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PAG LIN 1 1 Section 1. Section 255.3, Code 1997, is amended to read as 1 2 follows: 1 3 255.3"PATIENT" DEFINEDDEFINITIONS. 1 4The word "patient" as used in this chapter1 5 1. "Health care facility" or "hospital" means a health 1 6 care facility or hospital under contract with the state 1 7 university of Iowa to provide treatment or care under this 1 8 chapter. 1 9 2. "Patient" means the person against whom the complaint 1 10 is filed. 1 11 Sec. 2. Section 255.8, Code 1997, is amended to read as 1 12 follows: 1 13 255.8 HEARING ORDER EMERGENCY CASES CANCELLATION 1 14 OF COMMITMENTS. 1 15 The county attorney and the general assistance director, or 1 16 other agent of the board of supervisors of the county, shall 1 17 appear at the hearing. The complainant, the county attorney, 1 18 the general assistance director or other agent of the board of 1 19 supervisors, and the patient, or any person representing the 1 20 patient, may introduce evidence and be heard. If the court 1 21 finds that the patient is a legal resident of Iowa and is 1 22 pregnant or is suffering from a malady or deformity which can 1 23 probably be improved or cured or advantageously treated by 1 24 medical or surgical treatment or hospital care, and that 1 25 neither the patient nor any person legally chargeable with the 1 26 patient's support is able to pay the expenses, then the clerk 1 27 of court, except in obstetrical cases and orthopedic cases,1 28 shall immediatelyascertain from the admitting physician at1 29the university hospital whether the person can be received as1 30a patient within a period of thirty days, and if the patient1 31can be received, the court, or in the event of no actual1 32contest, the clerk of the court, shall enter an order1 33directing that the patient be sent to the university hospital1 34for proper medical and surgical treatment and hospital care.1 35If the court ascertain, except in obstetrical cases and2 1orthopedic cases, that a person of the age or sex of the2 2patient, or afflicted by the complaint, disease, or deformity2 3with which the person is afflicted, cannot be received as a2 4patient at the university hospital within the period of thirty2 5days, then the court or the clerk shallenter an order 2 6 directing the board of supervisors of the county to provide 2 7 adequate treatment at county expense for the patient at home 2 8 or inathe nearest hospital capable of providing appropriate 2 9 treatment.Obstetrical cases and orthopedic cases may be2 10committed to the university hospital without regard to the2 11limiting period of thirty days.2 12 In any case of emergency the court or the clerk without 2 13 previous inquiry may at its discretion order the patient to be 2 14 immediately taken to and accepted by theuniversity hospital2 15 nearest hospital capable of providing appropriate treatment 2 16 for the necessary care as provided in section 255.11, but if2 17such a patient cannot be immediately accepted at the2 18university hospital as ascertained by telephone if necessary,2 19the court or the clerk may enter an order as in certain cases2 20above set forth directing the board of supervisors to provide2 21adequate treatment at county expense for the said patient at2 22home or in a hospital. 2 23 Sec. 3. Section 255.13, Code 1997, is amended to read as 2 24 follows: 2 25 255.13 ATTENDANT PHYSICIAN COMPENSATION. 2 26 If the physician appointed to examine the patientshall2 27certifycertifies that an attendant to accompany the patient 2 28 to thesaidhospital is necessary, andthe universitya 2 29 hospital attendant and ambulance service is not available, 2 30thenthe court or judge or clerk of the court may appoint an 2 31 attendant who shall receive notexceedingmore than two 2 32 dollars per day for the timethusnecessarily employed and 2 33 actual necessary traveling expenses by the most feasible route 2 34 tosaidthe hospital whether by ambulance, train or 2 35 automobile; but ifsuchthe appointee is a relative of the 3 1 patient or a member of the patient's immediate family, or 3 2 receives a salary or other compensation from the public for 3 3 the appointee's services, nosuchper diem compensation shall 3 4 be paid for attendant services. The physician appointed by 3 5 the court or clerk to make the examination and report shall 3 6 receivethereforthree dollars for each examination and report 3 7somade and the physician's actual necessary expenses incurred 3 8 in making such examination, but ifsaidthe physician receives 3 9 a salary or other compensation from the public for the 3 10 physician's full-time services, then nosuchexamination fee 3 11 shall be paid. The actual, necessary expenses of transporting 3 12 and caring for the patient shall be paid ashereinafter3 13 provided in this chapter. 