Report: Protecting Seriously Ill Consumers from Utility Disconnections

PROTECTING SERIOUSLY ILL

CONSUMERS FROM UTILITY

DISCONNECTIONS

WHAT STATES CAN DO TO SAVE LIVES NOW

February 2021

Protecting Seriously Ill Consumers from Utility Disconnections

ABOUT THE AUTHORS

Olivia B. Wein has been an attorney at the National Consumer

Law Center (NCLC) for over 20 years. Olivia focuses on policies

and programs that protect low-income consumers’ access to

essential utility services, including water, energy, and telecom.

She advocates for a strong federal Lifeline telecommunications

program and other programs and policies that will close

the broadband divide. Olivia also works on the Low Income

Home Energy Assistance Program (LIHEAP), Weatherization

programs and intervenes in federal and state utility commission

proceedings in matters aecting low-income utility consumer

programs and protections. She is co-author of NCLC’s Access

to Utility Service.

Charlie Harak is senior attorney for energy and utilities

issues at the National Consumer Law Center. He represents

consumers before regulatory agencies, testiﬁes at legislative

hearings, and provides legal and policy counsel to low-income

advocates, legal services lawyers, and government ocials. He

also devotes much of his time to training lawyers, advocates,

and front-line social services sta regarding the rights of

utility customers, and contributes to NCLC legal manuals

and publications. Much of Charlie’s work also focuses on

energy eciency issues, including federal appliance eciency

standards and advocating for larger and smarter energy

eciency investments in aordable multifamily housing, and

climate change.

ACKNOWLEDGEMENTS

The authors thank current and former NCLC colleagues Jen

Bosco, Carolyn Carter, Ana Girón Vives, Andrew Pizor, John

Howat, Jan Kruse, and Stephen Rouzer, former interns Mark

Byrne and Allison Colton, and Massachusetts attorney Emily

Green Caplan for their invaluable assistance with this report.

The authors also thank the Annie E. Casey Foundation for its

support but acknowledge that the ﬁndings and conclusions

presented in this report are those of the authors alone, and do

not necessarily reﬂect the opinions of the Foundation.

NCLC.ORG

ABOUT THE NATIONAL

CONSUMER LAW CENTER

Since 1969, the nonproﬁt National

Consumer Law Center® (NCLC®)

has used its expertise in consumer

law and energy policy to work for

consumer justice and economic

security for low-income and other

disadvantaged people in the

United States. NCLC’s expertise

includes policy analysis and

advocacy; consumer law and energy

publications; litigation; expert

witness services, and training and

advice for advocates. NCLC works

with nonproﬁt and legal services

organizations, private attorneys,

policymakers, and federal and state

government and courts across the

nation to stop exploitative practices,

help ﬁnancially stressed families

build and retain wealth, and advance

economic fairness.

Protecting Seriously Ill Consumers from Utility Disconnections

TABLE OF CONTENTS

EXECUTIVE SUMMARY 3

Recommendations 3

INTRODUCTION 5

The Importance of Strong Serious Illness Protection Rules to Protect the Health

of Vulnerable Consumers

Principles for a Strong Serious Illness Rule 7

CRAFTING A STRONG SERIOUS ILLNESS PROTECTION POLICY 8

1. Eligibility for the protection should be broad and should include anyone with a

serious illness whose health and safety would be put at risk by involuntary

disconnection of energy service.

2. A wide range of entities should be allowed to certify serious illness, and the

utility company should be required to abide by their certification.

3. Seriously ill customers must be able to obtain the protection against

disconnection promptly, and the duration of the protection should correlate

with the customer’s health needs.

4. Utilities should be required to notify customers of the serious illness protection

rules, with an explanation of a clear and simple application procedure.

5 Utilities should act affirmatively to identify medically fragile customers and

avoid terminating their service.

6. Utilities should be required to collect, report, and analyze data to monitor the

administration of the protections.

RECOMMENDATIONS 19

ENDNOTES 21

PROTECTING SERIOUSLY ILL CONSUMERS

FROM UTILITY DISCONNECTIONS

WHAT STATES CAN DO TO SAVE LIVES NOW

Protecting Seriously Ill Consumers from Utility Disconnections

APPENDICES

APPENDIX A Serious Illness Criteria in Each of the 50 States and D.C. 23

APPENDIX B States That Allow Phone Call Followed by Written Certiﬁcation 28

APPENDIX C States With Sample Prompt Reconnection Protection Rules 29

APPENDIX D Sample Renewal Provisions of State Serious Illness Rules 30

APPENDIX E Sample Notice Provisions of State Serious Illness Protection Notice Rules 31

APPENDIX F Requirements for Documentation of Serious Illness and Sample Forms 33

TABLES

TABLE  Examples of States with In-Language Notice of Serious Illness Protection 14

TABLE  Examples of States with Special Process to Identify Medically Fragile

Customers

TABLE  Examples of States with a Requirement to Notify Commission Before

Disconnection of Medically Fragile Consumer

BOXES

BOX  Michigan Retiree Dies after Natural Gas is Terminated 13

BOX  Case Study of a Model Partnership: Maryland’s Critical Needs Program 17

Protecting Seriously Ill Consumers from Utility Disconnections

EXECUTIVE SUMMARY

Each year, millions of utility customers have their service terminated for non-pay-

ment. Many of those are low-income households in which someone is seriously ill. In

extreme cases, termination of service to those households has led to death. Much

more frequently, loss of electric or gas service makes existing illnesses or conditions

worse. Utility service is often essential, for example, for refrigerating medications,

powering needed medical equipment, or simply maintaining adequate temperature

in the home. Disconnection from utility service is especially dangerous for vulnerable

populations: the very ill and the very young and old, in particular.

In each of the 50 states and in D.C., utility commissions set the rules regarding when

and how the companies they regulate can terminate vital electric and gas service for

non-payment. As this report details, some states provide strong protections against

termination of households where someone is seriously ill, while other states provide

very little or no protection.

These diering rules can, quite literally, mean the dierence between life and death.

In 2019, an elderly customer with heart disease and diabetes was disconnected due

to having an arrearage of $51; she died. In 2018, an elderly customer dependent on an

oxygen machine died when her electricity was disconnected, despite frantic eorts

of family members to alert the company to the customer’s fragile status.

Strong serious illness protection rules can prevent tragedies like these from happen-

ing. Almost all the states already have some sort of serious illness protection in their

statutes or public utility rules. However, a few states—Alabama, Alaska, Louisiana,

and North Carolina—have no enforceable restrictions on terminating utility service

for seriously ill customers. Moreover, many of the existing state laws and regula-

tions are overly narrow, create protections that are dicult to access and not widely

known, or provide for an overly short period of protection.

Recommendations

1. Broad Scope: Eligibility for the protection should be broad and should include

anyone with a serious illness whose health and safety would be at risk by involun-

tary disconnection of energy service.

2. Diversity of Certiﬁers: A wide range of entities should be allowed to certify seri-

ous illness, and the utility company should be required to abide by their

certiﬁcation.

3. Prompt Initiation and Adequate Duration of Protection: Seriously ill customers

must be able to obtain the protection against disconnection promptly, and the

duration of the protection should correlate with the customer’s health needs.

Protecting Seriously Ill Consumers from Utility Disconnections

4. Adequate Notice and Easily-Accessible Process: Utilities should be required to

notify customers of the serious illness protection rules, with an explanation of a

clear and simple application procedure, and in multiple languages as appropriate

to that utility’s service territory.

5. Armative Outreach: Utilities should act armatively to identify medically fragile

customers and avoid terminating their service.

6. Monitoring and Enforcement:

Utilities should be required to collect, report, and

analyze data, at a granular level (e.g., by zip code), to monitor the administration of

the protections.

Protecting Seriously Ill Consumers from Utility Disconnections

INTRODUCTION

The Importance of Strong Serious Illness Protection Rules to Protect

the Health of Vulnerable Consumers

On July 5, 2018, the Public Service Electric and Gas Company of New Jersey shut

o the power to 68-year-old Linda Daniels, who depended on an electric-powered

oxygen tank, because she had a $51 arrearage. She died shortly thereafter.

On September 7, 2018, a day on which temperatures soared above 100° F, Arizona

Public Service cut o the electric service to 72-year-old Stephanie Pullman, based on

an overdue balance of $177. A week later, she was found dead in her apartment. The

coroner found that her death was caused by “environmental heat exposure in [a] set-

ting of signiﬁcant cardiovascular disease.”

These tragedies are predictable when utility service is terminated for seriously ill

customers. Utilities are not only a necessity of modern life,

but loss of utility service

can pose a direct threat to the health and well-being of those living in a home where

service is terminated.

The Health Risks Created By Termination of Utility Service

The health of any person can be endangered when exposed to prolonged periods of

extreme heat or extreme cold. The danger is much more pronounced for consumers

who have a serious illness, are medically vulnerable, rely on medical equipment that

requires electricity, or need medications that must be refrigerated.

Cold temperatures aect the cardiovascular and respiratory systems and can sup-

press immunological reactions. This can lead to illness, such as respiratory infections,

or even death. Overly warm temperatures have similarly negative eects on health,

especially among elderly populations. Extreme heat can easily lead to death.

Electricity and natural gas disconnections can exacerbate current health hazards

or lead to new ones. Cognitive disabilities may hinder a person from taking steps to

protect their own health and safety if electricity or natural gas service is disconnect-

ed.

Many consumers rely on electricity to keep their medications properly refriger-

ated or for medical equipment such as oxygen machines, hospital beds, or electric

wheelchairs.

Even when loss of electricity or natural gas does not create an immediate risk to life,

it can have serious negative health consequences. Low-income consumers with a

serious illness are at heightened risk of poor health outcomes when they are forced

to divert scarce funds for other essential needs to head o involuntary utility termina-

tions. This condition is referred to in the academic literature as “energy insecurity.”

