Text: H01885 Text: H01887 Text: H01800 - H01899 Text: H Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Amend the amendment, H-1866, to Senate File 549, as 1 2 amended, passed, and reprinted by the Senate, as 1 3 follows: 1 4 #1. Page 5, line 27, by striking the figure 1 5 "256A.3."" and inserting the following: "256A.3. 1 6 Sec. ___. Section 255.1, Code 1997, is amended by 1 7 adding the following new unnumbered paragraph: 1 8 NEW UNNUMBERED PARAGRAPH. It is the policy of this 1 9 state to provide medical and surgical treatment and 1 10 hospital care to medically indigent individuals in 1 11 this state, at the appropriate and necessary level, at 1 12 a licensed hospital or health care facility closest 1 13 and most available to the residence of the indigent 1 14 individual. In accordance with this policy, there is 1 15 created a statewide medical and surgical indigent 1 16 patient treatment and care program, which shall be 1 17 administered by the Iowa department of public health. 1 18 The department shall adopt administrative rules to 1 19 implement the program pursuant to chapter 17A. 1 20 Administrative costs of the department shall not 1 21 exceed three percent of the annual funds appropriated 1 22 for the program. 1 23 Sec. . Section 255.8, Code 1997, is amended to 1 24 read as follows: 1 25 255.8 HEARING ORDER EMERGENCY CASES 1 26 CANCELLATION OF COMMITMENTS. 1 27 The county attorney and the general assistance 1 28 director, or other agent of the board of supervisors 1 29 of the county, shall appear at the hearing. The 1 30 complainant, the county attorney, the general 1 31 assistance director or other agent of the board of 1 32 supervisors, and the patient, or any person 1 33 representing the patient, may introduce evidence and 1 34 be heard. If the court finds that the patient is a 1 35 legal resident of Iowa and is pregnant or is suffering 1 36 from a malady or deformity which can probably be 1 37 improved or cured or advantageously treated by medical 1 38 or surgical treatment or hospital care, and that 1 39 neither the patient nor any person legally chargeable 1 40 with the patient's support is able to pay the 1 41 expenses, then the clerk of court, except in1 42obstetrical cases and orthopedic cases,shall 1 43 immediatelyascertain from the admitting physician at1 44the university hospital whether the person can be1 45received as a patient within a period of thirty days,1 46and if the patient can be received, the court, or in1 47the event of no actual contest, the clerk of the1 48court, shall enter an order directing that the patient1 49be sent to the university hospital for proper medical1 50and surgical treatment and hospital care. If the2 1court ascertain, except in obstetrical cases and2 2orthopedic cases, that a person of the age or sex of2 3the patient, or afflicted by the complaint, disease,2 4or deformity with which the person is afflicted,2 5cannot be received as a patient at the university2 6hospital within the period of thirty days, then the2 7court or the clerk shallenter an order directing the 2 8 board of supervisors of the county to provide adequate 2 9 treatment at county expense for the patient at home or 2 10 inathe nearest hospital capable of providing 2 11 appropriate treatment.Obstetrical cases and2 12orthopedic cases may be committed to the university2 13hospital without regard to the limiting period of2 14thirty days.2 15 In any case of emergency the court or the clerk 2 16 without previous inquiry may at its discretion order 2 17 the patient to be immediately taken to and accepted by 2 18 theuniversity hospitalnearest hospital capable of 2 19 providing appropriate treatment for the necessary care 2 20 as provided in section 255.11, but if such a patient2 21cannot be immediately accepted at the university2 22hospital as ascertained by telephone if necessary, the2 23court or the clerk may enter an order as in certain2 24cases above set forth directing the board of2 25supervisors to provide adequate treatment at county2 26expense for the said patient at home or in a hospital. 2 27 Sec. ___. Section 255.13, Code 1997, is amended to 2 28 read as follows: 2 29 255.13 ATTENDANT PHYSICIAN COMPENSATION. 