Act 106 was described as a model law when it was written, legislating a minimum seven days detoxification, 30-day residential stay, and 30 outpatient visits per year. In the name of cost containment, however, insurance companies frequently limit accessibility to treatment; currently, insurers pay for an average of only 6 days of care, including detoxification and outpatient.

One of PRO-ACT's objectives is to establish a coordinated effort to handle complaints about insurance companies' failure to comply with the law. In November, PRO-ACT members brought representatives from the state departments of health and insurance and the attorney general's office together for a joint session.

"With overlapping jurisdictions and separate complaint forms, we knew we needed to get everyone talking together," said Sharon Brass, chair of PRO-ACT's Act 106 committee.

The attorney general's office, which has received the most complaints, offered to seek releases from cases it is investigating in order to share information with the other two departments. To offer evidence of a clear and consistent practice of violating the law, PRO-ACT agreed to supply cases to the insurance and health departments. The three groups will meet again early this year to review the evidence, explore means to enforce the law, and collaborate on improving access to care as well as the quality of programs available for those in treatment.

Additionally, recovery advocates from PRO-ACT developed an information packet for legislators concerning access to treatment. The packet defines the scope of the problem and identifies the barriers to effective treatment, including inadequate state funding. Pennsylvania counties often run out of state money for treatment long before the fiscal year is over.

Advocates are delivering the packet personally and speaking with their representatives. "The response has been strong and positive," said Brass. "Legislators come to understand the scope of the problem and the implications, not just for those directly affected but for the state budget and all our residents."

PRO-ACT also solicited policy statements from gubernatorial candidates Ed Rendell and Mike Fisher during the campaign. Rendell, who was later elected, said, "It is crucial that insurers in Pennsylvania fulfill this legal responsibility to these individuals and their families. As Governor, I will ensure that the Insurance Department, together with the Department of Health, which oversees the quality of care and access issues related to HMOs and other insurers, will improve its monitoring and enforce their obligations."