation. We will examine together the similaritiesanddifferencesamong several disability groups. The workshop will focus on blind, mobility impaired, hard-ofhearing, deaf, and deaf-blind, and multiply handicapped. It is not hard to see how we differ from each other. Come

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f u n k s e r by ~ r c ' ~ i n n e s o t aArc . - Minnesota is the founder of a nationwide movement dedicated to helping people with developmental disabilities.They currently have 54 chapters in Minnesota alone, with over 7000 members in counties throughout the state.




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HOWIt Works -co"t.frompage1 vider tax excludes revenue from Medicare, Medicaid, Health Right, GAMC, uncompensatedcareand nursing home payments. NOTE: Providers get an average 25 percent increase in Medicaid, children's health plan and GAMC reimbursements for outpatient care beginning October 1, 1992.

What's in the Bill for Small Business

with 2 to 29 employees one plan has a $500 per person and $1,000per family deductible...the other is based on co-paysratherthan deductibles. The bill expands the Public Employee Insurance Program (PEIP) to allow private sector groups to form large pools to access better rates. Dependent students can now stay on their parents' policy until age 25.

The bill offers two basic What's in the Billfor HeaUh benefit plans for businesses Care Providers

Physicianswill get an average 24 perkent increase in medical assistance reimbursementsfor primary care starting October 1,1992. Hospitals will get an average 20 percent increase in medical assistance reimbursements for outpatient servicesstarting October 1, 1992. While hospitals average less in the MA increase, they also pay less in MA surcharges which draw down federal dollars for the increase. Rebasing- will move more




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529-5019 CARE &INES



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2324 University Avenue West; Suite 115 Fully stocked showroom avaliable to the public.


Dave Moore of WCCO TV will be the honorary chairman of the evening.

Variety abounds, with Moore by Four and the Sheik's Sextet being joined by The Medicine Show Music Company. Jearlyn Steele Battle, Kate MacKenzieandPeter Ostroushko will be there as well as nationally renowned jazz An annual event, the Minnesota Celebrity pianist Butch Thompson. Gala will be heldatOrchestraHal1. All of the performers donate their services, many of Ticket prices start at $10.00. For ticket inforthem annually for this event. POP,jazz.and mation, call 333-6621.

We offer 24 hr. Emergency Service exclusivelv to our regular customers. UPS and deliveries to Mpls., St. Paul & Suburbs.


For more information call: Minneapolis Society for the Blind 871-2222 Lolly Lijewski 673-0439

ARC Minnesota G - ' -


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participate in the challenge to examine what common ground we have and increase communication across disability lines.