While the Low Income Home Energy Assistance Program (LIHEAP) helps to pay

the energy bills of low-income households, it is not an entitlement program and is

Protecting Seriously Ill Consumers from Utility Disconnections

chronically underfunded relative to the need. Recipients of LIHEAP report foregoing

medicine, medical care, and food to pay for essential heating service in the winter.

For many low-income households, energy insecurity can lead to “diculty access-

ing health care, fear of losing housing, and living in potentially unsafe buildings and

neighborhoods.”

Residents of energy-insecure households consume 10% fewer

calories and lose 10% more weight during the winter season.

Young children in households experiencing energy insecurity are also more likely to

face housing and food insecurity. These children are more likely to be in only fair or

poor health, be hospitalized at least once after birth, and “be at risk for developmen-

tal delays.”

ABOUT THIS REPORT

This report is a resource for state policymakers and consumer advocates seeking to

improve the statutes and rules in their states that protect against utility termination when

a household member is seriously ill. It starts with an articulation of the principles that

should guide the creation of these policies. It then addresses the question of the speciﬁc

provisions that states should adopt to implement these principles, and highlights exam-

ples that may serve as models. It concludes with recommendations for the states.

The statutes and rules cited in this report are those that apply to the investor-owned

electric and natural gas companies that are under the jurisdiction of the state utility

commission (typically called the Public Utility Commission, Public Service Commission,

Department of Public Utilities, or something similar). In some locales, gas or electricity is

provided by a publicly-owned municipal utility or a membership-owned utility coopera-

tive. State utility commissions usually do not have authority to regulate these entities, but

their governing bodies—the local government or agency, or cooperative board—have

the authority to adopt serious illness protections. This report can serve as a guide to

framing those protections as well as those adopted by public utility commissions.

How Serious Illness Protection Rules Work

Serious illness protection rules are the primary way that states

seek to prevent the health risks caused by terminating utility

service to a household that includes a seriously ill individual.

Typically, these rules prohibit termination of utility service when

a health care professional certiﬁes that an individual in a low-

income household has a serious illness. How long the prohibition

lasts and whether it can be renewed varies widely from state to

state. Often the household will be required to enter into some

sort of payment plan for the past-due bill in order to obtain the

protection against termination.

Alabama, Alaska,

Louisiana, and North

Carolina have no

enforceable restrictions

on terminating utility

service for seriously

ill customers.

Protecting Seriously Ill Consumers from Utility Disconnections

Most states have some sort of serious illness protection in their statutes or public

utility rules. However, a few states—Alabama, Alaska, Louisiana, and North Caro-

lina—have no enforceable restrictions on terminating utility service for seriously ill

customers.

Moreover, many of the existing laws and regulations are overly narrow,

create protections that are dicult to access and not widely known, or provide for an

overly short period of protection. There is much more than can and should be done.

Principles for a Strong Serious Illness Rule

A strong serious illness protection rule should meet six main principles:

1. Broad Scope: Eligibility for the protection should be broad and should include

anyone with a serious illness whose health and safety would be put at risk by

involuntary disconnection of energy service.

A state’s deﬁnition of “serious illness” should include a broad range of physical,

mental, and emotional conditions for customers who cannot aord to pay their

energy bills.

2. Diversity of Certiﬁers: A wide range of entities should be allowed to certify serious

illness, and the utility company should be required to abide by their certiﬁcation.

To reﬂect the limited access to health care and health care providers that many

low-income consumers encounter, the persons who can certify serious illness

should include a broad range of medical professionals and others who can attest

to the customer’s health status: for example, medical doctor, nurse practitioner,

physician assistant, psychiatrist, psychologist, and local board of health. The judg-

ment of the certifying professional should be conclusive unless challenged at the

utility commission by the utility.

3. Prompt Initiation and Adequate Duration of Protection: Seriously ill customers

must be able to obtain the protection against disconnection promptly, and the

duration of the protection should correlate with the customer’s health needs.

Serious illness protection rules must allow the customer to obtain protection

(whether a reconnection or a suspension of a termination) via a phone call, with

a health professional’s certiﬁcation of a serious illness to be submitted within an

approved time frame (for example, within 7 days).

The initial disconnection protection should last at least 30 days and should be

renewable for the duration of the medical condition.

4. Adequate Notice and Easily-Accessible Process: Utilities should be required to

notify customers of the serious illness protection rules, with an explanation of a

clear and simple application procedure.

Utilities should notify customers of the serious illness protection rules at initiation

of service and whenever collection and disconnection notices are sent. Notices

should be made available in multiple languages, where relevant to the territory.

Protecting Seriously Ill Consumers from Utility Disconnections

To simplify procedures, states should adopt a standard form for serious illness

certiﬁcation.

5. Armative Outreach: Utilities should act armatively to identify medically fragile

customers and avoid terminating their service.

States should ensure that company service representatives and ﬁeld agents are

trained to solicit information regarding any serious illness in the household, and

that they will postpone a termination pending certiﬁcation of the illness.

6. Monitoring and Enforcement: Utilities should be required to collect, report, and

analyze data, at a granular level (e.g., by zip code) to monitor the administration of

the protections.

CRAFTING A STRONG SERIOUS ILLNESS

PROTECTION POLICY

1. Eligibility for the protection should be broad and should include anyone

with a serious illness whose health and safety would be put at risk by

involuntary disconnection of energy service.

Eligibility for serious illness disconnection protection should be broadly deﬁned to

include low-income customers and members of their household whose health or

well-being could be compromised by disconnection of electric or natural gas service

due to an inability to pay the utility bill.

Deciding on the breadth of a serious illness protection involves a

trade-o between avoiding serious harm to households that would

be terminated under narrow rules versus the potential loss of reve-

nue to the utility under broader rules. As real-life examples demon-

strate, lives may be on the line when terminations occur, and health

and well-being are quite frequently at risk. Utility commissions

should err on the side of protecting lives and health. Utilities run the

risk of litigation and reputational harm if the customer needs to be

hospitalized or dies due to disconnection of essential utility service

while seriously ill.

The National Consumer Law Center (NCLC) recommends that states use expansive

criteria, making the protection applicable whenever a medical or other professional

familiar with the household member’s medical condition certiﬁes that there is a seri-

ous illness or medical condition which creates a risk of harm from disconnection of

utility service. The deﬁnition should be broad enough to include conditions that would

be aggravated by a loss of utility service, not just those that would result in an immedi-

ate threat to the customer’s life. It should include a broad range of medical conditions,

as loss of utility service can quickly lead to this range of bad outcomes. Appendix A

Eligibility for the

protection should be

broad and should include

anyone with a serious

illness whose health and

safety would be put at risk

by involuntary discon-

nection of energy service.

Protecting Seriously Ill Consumers from Utility Disconnections

summarizes the eligibility criteria for disconnection protections for each of the 50

states and the District of Columbia.

A number of states have an appropriately broad deﬁnition of what constitutes a seri-

ous illness that merits protection. Some simply require that there be a “serious ill-

ness,” without further description. In practice, the question whether there is “serious

illness” that gives rise to the protection is left to the judgment of the professional who

submits the letter or serious illness certiﬁcation form.

Massachusetts provides a good example of a strong serious illness protection that

covers a broad range of serious illnesses. The state’s regulation uses simple language

that leaves it up to the medical professional to determine who has a “serious illness”:

No company may shut o or refuse to restore utility service to the home of any

customer if:

(a) It is certiﬁed to the company:

. . . . . .

1. That the customer or someone living in the customer’s home is seriously ill.

Idaho,

Maryland,

and Pennsylvania

are other examples of states whose protec-

tions against termination apply to a broad range of individuals who are seriously ill.

On the other hand, some states, such as Florida, apply their protection to much more

limited situations, for example, to situations where the patient is dependent on elec-

trically-powered medical equipment to avoid loss of life or immediate hospitalization.

Such a narrow rule places too many low-income, seriously-ill households at risk.

Of course, the scope of the deﬁnition of “serious illness” is only part of the picture. If

the state’s substantive protections are weak, a broad scope will not do much good. In

addition, in some states with broad deﬁnitions of serious illness, some aspects of the

protection may vary depending on whether the illness is life-threatening.

Recommendation

State serious illness protections should apply to any household that includes a

person with a serious illness. Rather than attempting to deﬁne “serious illness”

more speciﬁcally, states should rely on the certifying professional’s judgment about

whether the condition is a serious illness.

2. A wide range of entities should be allowed to certify serious illness, and

the utility company should be required to abide by their certiﬁcation.

Serious illness protection rules require a health care provider or other professional

to submit a certiﬁcation of the customer’s condition. A well-designed serious illness

protection rule allows a broad array of persons, including licensed physicians,

osteopaths, registered nurses, physician assistants, certiﬁed nurse midwives, public

Protecting Seriously Ill Consumers from Utility Disconnections

health ocials, and behavioral health care providers to submit this

certiﬁcation.

A broad deﬁnition of the health care providers who can certify a

physical or mental health condition that will trigger protections is

especially appropriate for households that have limited access to

health care. Many of these are the same low-income households

that are likely to have a seriously ill household member and be

unable to pay their utility bills—exactly the households that the

regulation should be targeting, rather than excluding. Mental health

practitioners, public health agencies, and social service agencies

should all have authority to certify a serious illness. In particu-

lar, public health and social service agencies may already be providing services to

households in crisis that cannot aord medical care, so they will be knowledgeable

about the customer’s condition.

Some states, such as Nebraska,

give certiﬁcation authority only to duly licensed

physicians, a far too narrow approach. Arkansas is an example of a state that takes

a more realistic approach, allowing certiﬁcation by a physician, nurse, nurse practi-

tioner, physician assistant, and public or private agency providing physical or mental

health care services.

Wisconsin allows certiﬁcation by a physician or a public health,

social services, or law enforcement ocial.