3 14 Sec. 4. Section 255.14, Code 1997, is amended to read as 3 15 follows: 3 16 255.14 EXPENSES HOW PAID. 3 17 An itemized, verified statement of all charges provided for 3 18 in sections 255.8 and 255.13, in cases where the patient is 3 19 admitted or accepted for treatment atthe universitya 3 20 hospital shall be filed with thesuperintendentdirector or 3 21 administrator of theuniversityhospital, and upon the 3 22superintendent'sdirector's or administrator's recommendation 3 23 when approved by the judge or clerk of the courtunder whose3 24order the same were incurredwho issued the order for medical 3 25 or surgical treatment or hospital care,theyshall be charged 3 26 on the regular bill for the maintenance, transportation, and 3 27 treatment of the patient, and be audited and paid in the 3 28 manner ashereinafterprovided in this chapter. 3 29 Sec. 5. Section 255.15, Code 1997, is amended to read as 3 30 follows: 3 31 255.15 DUTY OF ADMITTING PHYSICIAN AT HOSPITAL. 3 32The authorities in control of the medical college shall3 33designate some physician to pass upon the admission of the3 34patient, and it shall be the physician's duty to receive the3 35patient into the hospital and to provide for the patient, if4 1available, a cot, bed, or room in the hospital, and to assign4 2the patient to the appropriate clinic and for treatment by the4 3proper physician, unless, in the physician's judgment, the4 4presence of the patient in the hospital would be dangerous to4 5other patients, or there is no reasonable probability that the4 6patient may be benefited by the proposed treatment or hospital4 7care.Ifthean admitting physician denies admission to the 4 8 hospital to which the patient has been assigned by a county 4 9 for medical or surgical treatment or hospital care in 4 10 accordance with this chapter, or if a clinic physician or 4 11 surgeon declines to treat the patient, the physician or 4 12 surgeon shall make a report of the reasons for the denial of 4 13 admission or treatment. The director or administrator shall 4 14 submit the report to the state university of Iowa within ten 4 15 days of the denial. The hospital shall also preserve a copy 4 16 in the records of the hospital. 4 17 Sec. 6. Section 255.16, Code 1997, is amended to read as 4 18 follows: 4 19 255.16 COUNTY QUOTAS. 4 20 Subject to subsequent qualifications in this section, there 4 21 shall be treated at the university hospital, or at a hospital 4 22 under contract with the state university of Iowa in accordance 4 23 with this chapter, during each fiscal year a number of 4 24 committed indigent patients from each county which bears the 4 25 same relation to the total number of committed indigent 4 26 patients admitted during the year as the population of the 4 27 county bears to the total population of the state according to 4 28 the last preceding official census. This standard applies to 4 29 indigent patients, the expenses of whose commitment, 4 30 transportation, care, and treatment are borne by appropriated 4 31 funds, and does not govern the admission of obstetrical 4 32 patients under chapter 255A or obstetrical or orthopedic 4 33 patients under this chapter in accordance with eligibility 4 34 standards pursuant to section 255A.5. If the number of 4 35 patients admitted to hospitals from any county in accordance 5 1 with this chapter exceeds by more than ten percent the county 5 2 quota as fixed under the first sentence of this section, the 5 3 charges and expenses of the care and treatment of the patients 5 4 in excess of ten percent of the quota shall be paid from the 5 5 funds of the county at actual cost; but if the number of 5 6 excess patients from any county does not exceed ten percent, 5 7 all costs, expenses, and charges incurred in their behalf 5 8 shall be paid from the state appropriation for the support of 5 9 thehospitaluniversity hospitals. Notwithstanding the quota 5 10 established for a county under this section, the governor, 5 11 upon a finding of necessity due to a regional or statewide 5 12 economic emergency, may increase a county's quota of the 5 13 number of committed indigent patients admitted tothe5 14universitya hospital as provided in this chapter. 5 15 Sec. 7. Section 255.17, Code 1997, is amended to read as 5 16 follows: 5 17 255.17 REPORT OF PHYSICIANIN CHARGE OF CLINIC. 5 18 If the physician or surgeonin charge of the clinic, orto 5 19 whom the patient has been assigned for treatment,under this 5 20 chapter declines to treat the patient, the physician or 5 21 surgeon shall make a report of the physician's or surgeon's 5 22 examination of the patient, and state in the report to the 5 23 state university of Iowa the reasons for declining the 5 24 treatment. 5 25 Sec. 8. Section 255.19, Code 1997, is amended to read as 5 26 follows: 5 27 255.19 TREATMENT OF OTHER PATIENTS USE OF EARNINGS FOR 5 28 NEW FACILITIES. 