May 10,1992

Access Press ~ Sister ~Kennv 7 Institute


May Is Better Hearing And Speech Month tening to excessively loud cer of the larynx (voice box), Communication is a complex furtherhindering the processmusic can cause hearing loss, mouth, and esophagus. Ex- process, involvingthe follow- ing of new information. The individual's communication The power and wonder of the the volume on radios and tape cessive use of alcohol com- ing steps: bined with smoking further players used with earphones with othersreflectstheconfuspoken word is reflected in. the face of a child as she care- should not be turned up more increasesthe incidenceof oral - You must be alert in order to sion and disorganization the or laryngeal cancer. receive information from person is experiencing. fully speaksa first word to her than half way. your surroundings; proud and excitedparents. On Occupational noise-induced Among U.S. males, use of You must concentrate on the Speech-lanmepathologists the other end of the spectrum, hearing loss is acondition that tobacco is responsible for information you are receiv- specialize in evaluation and an elderly man, disabled by a ing; develops after prolonged and about 90 percent of all lung treatment of speech,language, paralyzing stroke, struggles repeatedexposure to high levcancer, and 75 percent of all You must remember, or revoice, swallowing, and cogto make himself understood els of noise. Although a heartain the information in the tumors of the mouth, pharnitive problems. Someof the to his children. May is Better Hearing and Speech Month, ing loss may not be apparent ynx, larynx and esophagus. order or sequence it was common head trauma ailments seen by speech-lanand the Speech-Language for as many as 10 years after For U.S. females, tobacco use given; is responsible for 75 percent You must analyze and comexposure, any improvement guage pathologists at Sister Pathology Departmentat Sister Kenny Institute wants you in the work environment that of the lung cancers, and 40 pare the information with Kenny Institute Speech-Lanto take careof your communi- would reduce noise-induced percent of all tumors of the what you already know in guage Pathology include: hearing loss in new workers mouth, pharynx, larynx and order to bring meaning to cative health. would also benefit existing esophagus. Inaddition,chew- what is occumng; Aphasia-a1anguagepnx'~ssA variety of communication workers. Hearing protection ing tobacco may also cause - You must organize and re- ing disorder resulting from late the information with damage to the "language arproblems may result from devices should be worn by all cancer of the mouth. your ideas, feelings, and eas" of the brain, usually on brain injuries or disease, and woJrers in noisy environSmokers in certain occupa- beliefs so you can under- the left side. even carelessnessin our daily ments. tionsareat increasedriskfrom stand the interaction with activities. Then the ability to communicateis lost, replaced The Occupational Safety and the cambination of cigarette your surroundings and pre- Dysarthria- a disorder charby the struggle of trying to Health Adminisaaticn WHA) smokingandexposureto toxic dict what may result from it; acterized by slurred or disreports that 9.4 million U.S. substancessuch as dust from - You must then integrate and torted speech caused by a make oneself understood. p.oductionworkerseither~~)wcotton, silica and coal; fumes organizeyour reactions into variety of conditionsincl-udp'."'."~ommunicationis the m-work or have worked in in- from rubber and chlorine; and cess by which we receiverand dustrial locations with noise- fibers from asbestos. Uragive messages and share exposurelevelsof 8Odecibels nium miners who smoke also feel; :::.:%* .-m,..T...m .meaninnandideas,"saysJane or higher. As a result of their faceinc~cancerriskover - Now you are ready to Vans- b;$f$@@g - --, &rn, speech-~an- occupational exposure, 17 nonsmoking miners. iy .- rmaaehghlom. 'Wecando pencent of these workers have

ing oral cancer, cerebral palsy and brain tumors. Dysphagia- a swallowing disorder caused by a number of conditions including stroke,head trauma, MS and cancer. :L-

Communication problems associated with noise exposure, stroke, cancer, mental retardation,brain injuriesand other factors are often pre-:,-, ventable. "Prevention - z works,"says JaneHorn. "It's never too early to begin prac- . ticing a healthier lifestyle." A

To submit questions on !: medical or rehabilitative is- '2% sues for future columns, write: Medical Issues and Disability, Sister Kenny Institute, Dept. 16601,800 E: 28th St., Minneapolis, MN 55407-3799.

mil: a


Other skills may not be as obvious, but are &pally necessary. These are related ta cognitive functioning and include the ability ta p y attention and concentrate bn the tasks at hand; remembering information and using that infdmationtosolveproblems in our lives, and organizing thoughts in ways that make se& and can be understood by our listeners. All of these skills are essential to meaningful and effective communication.

In order to safeguardourcommunicative health, there are many simple things we can do. One of the most obvious is to maintain a healthy voice. Excessive coughing, throat clewing, crying and screaming are harmful to the voice. Coughing and throat clearing associated with colds can strain or imtate the larynx, leading to temporary voice loss known as laryngitis. If this occurs,excessive talking should be avoided to give the larynx time torecover. Whispering also should be avoided in order to maintain a healthy voice. Likewise, talking loudly to be heard over excessive noise can strain the voice.