2 30 If the physician appointed to examine the patient 2 31shall certifycertifies that an attendant to accompany 2 32 the patient to thesaidhospital is necessary, andthe2 33universitya hospital attendant and ambulance service 2 34 is not available,thenthe court or judge or clerk of 2 35 the court may appoint an attendant who shall receive 2 36 notexceedingmore than two dollars per day for the 2 37 timethusnecessarily employed and actual necessary 2 38 traveling expenses by the most feasible route tosaid2 39 the hospital whether by ambulance, train or 2 40 automobile; but ifsuchthe appointee is a relative of 2 41 the patient or a member of the patient's immediate 2 42 family, or receives a salary or other compensation 2 43 from the public for the appointee's services, nosuch2 44 per diem compensation shall be paid for attendant 2 45 services. The physician appointed by the court or 2 46 clerk to make the examination and report shall receive 2 47thereforthree dollars for each examination and report 2 48somade and the physician's actual necessary expenses 2 49 incurred in making such examination, but ifsaidthe 2 50 physician receives a salary or other compensation from 3 1 the public for the physician's full-time services, 3 2 then nosuchexamination fee shall be paid. The 3 3 actual, necessary expenses of transporting and caring 3 4 for the patient shall be paid ashereinafterprovided 3 5 in this chapter. 3 6 Sec. ___. Section 255.14, Code 1997, is amended to 3 7 read as follows: 3 8 255.14 EXPENSES HOW PAID. 3 9 An itemized, verified statement of all charges 3 10 provided for in sections 255.8 and 255.13, in cases 3 11 where the patient is admitted or accepted for 3 12 treatment atthe universitya hospital shall be filed 3 13 with thesuperintendentdirector or administrator of 3 14 theuniversityhospital, and upon thesuperintendent's3 15 director's or administrator's recommendation when 3 16 approved by the judge or clerk of the courtunder3 17whose order the same were incurredwho issued the 3 18 order for medical or surgical treatment or hospital 3 19 care,theyshall be charged on the regular bill for 3 20 the maintenance, transportation and treatment of the 3 21 patient, and be audited and paid in the manner as 3 22hereinafterprovided in this chapter. 3 23 Sec. ___. Section 255.15, Code 1997, is amended to 3 24 read as follows: 3 25 255.15 DUTY OF ADMITTING PHYSICIAN AT HOSPITAL. 3 26The authorities in control of the medical college3 27shall designate some physician to pass upon the3 28admission of the patient, and it shall be the3 29physician's duty to receive the patient into the3 30hospital and to provide for the patient, if available,3 31a cot, bed, or room in the hospital, and to assign the3 32patient to the appropriate clinic and for treatment by3 33the proper physician, unless, in the physician's3 34judgment, the presence of the patient in the hospital3 35would be dangerous to other patients, or there is no3 36reasonable probability that the patient may be3 37benefited by the proposed treatment or hospital care.3 38 Ifthean admitting physician denies admission to the 3 39 hospital to which the patient has been assigned by a 3 40 county for medical or surgical treatment or hospital 3 41 care in accordance with this chapter, or if a clinic 3 42 physician or surgeon declines to treat the patient, 3 43 the physician or surgeon shall make a report of the 3 44 reasons for the denial of admission or treatment. The 3 45 director or administrator shall submit the report to 3 46 the Iowa department of public health within ten days 3 47 of the denial. The hospital shall also preserve a 3 48 copy in the records of the hospital. 3 49 Sec. ___. Section 255.16, Code 1997, is amended to 3 50 read as follows: 4 1 255.16 COUNTY QUOTAS. 4 2 Subject to subsequent qualifications in this 4 3 section, there shall be treatedat the university4 4hospitalduring each fiscal year a number of committed 4 5 indigent patients from each county which bears the 4 6 same relation to the total number of committed 4 7 indigent patients admitted during the year as the 4 8 population of the county bears to the total population 4 9 of the state according to the last preceding official 4 10 census. This standard applies to indigent patients, 4 11 the expenses of whose commitment, transportation, 4 12 care, and treatment are borne by appropriated funds, 4 13 and does not govern the admission of obstetrical 4 14 patients under chapter 255A or obstetrical or 4 15 orthopedic patients under this chapter in accordance 4 16 with eligibility standards pursuant to section 255A.5. 