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PubMed1985

Social Security Disability Benefits Reform Act of 1984: legislative history and summary of provisions.

This article describes the legislative history of the Social Security Disability Benefits Reform Act of 1984 (Public Law 98-460), and contains a summary of the provisions in the new law. Major provisions include: standards for continuing disability reviews (CDR's) of disability insurance (DI) beneficiaries and supplemental security income (SSI) recipients who get payments based on disability or blindness; the right of a DI beneficiary or an SSI recipient to have payments continued during appeal of a CDR decision to an administrative law judge that disability or blindness has ceased; and suspension of CDR's of mentally impaired persons until the evaluation criteria for mental impairments are revised. The new law was enacted in response to problems that arose as a result of the implementation by the Social Security Administration (SSA) of a provision in the 1980 disability amendments that required periodic CDR's. In enacting the new law, Congress intended to assure more accurate, consistent, and uniform disability decisions at all levels and equitable and humane treatment not only to beneficiaries who must undergo CDR's but also to new applicants for DI benefits or SSI payments based on disability or blindness.

Blindness↗
PubMed1988

Effect of the legislative definition of the terms 'stillborn' and 'viable'. A medicolegal impasse.

Like so many other medicolegal issues, the legal procedure and legal consequences when a child is stillborn may seem simple and straightforward. However, in practice this is anything but the case. The legislative definitions of the terms 'stillborn' and 'viable' cause inordinate problems. Various legal, medical and social difficulties will only be obviated by amendment of the legal definitions of these terms--a task which should be initiated by the medical and nursing professions.

Burial↗
PubMed1986

Prevention of children's burns: legislation and fabric flammability.

Since 1980, legislation has regulated the ignition characteristics of commercially manufacturered children's nightwear to reduce risk of burns. Between 1971 and 1984, there were 699 hospital discharges of children treated for clothing ignition burns. This evaluation analysed discharge summaries of 493 children, surveyed children's nightwear in 101 retail shops, surveyed 476 Plunket parents regarding home-sewing practices and 28 fabric retailers for fibre content labelling. Burns resulting from clothing ignition, both daywear and nightwear, have decreased slightly in recent years. Most manufactured nightwear for children complied with the regulations. However, in 44% of families, a child might have worn home-sewn and thus unregulated night clothes. Consumers and sales assistants were generally ignorant about fabric flammability. High-fire risk fabrics were recommended by sales assistants and used by home-sewers. The relative involvement of manufactured and home-sewn nightwear in burns should be determined. Children's nightwear and fabrics should bear fibre content labels.

Burns↗
PubMed1985

Implications of the new hospice legislation and the accompanying regulations.

Recent government intervention into hospice care resulted from legislation designed to provide payment for care for Medicare recipients. The new regulations are reviewed, financial ramifications are investigated, and the possible implications of this reimbursement system are addressed.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1985

Medi-Cal hospital contracting--did it achieve its legislative objectives?

The 1982 Medi-Cal reforms and reductions established selective contracting with hospitals for inpatient care of Medi-Cal beneficiaries. The legislation established a special negotiator and criteria to be used in selecting contract hospitals. We report the findings of a study that analyzed the characteristics of contract and noncontract hospitals in Los Angeles County to assess how well these criteria were reflected in the outcome of the contracting process. We examine issues of beneficiary access to general inpatient care and to specialized services, the efficiency of contract hospitals compared with noncontract ones and quality-related issues.

California↗
PubMed1978

Social Security Amendments of 1977: legislative history and summary of provisions.

This article describes the legislative history of the Social Security Amendments of 1977 and contains a summary of the amendments. The major provisions revise the benefit structure so that future replacement rates--initial benefits as a percent of previous earnings--will be relatively stable and revise the tax structure to restore the financial soundness of the program in the short range and into the 21st century. Other significant provisions include: An increased special minimum benefit for long-term workers with future automatic adjustment to prices; a minimum benefit frozen at the December 1978 level (roughly $121) with automatic adjustment only for those on the rolls; a higher retirement test exempt amount of beneficiaries aged 65 and over; an annual measure of "quarter of coverage" and other changes in annual wage reporting provisions; and authorization for agreements with foreign countries for limited coordination between social security systems.

Marriage↗
PubMed1980

When legislation precedes the state of the art in teacher training: problems and implications.

