Hospitals generally are not allowed to turn away any person who needs emergency medical care. For hospitals located in areas of high poverty and homelessness, this can create a burden with large amounts of unreimbursed medical care expenses. Funding for the care of patients who cannot afford to pay for their healthcare is available, coming from a variety of sources, and is awarded to hospitals that document a track record of uncompensated medical care they have provided to indigent patients.
Indigent Care Trust
An indigent person is considered someone who lacks enough food, proper clothing and other life necessities, such as adequate healthcare, due to poverty. The Indigent Care Trust fund (ICTF) was established by Georgia's Department of Community Health in 1990 to bring Medicaid and other services to a broader base of indigent recipients, as well as to provide additional support to hospitals and other healthcare providers serving medically indigent patients.
The ICTF receives financial assistance from state funds, voluntary funds transferred from some public hospitals, fees from nursing home providers, revenues from breast cancer tags, license fees for ambulance licensing and Certificate of Need penalties. Georgia laws require ICTF contributions to be matched with funds from the federal government, charitable organizations or other public sources.
Each state has its own indigent care fund similar to the ICTF, and qualifications may vary between states. As an example, the Texas Department of State Health Services requires recipients of indigent care funds to live in the same county in which they applied for benefits, and the person must remain in the same county. The person must also not be eligible for Medicaid. The total resources a person has in his household may not exceed $2,000 in value, or $3,000 if the person has a legal responsibility to provide support for an elder who lives in the home. Additionally, a person’s net income per month must be less than 21 percent of the federal poverty guideline. Federal poverty guidelines start at $11,670 of income annually for one person, increasing approximately $4,000 for each additional member of the family or household.
To qualify for support funds from the ICTF, hospitals must provide Medicaid recipients with obstetrical services in non-emergency situations. They must also have a utilization rate for Medicaid inpatients of at least 1 percent. A formula is used based on the hospital's estimates of uncompensated Medicaid costs and uninsured care provided. The state’s division of financial management uses this information to determine how much funding each hospital can receive and distributes funds each year to eligible hospitals.