To reduce the burden of preparing the certiﬁcation, states should provide a sample

certiﬁcation form. Appendix F includes samples of certiﬁcation forms and certiﬁca-

tion requirements from several states. The certiﬁcation form, and the state’s rules,

should not require detailed information about the speciﬁc nature of the household

member’s illness, which is highly private, sensitive information. The certiﬁcation

should be limited to a general statement that the patient has a medical condition or—

if the state’s rules so require—relies on medical equipment, and that disconnection

of electricity or natural gas service would potentially endanger the person’s health or

meets other criteria.

Massachusetts, however, takes an alternative approach, which NCLC urges other

states to consider. In practice, some individual companies provide certifying practi-

tioners with forms they have drafted and which are therefore deemed sucient from

the company’s perspective. However, the serious illness regulations simply require

that the serious illness be certiﬁed by a doctor, nurse practitioner, physician assistant,

or board of health. There is no required form. Thus, in urgent situations, the certifying

practitioner can draft a simple letter and immediately fax or mail it to the company.

This avoids the delay that can occur when the company oers to ﬁrst mail the form to

the certifying practitioner, slowing down the certiﬁcation process.

A well-designed rule

allows a broad array of

persons to certify serious

illness and mandates

the utility to abide

by the certification

(see Massachusetts as

a good example).

Protecting Seriously Ill Consumers from Utility Disconnections

Utility regulators must also specify that the medical professional’s determination gov-

erns. The utility should not be allowed to second-guess the medical professional’s judg-

ment about whether termination of utility service would create a risk to the customer’s

health. If the utility wants to contest the certiﬁcation, it should ask the state regulator to

investigate it, and, in the meantime, should abide by the duty not to terminate utility ser-

vice. Maine and Massachusetts are examples of states that have such provisions.

Recommendations

Who can certify. The persons who can certify serious illness should include a broad

range of medical and social service professionals and others who can attest to the

health status of the customer: e.g., physicians, physician assistants, osteopaths,

nurse practitioners, nurses, mental health professionals, board of health or public

health ocials, and social service agencies.

No second-guessing. Utilities should not be allowed to second-guess the practitio-

ner’s certiﬁcation, but should be limited to asking the state regulator to resolve any

questions about the certiﬁcation’s legitimacy or suciency.

Form of certiﬁcation. States should provide a sample certiﬁcation form, and should

minimize the amount of speciﬁc information about the customer’s medical condition

that must be provided. However, if the certifying practitioner cannot quickly access

the form, a letter that contains the required information should be acceptable.

3. Seriously ill customers must be able to obtain the protection against

disconnection promptly, and the duration of the protection should

correlate with the customer’s health needs.

A strong serious illness protection rule should require the protection against ter-

mination to be implemented immediately upon a call by a consumer or health care

professional notifying the utility that there is a serious illness/medi-

cal situation. The rule should allow the written certiﬁcation of the

serious illness to be submitted within a reasonable period of time

following the phone call, recognizing that busy medical practices

need time to process the certiﬁcation. NCLC recommends a 7- to

10-day time frame. Appendix B contains a chart of states that have

clear rules regarding the process for initial phone calls and the

follow-up certiﬁcation.

States should not only require that any termination of utility service

be stopped for a household that includes a seriously ill individual,

but should also require prompt reconnection if the household

was already disconnected. The rules should require waiver of

Seriously ill customers

must be able to obtain the

protection against

disconnection promptly,

and the duration of the

protection should

correlate with the

customer’s health needs

(see Massachusetts rule

for model language).

Protecting Seriously Ill Consumers from Utility Disconnections

any reconnection fee. Appendix C gives examples of states with prompt reconnec-

tion rules.

The rule should set forth a clear and adequate time frame for the initial duration of the

protection. Given the diculties seriously ill customers are likely to face in managing

their aairs, and the burden upon medical professionals of having to resubmit certiﬁ-

cation papers, this initial period should be at least 30 days.

Most states’ serious illness protections meet this standard. More than a dozen states

provide a disconnection protection of 60 days or more,

and at least three of these

states—Massachusetts, Minnesota, and Montana—provide for an initial 180-day

period of protection.

Almost 20 states provide a 30- to 59-day protection.

How-

ever, 10 states provide less than a 30-day protection, and a few either leave the

protection period up to the discretion of the utility or do not specify the initial period.

Given that a majority of states mandate an initial period of 30 days or more, there is

strong precedent for states to mandate at least a 30-day initial period.

Serious illness protection rules should also address renewal of the initial period of

protection. About three dozen states have clear rules governing renewals. These

rules vary both as to the length of the renewal period (e.g., as short as 15 days and as

long as 6 to 12 months) and the number of renewals permitted (e.g., only for a limited

number of times, or for as long as the illness lasts, as certiﬁed by the appropriate

medical or other professional). Massachusetts places no limits on the number of

renewals.

Connecticut places no limit on the number of renewals for life-threatening

illnesses, and Michigan has no limit for critical care customers.

Appendix D pro-

vides details about the renewal provisions in these states, and examples of several

other states’ policies. Massachusetts’ rule is a model for the states with respect to the

promptness of the protection, its initial duration, and the ability to renew it.

Recommendations

Immediate implementation of an initial protection of at least 30 days. The pro-

tection against termination—including a requirement of prompt reconnection if the

household’s utility service has been terminated—should go into eect immediately

upon receipt of a phone call from the customer or a certifying professional, with a

requirement to submit a written certiﬁcation soon (7 to 10 days) thereafter. The initial

period of protection should be at least 30 days, and longer if speciﬁed in the letter

from the certifying entity.

Renewal. The initial protection should be renewable for the duration of the medical

condition, as long as the certifying professional periodically attests that the illness

is continuing. Any renewal period should be at least as long as the initial period of

protection.

Protecting Seriously Ill Consumers from Utility Disconnections

4. Utilities should be required to notify customers of the serious illness

protection rules, with an explanation of a clear and simple application

procedure.

For serious illness protections to be eective, consumers must be aware of them.

Often a state’s serious illness protection is not well publicized and may be underuti-

lized. Since serious illness protection rules typically put the onus on consumers to

notify the utility of a serious illness to

obtain disconnection protection, the

protections will be eective only if con-

sumers learn of them and how to apply.

Utilities should notify new consumers

of these protections at the time service

is initiated and annually thereafter, in

languages appropriate to the compa-

ny’s service territory. They should

ensure that customer service repre-

sentatives and ﬁeld agents are well-

trained regarding these protections,

and include information about these

protections in collection and discon-

nection notices sent to consumers.

Any post-disconnection correspon-

dence should also contain information

about the serious illness protection rule. All of these communications should include

simple, clear instructions about how consumers can avail themselves of the protection.

Connecticut is a good example of a state with strong requirements for notice to con-

sumers. It requires every termination notice to “plainly indicate that the utility com-

pany may not terminate residential utility service to the home of any customer during

such time as any resident therein is seriously ill.”

In addition, utili-

ties must give customers a summary of consumer rights, including

the serious illness protections, when service is initiated and annu-

ally thereafter.

Other states that require routine disclosure of

serious illness rights include Michigan, Montana, New York, Rhode

Island, Tennessee, Texas, and Wisconsin.

Pennsylvania requires a particularly proactive eort on the part of the utility to ensure

that customers know of the protection. The disconnection notice must include a

medical certiﬁcate notice. At least three days before the scheduled termination,

the utility must attempt to contact the customer or a responsible adult occupant by

telephone, in person, or, with the customer’s consent, electronically. If the utility suc-

ceeds in making contact, it must inform the customer of the serious illness protection,

Michigan Retiree Dies after

Natural Gas is Terminated

John Skelley, 69, a retired autoworker in Flint,

Michigan, died on January 31, 2015 from hypothermia,

11 days after the natural gas for his home was

disconnected for non-payment. Mr. Skelley also

suffered from chronic heart disease, esophagogastric

cancer, and bronchopneumonia, all of which

contributed to his death. If the utility company had

been notified of these medical conditions, Mr. Skelley

would have qualified for the state’s medical

exemptions from utility termination.

Source: “Hypothermia caused man’s death after utility shut-off,

autopsy finds,” Lansing News, May 1, 2015.

Connecticut is a good

example of a state with

strong requirements for

notice to consumers.

Protecting Seriously Ill Consumers from Utility Disconnections

among other things. In addition, immediately before performing

the termination, the utility employee assigned to that task must

make another attempt, at the customer’s residence, to contact

the customer, and must not proceed with the termination if there

is evidence that a serious illness or medical condition exists. If the

customer contacts the utility after the issuance of the initial termi-

nation notice but before the actual termination, the utility must fully

explain the serious illness protection.

Pennsylvania and Maine also require a post-termination notice. In

Maine, this notice must include an information packet about the

serious illness protection.

In Pennsylvania, immediately after ser-

vice is terminated the utility must post a notice about the serious ill-

ness protection at the home or deliver it personally to a responsible adult occupant.

Appendix E provides more examples of state notice requirements for serious illness

protection rules.

Consumers with limited English proﬁciency (LEP) are particularly vulnerable to lack

of awareness about serious illness protections where utility information is provided

only in English. State utility commissions should require utilities to provide information

State utility commissions

should require utilities

to provide information

about the serious illness

protection in languages

other than English that

are spoken by substantial

numbers of their

customers.

TABLE  Examples of States with In-Language Notice of Serious Illness Protection

STATE CITATION SUMMARY

Colorado

4 Colo. Admin. Code §§

723-3:3408 (d) (electric);

4 Colo. Admin. Code

§ 723-4:4408 (d) (gas).

English and specific language(s) where 10% speak a language

other than English.

Connecticut

Conn. Agencies Regs.

§ 16-3-100(c)(1)(D).

English and Spanish if substantial number of Spanish-

speaking people live in the service territory.

New Jersey

N.J. Admin. Code §

14:3-3A.3(e).

Upon notice of customer, notice shall be sent in Spanish.

