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– Medical services/indigent/residence
SENATE BILL NO. 1363
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S1363.................................................by HEALTH AND WELFARE
INDIGENT MEDICAL SERVICES - Amends existing law relating to indigent
medical services to revise the event used to determine county residency; to
remove a provision providing that reimbursement moneys received by a county
need not be budgeted or appropriated pursuant to statute; and to provide
that the portion of moneys received by the county as reimbursement not
assigned to the state Catastrophic Health Care Fund shall be credited to
the county indigent fund.
02/01 Senate intro - 1st rdg - to printing
02/04 Rpt prt - to Health/Wel
02/07 Rpt out - rec d/p - to 2nd rdg
02/08 2nd rdg - to 3rd rdg
02/13 3rd rdg - PASSED - 33-0-2
AYES -- Andreason, Bair, Bastian, Bilyeu, Broadsword, Burkett,
Cameron, Coiner, Corder, Darrington, Davis, Fulcher, Gannon, Geddes,
Goedde, Hammond, Heinrich, Hill, Jorgenson, Kelly, Keough, Langhorst,
Little, Malepeai(Sagness), McGee, McKague, Pearce, Richardson,
Schroeder, Siddoway, Stegner, Stennett, Werk
NAYS -- None
Absent and excused -- Lodge, McKenzie
Floor Sponsor - McGee
Title apvd - to House
02/14 House intro - 1st rdg - to Health/Wel
03/11 Rpt out - rec d/p - to 2nd rdg
03/12 2nd rdg - to 3rd rdg
03/13 3rd rdg - PASSED - 69-0-1
AYES -- Anderson, Andrus, Barrett, Bayer, Bedke, Bell, Black, Block,
Bock, Boe, Bolz, Bowers, Brackett, Bradford, Chadderdon, Chavez,
Chew, Clark, Collins, Crane, Durst, Eskridge, Hagedorn, Hart,
Harwood, Henbest, Henderson, Jaquet, Killen, King, Kren, Labrador,
Lake, LeFavour, Loertscher, Luker, Marriott, Mathews, McGeachin,
Mortimer, Moyle, Nielsen, Nonini, Pasley-Stuart, Patrick, Pence,
Raybould, Ringo, Roberts, Ruchti, Rusche, Sayler, Schaefer,
Shepherd(02), Shepherd(08), Shirley, Shively, Smith(30), Smith(24),
Snodgrass, Stevenson, Thayn, Thomas, Trail, Vander Woude, Wills,
Wood(27), Wood(35), Mr. Speaker
NAYS -- None
Absent and excused -- Bilbao
Floor Sponsor - Loertscher
Title apvd - to Senate
03/14 To enrol
03/17 Rpt enrol - Pres signed - Sp signed
03/18 To Governor
03/18 Governor signed
Session Law Chapter 189
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]]
Fifty-ninth Legislature Second Regular Session - 2008
IN THE SENATE
SENATE BILL NO. 1363
BY HEALTH AND WELFARE COMMITTEE
1 AN ACT
2 RELATING TO INDIGENT MEDICAL SERVICES; AMENDING SECTION 31-3506, IDAHO CODE,
3 TO REVISE THE EVENT USED TO DETERMINE COUNTY RESIDENCY; AND AMENDING SEC-
4 TION 31-3510A, IDAHO CODE, TO REMOVE A PROVISION PROVIDING THAT REIMBURSE-
5 MENT MONEYS RECEIVED BY A COUNTY NEED NOT BE BUDGETED OR APPROPRIATED PUR-
6 SUANT TO STATUTE AND TO PROVIDE THAT THE PORTION OF MONEYS RECEIVED BY THE
7 COUNTY AS REIMBURSEMENT NOT ASSIGNED TO THE STATE CATASTROPHIC HEALTH CARE
8 FUND SHALL BE CREDITED TO THE COUNTY INDIGENT FUND.
9 Be It Enacted by the Legislature of the State of Idaho:
10 SECTION 1. That Section 31-3506, Idaho Code, be, and the same is hereby
11 amended to read as follows:
12 31-3506. OBLIGATED COUNTY. The county obligated for payment shall be
13 determined as follows:
14 (1) The obligated county for payment of pharmaceuticals for
15 noninstitutionalized individuals shall be the county where the applicant cur-
16 rently resides.
17 (2) The obligated county for payment of necessary medical services for
18 medical indigent individuals shall be as follows:
19 (a) The last county in which the applicant or head of household has main-
20 tained a residence for six (6) consecutive months or longer within the
21 past five (5) years preceding application incurrence shall be obligated.