Controlling high blood pressure is anotherhn-m. ventative measure. . ~e;$:$ 500,OQO A~~I'@$wnffkr txmtdd'888mgeas&sirah mu-*. of cer deaths, 75 percent of these patients suffer from esophagealcancerdeaths,and whileremembering and orgas l d or imprecise speech 30 percent of fatal liver canwhich is difficult to under- cers. stand. The National Heart, ThesebasiccognitiveskillsLung andBloodinstituteesti- Aside from those behaviors paying attention, remembermatestwo-thirdsof thosewho we canundertaketo safeguijrd ing and organizing informasufferastrokehavehighbload our communicative health, tiocrucial to the compressure. A d d i t i d y , the there are many communica- municatiod grocess. American Heart Asmiation tion problems which may re~ 1 1 p e r c e n t ( 2 4 0 , 0 0 0sult from head injury. Prob- When cognitive functioning cases)of strokescouldbe pre- lems following traumatic is reduced it is reflected in all vented if smokingwereelimi- brain injury may include dif- areas of interaction within a "WECARE" ficulty speaking due to weak- person's environment. Indinated. ness and i n a n a t i o n of the viduals with. these cognitive PROFESSIONAL - SENSITIVE - DISCREET In order to guard against the muscles used for speech and - problemsrespond to their surTOM,MARY,BILL risk of stroke, report to your voice, and difficulty under- roundings in a confused, disdoctor any signs of standingand expressing ideas organized manna and expeFREE RX DELIVERY COMPETITIVE PRICES 3400 University Avenue SE, Minneapolis minkmkes. 'Ihese precur- because of a disturbance in rience difficulty analyzing, sorsof a full blown strokeare language functions or im- problem solving and learning new information. Short-term characterizedby sudden dim- paired hearing. memory may alsobeaffected, ming or lossof vision; paralysis or sagging of one side of the face; dizziness, usually HEALTH CARE PRODUCTS Tel612 with a loss of vision; temporary difficulty in speaking or 455 1 Bloomington Avenue South Minneapolis, Minnesota 55407 understanding speech;or loss of musclecooldination. These conditionsshouldbe reported SPECIALIZING IN HOME HEALTH CARE PRODUCTS to a doctor even when symptoms disappearin a few hours. Urological / Ostomy Following your doctor's orders can mean the difference between health and recurring Incontinence / Skin Care symptoms including a stroke.

Another way to protect your Avoidingprolonged exposme communicative health is to to loud noise is an excellent stop smoking. Smoking is way to protect against hear- causally associated with caning impairment. Because lis-






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Hello Nicole:

by Peter McLaughlin Iieinepin County ~ommksioner ing, test results and, for MIS positions, ranking on their oral

During 1985 the IBM corporation called together the Chief Information Officers from major Twin Cities corporationstodiscussthepossibility of implementing the model computer training program it had designed for persons with severephysical disabilities. One of the key aspects of the IBM model is the formation of a Business Advisory Council (BAC) to assist operations staff in curriculumdevelopment,student recruitment, selection and evaluation, development of internship opportunities, and placement. Among the initial 30 respondents was the Director of Hennepin County's

and provides a one-year training and internship curriculum -leading to the placement as an entry level computer programmer. College level credit is earned by students in the program through the Minneapolis Community College. Financia1suppo~andstudent referrals have consistently come from the Minnesota Division of Rehabilitation Services, State Services for the Blind, U.S. Department of Veteran Affairs, and private insurers.

the Co~nmunityServices Departmentjoined the BAC and has added new opportunities and support for the training program. As members of the BAC, Hennepin County staff have served as guest instructors providing technical and business-oriented presentation to students; reviewed cuniculum;conductedadmissjon interviews and participated in quarterly progress evaluations of students. To date, eight students have completed internshipswithin Hennepin County. Two were hired within the Information Services Department as programmer trainees, and six individuals were hirq in the Community Services Department, four as Management

The MRC Computer Training Program is currentlytraining its seventh class. The first six classes have graduated 53 individuals, 49 of whom were successfully placed in data processing positions. The

wereevaluated and ranked against all other job applicants, County Departments ..................................... ............... with personnel vacancies then .'aimt#i receive a listing of the top fi seven applicants for consideration. Graduates from the MRC training program have consistently been ranked among. the top seven for,all ................................................................ ............ ,'mi@~fgdas'*j;i::jii$jH'i& ws!t openpositions. ............ ............................................................. ..;... ................. ................................................................... ....





The partnership of business and government through the BAC with this specialized program is working. At Hennepin County eight persons with disabilities are now fully employed and, according to their supervisors, are ............................... performing their work well. lntg@a@&@ry This parulership is definitely a win-win-win, that is, aplus for the employees, Hhnepin County as employer, and the taxpayers. It is a great example of how training can

two years was $25,500 per trainees. At the present time zens. The early BAC meetings year. sevenof these individuals and one additionalprogram gradu-0 .The MRC Computer Trainsulted in thedevelopmentof a

County all of these individuals had to compete for their positions under the Colinty's open-competitive hiring process. Their experience. train-

gram. 1tis &rated by ~ u l t i - County's in-house data pro. Resource Centers, Inc. cessing staff) has been an ac(MRC). The program is tive participant on the BAC. geared for individuals with In the Fall of 1989, the Inforsevere ~hvsicaldisabilities mation Resources Propfam of

'To the WW:



apply or have questionsabout the program, please contact JaneLarson, Director,at 8712402.