New Mexico

N.M. Admin. Code

§ 17.5.410.23, -.29, -.31,

-.33, & -.42.

Various notices regarding customer rights, availability

of energy assistance/winter moratorium, and regarding

termination must be in English and Spanish.

Oregon

Or. Admin R.

860-021-0010(7).

When service is initiated, utility must ask if customer would like

notices in a language other than English. Utility must inform

consumers of the translations available. Utility must annually

report to the commission the number of requests for notices

and summaries in non-English and the number of requests for

each language.

Rhode

Island

810 R.I. Code R. pt.

10-00-1.5(D).

Utility must include on all termination notices, in English,

Spanish, Portuguese, French, and any other languages utility

deems appropriate, the following statement: “This is a utility

service termination notice. Translate immediately.”

Texas

16 Tex. Admin. Code

§ 25.29(k)(4).

Disconnection notices must be in English and Spanish.

Protecting Seriously Ill Consumers from Utility Disconnections

about the serious illness protection in languages other than English that are spoken

by substantial numbers of their customers. (See Table 1 for examples.) The public

utility commission can facilitate this practice by translating serious illness protection

notices—as well as other collection and disconnection notices—into Spanish and

any other non-English language spoken in service areas in the state.

Recommendation

Utilities should be required to notify customers of the serious illness protection rules

when customers start service, annually thereafter, in collection and disconnection

notices and communications, and in any post-disconnection communications, in both

English and any other language used by substantial numbers of their customers.

5. Utilities should act armatively to identify medically fragile customers

and avoid terminating their service.

Making sure that customers receive notices about serious illness protections at key

points is an essential ﬁrst step, but utilities should go farther and proactively seek to

identify and help seriously ill customers. A grave illness is likely to impair a customer’s

ability even to remember an annual notice of a serious illness protection, much less to

ﬁnd it and take the steps necessary to initiate the protection.

A number of states have stepped up to this challenge and require utilities to take ar-

mative steps to identify households with seriously ill members and help them take

advantage of the protection (see Table 2).

TABLE  Examples of States with Special Process to Identify Medically Fragile

Customers

STATE CITATION SUMMARY

Arkansas

Ark. Admin. Code §

126.03.2-6.18 (elderly &

disabled).

Utilities must attempt to identify elderly and individuals with

disabilities at time of application, when customers ask if there

are options for elderly or people with disabilities, and when

contacting customers about disconnection.

Delaware

26-3002 Del. Code

Regs. § 3.3.6.

Final contact: utility field agent can accept serious illness

certification to stop disconnection.

New Jersey

N.J. Admin. Code § 14:3-

3A.4(c), (d).

Utility should also make good faith efforts to determine which

customers are over 65 (§ 14:3-3A.4(c)).

At least quarterly, companies shall solicit information from

residential customers to determine the presence of any

life-sustaining equipment on the customer’s premises (§

14:3-3A.4(d)).

North

Dakota

N.D. Admin. Code §§ 69-

09-02-05.1(2) (electric);

69-09-01-18.1(2) (gas).

Utility shall send annually, as part of the October monthly bill,

a preaddressed, postage-paid postcard that asks customer

to identify if resident is 65 or older, or has a disability, or has an

emergency medical problem.

Protecting Seriously Ill Consumers from Utility Disconnections

Another best practice is to give utility ﬁeld agents clear authority to stop a discon-

nection if they identify a medical risk to the health of a resident of the household. For

example, New Mexico requires that utility employees “shall note any information from

the residential customer that a person living in the residential customer’s residence is

seriously or chronically ill” and that a supervisor shall then either halt the termination or

state in writing why it will not be delayed.

During cold weather, New York requires that,

prior to terminating a heat-related account, ﬁeld personnel must ascertain whether a

serious impairment to health or safety is likely, and may not terminate except by giving

advance notice and obtaining approval from the local social services commissioner.

Some states impose an additional restraint by requiring utilities to notify the state com-

mission prior to disconnection of a residence where someone has been identiﬁed as seri-

ously ill. In some states, the utility must get the commission’s prior approval (see Table 3).

Recommendations

Proactive outreach. Utilities should be required to act armatively to identify house-

holds with seriously ill individuals and help them invoke the serious illness protections,

including through extra notiﬁcation eorts and the grant of authority to ﬁeld agents to

stop terminations.

Public utility commission approval. States should require notice to and approval by

the public utility commission before disconnection of a seriously ill customer.

TABLE  Examples of States with a Requirement to Notify Commission Before

Disconnection of Medically Fragile Consumer

STATE CITATION NOTIFICATION REQUIREMENT

Hawaii

Haw. Admin. Rules §

6-60-8(c)(3).

Utility may not disconnect service to elderly or disabled

customers without an advance written report to the

commission, 5 days ahead of scheduled termination.

Montana

Mont. Admin. R. 38.5.1411. Utility must provide notice to commission at beginning of

termination process; commission may require a different

payment arrangement than utility offered, or delay

termination.

New

Hampshire

N.H. Code Admin. R. Ann.

PUC 1205.03(b), (e).

For medical emergency customers not on a payment

plan, utility must request permission from commission to

disconnect. No disconnection if demonstration of good faith

effort to pay.

Oregon

Or. Admin. R.

860-021-0410(6).

If medical customer fails to enter into payment arrangement

or fails to abide by its terms, utility must notify commission’s

Consumer Service Division of its intent to disconnect and

reason for the disconnection. A hearing may be held to

determine whether utility shall be permitted to disconnect.

Rhode

Island

810 R.I. Code R. pt. 10-

00-1.4(K), 10-00-1.17.

Utilities must obtain written approval from the Division of

Public Utilities and Carriers to disconnect residences where

all adults are 62 years of age or older, or where any resident is

disabled.

Protecting Seriously Ill Consumers from Utility Disconnections

Case Study of a Model Partnership:

Maryland’s Critical Needs Program

An innovative program in Maryland combines

many of NCLC’s recommendations to not only

help sick consumers access that state’s

serious illness protection, but also enroll them

in other energy assistance programs in an

expedited and holistic manner. The Critical

Medical Needs Partnership (CMNP) began as a

pilot that included the Maryland Office of

People’s Counsel, Baltimore Gas and Electric

Company, the Maryland Office of Home Energy

Programs, Maryland Department of Housing

and Community Development, the Fuel Fund of

Maryland and the Cancer Support Foundation,

medical facilities, and others. Subsequently, a

state law made this program permanent and

expands it throughout the state.

The program recognizes that very ill

consumers who have fallen behind on their

utility bills may not have the capacity to

research and apply for serious illness

protection, negotiate reasonable payment

plans, and complete applications for federal

and charitable bill payment assistance, energy

efficiency programs. Yet, their fragile medical

conditions make them particularly susceptible

to harm should they become disconnected

from electricity or natural gas service.

In response, the CMNP streamlines and

expedites the processes to help very sick utility

customers stay connected. In developing the

initial pilot, the goal was to create a system to

fast-track access to the existing array of utility

assistance, including repair/replacement of

broken heating equipment, and consumer

protections for medically fragile consumers.

CMNP is a voluntary program that trains patient

“navigators,” who are located in hospitals,

oncology centers, and public and private

assistance agencies that help seriously ill

patients. A simple CMNP form was created,

and a fast-track protocol was developed by the

utilities and the agencies that administer low-

income utility assistance programs. The CMNP

provides an expedited process to stop a

disconnection or quickly reconnect service for

a seriously ill consumer and expedite access to

other utility assistance to help keep the

household connected to essential utility

service. The program is housed in the Office of

Home Energy Programs of the Family

Investment Administration within the Maryland

Department of Human Services.

The Maryland program is just one example of

the type of partnership with social services and

patient advocacy organizations that utilities

can explore as a way of proactively identifying

and protecting seriously ill customers. These

partnerships can create a network of trained

patient navigators to help sick patients easily

access critical protections, such as the serious

illness protections, to preserve access to

essential utility services.

Protecting Seriously Ill Consumers from Utility Disconnections

6. Utilities should be required to collect, report, and analyze data to

monitor the administration of the protections.

States should track utilities’ use of the serious illness protection rule to identify if the

protection is being readily accessed by customers and implemented without unnec-

essary barriers.

New Mexico is an example of a state that requires data reporting

along these lines. It requires its utilities to maintain records on the

number of medical certiﬁcates received before and after termina-

tion of service; the number of instances when restoration of service

took more than 12 hours from the receipt of a medical certiﬁcate;

and the number of customer households known to the utility where

an elderly, disabled, or other person might suer injury or death if

service were discontinued.

Recommendation

States should require utilities to collect, report, and analyze data regarding the imple-

mentation of their serious illness rules. This reporting should be broken down by zip

code and should include:



Number of serious illness protection requests



Number of serious illness protection requests granted



Number of payment agreements (in states where payment agreements

are required)



Number of serious illness account disconnections



Number of serious illness protection reconnections.

Utilities should be

required to collect, report,

and analyze data to

monitor the administra-

tion of the protections

(see New Mexico rule).

Protecting Seriously Ill Consumers from Utility Disconnections

RECOMMENDATIONS

Broad Scope: State serious illness protections should apply to any household

that includes a person with a serious illness. Rather than attempting to deﬁne “seri-

ous illness” more speciﬁcally, states should rely on the certifying professional’s judg-

ment about whether the condition is a serious illness.

Certiﬁcation Process: Who can certify: The persons who can certify serious ill-

ness should include a broad range of medical and social service professionals and

others who can attest to the health status of the customer: e.g., physicians, physi-

cian assistants, osteopaths, nurse practitioners, nurses, mental health professionals,

board of health or public health ocials, and social service agencies.

No second-guessing: Utilities should not be allowed to second-guess the practi-

tioner’s certiﬁcation, but should be limited to asking the state regulator to resolve any

questions about the certiﬁcation’s legitimacy or suciency.

Form of certiﬁcation: States should provide a sample certiﬁcation form, and

should minimize the amount of speciﬁc information about the customer’s medical

condition that must be provided.

