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December 7, 1995

Therapeutic abortions are covered in all Pitt health plans, Senate committee told

Therapeutic abortions are covered under all four of the Blue Cross plans offered to Pitt employees, according to the University's Office of Human Resources.

Some faculty members recently questioned whether abortion was covered by all of the plans because it is mentioned only in the current contract between Pitt and Blue Cross's Comprehensive Deductible plan. Abortion is not mentioned in the University's contracts with the three other Blue Cross plans offered here: SelectBlue, the University Health Network and the Keystone health maintenance organization.

All of the contracts state that procedures not explicitly mentioned are not covered.

However, therapeutic abortions currently are covered under all four plans and language will be added to the contracts to say so, said Pitt benefits manager Nancy Gilkes.

For an abortion to be paid for by Blue Cross, a physician must deem the procedure necessary to the safety of the patient, Gilkes said. But "safety" is not limited to life-and-death physical threats. For example, a physician could justify an abortion on the grounds that it is vital to the patient's psychological health, Gilkes noted.

Human Resources staff met last week with the University Senate benefits and welfare committee to discuss questions of abortion coverage and other issues regarding Blue Cross coverage.

Last month, committee members raised a number of questions about the contracts that took effect July 1 when Pitt dropped HealthAmerica and made Blue Cross the sole health insurer for faculty and staff here. Among those questions (as reported in more detail in the Nov. 22 University Times) were the following: * Do the contracts, in some cases, exclude coverage of new subscribers' pre-existing health problems — contrary to a Pitt-Blue Cross agreement forbidding such exclusions? * Do the contracts take away the legal prerogative of employees' physicians to provide medical care and give that prerogative instead to Blue Cross? At last week's meeting, Senate committee members outlined their concerns to Human Resources staff. Darlene Lewis, associate vice chancellor for Human Resources, emphasized that "the door is not closed" to re-negotiating details of Pitt's Blue Cross contracts for the current fiscal year.

The two groups will meet together again Dec. 14 in an effort to resolve the committee's concerns.

In other meeting business, committee member Barbara Epstein reported on faculty and staff use of the Employee Assistance Program last year. The program provides up to eight free sessions of counseling to faculty and staff with personal and work-related problems such as depression, alcohol and drug abuse, family crises and conflicts with supervisors.

The program has long been available to University of Pittsburgh Medical Center employees. Last year, it was extended to Pitt faculty and staff.

During the Pitt fiscal year that ended June 30, 1995, 3.9 percent of the University's 9,700 eligible employees used the program — "which was about the expected participation rate," said Epstein, who is a faculty representative on the program's advisory committee.

For every person who was referred to the program by his or her supervisor, 10 were self-referrals, she noted.

Among the problems employees cited in seeking help were: family and personal problems (37 percent of program users), psychological/emotional (30 percent), work-related (20 percent), drug and alcohol abuse (6.4 percent) and conflicts with supervisors (4 percent).

Only 10 percent of clients were faculty members, although faculty comprise 40 percent of Pitt personnel eligible to use the program, Epstein said. Advisory committee members speculated that faculty tend to be more reluctant than staff to use a University service, and more likely to seek outside help, according to Epstein. "We quickly rejected the idea that faculty are more mentally healthy," she deadpanned.

Partly to encourage more faculty use, the program has been renamed the University of Pittsburgh Faculty and Staff Assistance Program. Many professors resent being referred to as "employees," Epstein noted.

David Epperson, dean of Pitt's social work school, chairs a committee that will formally evaluate the program after its first two years of being offered to University personnel.

— Bruce Steele

Filed under: Feature,Volume 28 Issue 8

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