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A prime example of IYll is ladmPipmthepartof0w; ent voter, but how can they Carlsan; the justify what will amount dluby the ;ro



acdrizedvery often by kudos livesof d i s a k l e d c i wht) ~ depend daily on its senic4 and criticisms. Theydependon it for m e d i d As the session is evduatedby smviw,fnrw&f' social/ the concerned cmstituency, recrqWneeds,forchu~b it becomesclear to tk@a that 9 1 P d d h m y orheradvanwhile hallmark kgislation tagm of am&mity living s$

Henj Kallis; and ness which we &eforgraatd othermerah of the legisla- ai the right and privilege of turn, all of wrh9m knew that being whole? the$lSIO,aX)mmmencM ww far iort of the needed. Harold Kemer d o k to maintain thesystea. Minneapolis at its current level of service.

Healthrite) other legisZaPon disabled romrnuniEy. . critical @thelivesof dismad people died bemiuse of the The m a w this program lack of leadership. hclcdlhcf*g&ws duein alargemmuretofailed

These unaffected individuals will see themselves as having donewhat they couldand will this letter as being that of a dismntled constitu-

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.................. -.......... ........ ............. h ' ~ m i t hJI. , ....,.;....,...............,.................................. ............................. Charles smith . ........... . Adam Qulnh I ., ......,......., ,.....,..,............ ............................. ..,...,,.................... ............... .......... .....Presentation Scott A W l . . Images . ................,...-. .......................................... Renee Smith

~ublbhv ~dfboa IStaff WrfterlPhdographer .I Cartoonist Production . ............................... Circulation-Distribution Manager






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ACCESS PRESS is a month1y tabloid newspapler *tisip3 for pasons with disabifiti~@ Polychrome, Ltd., W.A. Smith, Jr., President. C h W i s 10,000, distributed the first w & q E w month through more than 100 locations smtewida. Appmximat&ly650 wpies are mailed m y @I political, business, institutional and civic leaders. M p t i o n s are available for Slyyl. Editorial submissions and news releases an topics of interest to persons withdiibiliti&, qr pawns serving those with disabilities, are welcomed. Paid advextising is available at rates ranging frm $6 to Sl2/wlurnn inch, &p+hg frequency. ClassifKd ads are $7.00. plus 20 cents/wd over 35 words.

a &&and . Adv-g and editorial deadlines are the 30th of $e month preceding pubfication; special scheduling available for camera-ready art.




Inquiries should be directed m: ACCESS PRESS 3338 University Ave. SK. Minne~poliis. Umnesota 55414 (612) 379-0989 Fax (612) 379-2730


An entry indicates that park facility is likely to be functional for most people with physical disabilities.

by Lisa Taylor Lake Spring has arrived at the MinnesotaLandscapeArboretum! Daffodils and tulips are blooming in great sweeps of color. The rock garden with

Picnic areas are open in two sites, or you may lunch at any ofthebenchesalongthepaths. Therearealsoday and evening classes in gardening topics.

blooms to come. The magnol i a m i s in full fragrantbloom and forsythia is not far behind. There are even early sproutsof radishes, onionsand strawberries in the Home

(Arboretum members may rent facilities for private functions). Free walking tours are offered every Tuesday and Wednes-

As summer progresses, the September. The tours are 90

gardens will continue to un- minutes long and start at the fold with each bloom in its lobby reception desk. season: Iris in May through

Cost is $1.50 perrider, infants ride free. The tram has space The Arboretum's gardens are for two wheelchairs. Tickets linkedbypaved,handicapped- are available at the lobby reaccessible paths. The Rose ception desk. Garden's addition,under conreserve bus or walking tours two weeks in advance.


Ramsey County Parks Idor-

all with aganien-



,-Andasen Horticultoral Li- Hennepm Parks Information bray has nedy 10,000 vol- 559-m,TDD 559-6719 umes and hundreds d periodicalsand flyerson M c u l - City of Minneapolis Parks t d and gardening topics. Information 348-2226 There is a seztion covering R e c d o n LRisureLhe (24horticultund therapy, which .hr. recorded info) 348-7275 tells of gardening techniques . wndmodificatimsthatcan~- City of St. Paul Parks cornmodate gardeners who information 292-7400 aren't able to bend down, or usecertain tds,or haveocher City of Richfield Woad Lake limitationsthat canbmom- Nature Center .godated with alternative Information 861-9365 '





Module ramp available for rent


~r3ecializd tra~s~ortan~an for e ~ a i i y and handicapped.

