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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 Effective: 07/01/08
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]] Fifty-ninth Legislature Second Regular Session - 2008IN 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 precedingapplicationincurrence 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 35 described. 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- 2 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 mMoneys 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 appropriated37in the manner required by chapter 16, title 31, Idaho Code, but shall be38available for expenditure at any time for the purposes of the county indigent39fund.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 RS 17726 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 counties. 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. FISCAL IMPACT No impact on the state general fund or any taxing districts. Contact Name: Dan Chadwick, Idaho Association of Counties Phone: 208-345-9126 Tony Poinelli Sharon Burke STATEMENT OF PURPOSE/FISCAL NOTE S 1363