4 17 If the number of patients admitted to the hospital 4 18 from any county in accordance with this chapter 4 19 exceeds by more than ten percent the county quota as 4 20 fixed under the first sentence of this section, the 4 21 charges and expenses of the care and treatment of the 4 22 patients in excess of ten percent of the quota shall 4 23 be paid from the funds of the county at actual cost; 4 24 but if the number of excess patients from any county 4 25 does not exceed ten percent, all costs, expenses, and 4 26 charges incurred in their behalf shall be paid from 4 27 the appropriation to the county for the support of the 4 28 county public hospital or merged area hospital that 4 29 serves the county. Notwithstanding the quota 4 30 established for a county under this section, the 4 31 governor, upon a finding of necessity due to a 4 32 regional or statewide economic emergency, may increase 4 33 a county's quota of the number of committed indigent 4 34 patients admitted tothe universitya hospital as 4 35 provided in this chapter. 4 36 Sec. ___. Section 255.19, Code 1997, is amended to 4 37 read as follows: 4 38 255.19 TREATMENT OF OTHER PATIENTS USE OF 4 39 EARNINGS FOR NEW FACILITIES. 4 40The university hospitalHospital authorities may at 4 41 their discretion receive into the hospital for 4 42 medical, obstetrical or surgical treatment or hospital 4 43 care, patients not committedtheretounder the 4 44 provisions of this chapter; but the treatment or care 4 45 of such patients shall not in any way interfere with 4 46 the proper medical or surgical treatment or hospital 4 47 care of committed patients.The university hospital4 48 Hospital ambulances and ambulance personnel may be 4 49 used for the transportation ofsuchthe patients at a 4 50 reasonable charge if specialized equipment is required 5 1 and is not otherwise available and if such use does 5 2 not interfere with the ambulance transportation of 5 3 patients committed to the hospital. 5 4 All of the provisions of this chapter except as to 5 5 commitment of patients shall apply to such patients. 5 6The university hospitalHospital authorities shall 5 7 collect from the person or persons liable for the 5 8 support ofsuchthe patients reasonable charges for 5 9 hospital care and service and deposit the same with 5 10 the treasurer of theuniversityhospital for the use 5 11 and benefit of theuniversityhospital except as 5 12 specified for obstetrical patients pursuant to section 5 13 255A.9.Earnings of the hospital whether from private5 14patients, cost patients, or indigents shall be5 15administered so as to increase as much as possible,5 16the service available for indigents, including the5 17acquisition, construction, reconstruction, completion,5 18equipment, improvement, repair, and remodeling of5 19medical buildings and facilities and additions thereto5 20and the payment of principal and interest on bonds5 21issued to finance the cost thereof as authorized by5 22the provisions of chapter 263A.The physicians and 5 23 surgeons on the hospital staff who care for patients 5 24 provided for in this section may charge the home 5 25 county of the patient for their medical servicesunder5 26such rules, regulations and plan therefor as approved5 27by the state board of regents. 5 28 Sec. ___. Section 255.21, Code 1997, is amended to 5 29 read as follows: 5 30 255.21 TREATMENT OUTSIDE HOSPITAL ATTENDANT. 5 31 If, in the judgment of the physician or surgeon to 5 32 whom the patient has been assigned for treatment, 5 33 continuous residence of the patient in the hospital is 5 34 unnecessary, such patient may, by the hospital 5 35 authorities, be sent to the patient's home or other 5 36 appropriate place, and be required to return to the 5 37 hospital when and for such length of time as may be 5 38 for the patient's benefit. The hospital authorities 5 39 may, if necessary, appoint an attendant to accompany 5 40 such patient and discharged patients, and the 5 41 compensation of such attendant shall be fixed by the 5 42state board of regentsIowa department of public 5 43 health and charged by the hospital as part of the 5 44 costs of transporting patients. The compensation paid 5 45 to and the expenses of the attendant shall be audited 5 46 and paid in the same manner as is provided by law for 5 47 the compensation of an attendant appointed by the 5 48 court. 