3.98.010 Indigent care policy.
(1) Reference. The following criteria for the provision of financial assistance for EMS transport will be consistent with the requirements of WAC 246-453-001 through 246-453-060.
(2) Policy.
(a) It is the policy of town of Cathlamet (hereinafter referred to as the “town”) that no person will be denied needed prehospital care services because of an inability to pay for such service. The town will provide needed prehospital services without discrimination to those persons with no or inadequate means to pay for needed care.
(b) The town will use the most recent Federal Poverty Guidelines to implement a process for debt forgiveness detailed in the financial assistance policy. The town council reserves the right to extend debt forgiveness to persons unable to complete the required application process. The town’s clerktreasurer will review this on an individual basis.
(c) Financial assistance applications are available upon request from the clerktreasurer’s office.
(3) Definitions.
(a) “Debt forgiveness” is the act of cancelling a debt owed to the town for services rendered, either partial or in full.
(b) “Financial assistance” shall refer to the act of providing medical assistance to persons without ability to pay for such services, either partial or in full payment, also known as “indigent care.”
(4) Responsibilities.
(a) The town’s EMS billing clerk or the town clerk-treasurer will ascertain whether those persons claiming to need financial assistance actually meet criteria according to the current Federal Poverty Guidelines. These guidelines are also used by hospitals to establish the need for economic assistance.
(b) It is the responsibility of the EMS battalion chief or his/her designee to review the documentation requesting debt forgiveness according to the financial assistance guidelines. The EMS battalion chief signs the approval document and transmits it to the clerk-treasurer for final processing. A copy of this request is kept on file for future reference.
(5) Guidelines.
(a) The following criteria will assist staff in making consistent and objective decisions regarding the eligibility for financial assistance while ensuring the maintenance of a sound financial base:
(i) Service Categories. Emergency medical services will be provided for persons needing financial assistance.
(ii) Eligibility Criteria. Debt forgiveness is secondary to all other financial resources available to the patient including insurance, government programs, third-party liability, and liquid assets.
(iii) Full debt forgiveness will be provided to a patient with a gross family income at or below 100 percent of current Federal Poverty Income Guidelines.
(iv) A partial debt forgiveness schedule will be used to determine financial assistance according to current published Federal Poverty Income Guidelines.
(v) Debt forgiveness may be provided to a responsible party with gross family annual income greater than 200 percent of the Federal Poverty Guidelines if circumstances such as extraordinary nondiscretionary expenses, future earning capacity, and the ability to make payments over an extended period of time warrant consideration.
(vi) Reasonable payment arrangements, consistent with the eligible responsible party’s ability to make payments, will be extended for amounts not eligible for debt forgiveness. Up to four monthly payments without interest may be arranged. The town reserves the right to revoke any debt forgiveness and assign all unpaid balances to collections if an extended payment agreement is in default.
(b) Eligibility Determination. Requests for consideration may be proposed by sources such as physician, community or religious groups, social services, hospital personnel, the patient, guarantor, or family member. The town will use an application process for determining initial interest in and qualification for financial assistance. The town’s decision to provide debt forgiveness in no way affects the responsible party’s financial obligations to physicians or other healthcare providers.
(i) The town will base its decision as to eligibility upon the data provided by the third-party billing company and/or the applicant or applicant’s representative.
(ii) Applications for debt forgiveness are available through the clerk-treasurer’s office.
(iii) Criteria for meeting debt forgiveness eligibility are verified through utilization of the current Federal Poverty Guidelines, which are also utilized by most healthcare institutions. The town utilizes documentation provided by the patient or patient’s authorized representative to verify the need for charity. Such documentation may include tax returns, payroll check stubs, letters of verification of absence of income from responsible parties, etc.
(iv) A letter of denial is to be sent by the town to those persons not meeting financial assistance policy requirements.
(v) Appeals. The responsible party may appeal the determination of eligibility for debt forgiveness by providing additional information or verification of income or family size to the town clerk-treasurer.
(vi) The town realizes that certain persons may have no financial means to pay for their transport services and also lack the social network/family necessary to help them complete required paperwork to apply for financial assistance. It is with this limited population in mind that the town realizes there may be individual cases in which there will be no application process completed.
(6) Additional References.
(7) Appendix. N/A. (Res. 383 § 3, 2020)