Galen Scott

Indigent care costs are high at Campbell Health System.

According to the hospital’s balance sheet, more than $470,000 were listed as deductions from revenue in the month of January alone.

In an effort to lessen the financial strain of charity care, Campbell’s chief financial officer, Nancy Cook, recommended five alterations to the county’s current charity care program during a board meeting Thursday.

The changes would establish a minimum age of 19 for coverage, require a patient credit check and establish a gross overall limit for vehicle values at $10,000.

Household composition rules would also change and adopting the 2006 Federal Poverty Guidelines was recommended.

Cook defended the changes to board members.

Patients under 18 are eligible for Medicaid, she explained. Medicaid is reimbursed by state and federal funding and preferable, from the hospital’s standpoint, to charity care.

Cook said the credit check was a way to identify people who have the ability for health care rather than a way to deter those who truly need it.

Under the proposed change to household composition requirements, if a mother and father of the same child live in the same house, the situation would be considered a household, regardless of the parents’ marital status.

If a friend or family member has been an applicant’s sole supporter for more than six months, the situation would also be considered a household.

The current charity care policy does not provide for the distinctions.

“We do have indigents that qualify but maybe shouldn’t because they are living with someone who can contribute to their health care costs,” Cook said. “This will help us to identify those people who actually should be covered.”

Though other policy changes would lessen the number of qualified charity care applicants, the alterations relating to an applicant’s vehicles are actually more inclusive.

The proposal mandates if the Blue Book (NADA Used Car Guide) value of an applicant’s vehicles exceeds $10,000, they would be above the resource limit. The current vehicle-value limit is only $1,500.

Cook told board members the vehicle-value limit hadn’t been adjusted in some time.

The United States Department of Health and Human Services releases new poverty guidelines every year. Cook recommended adopting the 2006 figures, which changed only slightly, as a matter of protocol.

Though local hospital districts have the authority to set their own charity care policies, Cook said the new proposals would mirror the state’s policies in many ways.

Board President Mike Carter asked how the changes would affect indigent care provided to illegal immigrants, touching on a hot-button issue.

Cook acknowledged there are some federal reimbursements to deal with illegal-immigrant costs.

“But honestly, most of those individuals don’t apply,” she said.

A public hearing to address the proposed changes is scheduled for April 27 hospital board meeting.

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