Implementation and Duration of the Protection:

Immediate implementation of an initial protection of at least 30 days. The protec-

tion against termination—including a requirement of prompt reconnection if the

household’s utility service has already been terminated—should go into eect

immediately upon receipt of a phone call from the customer or a certifying profes-

sional, with a requirement to submit a written certiﬁcation shortly (7 to 10 days) there-

after. The initial period of protection should be at least 30 days, and longer if speciﬁed

in the letter from the certifying entity.

Renewal. The initial protection should be renewable for the duration of the medi-

cal condition, as long as the certifying professional periodically attests that the ill-

ness is continuing. Any renewal period should be at least as long as the initial period of

protection.

Adequate Notice and Easily-Accessible Process: Utilities should be required to

notify customers of the serious illness protection rules when customers start ser-

vice, annually thereafter, in collection and disconnection notices, and in any post-

disconnection communications, in both English and any other language used by

substantial numbers of their customers.

Protecting Seriously Ill Consumers from Utility Disconnections

Armative Outreach:

Proactive outreach: Utilities should be required to act armatively to identify

households with seriously ill individuals and help them invoke the serious illness

protections, including through extra notiﬁcation eorts and the grant of authority to

ﬁeld agents to stop terminations.

Public utility commission approval: States should require notice to an approval by

the public utility commission before disconnection of a seriously ill customer.

Data Collection, Reporting, and Analysis: States should require utilities to col-

lect, report, and analyze data regarding the implementation of their serious illness

rules. This reporting should be broken down by zip code and should include:



Number of serious illness protection requests



Number of serious illness protection requests granted



Number of payment agreements



Number of serious illness account disconnections



Number of serious illness protection reconnections.

All of these protections should be incorporated into clear, formally adopted state

rules, to create a uniform, baseline level of protection throughout the state for

customers of regulated natural gas and electric companies. Uniform rules also make

it easier for the state utilities commission, utilities, advocates, and others to develop

outreach materials on serious illness protections.

Protecting Seriously Ill Consumers from Utility Disconnections

ENDNOTES

1. Carma Hassan, A New Jersey Woman on Oxygen Dies After the Power Company Shuts O Her

Electricity, CNN, July 10, 2018.

2. Elizabeth Whitman, On 107-Degree Day, APS Cut Power to Stephanie Pullman’s Home. She Didn’t

Live, Phoenix New Times, June 13, 2019.

3. See, e.g., Memphis Light, Gas & Water Div. v. Craft, 436 U.S. 1, 18 (1978) (“utility service is a

necessity of modern life [and] the discontinuance of . . . heating for even short periods of time may

threaten health and safety”); Antonio Gasparrini, et al., Mortality risk attributable to high and low

ambient temperature: a multicountry observational study, 386 The Lancet 369-375 (July 25, 2015).

4. See, e.g., Antonio Gasparrini, et al., Mortality risk attributable to high and low ambient temperature: a

multicountry observational study, 386 The Lancet 369-375 (July 25, 2015); Jane E. Brody, Beware:

Winter is Coming, N.Y. Times, Dec. 19, 2016 (cold weather is a “stealth killer” with increases in

related deaths “occurring as long as three or four weeks after a cold snap”); World Health

Organization, Climate change and health (Feb. 1, 2018).

5. Environmental & Climate Justice Program, NAACP, Lights Out in the Cold—Reforming Utility Shut-

O Policies as If Human Rights Matter (Mar. 2017); Rachel Zimmerman, Study of Boston Families in

Poverty Finds ‘Energy Insecurity’ Can Also Bring Health Woes - From Asthma to Anxiety, WBUR,

Sept. 12, 2016.

6. National Energy Assistance Directors’ Association, 2018 National Energy Assistance Survey

Final Report 18-24 (Dec. 2018).

7. Ariel Drehobl & Lauren Ross, American Council for an Energy-Ecient Economy, Lifting the High

Energy Burden in America’s Largest Cities: How Energy Eciency Can Improve Low Income and

Underserved Communities (Apr. 2016).

8. Diana Hernandez, Energy Insecurity: A Framework for Understanding Energy, the Built Environment,

and Health Among Vulnerable Populations in the Context of Climate Change, 103 Am. J. Pub. Health

32-34 (Apr. 2013).

9. Alabama has a rule regarding serious illnesses, Ala. Pub. Serv. Comm’n Gen. R. 770-X-1-.12 (5), but

it merely requires utility taris to set out termination rules “when life or health may be threatened

by termination” or customer needs special consideration due to “age or handicap.” An Alaska rule,

Alaska Admin. Code tit. 3, § 52.450( c)(2), provides that a customer who is seriously ill, elderly,

disabled, or dependent on life-support systems is entitled to a longer pre-termination notice, but

does not provide any protection against termination. Louisiana appears to have no statute or rule

that addresses serious illness protections. Two North Carolina rules, 4 N.C. Admin. Code 11.R.12-

10 (gas), R.12-11 (electric), address serious illness but merely allow utility providers, if they choose,

to delay termination if it would cause undue hardship or be especially dangerous to health, or

where a resident is elderly or has a disability.

10. 220 Mass. Code Regs § 25.03(1). The medical professional’s certiﬁcation of serious illness is

presumed valid, “unless otherwise determined by the Department [of Public Utilities] after

investigation.” 220 Mass. Code Regs. § 25.03(3). The serious illness letter must be renewed

quarterly, “except that where illness is certiﬁed as chronic, the serious illness shall be renewed

every six months.” 220 Mass. Code Regs § 25.03(4). There is no limit on the number of renewals.

11. Idaho Admin. Code r. 31.21.01.308 (applies if resident is seriously ill or has a medical emergency,

or will become seriously ill or have a medical emergency if utility service is disconnected).

12. Md. Code Regs. 20.31.03.01 (applies when “serious illness” or “need for life-support equipment”

is certiﬁed).

Protecting Seriously Ill Consumers from Utility Disconnections

13. 56 Pa. Code s. 56.2 (protection applies when there is certiﬁcation that a customer or member of

the customer’s household is seriously ill or has been diagnosed with a medical condition which

requires the continuation of service to treat the medical condition).

14. For example, some states absolutely prohibit termination if the customer is on utility-driven

life support equipment or if termination would likely result in death. If the illness is less serious than

that, the customer must enter into a payment plan on the overdue amount and/or renew the

serious illness certiﬁcation letter regularly. Conn. Gen. Stat. § 16-262c(b)(1); Conn. Agencies

Regs. § 16-3-100(e); Nev. Admin. Code §§ 704.370 (serioous illness), 704.375(3) (life support

equipment/risk of death).

15. Neb. Rev. Stat. § 70-1606(1)(g).

16. Ark. Admin. Code § 126.03.2-6.17(B).

17. Wis. Admin. Code PSC §§ 113.0301(13) (electric), 134.062(11) (gas).

18. Me. Admin. Code 65-407 ch. 815, § 11(C) (electric and gas: utility “may not challenge the

validity of an oral or written certiﬁcation with a physician or a physician’s agent, unless the utility

has reason to believe that fraudulent information has been provided by the customer,” at which

point the utility “should ﬁle for an exemption” from the Consumer Assistance Division); 220 Mass.

Code Regs. § 25.03(3) (“Certiﬁcation of serious illness . . . shall be conclusive evidence of the

existence of the condition claimed unless otherwise determined by the Department after

investigation.”). See also 4 Colo. Code Regs. § 723-3:3407(e)(IV)(C) (electric); 4 Colo. Code Regs.

§ 723-4:4407(e)(IV)(C) (gas) (medical certiﬁcate “shall be incontestable by the utility as to the

medical judgment” but utility can use “reasonable means to verify the authenticity of such

certiﬁcation”).

19. Colorado, Connecticut, Delaware, Massachusetts, Minnesota, Mississippi, Montana, New

Hampshire, New Jersey, New Mexico, Oregon, Texas, and Washington.

20. 220 Mass. Code Regs. § 25.03(3) (180 days, if the illness is denoted as “chronic”); Minn. Stat.

§ 216B.098 subdiv. 5(c)-(e); Mont. Admin. R. 38.5.1411(1).

21. Arkansas, Florida, Georgia, Iowa, Kentucky, Maine, Nebraska, Nevada, New York, North Dakota,

Ohio, Oklahoma, Pennsylvania, South Dakota, Tennessee, Utah, Vermont, and Virginia.

22. 220 Mass. Code Regs. § 25.03(3).

23. Conn. Agencies Regs. § 16-3-100(e)(3)(B); Mich. Admin. Code r. 460.130a(1), (2).

24. Conn. Agencies Regs. § 16-3-100(e)

25. Conn. Agencies Regs. § 16-3-100(c).

26. 52 Pa. Code §§ 56.91(b)(8), 56.93(b), 56.94(1), 56.96, 56.97.

27. Me. Admin. Code 65-407 ch.815, § 10(L)(4).

28. 52 Pa. Code § 56.96.

29. N.M. Admin. Code § 17.5.410.33(B).

30. N. Y. Comp. Codes R. & Regs. tit. 16, § 11.5(c).

31. Chapter 282, HB 1189, Home Energy Assistance - Critical Medical Needs Program (Apr.

30, 2019).

32. N.M. Admin. Code § 17.5.410.25(F)(9)-(11).

Protecting Seriously Ill Consumers from Utility Disconnections

APPENDIX A

SERIOUS ILLNESS CRITERIA IN EACH OF THE

 STATES AND D.C.

This table summarizes the illness/medical condition/age criteria customers must

meet either to be protected against termination, or to receive additional notice prior

to termination. NOTE that, in some states, only the latter applies—additional notice—

and that there is no protection against being terminated.

STATE CITATION DEFINITION

Alabama

Ala. Pub. Serv. Comm’n Gen. R.

770-X-1-.12 (5).

