Organization and Financing of Indigent Hospital Care in South Florida

By Catherine A. Jackson; Amanda Beatty | Go to book overview

1
INTRODUCTION

Over 2 million persons under age 65 in Florida lack health insurance. Thirty-five percent live in Broward, Miami-Dade and Palm Beach counties.4 When uninsured persons require hospitalization, access to non-emergency care may be difficult. All south Florida hospitals provide care to the uninsured. Federal regulation, specifically the Emergency Medical Treatment and Active Labor Act of 1986 (EMTALA), requires all hospitals to provide emergency care regardless of the patient's ability to pay. Historically, tax-exempt hospitals provide care to the uninsured as a form of reciprocity for their tax exemption. In addition, social mores compel tax-exempt and tax-paying hospitals and community doctors to provide care to uninsured persons as well.

Florida state statute delegates responsibility for caring for the uninsured to the counties, and consequently it is flexible regarding how counties provide this care.

The state, however, is very specific in defining charity care. Specifically,

(2)“Charity care” or “uncompensated charity care” means that portion of hospital charges reported to the agency for which there is no compensation for care provided to a patient whose family income for the 12 months preceding the determination is less than or equal to 150 percent of the federal poverty level, unless the amount of hospital charges due from the patient exceeds 25 percent of the annual family income. However, in no case shall the hospital charges for a patient whose family income exceeds four times the federal poverty level for a family of four be considered charity.” 5

Thus, a hospital can categorize a patient as one who will receive charity care if on admission he meets this criteria.

While counties in Florida are given autonomy regarding how they structure the funding mechanisms and service provision for indigent care, the segment of the population entitled “charity care” is uniformly defined. However, the uninsured include others who do not satisfy these criteria. These indigent

____________________
4
Duncan et al., (2000), Florida Health Insurance Survey, 1999.
5
Florida State Statute, Title XXIX, Public Health, Chapter 395, Hospital Licensing and Regulation at:

http://www.f1senate.gov/Statutes/index.cfm?App_mode=Display Statute&URL=Ch0395/ch0395.htm.

-1-

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