22 If the applicant or head of household maintains another residence in a
23 different county or state for purposes of employment, the county where the
24 family residence is maintained shall be deemed the applicant's or head of
25 household's place of residence.
26 (b) If an individual has not resided in any county for a period of six
27 (6) months within the five (5) years preceding incurrence of medical costs
28 for which counties have a responsibility in whole or in part, then the
29 county where the applicant maintained a residence for at least thirty (30)
30 days immediately preceding such incurrence shall be the obligated county.
31 (c) Active military duty, or being admitted as a patient in a hospital,
32 nursing home, other medical facility or institution, shall not change the
33 obligated county. The county obligated shall remain the same county that
34 would have been obligated prior to institutionalization as above
36 (d) For full-time students at public institutions of higher learning, the
37 obligated county shall be the county of residence of the applicant unless
38 an obligated person, for whom the applicant is claimed as a dependent,
39 resides in another county or state.
40 (e) If an individual has not resided in any county for a consecutive
41 period of thirty (30) days but has resided in the state of Idaho for a
42 consecutive period of thirty (30) days then the county where the individ-
43 ual last resided prior to receiving medical services shall be the obli-
1 gated county.
2 SECTION 2. That Section 31-3510A, Idaho Code, be, and the same is hereby
3 amended to read as follows:
4 31-3510A. REIMBURSEMENT. (1) Receipt of financial assistance pursuant to
5 this chapter shall obligate an applicant to reimburse the county from which
6 assistance is received and the catastrophic health care costs program for such
7 reasonable portion of the financial assistance paid on behalf of the applicant
8 as the board may determine that the applicant is able to pay from resources
9 over a reasonable period of time. Cash amounts received shall be prorated
10 between the county and the state in proportion to the amount each has paid.
11 (2) A final determination shall not relieve the applicant's duty to make
12 additional reimbursement from resources if the board subsequently finds within
13 a reasonable period of time that there has been a substantial change in cir-
14 cumstances such that the applicant is able to pay additional amounts up to the
15 total claim paid on behalf of the applicant.
16 (3) A final determination shall not prohibit the board from reviewing a
17 petition from an applicant to reduce an order of reimbursement based on a sub-
18 stantial change in circumstances.
19 (4) The automatic lien created pursuant to the chapter may be filed and
20 recorded in any county of this state wherein the applicant has resources and
21 may be liquidated or unliquidated in amount. Nothing herein shall prohibit an
22 applicant from executing a consensual lien in addition to the automatic lien
23 created by filing an application pursuant to this chapter. In the event that
24 resources can be located in another state, the clerk may file the lien with
25 the district court and provide notice to the recipient. The recipient shall
26 have twenty (20) days to object, following which the district court shall
27 enter judgment against the recipient. The judgment entered may thereafter be
28 filed as provided for the filing of a foreign judgment in that jurisdiction.
29 (5) The county shall have the same right of recovery as provided to the
30 state of Idaho pursuant to sections 56-218 and 56-218A, Idaho Code.
31 (6) The board may require the employment of such of the medically indi-
32 gent as are capable and able to work and whose attending physician certifies
33 they are capable of working.
34 (7) That portion of the m Moneys received by a county as reimbursement
35 that are not assigned to the state catastrophic health care fund shall be
36 credited to the county indigent fund. and need not be budgeted or appropriated
37 in the manner required by chapter 16, title 31, Idaho Code, but shall be
38 available for expenditure at any time for the purposes of the county indigent
40 (8) If, after a hearing, the final determination of the board is to
41 require a reimbursement amount or rate the applicant believes excessive, the
42 applicant may seek judicial review of the final determination of the board in
43 the manner provided in section 31-1506, Idaho Code.
STATEMENT OF PURPOSE
The purpose of this bill is to clarify the handling of indigent
reimbursements. It would allow for the portion of funds received
that are to be reimbursed to the catastrophic (CAT) fund to be put
into a trust and then sent to the CAT fund without being budgeted.
Funds that would be distributed to the county indigent fund would
be allowed to be utilized as long as they were budgeted as provided
by law. This codifies the practice currently utilized by many
The indigent law was amended in 1996 to specify that an application
may be filed on an indigent person within 30 days of receiving
necessary medical services. Section 31-3506 (2)(a) dealing with
obligated county has some inconsistencies in that one section deals
with "preceding application" and another section uses the
terminology "preceding incurrence." Any delay in the filing of an
Application for County Aid should not determine which county would
be the "obligated county". This would clarify that statute by
eliminating the conflicting terminology.
No impact on the state general fund or any taxing districts.
Name: Dan Chadwick, Idaho Association of Counties
STATEMENT OF PURPOSE/FISCAL NOTE S 1363