Passage of Public Law 94-142, the Education for all Handicapped Children Act requires the development of an Individualized Education Program (IEP) for each handicapped child served. While administration are inclined to view the IEP as a document intended to monitor the provision of special services, teachers focused on the potential instructional value of the IEP. Professionals agree that this has been one of the most difficult components of the law to implement. Policymakers designing the law posited that training technology was adequate to support the instructional requirements outlined in the legislation. The present study challenges that assumption. It is also argued that studies which attempt to integrate multiple operations to clarify findings can provide more accurate and consequently more useful data of critical value in the beginning stages of policy formation. The multiple data collection strategies employed in this study yielded increasingly specific information on the status of present training technology--particularly in relation to teacher skills related to the instructional aspects of the IEP planning process. Teacher perceptions of their training needs were compared with actual skill performances on selected IEP tasks. Data reveal the inadequacy of essential skills in formulating required goal and objective statements. Special education and regular classroom teachers show similar patterns in specific skills which are problematic. Statements from teacher interviews corroborated deficits in past training. Suggestions for future training are offered as are emphases for needed research. Implications for implementation of the IEP are also discussed.

Child↗
PubMed1981

Social Security Disability Amendments of 1980: legislative history and summary of provisions.

This article describes the legislative history of Public Law 96-265, the Social Security Disability Amendments of 1980, and contains a summary of the provisions of the new law. In passing these major disability insurance and supplemental security income provisions, the Congress hoped to improve the equity of the program, remove disincentives to rehabilitation and work, increase positive work incentives, and strengthen program administration. Other provisions were intended to strengthen and improve the administration of both the aid to families with dependent children and the child support enforcement programs.

Persons with Disabilities↗
PubMed1978

[Physician's duty to secrecy in social legislation].

It is reported on the physicians duty of secrecy in social legislation for the protection of individuals claiming or receiving social security, on the penalty regulations of unauthorized revelation of the medical secret, on the authorized revelation of the secret, on the duty of secrecy by the medical expert, on the right of the physician to refuse insurance institutions (AOK,LVA,BfA,BG etc.), and on official help among the social insurance institutions.

Confidentiality↗
PubMed1994

Intermediate intensive units: definition, legislation and need in Italy.

This paper deals with the definition of intensive care medicine and the organization of different levels of care; intermediate and high level. The organization, facilities and personnel for intermediate care are discussed. The available public data on the organization of intensive medicine and modifications planned by the Legislator are considered. Finally, the usefulness of intermediate care and an estimate of the actual need, based on prospective multicentre ad hoc studies, are discussed.

Health Services Needs and Demand↗
PubMed1995

Legislative and regulatory mandates for mammography quality assurance.

The current practice of screening mammography in the United States has been the focus of numerous legislative and regulatory mandates at the state and federal levels, both in terms of increasing access to age-eligible women and elevating the quality of mammographic imaging. Several parameters have emerged as central to a comprehensive mammography quality assurance program: (1) equipment specifications, (2) equipment performance testing including radiation dose limits, (3) facility quality assurance procedures, and (4) personnel qualifications. In 1992, Congress enacted the Mammography Quality Standards Act (MQSA) (P.L. 102-539) to address the problem of differences in mandated standards across states. By October 1994, all facilities will be required to comply with interim MQSA regulations which were released in December 1993. However, depending upon the specific requirements of applicable state standards, the extent and nature of modifications of existing quality assurance procedures will differ for facilities across states as they attempt to come into compliance with uniform Federal standards. In addition, because some provisions within state standards are likely to be more stringent than Federal standards, some level of variation will persist. This paper reviews the components of mandated standards established by states and the standards established by other organizations, including the Federal Government, prior to the MQSA interim regulations. This review will provide an understanding of the highly technical and complicated requirements surrounding mammography quality assurance.

Ambulatory Care Facilities↗
PubMed1995

[Voluntary female sterilization: legislation and jurisprudence in France].

Female sterilisation, widely used as a contraceptive technique in France for many decades, is now a cause for concern among clinicians in relation to the personal legal risks involved in such procedures. Questions concerning the position of insurers in relation to application of civil hability insurance in the context of these procedures and their possible complications reinforce this uncertainty. Sterilisation, in the absence of any therapeutic objective, which is at the centre of the current debate, can be considered to be a deliberate mutilation, performed as an illegal procedure and the insurer, on principle, cannot insure the consequences of such an intentionally concomitted act. As described in this paper, the absence of legislation concerning this procedure and the limited legal debate on this subject tend to perpetuate the ambiguity between what is prohibited by law, but largely tolerated in reality.

Female↗
PubMed1993

[Liver transplant in children: comments and legislative proposal].