Utility tariffs shall set out termination rules “when

life or health may be threatened by termination”

or customer needs special consideration due to

“age or handicap.”

Alaska

Alaska Admin. Code tit. 3, §

52.450( c)(2).

Customer who is seriously ill, elderly, disabled,

or dependent on life-support systems entitled to

longer pre-termination notice, but no protection

against termination.

Arizona

Ariz. Admin. Code § R14-2-211(A)

(5), (6) (electric).

No disconnection if customer is unable to pay

and certifies termination “would be especially

dangerous” to health; “[l]ife supporting equipment

… is dependent on utility service”; but payment

plan may be required.

Arkansas

Ark. Admin. Code § 126.03.2-

6.17(A) (serious illness).

Termination of service postponed for 30 days

(renewable once) if medical certificate certifies

that termination would cause “substantial risk of

death or gravely impair the health” of customer or

permanent household member.

California

Cal. Pub. Util. Code §§ 779(b)(3)

(regular serious illness), 779.3

(medical baseline).

Regular serious illness protection: Financially

unable to pay & willing to enter into a deferred

payment agreement (DPA); if loss of service is life

threatening.

Medical baseline eligibility: If customer is

financially unable to pay and willing to enter into

DPA, no termination if: customer under hospice

care, depends on life-support equipment, or has a

life-threatening condition.

Colorado

4 Colo. Code Regs. §§ 723-3:3407

(electric), 723-4:4407 (gas).

Discontinuance of service will aggravate an

existing condition or create a medical emergency.

Connecticut

Conn. Gen. Stat. § 16-262c(b)

(1) (seriously ill, life- threatening

condition, child under 24 months

recently released from the

hospital); Conn. Agencies Regs.

§ 16-3-100(e).

No termination when “any resident therein

is seriously ill” as certified by a “registered

physician” (Conn. Agencies Regs. § §16-3-

100(e)). Absolute protection, year-round, in

financial hardship cases where termination would

“create a life-threatening situation” or when a child

under 2 has been released from hospital with

doctor’s note specifying need for utility service;

protection, from Nov. 1 to May 1, for “hardship”

cases, including those with serious illness (Conn.

Gen. Stat. § 16-262c(b)(1)).

Protecting Seriously Ill Consumers from Utility Disconnections

STATE CITATION DEFINITION

Delaware

Del. Code Ann. tit. 26, § 117(d). So ill that disconnection will adversely affect

resident’s health or recovery.

District of

Columbia

D.C. Mun. Regs tit.15, § 311.1(A). Disconnection is detrimental to health and safety

of occupant.

Florida

Fla. Stat

366.15 (utility tariffs). Medically essential: dependence on electric-

powered equipment that must be operated

continuously or per physician’s instruction to

avoid loss of life or immediate hospitalization.

Georgia

Ga. Comp. R. & Regs. 515-3-2.03

(electric and gas); 515-3-3.03

(marketers).

Serious illness which would be aggravated by

disconnection.

Hawaii

Haw. Admin. Rules § 6-60-8. Special disconnection process for elderly and

disabled.

Idaho

Idaho Admin. Code r. 31.21.01.308. Resident is seriously ill, or has a medical

emergency, or will become seriously ill or

have a medical emergency if utility service is

disconnected.

Illinois

Ill. Admin Code tit. 83, §§

280.130(m), 280.160(g),

280.160(d)(4), (j).

Disconnection will aggravate an existing medical

emergency or create a medical emergency.

Indiana

170 Ind. Admin. Code 4-1-16 (c)

(electric), 5-1-16(c) (gas).

Disconnection would be a serious and immediate

threat to the health and safety of resident.

Iowa

Iowa Admin Code rr. 199-19.4(476)

(gas), 199-20.4(476) (electric).

Disconnection poses especial danger to the

health of any permanent resident. “Especial

danger” is indicated if person appears to be

seriously impaired (because of mental or physical

problems), is unable to manage his/her own

resources, carry out activities of daily living, or

needs assistance from others to be protected

from neglect or hazardous situations. Indicators

of an especial danger to health include but are not

limited to: age, infirmity, or mental incapacitations;

serious illness; physical disability, including

blindness and limited mobility; and any other

factual circumstance which indicate a severe or

hazardous health situation.

Kansas

Kansas Corp. Comm’n Electric,

Nat. Gas, Water Billing Standards

(Jan 20, 2012).

Disconnection would be especially dangerous

to the health of resident. Consideration is given

to weather, resident’s medical condition, age, or

disability.

Kentucky

807 Ky. Admin. Regs 5:006 (sect.

15).

Disconnection would aggravate a debilitating

illness or infirmity currently suffered by resident.

Louisiana

No serious illness rule.

APPENDIX A (cont.)

SERIOUS ILLNESS CRITERIA IN EACH OF THE

 STATES AND D.C.

Protecting Seriously Ill Consumers from Utility Disconnections

STATE CITATION DEFINITION

Maine

Me. Admin. Code 65-407 ch. 815,

§ 11.

A medical emergency.

Maryland

Md. Code Regs. 20.31.03.01. Disconnection will aggravate a serious illness or

prevent the use of life-support equipment.

Massachusetts

220 Mass. Code Regs. § 25.03. A serious illness as certified by appropriate

authority listed in the regulation.

Michigan

Mich Admin Code RR. 460.130

(medical emergency), 460.130a

(critical care customer).

Medical emergency: Resident has a medical

condition, requires medical equipment for a

medical emergency, and certification sets out

the specific time period where disconnection will

aggravate the medical emergency.

Critical care customer: One for whom an

interruption of service would be immediately

life-threatening.

Minnesota

Minn. Stat. § 216B.098 subdiv. 5. Medical emergency or medical equipment

requiring electricity to sustain life.

Mississippi

39 Miss. Admin. Code

RR. 8.120 (mid-winter and

medical emergency), 8.125

(life-threatening).

No termination Dec. through March, if certification

of financial hardship and (undefined) “medical

emergency” + payment plan made (R. 8.120);

separately, 60 days of protection if life threatening

situation certified (R. 8.125).

Missouri

4 Mo. Code Regs Ann. tit. 4, §

240-13.050 (risk of death/gravely

impair health).

Serious medical condition: disconnection would

rapidly give rise to a substantial risk of death or

gravely impair the health of resident.

Montana

Mont. Admin. R. 38.5.1411. Loss of service would aggravate an existing

medical condition which would threaten the

health of resident.

Nebraska

Neb. Rev. Stat. § 70-1606(1)(g). Resident has an existing illness or disability that

would cause the resident to suffer an immediate

and serious health hazard by the disconnection of

the utility’s service to that household

Nevada

Nev. Admin. Code §§ 704.370

(serious illness), 704.375 (life-

support equipment).

Regular serious illness: Termination would be

especially dangerous to the health of resident and

constitute an emergency affecting health. May

consider the feebleness, advanced age, physical

disability, mental incapacity, serious illness, or

other infirmity of resident.

Life support: Resident is confined to location

where service is provided; on a life-support

device; will likely die if service is terminated.

New

Hampshire

N.H. Code Admin. R. Ann. PUC

1205.02.

Physical or mental health condition which would

be a danger to the physical or mental health of the

resident.

APPENDIX A (cont.)

SERIOUS ILLNESS CRITERIA IN EACH OF THE

 STATES AND D.C.

Protecting Seriously Ill Consumers from Utility Disconnections

STATE CITATION DEFINITION

New Jersey

N.J. Admin. Code § 14:3-3A.2; see

also N.J. Stat. Ann. § 48:2-29.48 to

48:2-29.53 (Linda’s Law, eff. Jan.1,

2020 re: electric service).

Serious illness: Medical emergency which would

be aggravated by disconnection.

New Linda’s Law: Resident uses life-sustaining

equipment powered by electricity.

New Mexico

N.M. Admin. Code §§ 17.5.410.7,

17.5.410.43 (form).

An illness or injury that results in a medical

professional’s determination that disconnection

will give rise to a substantial risk of death or would

gravely impair health.

New York

16 N.Y. Comp. Codes R. & Regs. tit.

16, § 14.5.

Medical emergency: Resident suffers from a

serious illness or a medical condition that severely

affects his well-being. If certification notes

chronic condition, renewal period is 60 days or

longer. If certification notes life-support system,

certification remains effective until terminated by

commission (consumer must still renew “inability

to pay” forms quarterly).

North Carolina

4 N.C. Admin. Code 11.R.12-10

(gas), R.12-11 (electric).

Companies may, if they choose, delay termination

if it would cause undue hardship or be especially

dangerous to health, or where resident is elderly

or has a disability.

North Dakota

N.D. Admin. Code §§ 69-09-02-

05.1 (electric), 69-09-01-18.1.1(gas).

Dangerous health condition exists (includes

life support), customer is 65 or older or has a

disability.

Ohio

Ohio Admin. Code

4901:1-18-06(C).

Disconnection would be especially dangerous

to health, or medical or life-support equipment

would be impossible or impractical to operate.

Oklahoma

Okla. Admin. Code §§ 165:35-21-

10 (electric), 165:45-11-14 (gas).

Life-threatening situation: resident dependent

on life-sustaining equipment.

Oregon

Or. Admin. R. 860-021-0410. Disconnection would significantly endanger the

physical health of household member.

Pennsylvania

52 Pa. Code §

56.2. Customer or household member is seriously

ill/diagnosed with a medical condition which

requires the continuation of service to treat the

medical condition.

Rhode Island

810 R.I. Code R. pts. 10-00-1.2,

10-00-1.4.

“Seriously ill”: actually or potentially “life-

threatening or that will cause irreversible adverse

consequences to human health” (10-00-1.2);

“disabled”: “physical or mental impairment…

which substantially limits one or more of such

person’s major life activities.”

APPENDIX A (cont.)

SERIOUS ILLNESS CRITERIA IN EACH OF THE

 STATES AND D.C.

