NEW YORK - New Yorkers can breathe a sigh of relief this month because they now have new protections from so-called surprise medical bills.

Many New Yorkers ended up with big bills for out-of-network care because of visits to the emergency room. Chuck Bell, programs director for Consumers Union, said a new law that took effect this month provides much-needed protections.

"Through this new law, our consumers in New York state will be able to avoid getting most surprise medical bills in the first place," he said, "and when they do get a surprise bill, this law will help them prevent protracted financial disputes."

On average, Bell said, about 2,000 New York consumers per year filed complaints about surprise medical bills.

Heidi Siegfried, project director for New Yorkers for Accessible Health Coverage, said the new law puts the responsibility on doctors and health networks to ensure that their network information is up to date, and protects consumers who may have relied on outdated information.

"The plan and the provider have to work out what the payment is going to be," she said, "and the patient does not have to pay anything other than the normal in-network charges if they are seeing an out-of-network provider and it wasn't their fault."

Bell said the law also protects New Yorkers from so-called drive-by doctors who were not in the initial game plan when patients underwent a procedure.

"A physician that you didn't expect sometimes shows up during the procedure, and afterwards you find you have a bill for visiting an out-of-network doctor," Bell said. "So the law provides for greatly expanded disclosure to consumers when out-of-network doctors are going to be involved in your care."

The new law also calls for an examination of health networks to make sure they actually provide all of the suitable care that New Yorkers need. If any network is found not to have a provider, New Yorkers will be able to go out of network without paying extra. Consumers still need to do their homework and see an in-network provider when they are available.


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WATERLOO, Iowa -- Advocates for Iowans with disabilities are sounding the alarm over what they describe as a caregiver crisis, pleading with lawmakers to give the issue more priority, so these individuals are not pushed from their homes because of the scarcity of providers.

Tucker Cassidy, a person with quadriplegia from Waterloo, said the workforce shortage has been building for years, but in the past month and a half, it has become much worse.

He noted it is difficult for the agency he works with to send over enough caregivers to help with his daily routine. Stuck in bed more than he is used to, Cassidy admitted the shortage leaves him worried about his future.

"Is this going to be the week that they kick me off?" Cassidy questioned. "And then, where am I supposed to go? You know, I own my own house."

Advocates say the crisis is largely driven by low wages for caregivers. According to Indeed, the average starting pay for in-home caregivers in Iowa is around $13 an hour.

Lutheran Services in Iowa estimates it has been forced to reduce its client base by 350 in recent years. The shortage comes as Iowa touts a budget surplus of $1.24 billion.

Matt Grillot of DeWitt has used a wheelchair most of his life due to a spinal injury. He has been in his own house for the past 18 years, but he has struggled to hire a caregiver in recent months, forcing him to consider alternatives he would rather avoid.

"I have broken down within the last month and started looking at nursing homes and group homes," Grillot acknowledged.

But he said he faces barriers in moving to those places, adding to his stress in planning his care.

Cody Lewton, director of services for people with disabilities at Lutheran Services in Iowa, said they are down roughly 250 caregivers, citing the struggle to pay them enough money.

"It's less than a living wage, and it's only become worse," Lewton observed. "The funding has, over the last 20 years really, has not kept up with the cost of living."

The Iowa Developmental Disabilities Council said it is also concerned about the crisis, adding it will be the group's number one legislative priority next session.

FARGO, N.D. - People with Down syndrome are having a bigger impact on society, and their advocates in the Dakota region say it's time for the public to take notice.

October is Down Syndrome Awareness Month. It's widely known that people born with this condition have an extra chromosome that affects their development, but some say there's more to it.

The New Directions Down Syndrome Association connects parents in a four-state region, including parts of North Dakota. Brandon Tilus, president of its board of directors, said he feels public perception is being outdated by the lives many with Down syndrome are carving out for themselves.

"People with Down syndrome born today have a really good chance of living a life where they're independent, that they get married, that they do all of these things that we expect all individuals to do," he said.

He credited early-intervention programs and advancements in therapy for establishing better outcomes. However, he said strong government funding still is needed to ensure more families have access to these services. According to the Centers for Disease Control and Prevention, Down syndrome occurs in about one in every 700 births.

Tilus said another way to overcome any stigma is for people to make others with Down syndrome feel more at ease in their interactions. He also advises that some ways of communicating should be avoided.

"'I use my hands more to talk to them, because I'm not sure they're going to understand me.' And, those types of things - sort of, coming into an interaction with those individuals with those preconceived notions - I think can make it a little bit more difficult," he said.

Tilus, whose 6-year-old daughter was born with the condition, said the best thing to do is treat a person with Down syndrome like anybody else. All they may need is a little extra time to respond, and be given the opportunity to take the lead in a conversation, to feel comfortable.

SPRINGFIELD, Ill. -- As businesses across Illinois and the nation work to fill open positions, advocates for people with disabilities say they should take a more inclusive approach.

According to federal data, the jobless rate for people with disabilities is 11.5%, compared with slightly more than 5% for the rest of the population.

Kim Mercer-Schleider, director of the Illinois Developmental Disabilities Council, said with workforce shortages across many industries, there is no reason for people with disabilities to be underemployed.

"I would ask for employers to be open to taking a look at, what positions do you need to have filled?" Mercer-Schleider suggested. "How can they be broken up or looked at differently, that capitalizes on somebody's skill set?"

She noted it is important to acknowledge some people might need accommodations in some areas, but can really thrive in others. October is National Disability Employment Awareness Month, and she pointed out it is the perfect time to reflect on how to make hiring practices more inclusive.

Mercer-Schleider added it is also important to make sure the hiring process itself is accessible. She observed some online applications are not compatible with screen readers, for instance.

"Are your materials accessible? Can they be accessed with assistive technology, etc.? Are you opening up the door wide enough?" Mercer-Schleider outlined.

She emphasized the pandemic also has shown more flexible work is possible, for instance, working from home is a viable option for people who may have mobility issues or lack transportation. She hopes employers will embrace it as an option for accessibility beyond the COVID crisis.