Chapter 7.56
MEDICAL CARE FOR COUNTY INDIGENTS

Sections:

7.56.010    Purpose of provisions.

7.56.020    Definitions.

7.56.030    Regulations and procedures adopted.

7.56.040    Medical indigent eligibility standards.

7.56.050    Medical care—Special need and/or unusual financial hardship cases.

7.56.010 Purpose of provisions.

(A)    The Board of Supervisors finds that State and Federal medical programs are providing necessary elective medical care to qualified needy persons who were formerly the County’s sole responsibility. The Board intends to provide by this chapter for:

(1)    Necessary medical care to those needy persons in the County who for one reason or another are not eligible for the State Medi-Cal Program or the Federal Medicare Program; and

(2)    Compensation to medical providers under contract with the County for providing medical services to such County indigents and other County responsibility patients which were provided by the County prior to the close of the Santa Cruz General Hospital.

(B)    It is not the intent of this chapter to transfer from the County to any hospital under contract with the County, or to transfer from such hospital to the County, any costs for hospital services borne by the County or such hospital prior to the close of the Santa Cruz County General Hospital. [Ord. 2001, 1974; prior code § 5.50.010].

7.56.020 Definitions.

For the purposes of this chapter:

(A)    “County” means the County of Santa Cruz.

(B)    “County medical indigent” means those persons eligible under the provisions of this chapter to receive medical care at the expense of the County, subject to the reimbursement provisions of State law (Sections 17000 et seq. of the Welfare and Institutions Code).

(C)    “Emergency medical care” means those services required for alleviation of severe pain; or immediate diagnosis and treatment of unforeseen medical conditions which, if not immediately diagnosed and treated, would lead to disability or death.

(D)    “Medical care” means and includes both inpatient and outpatient hospital care and physician services provided by County facilities and personnel and/or by contract agencies and medical personnel, and ambulance or other transportation services, crutches and canes, artificial limbs, and other prostheses. [Ord. 2001, 1974; prior code § 5.50.020].

7.56.030 Regulations and procedures adopted.

In order to carry out the intent and purposes of this chapter, and in order to provide for implementation of the agreements heretofore entered into by County and medical providers for the provision of medical services, the Director of the County Health Services Agency and the County Social Welfare Director are authorized jointly to develop, after consultation with the medical providers under contract with the County, such regulations as are necessary to give effect to the terms of this chapter and said agreements. The substance of such regulations shall be in accordance with the terms of this chapter, and with any State and Federal laws and regulations pertaining to the provision of medical care to County indigents and the recovery of the cost of such care. Such regulations shall become effective upon filing with the Board of Supervisors. [Ord. 2001, 1974; prior code § 5.50.030].

7.56.040 Medical indigent eligibility standards.

The Director of the County Health Services Agency or his authorized representatives shall make all certifications of the eligibility of persons to receive medical care as a County medical indigent, in accordance with the following standards:

(A)    The financial standards for eligibility to receive medical care as a County medical indigent shall be the same as those standards in use at the time of service to determine eligibility for the Federal/State Medicaid Program (known as Medi-Cal in California) or its successor, except as such standards are modified by regulations approved by the Board of Supervisors.

(B)    The County shall have no financial responsibility for medical care provided to persons certified as eligible for Medicare or Medi-Cal, including Medi-Cal “spend-down” patients. (“Spend-down” patients are those persons certified as eligible for Medi-Cal coverage after payment of a specified monthly liability based upon excess income or assets.)

(C)    Prior certification as a County medical indigent for specified medical care shall entitle the person to receive such medical care at the expense of the County subject to the reimbursement provisions in State law for recovery of the cost of the medical care in appropriate cases from the County medical indigent, his estate, his spouse, his parents, and his adult children. Retroactive certification as a County medical indigent shall be made by the County Health Services Agency in otherwise appropriate cases whenever sufficient information for such determination cannot be obtained prior to the provision of emergency medical care. [Ord. 3812 § 1, 1987; Ord. 3263 § 1, 1982; Ord. 2001, 1974; prior code § 5.50.040].

7.56.050 Medical care—Special need and/or unusual financial hardship cases.

Notwithstanding any other terms of this chapter, in cases of special medical need and/or unusual financial hardship, the County Health Services Agency is authorized to approve the provision of medical care when such medical care for a person, whether resident or nonresident, appears necessary to avert a future medical condition for which the County would be required to provide emergency medical care. A record of cases processed under this section shall be retained by the County Health Services Agency. [Ord. 2001, 1974; prior code § 5.50.050].