5 29The university hospitalHospital authorities may at their 5 30 discretion receive into the hospital for medical, obstetrical 5 31 or surgical treatment or hospital care, patients not committed 5 32theretounder the provisions of this chapter; but the 5 33 treatment or care of such patients shall not in any way 5 34 interfere with the proper medical or surgical treatment or 5 35 hospital care of committed patients.The university hospital6 1 Hospital ambulances and ambulance personnel may be used for 6 2 the transportation ofsuchthe patients at a reasonable charge 6 3 if specialized equipment is required and is not otherwise 6 4 available and if such use does not interfere with the 6 5 ambulance transportation of patients committed to the 6 6 hospital. 6 7 All of the provisions of this chapter except as to 6 8 commitment of patients shall apply to such patients.The6 9university hospitalHospital authorities shall collect from 6 10 the person or persons liable for the support ofsuch patients6 11 a patient's reasonable charges for hospital care and service 6 12 and deposit the same with the treasurer of theuniversity6 13 hospital for the use and benefit of theuniversityhospital 6 14 except as specified for obstetrical patients pursuant to 6 15 section 255A.9.Earnings of the hospital whether from private6 16patients, cost patients, or indigents shall be administered so6 17as to increase as much as possible, the service available for6 18indigents, including the acquisition, construction,6 19reconstruction, completion, equipment, improvement, repair,6 20and remodeling of medical buildings and facilities and6 21additions thereto and the payment of principal and interest on6 22bonds issued to finance the cost thereof as authorized by the6 23provisions of chapter 263A.The physicians and surgeons on 6 24 the hospital staff who care for patients provided for in this 6 25 section may charge for their medical servicesunder such6 26rules, regulations and plan therefor as approved by the state6 27board of regents. 6 28 Sec. 9. Section 255.23, Code 1997, is amended to read as 6 29 follows: 6 30 255.23 TREATMENT GRATUITOUS EXCEPTION. 6 31NoA physician, surgeon, or nurse employed by the state 6 32 board of regents who shall treat or care forsucha patient 6 33 under this chapter shall not charge or receive any 6 34 compensationthereforfor the treatment or care provided 6 35 except the salary or compensation fixed by the state board of 7 1 regents to be paid from the hospital funds. If the physician, 7 2 surgeon, or nurse is not in the regular employ of the state 7 3 board of regents, the compensation shall be paid by the county 7 4 upon approval of the board of supervisors. 7 5 Sec. 10. Section 255.24, Code 1997, is amended to read as 7 6 follows: 7 7 255.24 RECORD AND REPORT OF EXPENSES PURCHASES. 7 8 Thesuperintendentdirector or administrator ofsaidthe 7 9 hospital shall keep a correct account of all medicine, care, 7 10 and maintenance furnished tosaidpatients who receive 7 11 treatment as provided under this chapter, and shall make and 7 12 file with the director of revenue and finance an itemized, 7 13 sworn statement of all expensesthereofincurred insaidthe 7 14 hospital as provided in this chapter.But the superintendent7 15 The director or administrator shall render separate bills 7 16 showing the actual cost of all appliances, instruments, X-ray, 7 17 and other special services used in connection with such 7 18 treatment, commitments, and transportation to and from the 7 19said universityhospital, including the expenses of attendants 7 20 and escorts. 7 21 All purchases of materials, appliances, instruments, and 7 22 supplies by theuniversityhospital, in cases where more than 7 23 one hundred dollars is to be expended, and where the prices of 7 24 the commodity or commodities to be purchased are subject to 7 25 competition, shall be upon open competitive quotations, and 7 26 all contractsthereforshall be subject to the provisions of 7 27 chapter 72. However, purchases may be made through a hospital 7 28 group purchasing organization provided thatuniversity7 29hospitalsthe hospital is a member of the organization and the 7 30 group purchasing organization selects the items to be offered 7 31 to members through a competitive bidding process. 7 32 Sec. 11. Section 255.28, Code 1997, is amended to read as 7 33 follows: 7 34 255.28 TRANSFER OF PATIENTS FROM STATE INSTITUTIONS. 7 35 The directorof the departmentof human services, in 8 1 respect to institutions under the director's control, the 8 2 administrator of any of the divisions of the department, in 8 3 respect to the institutions under the administrator's control, 8 4 the director of the Iowa department of corrections, in respect 8 5 to the institutions under the department's control, and the 8 6 state board of regentsinwith respect to the Iowa braille and 8 7 sight saving school and the Iowa school for the deaf, may send 8 8 any inmate, student, or patient of an institution, or any 8 9 person committed or applying for admission to an institution, 8 10 to the nearest hospitalof the medical college of the state8 11universityfor treatment and care as provided in this chapter, 8 12 without securing the order of court required in other cases. 