5 49 Sec. ___. Section 255.24, Code 1997, is amended to 5 50 read as follows: 6 1 255.24 RECORD AND REPORT OF EXPENSES PURCHASES. 6 2 Thesuperintendentdirector or administrator of 6 3saidthe hospital shall keep a correct account of all 6 4 medicine, care, and maintenance furnished tosaid6 5 patients that receive treatment as provided under this 6 6 chapter, and shall make and file with the director of 6 7 revenue and finance an itemized, sworn statement of 6 8 all expensesthereofincurred insaidthe hospital as 6 9 provided in this chapter.But the superintendentThe 6 10 director or administrator shall render separate bills 6 11 showing the actual cost of all appliances, 6 12 instruments, X-ray and other special services used in 6 13 connection with such treatment, commitments, and 6 14 transportation to and from thesaid university6 15 hospital, including the expenses of attendants and 6 16 escorts. 6 17 All purchases of materials, appliances, instruments 6 18 and supplies by theuniversityhospital, in cases 6 19 where more than one hundred dollars is to be expended, 6 20 and where the prices of the commodity or commodities 6 21 to be purchased are subject to competition, shall be 6 22 upon open competitive quotations, and all contracts 6 23thereforshall be subject to the provisions of chapter 6 24 72. However, purchases may be made through a hospital 6 25 group purchasing organization provided thatuniversity6 26hospitalsthe hospital is a member of the organization 6 27 and the group purchasing organization selects the 6 28 items to be offered to members through a competitive 6 29 bidding process. 6 30 Sec. ___. Section 255.24A, Code 1997, is amended 6 31 to read as follows: 6 32 255.24A INDIGENT PATIENT PROGRAM REPORT. 6 33 Funds shall not be allocated tothe universitya 6 34 hospitalfunduntil thesuperintendentdirector or 6 35 administrator of theuniversity of Iowa hospitals and6 36clinics has filedhospital files with the Iowa 6 37 department ofrevenue and financepublic health and 6 38 the legislative fiscal bureau a quarterly report 6 39 containing the account required in section 255.24. 6 40 The report shall include information required in 6 41 section 255.24 for patients by the type of service 6 42 provided. 6 43 Sec. ___. Section 255.25, Code 1997, is amended to 6 44 read as follows: 6 45 255.25 AUDIT OF ACCOUNTS OF HOSPITAL. 6 46 To arrive at a proper basis for the payment ofsaid6 47 bills for treatment, care, and maintenance provided in 6 48 accordance with this chapter, thestate board of6 49regents shallIowa department of public health may 6 50 cause to be made annually an audit of the accounts of 7 1the universitya hospital that has submitted to the 7 2 department bills for treatment, care, and maintenance 7 3 provided in accordance with this chapter, and shall 7 4 determine the average cost per day for the care and 7 5 maintenance of each patienttherein, exclusive of the7 6salaries of the members of the faculty of said7 7university college of medicinethat receives 7 8 treatment, care, and maintenance under the provisions 7 9 of this chapter, andsaidthe bills shall be allowed 7 10 atsuchthe average cost as determined by the 7 11 department. All accounts shall be so adjusted and 7 12 paid as to reimburse thefunds of thehospitalused7 13 for the purposes of this chapter. 7 14 Sec. ___. Section 255.26, Code 1997, is amended to 7 15 read as follows: 7 16 255.26 EXPENSES HOW PAID ACTION TO REIMBURSE 7 17 COUNTY. 7 18 Warrants issued under section 255.25 shall be 7 19 promptly drawn on the treasurer of state and forwarded 7 20 by the director ofrevenue and financepublic health 7 21 to thetreasurer of the state university, and the same7 22shall be by the treasurer of the state university7 23placed to the credit of the funds which are set aside7 24for the support of saidhospital.However, warrants7 25shall not be paid unless the UB-82 claim required7 26pursuant to section 255A.13 has been filed with the7 27Iowa health data commission.Thesuperintendent7 28 director or administrator of thesaid university7 29 hospital shall certify to the auditor of state on the 7 30 first day of January, April, July, and October of each 7 31 year, the amount ashereinprovided in this section 7 32 not previously certified by thesuperintendent7 33 director or administrator of the hospital due the 7 34 state from the several counties having patients 7 35 chargeablethereto, and the auditor of state shall 7 36thereuponcharge the same to the county so owing. A 7 37 duplicate certificate shall also be mailed to the 7 38 auditor of each county having patients chargeable 7 39thereto. Expenses for obstetrical patients served 7 40 under section 255A.9 shall be reimbursed as specified 7 41 in section 255A.9. 