Having examined the literature on this subject, the authors raise the problem of segmentary liver transplant from a liver donor to a pediatric patient. They evaluate the current Italian legislation regarding the donation of organs and on the basis of foreign experience they draft a possible amendment to the law currently in force.

Child↗
PubMed1993

[Office surgery: organization, legislative, and medico-legal problems. Personal experience].

INTRODUCTION: The authors approach the subject of office surgery by underlining the advantages of this procedure. In particular, they focus attention on the anesthesiological and legislative problems. Depending on the setting used for surgery and the duration of hospitalisation, ambulatorial surgery can be divided into: day-hospital, office surgery, one-day surgery, short-stay surgery, same-day surgery, MATERIALS AND METHODS: The authors report their own experience relating to 103 cases with relative complications. A total of 103 operations of medium-to- major ambulatorial surgery were performed (100 females and 3 males, mean age 36.8). One week prior to surgery all patients attended a medical out-patient examination in order to fill in medical records and be prescribed routine hematochemical tests, chest X-ray and ECG. The preoperative anesthesiological evaluation was made at the time of surgery. All patients received antibiotic prophylactic treatment. RESULTS: Postoperative complications were reported above all following neuroleptoanalgesia and amounted to a total of 5 cases: nausea (4 cases) associated with vomit (1 case), and postural hypotension (1 case). No infective complications were observed. DISCUSSION AND CONCLUSIONS: The authors emphasise the importance of a careful preoperative selection of patients; an out-patient structure equipped with the appropriate instrument and machinery for surgery and the constant presence of anesthetists to ensure correct anesthesia (local, neuroleptoanalgesic, peridural general), reanimation and postoperative care. The aims of ambulatorial surgery are, in broad terms, the safety of procedures, convenience for the patient and organisational and economic savings for health structures. Ambulatorial surgery has an extremely high acceptance rate by patients. Lastly, the authors also report the juridical and bureaucratic problems faced by ambulatorial surgery and look forward to its wider diffusion. In the future office surgery might represent an important contribution to surgical therapeutic strategies, allowing, if well organised, an excellent compromise between safety, convenience and reduced costs for the patient.

Adult↗
PubMedDate not supplied

Analysis of prevention benefits in comprehensive health care reform legislation in the 102nd Congress.

One of the most important factors affecting the use of preventive services is health insurance coverage; however, until recently, most public and private health plans have explicitly excluded coverage of most preventive care. As a result, preventive services are used less frequently than recommended guidelines suggest, which contributes to the high incidence of preventable morbidity and mortality in the United States. Recent congressional efforts to enact national health care reform legislation present an important opportunity to analyze coverage for preventive services. This article presents the results of an analysis of the prevention benefits in 23 comprehensive health care reform bills introduced in 1991 during the first session of the 102nd Congress. I classified each bill by type (employer-based, single payer, managed competition, tax credit, and insurance market reform) and through a content analysis identified benefits for immunization, screening, and counseling services (including cost-sharing provisions), as well as funding for community-based health promotion. I interviewed congressional staff members of the sponsors of each bill to discuss their rationale for including or excluding specific prevention benefits and their reliance on existing policy, guidelines, and health services research or on the involvement of interest groups in developing prevention benefits. I conclude that health care reform is likely to address prevention, particularly in covering specific clinical preventive services, such as well-child visits, prenatal care, immunizations, family planning, and cancer screening. The prevention benefits least likely to be included in health care reform are coverage for counseling services and funding for community-based health promotion.

Health Care Reform↗
PubMed1993

Legislative efforts affecting the reproductive biology laboratory.

Legislative initiatives recently enacted in the USA will affect daily operations in the reproductive biology laboratory. These regulations affect laboratory safety, staffing, quality assurance, and record keeping. They mandate laboratory accreditation including certification, inspection, and proficiency testing. Laboratory standards of practice and costs of operation may be increased with mandatory compliance.

Accreditation↗
PubMed1993

Affected by the tooth of time: legislation on infectious diseases control in five European countries.

The exercise of compulsory powers for the protection of society against the spread of infectious diseases may impose severe restrictions on individual liberty. The law should therefore enable public health officials to strike the proper balance between public health and individual rights. An overview of the infectious diseases control legislation of five European countries (Germany, Switzerland, England, Sweden and the Netherlands) shows outdated medical approaches to infectious diseases, deficiencies in substantive statutory criteria and a lack of suitable procedural protection. The law has to be modified not only to fit current epidemiological insights, but also to give full weight to evolving individual rights.

Communicable Disease Control↗