8 13 The department of human services, the Iowa department of 8 14 corrections, and the state board of regents,shall 8 15 respectively pay the traveling expenses of a patient thus 8 16 committed, and when necessary the traveling expenses of an 8 17 attendant for the patient, out of funds appropriated for the 8 18 use of the institution from which the patient is sent. 8 19 Sec. 12. Section 255.29, Code 1997, is amended to read as 8 20 follows: 8 21 255.29 MEDICAL CARE FOR PAROLEES AND PERSONS ON WORK 8 22 RELEASE. 8 23 The director of the Iowa department of corrections may send 8 24 former inmates of the institutions provided for in section 8 25 904.102, while on parole or work release, to the nearest 8 26 hospitalof the college of medicine of the state University of8 27Iowafor treatment and care as provided in this chapter, 8 28 without securing the order of the court required in other 8 29 cases. The director may pay the traveling expenses of any 8 30 patient thus committed, and when necessary the traveling 8 31 expenses of an attendant of the patient out of funds 8 32 appropriated for the use of the department. 8 33 Sec. 13. NEW SECTION. 255.31 CONTRACTS FOR NEAREST 8 34 HOSPITAL TREATMENT AND CARE. 8 35 The state university of Iowa, in consultation with the 9 1 department of inspections and appeals and the department of 9 2 public health, shall contract with hospitals and health care 9 3 facilities licensed under chapter 135B or 135C to provide the 9 4 nearest safe and adequate treatment possible for patients 9 5 served under this chapter. All providers of services under 9 6 this chapter shall agree to accept as full payment the 9 7 reimbursements allowable under the medical assistance program 9 8 established pursuant to chapter 249A, adjusted for intensity 9 9 of care. 9 10 Sec. 14. Section 255A.2, Code 1997, is amended to read as 9 11 follows: 9 12 255A.2 OBSTETRICAL AND NEWBORN INDIGENT PATIENT CARE 9 13 PROGRAM. 9 14 A statewide obstetrical and newborn indigent patient care 9 15 program is established for the purpose of providing 9 16 obstetrical and newborn care to medically indigent residents 9 17 of this state. Appropriations by the general assembly for 9 18 this chapter shall be allocated for the obstetrical and 9 19 newborn patient care fund within the Iowa department of public 9 20 health and shall be utilized for the obstetrical and newborn 9 21 indigent patient care program as specified in this chapter. 9 22Indigent patients in need of such care residing in the9 23counties of Cedar, Clinton, Iowa, Johnson, Keokuk, Louisa,9 24Muscatine, Scott, and Washington shall be provided the care at9 25the university hospitals under the nonquota obstetrical9 26program under chapter 255.9 27 Sec. 15. Section 255A.4, unnumbered paragraph 2, Code 9 28 1997, is amended to read as follows: 9 29 A woman who resides in a county which exceeds the patient 9 30 quota allocated for the county, and who has been deemed 9 31 eligible under section 255A.5, shall be servedat the9 32University of Iowa hospitals and clinicspursuant to section 9 33 255.16. 9 34 Sec. 16. Section 255A.8, Code 1997, is amended to read as 9 35 follows: 10 1 255A.8 REIMBURSABLE COSTS OF CARE. 10 2 The obstetrical and newborn care costs of a person 10 3 certified for such care under this chapter at a licensed 10 4 hospital or health care facility or from licensed physicians 10 5 shall be paid by the Iowa department of public health from the 10 6 obstetrical and newborn patient care fund. However, a 10 7 physician who is in the employ of the university of Iowa 10 8 hospitals and clinics and who provides obstetrical or newborn 10 9 care at theUniversityuniversity of Iowa hospitals and 10 10 clinics to a person certified for care under this chapter is 10 11 not entitled to receive any compensation for the provision of 10 12 such carein accordance with section 255.23. 10 13 EXPLANATION 10 14 This bill requires the state university of Iowa, in 10 15 consultation with the department of inspections and appeals 10 16 and the department of public health, to contract with licensed 10 17 hospitals and health care facilities to provide the nearest 10 18 safe and adequate treatment possible for patients served under 10 19 this Code chapter 255. All providers of services under this 10 20 Code chapter must agree to accept as full payment the 10 21 reimbursements allowable under the medical assistance program 10 22 established pursuant to Code chapter 249A, adjusted for 10 23 intensity of care. 10 24 LSB 3766HH 77 10 25 kh/jl/8
Text: HF02325 Text: HF02327 Text: HF02300 - HF02399 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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