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Understanding County Medical Relief: Eligibility and Resources for the Medically Poor

This presentation outlines the qualifying circumstances for county medical relief, focusing on Medicaid's role and the gaps in Social Security Disability. It highlights how decreased income leads to increased health problems and explores eligibility criteria including residency, income, and household factors. Additionally, the presentation discusses the resources available to counties, such as federal risk pools, prescription assistance programs, and community health clinics. Understanding these factors can greatly aid those in need of medical relief.

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Understanding County Medical Relief: Eligibility and Resources for the Medically Poor

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Presentation Transcript

  1. Medicaid Task Force Presentation April 24, 2013 County Medical Relief

  2. Qualifying Circumstances for County Medical Poor Relief • Social Security Disability- insurance gap • Increased health problems with decreased income • Illness or injury • Pre-existing condition/ uninsurable • Health insurance unaffordable

  3. ELIGIBILITY CHECKLIST Hospital Notice SDCL 28-13-34.1 Application for Poor Relief SDCL 28-13-32.3 & 32.4 Residency Requirement SDCL 28-13-3 & 28-14-2.1 Post- Secondary Student SDCL 28-13-27(6)(b) Veteran or Indian Health Services SDCL 28-13-1.3(5) Emergency vs. non-emergency admissions SDCL 28-13-33 Ability to purchase Health Insurance SDCL 28-13-27(c)(d) Hospital must exhaust all avenues of payment SDCL 28-13-33.2

  4. Household resources (SDCL 28-12-32.8)

  5. Household Income (SDCL 28-13-32.7)

  6. Determining person’s ability to pay (SDCL 28-13-32.9) • Household Factors • contributions • expenses • discretionary income

  7. Ability to purchase health insurance (SDCL 28-13-32.11)

  8. Cost saving Resources to Counties • Federal Risk Pool • South Dakota Risk Pool • COBRA Premiums • Community Health Clinics (CHC) • Prescription Assistance Programs • Veteran Health • Indian Health Services • Medicaid Programs

  9. Statewide County Medical Expenses

  10. Counties not reported Douglas, Faulk, Yankton 2011 Yankton 2012Charles Mix, Douglas, Mellette, Yankton

  11. Payments or reimbursement to counties Note: includes payments for non-medical items

  12. Sarah Petersen Codington County Welfare Director President SDACWO 605-882-6286 e-mail codwelfare@codington.org

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