7 42 The county auditor, upon receipt of the 7 43 certificate, shall enter it to the credit of the state 7 44 in the ledger of state accounts, and at once issue a 7 45 notice to the county treasurer authorizing the county 7 46 treasurer to transfer the amount to the general state 7 47 revenue, which notice shall be filed by the treasurer 7 48 as authority for making the transfer. The county 7 49 treasurer shall include the amount transferred in the 7 50 next remittance of state taxes to the treasurer of 8 1 state, to accrue to the credit of the university8 2hospital fund. 8 3 The state auditor shall certify the total cost of 8 4 commitment and caring for each indigent patient under 8 5 the terms of this statute to the county auditor of 8 6suchthe patient's legal residence, andsuchthe 8 7 certificate shall be preserved by the county auditor 8 8 and shall be a debt due from the patient or the 8 9 persons legally responsible for the patient's care, 8 10 maintenance, or support; and whenever in the judgment 8 11 of the board of supervisors the same or any part 8 12 thereof shall be collectible, thesaidboard may in 8 13 its own name collect the same and isherebyauthorized 8 14 to institute suits for such purpose; and after 8 15 deducting the county's share ofsuchthe cost shall 8 16 cause the balance to be paid into the state treasury 8 17to reimburse the university hospital fund. 8 18 Transportation shall be provided at no charge to a 8 19 patient who is certified for medical assistance under 8 20 chapter 249A, and shall be reimbursedfrom the8 21university hospital fundby the Iowa department of 8 22 public health. 8 23 Should any county fail to pay these bills within 8 24 sixty days from the date of certificate from the 8 25superintendentdirector or administrator of the 8 26 hospital, the director ofrevenue and financepublic 8 27 health shall charge the delinquent county the penalty 8 28 of one percent per month on and after sixty days from 8 29 date of certificate until paid. Such penalties shall 8 30 be credited to the general fund of the state. 8 31 Sec. ___. Section 255.28, Code 1997, is amended to 8 32 read as follows: 8 33 255.28 TRANSFER OF PATIENTS FROM STATE 8 34 INSTITUTIONS. 8 35 The director of the department of human services, 8 36 in respect to institutions under the director's 8 37 control, the administrator of any of the divisions of 8 38 the department, in respect to the institutions under 8 39 the administrator's control, the director of the Iowa 8 40 department of corrections, in respect to the 8 41 institutions under the department's control, and the 8 42 state board of regents in respect to the Iowa braille 8 43 and sight saving school and the Iowa school for the 8 44 deaf, may send any inmate, student, or patient of an 8 45 institution, or any person committed or applying for 8 46 admission to an institution, totheany hospitalof8 47the medical college of the state universitylocated 8 48 within the state which is willing and able, for 8 49 treatment and care as provided in this chapter, 8 50 without securing the order of court required in other 9 1 cases. The department of human services, the Iowa 9 2 department of corrections and the state board of 9 3 regents, shall respectively pay the traveling expenses 9 4 of a patient thus committed, and when necessary the 9 5 traveling expenses of an attendant for the patient, 9 6 out of funds appropriated for the use of the 9 7 institution from which the patient is sent. 9 8 Sec. ___. Section 255.29, Code 1997, is amended to 9 9 read as follows: 9 10 255.29 MEDICAL CARE FOR PAROLEES AND PERSONS ON 9 11 WORK RELEASE. 