Ramps & Decks D o m a y Alterations Kitchens and Bathrooms Redesign@ & Remodeled New Additions to Your Specifications Complete Conmlrx Service 755-0904

331-4200 U ~ E T R O M O B U T Y ~ M ~ P R ~ ~ ~ ~ ~ r*



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May 10,1992


Access Press

Health Care I C0nditi0tl senator Linda Berglin by


During the eighties, overall health care spendingrose 163 percent. By 1991, health care equaled 12.2 percent of our total Gross National Product (GNP). These increases are cutting into the budgets of government, business and families. According to the President's Budget Director Richard Darman, health care spending will overtake Social Security as the biggest item in the federal budget by the year 2000 if reforms are not made. He warns that these increases are jeopardizing the nation's long term economic stability and sinking the federal government deeper into debt.


In 1991, Mr. Darman told Senate Finance Committee members, "I would contend.. . (this) is not realistic. Somewhere, somehow, something is going to have to give."

physician services,dental,eye care, chemical dependency Theplan,calledHealthRight, treatment, mental health seris acomprehensiveproposal vices, outpatient hospital serto control health care costs, vices, and inpatient services reform our insurance indus- with a $10,000 limit on inpatry, provide greater access to tient services. HealthRight health care providers in rural will be coordinated with our areas, and offer subsidized medical asshnce spenddown health care coverage to program so the inpatient hosMinnesota's "working poor." pital limit will not apply to It is a reformer's bill, not a children, single parents or revolutionary's bill. It builds unemployed families. The upon the strengths of our sys- poorest of the working poor will receive larger subsidies, tem. those making more, receive This pioneering proposal was smaller subsidies. The state supportedby both Democrats will contract with managed and Republicans, as well as health care providers for both several organizations repre- the HealthRight program and senting medical providers, for the families on medical insurance companies, labor, assistance. Our goal is to business, seniorsandchildren. eliminate the stigma of welfare from our medical proHealthRight is an important grams while providing care step forward for Minnesota. I through the most cost effecbelieve it may also be a blue- tive system. print for other states to work Besides income eligibility from. limitations, participants must HealthRightbegins by recog- also be permanent state resinizing that access and cost dents and have lived in the control are linked together. state for at least six months. Therefore, HealthRight in- Eligibleparticipantsmustalso cludes several proposals to have been uninsured for at expand access to health care least 4 months. in both the individual and

be popular since they are less costly than plans currently on the market and they will provideemployerswith healthier, more satisfied employees. Benefits for these plans are basic. They emphasize preventive care while including some prescription, mental health and chemical dependency coverage. Additional benefits are available. Another option for all business will be to join an insurance pool with counties, cities and school districts. This new underwriting option allows employers to spread the health care risks of their employees among a larger population than insurance companies presently provide. This reduces the cost of insurance and also stabilizes the insurance pool. This plan offers employers a broader benefit package than what's included in the other business plans. Employers choosing this option are required to pay for at least onehalf of each employee's premium.

preexisting condition limitations or exclusions. An important change requires that insurance is portable, allowing workers to change jobs and take their insurance with them without losing coverage or being denied care for certain illnesses or having further pre-existing exclusions in their policies.

ers of health care.

Health care access and cost issues vary greatly in Minnesota's rural areas compared to its metro region. To betteraddresstheserural questions aRural Health Advisory Council will be established. Its task is to developasystematic and cohesive approach toward rural health issues and To assist self-employed in planning. their attemptsto afford health care coverage, all farmers and One typical problem that exother self-employed people ists in rural areas is getting will be allowed to deduct the health care professionals to entire cost of their personal locate there. HealthRight rehealth insurance premiums sponds to this by expanding from their state income taxes. on Minnesota's current loan forgiveness programs. DocExpandingaccess is only half tors, nurses and mid-level the problem, however, so practitioners who agree to HealthRight includes several serve in rural areas will have provisions to control cost as portions of their student loans well. Some of these provi- forgiven in return. sions include: HealthRight also proposes to increase graduation rates by -uniform billing forms and 20%forpediatriciansand farnprocedures to reduce spend- ily practice doctors, by funding on administrative costs; ing the University of Minne-medical practice guidelines/ sota Medical School residency parameters will be created to program. minimize unnecessary and ineffective care; Because rural areas typically -creation of stateandregional have a high number of eldboards to set the future rate of erly, receive low Medicare