Protecting Seriously Ill Consumers from Utility Disconnections

STATE CITATION DEFINITION

South Carolina

S.C. Code Ann. Regs. 103-352

(electric), 103-452 (gas); S.C. Code

Ann. §§ 58-5-1110, 58-5-1120,

58-27-2510, 58-27-2520 (“special

needs” customers).

No termination Dec. to Mar. if it “would be

especially dangerous to such person’s health”

(S.C. Code Ann. Regs. 103-352, 103-452).

“Special needs customers” entitled to additional

notice and payment arrangements prior to

termination (S.C. Code Ann. §§ 58-5-1120,

58-27-2510).

South Dakota

S.D. Admin. R. 20.10.20.11. Disconnection will aggravate an existing medical

emergency.

Tennessee

Tenn. Comp. R. & Regs 1220-

04-05-.18 (gas), 1220-04-04-.19

(electric).

Disconnection will aggravate an existing medical

emergency.

Texas

16 Tex. Admin. Code §§ 25.29(g)

(electric service providers),

25.483(g) (retail electric service

providers), 25.497 (“Chronic

Condition” and “Critical Care”

customers).

Various levels of protection for “seriously ill”

customers, “Chronic Condition Residential

Customers,” and “Critical Care Residential

Customers.”

Utah

Utah Admin. Code r. 746-200-7(A)

(3), (A)(4), (D)(1), (D)(2).

Protected categories include “serious illness or

infirmity” disconnection will “injure the person’s

health or aggravate the person’s illness” ((A)

(4)(c)(i) and those on “life support equipment”:

“immediate assistance from medical personnel to

sustain life would be required if the life supporting

equipment ceased normal operations” ((A)(3)(b)

(vi)).

Vermont

Vt. Admin. Code 18-1-4:3.302. Resident would suffer immediate and serious

health hazard by disconnection or failure to

reconnect.

Virginia

20 Va. Admin. Code §§ 5-330-20,

5-330-40.

Serious medical condition: Physical or

psychiatric condition that requires medical

intervention to prevent further disability, loss of

function, or death.

Washington

Wash. Admin. Code 480-100-128

(electric), 480-90-128 (gas).

Disconnection would aggravate an existing

medical condition.

West Virginia

W. Va. Code R. §§ 150-3-4.8.1.e.1

(electric), 150-4-4.8.1.e.1 (gas).

Certified Health Condition: Disconnection would

be dangerous to resident for medical reasons. If

certified as permanent condition, does not need

to be renewed.

Wisconsin

Wis. Admin. Code PSC §§

113.0301(13) (electric), 134.062(11)

(gas).

Disconnection will aggravate an existing medical

or protective service emergency.

Wyoming

023.0002.3 Wyo. Code R. § 9. Health and safety would seriously be endangered

if service disconnected.

APPENDIX A (cont.)

SERIOUS ILLNESS CRITERIA IN EACH OF THE

 STATES AND D.C.

Protecting Seriously Ill Consumers from Utility Disconnections

APPENDIX B

STATES THAT ALLOW PHONE CALL FOLLOWED

BY WRITTEN CERTIFICATION

States that allow a phone call followed by written certiﬁcation to stop termination

of electric or gas utility for a household with a seriously ill person

STATE CITATION DESCRIPTION

Arkansas

Ark. Admin. Code §

126.03.2-6.17(B).

Initial phone or letter; written certification within 7

days.

Connecticut

Conn. Agencies Regs. §

16-3-100(e).

Initial notice can be by phone; written certification

within 7 days.

Georgia

Ga. Comp. R. & Regs. 515-3-2.03,

515-3.03.

Initial notice can be oral or written from customer,

followed by written certification within 10 days.

Massachusetts

220 Mass. Code. Regs. § 25.03(2). Initial notice from listed medical professionals

may be by phone; certification form must be

returned to the utility within 7 days.

Minnesota

Minn. Stat. § 216B.098 subdiv.5. Initial phone certification followed by written

certification within 5 days.

Nebraska

Neb. Rev. Stat, § 70-60691)(g). Initial notice followed by written certificate within

5 days.

New York

N.Y. Comp. Codes R. & Regs. tit. 16,

§ 11.5(a)(3).

May be initiated by phone call followed by written

certification within 5 business days.

Oregon

Or. Admin. R. 860-021-0410. Initial certification may be oral if followed by

written certification within 14 days.

Virginia

20 Va. Admin. Code § 5-330-40

(electric).

Customer can initiate protection by notifying

utility, but written certification is provided within

10 days.

Washington

Wash. Admin. Code 480-100-128

(electric), 480-90-128 (gas).

Verbal notification of a medical emergency

can stop a termination for 5 days so a written

certification can be submitted.

Protecting Seriously Ill Consumers from Utility Disconnections

APPENDIX C

STATES WITH SAMPLE PROMPT RECONNECTION

PROTECTION RULES

STATE CITATION DESCRIPTION

Maine

Me. Admin. Code 65-407 ch.815,

§ 11(D).

Reconnection of service: When a utility is required

to reconnect service under this section, the

utility shall attempt to provide service on the day

it receives the certification. In any case, service

must be provided by 5:00 p.m. of the next day.

Pennsylvania

52 Pa. Code § 56.115. When service is required to be restored under

this section and §§ 56.114, 56.116 to-56.118, and

56.191, the public utility shall make a diligent effort

to have service restored on the day of receipt

of the medical certification. In any case, service

shall be reconnected within 24 hours. Each public

utility shall have employees available or on call to

restore service in emergencies.

Rhode Island

810 R.I. Code R. pts.

10-00-1.4(H),10-00-1.17(A).

In those instances where a Protected Status

Customer has his or her utility service terminated

because he or she and/or the public utility are

unaware of that individual’s protected status,

that individual’s utility service shall be restored

immediately (10-00-1.4(H)); Restoration of

service by Commission Action: The Administrator

of the Division of Public Utilities and Carriers has

the emergency authority to order immediate

restoration of service when necessary to protect

the health, welfare, and safety of the residents

(10-00- 1.17(A)).

Virginia

20 Va. Admin. Code §

5-330-40(C).

If customer was disconnected within preceding

14 days and serious illness certificate is provided,

utility shall promptly reconnect and not require

reconnection fees.

Protecting Seriously Ill Consumers from Utility Disconnections

APPENDIX D

SAMPLE RENEWAL PROVISIONS OF STATE

SERIOUS ILLNESS RULES

STATE CITATION DESCRIPTION

Connecticut

Conn. Agencies Regs. § 16-3-

100(e)(3)(B),

Duration is as set forth in physician’s certificate; 15

days if not specified. Renewals must be submitted

by last day of protection; if none specified in

renewal letter, renewals last 15 days; can be

renewed indefinitely for life- threatening illnesses.

Massachusetts

220 Mass. Code Regs. § 25.03(3). Certification renewed quarterly, unless chronic

condition, then every 6 months.

Michigan

Mich. Admin. Code rr. 460.130(5), (

6) (serious illness), 460.130a(1), (2)

(critical care customers).

Non-critical serious illness: Initial protection

of 21 days renewable twice per household

member (i.e., up to 63 days per year); Critical care

customers: Must be renewed annually; no limit on

renewals.

Minnesota

Minn. Stat. § 216B.098

subdiv.5(c)-(e).

Initial certification can last 6 months; in discretion

of utility, can be extended for up to 12 months.

Oregon

Or. Admin. R. 860-021-0410(4). Notice to renew provided at least 15 days prior to

certificate’s end date (serious illness protection

is valid for length of time on certificate, but up to

6 months for serious illness and 12 months for a

chronic condition).

Protecting Seriously Ill Consumers from Utility Disconnections

APPENDIX E

SAMPLE NOTICE PROVISIONS OF STATE SERIOUS

ILLNESS PROTECTION NOTICE RULES

STATE CITATION NOTICE REQUIREMENTS

Arkansas

Ark. Admin. Code §

126.03.2-6.07(G).

Every shutoff notice shall include a statement that

customer with serious medical condition, over 65,

or with a disability may contact the utility about

qualifying for delaying termination of service.

Connecticut

Conn. Agencies Regs. § 16-3-

100(c), (e).

Every termination notice “shall plainly indicate that

the utility company may not terminate residential

utility service to the home of any customer during

such time as any resident therein is seriously ill”

(§ 16-3-100(e)). A summary of customer rights,

including as to serious illness, must be provided

when service initiated and annually thereafter (§

16-3-100(c)).

Delaware

26-3002 Del. Code Regs. § 3.2.5. Notice of termination must include notice of

the protection that if any occupant is so ill that

disconnection would adversely affect health

or recovery, and this has been duly certified,

termination is prohibited.

Georgia

Ga. Comp. R. & Regs. 515-3-2-

.02(a)(4).

Written disconnection notices shall include the

procedure for preventing disconnection where

there is a medical emergency.

Idaho

Idaho Admin. Code r. 31.21.01.305. Termination notice must include a statement that

a certificate notifying the utility of a serious illness

or medical emergency may delay termination.

Maine

Me. Admin. Code 65-407 ch. 815,

§ 10(J).

Disconnection notice must contain statement

about customer’s right to postpone disconnection

due to a medical emergency.

Massachusetts

220 Mass. Code Regs. § 25.03(5). Collections notices must include description of

serious illness protection.

Michigan

Mich. Admin. Code r. 460.140(2)(f). Disconnection notice must contain information

that the utility will postpone shutoff if there is a

documented, certified medical emergency.

Nebraska

Neb. Rev. Stat. § 70-1606(1)(g). Disconnection notices must include a statement

that disconnections can be postponed or

prevented with a physician’s certificate of an

existing illness or disability.

New Mexico

N.M. Admin. Code.§ 17.5.410.42. 15-day disconnection notice shall include specific

notice about medical certifications protections.

North Dakota

N.D. Admin. Code § 69-09-02-

05.1 (electric).