9 12 The director of the Iowa department of corrections 9 13 may send former inmates of the institutions provided 9 14 for in section 904.102, while on parole or work 9 15 release, to the nearest hospitalof the college of9 16medicine of the state University of Iowawilling and 9 17 able to provide appropriate service for treatment and 9 18 care as provided in this chapter, without securing the 9 19 order of the court required in other cases. The 9 20 director may pay the traveling expenses of any patient 9 21 thus committed, and when necessary the traveling 9 22 expenses of an attendant of the patient out of funds 9 23 appropriated for the use of the department. 9 24 Sec. ___. Section 255.30, Code 1997, is amended to 9 25 read as follows: 9 26 255.30 COLLECTING AND SETTLING CLAIMS FOR CARE. 9 27 Whenever a patient or person legally liable for the 9 28 patient's care at the hospital has insurance, an 9 29 estate, rights of action against others, or other 9 30 assets, any of which can be subjected thereto, the 9 31universityhospital, by its superintendent or the9 32superintendent's assistants through the facilities of9 33the attorney general's office, is herebyshall be 9 34 authorized to file claims, institute or defend suits 9 35 in courts, and use such other legal means as may be 9 36 available to collect accounts incurred for the care of 9 37 indigent or private patients, and may compromise,9 38settle and release the same, all under such rules and9 39procedures therefor as may be prescribed by the9 40president of the university and the attorney general. 9 41 If a county has paid any part ofsuchthe patient's 9 42 care, a pro rata part of the amount collected, after 9 43 deduction for cost of collection, shall be remitted to 9 44saidthe countyand the balance shall go into the9 45hospital fund. 9 46 Sec. ___. Section 255A.2, Code 1997, is amended to 9 47 read as follows: 9 48 255A.2 OBSTETRICAL AND NEWBORN INDIGENT PATIENT 9 49 CARE PROGRAM. 9 50 A statewide obstetrical and newborn indigent 10 1 patient care program is established for the purpose of 10 2 providing obstetrical and newborn care to medically 10 3 indigent residents of this state. Appropriations by 10 4 the general assembly for this chapter shall be 10 5 allocated for the obstetrical and newborn patient care 10 6 fund within the Iowa department of public health and 10 7 shall be utilized for the obstetrical and newborn 10 8 indigent patient care program as specified in this 10 9 chapter.Indigent patients in need of such care10 10residing in the counties of Cedar, Clinton, Iowa,10 11Johnson, Keokuk, Louisa, Muscatine, Scott, and10 12Washington shall be provided the care at the10 13university hospitals under the nonquota obstetrical10 14program under chapter 255.10 15 Sec. ___. Section 255A.4, unnumbered paragraph 2, 10 16 Code 1997, is amended to read as follows: 10 17 A woman who resides in a county which exceeds the 10 18 patient quota allocated for the county, and who has 10 19 been deemed eligible under section 255A.5, shall be 10 20 servedat the University of Iowa hospitals and clinics10 21 pursuant to section 255.16. 10 22 Sec. ___. Section 255A.8, Code 1997, is amended to 10 23 read as follows: 10 24 255A.8 REIMBURSABLE COSTS OF CARE. 10 25 The obstetrical and newborn care costs of a person 10 26 certified for such care under this chapter at a 10 27 licensed hospital or health care facility or from 10 28 licensed physicians shall be paid by the Iowa 10 29 department of public health from the obstetrical and 10 30 newborn patient care fund. However, a physician who 10 31 is in the employ of the university of Iowa hospitals 10 32 and clinics and who provides obstetrical or newborn 10 33 care at theUniversityuniversity of Iowa hospitals 10 34 and clinics to a person certified for care under this 10 35 chapter is not entitled to receive any compensation 10 36 for the provision of such carein accordance with10 37section 255.23."" 10 38 #2. Page 8, line 8, by striking the word 10 39 "repealed." and inserting the following: "repealed. 10 40 Sec. ___. Sections 255.17, 255.18, 255.23, 255.27, 10 41 and 255A.13, Code 1997, are repealed."" 10 42 #3. By renumbering as necessary. 10 43 10 44 10 45 10 46 LARSON of Linn 10 47 SF 549.210 77 10 48 kh/jj/28
Text: H01885 Text: H01887 Text: H01800 - H01899 Text: H Index Bills and Amendments: General Index Bill History: General Index
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