:-HealthRight: Massive

p. IJ

Cost Containment Pays For Affordable Care I

by Representative Paul Anders Ogren The state of health care in ernment talks but does noth- Washington-thehugevested Q and some of the providMinnesota and America is in ing. Several states are trying interests are flexing. their ers, such as medical doctor collapse. Just look at the dol- to take action, but- just as in muscle. The insurance indus- associations, don't want to turn off the money lars we spend and what machine. Thosewho it means to all of us: benefit from rampant >The average Ameriinflation and waste can per employeehealth are fighting genuine plan cost rose 46.3 perreform that would benefit the rest of us. cent between 1988and Their clout is awe1990 and another 12 percent in 1991, four times the rate of inflaBut in Minnesota a remarkable thing has >56 percent of business pre-tax profit now goes happened. Republicans and Democrats to health care. came together and >8 out of every 10 agreed to put vested strikes are over health care. interestsasideandreally get a grip on >24 cents out of every costs,reform the sysdollar spent in health tem and- by saving care is spent on administration. money - find the dollars to offer all >In America some 37 Minnesotans access

The agreementy<'cost containment interventions are immediate and intensive.

The cost containment provisions get a grip on what's unnecessary. And that allows us to deal with what's so unfortunate. Our hospitals, for example, spend $1 20 million a year in Minnesota in care

- such as loan forgiveness programs - will get more

be offeredto Minnesoam-ssthestate. ~tswith a5 centcigarettetax and a 2 percent revenue lax on hospitals. Other health care providers will be phased up to that 2 percent level by

practitioners into cost effective care where they are most needed in rural Minnesota. >Outcome-based research will tell us which procedures >Strong conflict of work and which don't and 19%. interest prohibitions allow us to peg futurefunding that Stop providers to the most effectivekinds of Justwhere does that2percent from referring tests and procedures to businesses in which Better Care

How will this picture change by the year 2000? Without dramatic change, eachand every statistic will only get worse. More people will be forced to drop coverage, the average per employee health plan willcost $22,000a year and insurance companies will carve out more of the sick and

Medical, I ~ c . "Your Home HsaIth Care Center"

'sm00 1971'

>An end to the high tech medical arms race by limiting new equipment and capital purchases to what

ment that will prohibit doctors from billing senior citizens over the Medicare

As a nation and state we will spend much more

How has government responded? The federal gov-

care while minimizing wasteful practices. Providers will practice less "defensive medicine" in fear of malpractice suits and the public will be able to pick providers based on performance. >The Commissioner of Commerce's rate setting authority will addstrongenforcement to fair insurance rates and anti-discrimination law. >Medicaid reimbursements for primary and outpatient hos~italcarewill be increased 25 percent, adding to our providers' revenue base and encouraging to see - - providers . patients whose bills will be mostly paid for with federal dollars. >Providers who take patients under state plans - such as workers' combensation, Health Right, MCHA and the State Employees Plan -will be requrred to take Medicaid and other public patients as well. >Dependent students will be able to stay covered under their less costly parent's policies until age 25.

-mentnowworkink its' tice and pediatrics in clinics That brings us tohow we find' way through the pub- throughout the state. the money to pa; for Health

>Inflation in health care has soared between 13 and 20 percent annually in recent years. >Health care costs now make up almost $1 out of every $7 spent in our entire economy. Since 1983health care spending has doubled.

coverage. ..meaning health care outcomes-will only get worse. We'll have less money tospend on education, police, our environment, food on the table, shelter and the simple pleasures of life.

forms that will immediately save 3 to 5 percent in administrative costs. >Insurance companieswill be limited to spending no more than 25 percent of the premiums we pay for administration and profit. Over the next five years this limitation would be narrowed to 80 percent. >Medical malpractice reforms would streamline the legal process and reduce the cost of liability insurance that providers cany. >Comprehensive health care budgeting on state and regional levels will ensure that we put our health care dollar into the most efficaciousand cost effectivehealth care services. >Insurance reform would begin the process of ending discriminationby age,health history, occu~ationand home town in the private hsurance market. Discrimination based on gender is eliminated immediately. >A number of weflness in' centives-such as not smoking, exercising and getting annualcheck-ups-will promote individual responsibility and reduce premiums for those who practicegood health habits. >Small groups will be able to combine into larger groups to









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May 1992  

May 1992 Issue