Disconnection notice includes notice that

customer can delay termination for up to 30

days if there is a “dangerous health condition,” or

resident 65 or older or with a disability.

Protecting Seriously Ill Consumers from Utility Disconnections

STATE CITATION NOTICE REQUIREMENTS

Ohio

Ohio Admin. Code 4901:1-18-06(A)

(5)(h).

Disconnection notice includes information that

medical certification program and forms are

available from utility where disconnections would

be especially dangerous to health.

Pennsylvania

52 Pa. Code §§ 56.91(b)

(8),56.93(b),56.94(1), 56.96, 56.97.

Disconnection notice must include medical

certificate notice (§ 56.91(b)(8)). Required

personal contact before disconnection shall

include information on emergency medical

procedures (§ 56.93(b)). At time of effectuating

termination, if evidence of serious illness or

medical condition, termination may not occur (§

56.94(1)). Immediately post-termination, medical

emergency notice shall be conspicuously posted

or delivered to a responsible adult/occupant (§

56.96)). If customer contacts utility after issuance

of initial termination notice and before the actual

termination, the utility shall fully explain the

medical emergency procedures (§ 56.97)).

Wyoming

023.0002.3 Wyo. Code R. § 9. Disconnection notice must include explicit

information about the serious illness protection.

APPENDIX E (cont.)

SAMPLE NOTICE PROVISIONS OF STATE SERIOUS

ILLNESS PROTECTION NOTICE RULES

Protecting Seriously Ill Consumers from Utility Disconnections

APPENDIX F

REQUIREMENTS FOR DOCUMENTATION OF

SERIOUS ILLNESS AND SAMPLE FORMS*

Following are sample forms of states that have eective language to document seri-

ous illness.

Arkansas

Ark. Admin. Code § 126.03.2-6.17(D).

D. Physician’s Certiﬁcate

A completed physician’s certiﬁcate must be signed by a physician and must be in the

following form. The utility shall provide a copy of the physician’s certiﬁcate form to the

physician.

PHYSICIAN’S CERTIFICATE OF MEDICAL NEED FOR UTILITY SERVICE

The Arkansas Public Service Commission requires utilities under its jurisdiction to

honor physician’s certiﬁcates which attest to the fact that a utility customer or any

permanent resident of the household has a serious medical condition. The certiﬁcate

must clearly state that the suspension of utility service would give rise to a substan-

tial risk of death or gravely impair the health of the customer or another permanent

household resident.

A licensed physician or other health care professional providing health care services

to the patient may notify the utility of the serious medical condition. The notice must

be followed within 7 days by a certiﬁcate. The certiﬁcate is valid for up to 30 days and

may be extended for one additional 30 day period by reveriﬁcation by the physician or

health care professional prior to the expiration date of the ﬁrst certiﬁcate. This reveri-

ﬁcation requires that an additional certiﬁcate be submitted to the utility.

You are being asked to verify that the stated condition exists. This certiﬁcate allows

the utility customer time to secure payment for utility service or to make alternate

arrangements for care of the patient.

Thank you for your cooperation.

*These forms are the most recent available. For updates, please consult the utility company or state

utility commission

Protecting Seriously Ill Consumers from Utility Disconnections

To: _________________________________________ ___________________________________

(Name of Utility) Date

I certify that loss of utility service would give rise to a substantial risk of death or

gravely impair the health of who lives at

_____________________________________________________________________________________.

The nature of the serious medical condition is

_____________________________________________________________________________________.

The eect of loss of utility service would be

_____________________________________________________________________________________.

This condition is expected to continue __________ days.

I am licensed to practice medicine by the Arkansas State Medical Board or a

comparable licensing authority in the State of ______________________________________.

Physician ____________________________________________________________________

Address ____________________________________________________________________

Phone number ____________________________________________________________________

APPENDIX F (cont.)

REQUIREMENTS FOR DOCUMENTATION OF

SERIOUS ILLNESS AND SAMPLE FORMS

Protecting Seriously Ill Consumers from Utility Disconnections

Idaho

Idaho Admin Code r. 31.21.01.308.01.

The certiﬁcate must contain the following information:

a. A statement that the customer, a member of the customer’s family, or other

permanent resident of the premises where service is rendered is seriously ill or

has a medical emergency or will become seriously ill or have a medical emergency

because of termination of service, and that termination of utility service would

adversely aect the health of that customer, member of the customer’s family, or

resident of the household.

b. The name of the person whose serious illness or medical emergency would be

adversely aected by termination and the relationship to the customer, and

c. The name, title, and signature of the person certifying the serious illness or medical

emergency.

Illinois

Ill. Admin. Code tit. 83, § 280.160(d).

d) Certiﬁcate Content:

1) Name and contact information for the certifying party;

2) Service address and name of patient;

3) A statement that the patient resides at the premises in question; and

4) A statement that the disconnection of utility service will aggravate an existing

medical emergency or create a medical emergency for the patient.

Maine

Me. Admin. Code 65-407 ch.815, §11(C).

The utility may require that a written certiﬁcation include the following if the utility

provides a form for the physician to complete:

1. The name and service location of the customer (to be provided by the utility).

2. The name and address of the person with the medical emergency.

APPENDIX F (cont.)

REQUIREMENTS FOR DOCUMENTATION OF

SERIOUS ILLNESS AND SAMPLE FORMS

Protecting Seriously Ill Consumers from Utility Disconnections

3. A statement that a serious illness or medical condition exists which would be

seriously aggravated by lack of utility service.

4. The anticipated length of the medical emergency.

5. The speciﬁc reason why continued service is required.

6. The name, oce address, telephone number and signature of the certifying

physician.

Massachusetts

220 Mass. Code Regs. § 25.03(2)(a).

Said certiﬁcate shall state the name and address of the seriously ill person, the nature

of the illness and the business address and telephone number of the certifying

physician, physician assistant, nurse practitioner or local board of health;

Sample template for Serious Illness letter

(no ocial form required to document illness):

To Whom It May Concern:

[Name of patient] who resides at [address] is a patient of mine [or: is under my care].

[Name of patient] is being treated for [describe illness or condition], a serious illness.

Sincerely,

[Health professional’s name and contact information]

Sample template for Serious Chronic Illness letter

(no ocial form required to document illness):

To Whom It May Concern:

[Name of patient] who resides at [address] is a patient of mine [or: is under my care].

[Name of patient] is being treated for [describe illness or condition], a chronic illness.

Sincerely,

[Health professional’s name and contact information]

APPENDIX F (cont.)

REQUIREMENTS FOR DOCUMENTATION OF

SERIOUS ILLNESS AND SAMPLE FORMS

Protecting Seriously Ill Consumers from Utility Disconnections

Montana

Mont. Admin. R. 38.5.1411.

All certiﬁcations must be in writing and provide the name and address of the person

with the medical condition that would be aggravated by a termination of service. The

certiﬁcation must include the printed name, signature, oce address, and telephone

number of the certifying licensed health care professional.

Ohio

Ohio Admin. Code 4901:1-18-06(C)(3)(b).

(b) The certiﬁcation of the medical condition or the need for the medical or life-

supporting equipment required by paragraph (C)(1) of this rule shall be in writing and

shall include the name of the person to be certiﬁed; a statement that the person is

a permanent resident of the premises in question; the name, business address, and

telephone number of the certifying party; a statement of the need for the medical or

life-supporting equipment, if applicable; and a signed statement by the certifying

party that disconnection of service will be especially dangerous to the health of a

permanent resident of the premises.

PUCO Sample form (see next page).

APPENDIX F (cont.)

REQUIREMENTS FOR DOCUMENTATION OF

SERIOUS ILLNESS AND SAMPLE FORMS

Protecting Seriously Ill Consumers from Utility Disconnections

30-Day Medical Certification

(Name of Utility Company)

Instructions:

The following is to be completed by a licensed medical professional and only after you, or someone in your

office, has examined the individual whose name appears as the patient on the form below. This form applies only in

situations where, in your professional opinion, termination of _(gas/electric/water)_ utility service would be especially

dangerous to the health of that individual. If, in your professional opinion an especially dangerous situation does not

exist, please do not sign this form.

If you have any questions regarding this form, please contact: (utility company name and phone number).

You may fax the completed form to us at _(fax number)_.

_____________________________________________________________

I certify that, to the best of my knowledge, the information provided below is true.

The following medical information must be certified by one of the following. Please indicate if you are a:

□ licensed physician □ physician assistant

□ clinical nurse specialist □ certified nurse practitioner

□ certified nurse-midwife □ local board of health physician

Please complete the following. Please print.

I certify that my patient has been examined by me and I have determined the following to be true:

Name of patient: ______________________________________________________________

Patient’s permanent residence: (street address)_______________________________________

(

city, state, zip code)____________________________________

Check the box of the applicable condition:

□ This patient suffers from a hazardous medical condition and termination of

__(gas/electric/water)__utility service would be especially dangerous or life-

threatening.

□ This patient uses medical or life-supporting equipment and termination of

__(gas/electric/water)__utility service would make operation of that

equipment impossible or impractical.

I certify that I advised my patient that disclosure of the requested information may be subject to

redisclosure by the recipient and no longer be protected by the HIPAA rules and regulations.

Authorized Signature_________________________________________________

Date _______________________________________

(Please Print)

Name of Licensed Medical Professional________________________________________

Business Address _________________________________________________________

Business Telephone_______________________________________________________

Current State License or Certificate Number: __________________________________

All sections must be fully completed in order to process the medical

certification request.

APPENDIX F (cont.)

REQUIREMENTS FOR DOCUMENTATION OF

SERIOUS ILLNESS AND SAMPLE FORMS

WASHINGTON OFFICE

Spanogle Institute for Consumer Advocacy

1001 Connecticut Ave, NW, Suite 510

Washington, DC, 20036

(202) 452-6252

NATIONAL HEADQUARTERS

7 Winthrop Square, Boston, MA 02110

(617) 542-8010

NCLC.ORG