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Show Handling Indigent Claims Is Toughest County Job By GARY R. BLODGETT FARMINGTON Are Utah's indigent care programs too lenient. Are Utah and Davis County taxpayers being taken advantage of by unauthorized persons? THIS TWO-barreled question ques-tion meets with a lot of controversy, con-troversy, especially from those who work closely with the indigent care program of Davis County. "Handling indigent claims has been the hardest part of my job as county commissioner," said Commission Chairman Ernest Eberhard, who has been assigned the unpleasant and thankless task for the past couple of years. "YOU'RE ALWAYS behind the eight ball when it comes to dealing with indigent cases because be-cause you must be concerned about the taxpayers money being spent as well as paying for the care of those who need it." But he was quick to add, "We could take care of the poor without too much trouble. trou-ble. It's the dependent those who rely on someone else for everything they have that create the problems. "I'M NOT against helping those who really need help, the true indigent person," he said. "But there are far too many who are dependent on the government gov-ernment although they have the ability to pay. Those are the ones that I can't tolerate." Com. Eberhard admits that Davis County has had its share of the latter, as well as those who have applied for indigent care without good reason. "WE'VE HAD claims from those who have no good reason to look for handouts," he said, citing a few cases that vividly stand out in his mind. Like the woman who came to Utah for an operation to help her get pregnant because "her home state wouldn't do the operation as an indigent; the man who applied for indi gent medical care when he fell off the bar stool and broke his leg; the man who was stabbed during a fight in a bar; and the woman who wanted indigent care although both she and her husband were working. BUT THE welfare case "to take the cake" although it does not pertain directly to indigent in-digent care is the case of Weber We-ber County where a woman moved to Utah in 1979 with one child, eight months pregnant pre-gnant with another, and not yet divorced. State Senator Bryce C. Flamm said he made personal contact with the person involved late last April and, by the woman's own admission, is receiving the following state welfare aid: COLLEGE TUITION and books, $140; aid for her two children, (cash), $348; food stamps, $91; rent subsidy, $183; day care service for her children, $200; medical care, $150; dental care, $32; legal services, $25; social security, $100; federal income tax if employed, em-ployed, $230; and state tax if employed, $60. That's a total of $1,569 of equivalent salary per month! THE CASES earlier referred to in Davis County were not paid by indigent care funds because be-cause they did not meet the criteria as established by the State Policy and Procedure Manual of the Indigent Medical Medic-al Care Program. Marilyn Kelsey, investigator investiga-tor of indigent medical claims for the county through the United Un-ited Way, explained that no alcohol-related injuries or illnesses are treated as indigent cases. AMONG OTHER welfare income guidelines, indigents are classified as those persons who do not have the capability to pay for medical services rendered. However, an "indigent" may own a home, a car and have $1,500 in savings. If the indigent is married, they may have up to $2,250 in savings. SHE STRESSED, however, that their are other strict guidelines guide-lines that the county must follow fol-low especially dealing with income in-come of the person or family involved. Only "low income" familes can be termed indigent. indi-gent. Tere are also restrictions placed on types of medical service ser-vice with qualify for indigent aid. These shall be generally limited to treatment of acute or life-threatening disorders and infections. There will be no reimbursement to persons for elective surgery. MOST EMERGENCY services ser-vices are allowable for indigent care but inpatient care is more selective and limited usually for only the first five days but in some cases extended to "long-term" care. Mrs. Kelsey emphasized that indigent care is only the last resort and that where ever possible, indigent claims are tunneled to other agencies especially insurance companies com-panies and charity organizations. organiza-tions. WHO DETERMINES if a claimant is eligible for indigent aid? In Davis County, a three-member three-member screening committee reviews every application and each claim is investigated by Mrs. Kelsey, whose primary job is to see that if at all possible possi-ble the payment of medical service ser-vice is made by someone other than the county. DAVIS COUNTY Commission Commis-sion does not accept or reject any application. This is done by the screening committee and the commission acts only as an appeals board, Com. Eberhard emphasized. Nearly all applications are originated by the county's tow hospitals with a vast majority major-ity of the claims coming from Davis North Medical Center. "WE HAVE received only a few indigent claims from Lake- view Hospital in the past few years," said Com. Eberhard. "Most physicians do not file claims and Lakeview Hospital has absorbed most of the indi- gent cost it has incurred." Com. Eberhard said Davis County will continue to review and pay eligible claims received re-ceived through June 30. After that, all payments will be made directly through the state indigent indi-gent care fund. TO COMPENSATE for the service, Davis County will levy a one-quarter mill which . is slightly more than the county coun-ty was paying when it operated its own program. "But the difference is not much," stressed Com. Eberhard. "And the little difference dif-ference is well worth it because be-cause of problems and threats of problems that exist with your own program." HE NOTED that there was always the fear of liability suits being filed against the county, such as the five-county suit that Davis County is presently involved in regarding a man who was shot. But perhaps the biggest problem facing Davis County officials prior to June 30 was the fear that a "major" medical medic-al bill would be submitted that could all but wipe out their indigent in-digent account. "IT'S VERY conceivable that a car loaded with indigent persons could have an accident acci-dent in the county and county taxpayers would be stuck with the bill," the commissioner said. "We didn't have a maximum max-imum payment plan in force because the law states that the county will pay for the services rendered." The commissioner explained ex-plained that a worldwide search including Lloyds of London was made to get insurance in-surance against extremely ' j large or long-term medical payments for indigents. "NO ONE would even talk to us about it," the commissioner commis-sioner explained. |