Medicaid Task ForcePresentation

April 24, 2013

County Medical Relief

• Social Security Disability- insurance gap

• Increased health problems with decreased income

• Illness or injury

• Pre-existing condition/ uninsurable

• Health insurance unaffordable

Qualifying Circumstances for County Medical Poor Relief

Hospital Notice SDCL 28-13-34.1

Application for Poor ReliefSDCL 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 paymentSDCL 28-13-33.2

ELIGIBILITY CHECKLIST

Household resources

(SDCL 28-12-32.8)

Household Income

(SDCL 28-13-32.7)

Determining person’s ability to pay (SDCL 28-13-32.9)

Household Factors

• contributions • expenses• discretionary income

Ability to purchase health insurance

(SDCL 28-13-32.11)

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

Statewide County Medical Expenses

Counties not reported

2010 Douglas, Faulk, Yankton

2011 Yankton

2012 Charles Mix, Douglas, Mellette, Yankton

County Medical Indigent Expense

2010 $3,142,646.00

2011 $3,153,617.69

2012 $2,543,429.05

County Jail Medical Expense

2010 $2,470,838.05

2011 $2,488,687.29

2012 $2,786,048.93

Involuntary Alcohol and Mental Health

2010 $1,861,917.61

2011 $1,966,633.91

2012 $2,543,429.05

Payments or reimbursement to countiesNote: includes payments for non-medical items

Client Payments

Third Party Reimbursement Total

2010 $830,475.49 $213,084.47 $1,043,559.962011 $1,117,148.13 $280,384.28 $1,397,532.412012 $920,516.56 $208,702.53 $1,129,219.09

Catastrophic Medical Pool

Reimbursements County Contributions$313,006.46 $327,568.00$418,895.95 $306,371.00$171,407.06 $395,459.00

2010 Medical Expenses Health InsuranceCounty Total County Total County Health Insurance

Total $3,142,646.00 Total $106,134.08MINNEHAHA $1,020,529.00 BON HOMME $13,011.42 MINNEHAHA $65,754.00BROWN $437,165.77 LAKE $10,994.52 PENNINGTON $19,346.07PENNINGTON $223,718.82 LAWRENCE $9,159.02 BROWN $12,123.25DAVISON $219,959.32 MC PHERSON $8,628.40 GRANT $3,579.75LINCOLN $209,317.93 CLAY $7,980.31 DAVISON $3,265.09BROOKINGS $102,477.50 CLARK $7,422.33 CODINGTON $1,094.68MOODY $92,314.09 STANLEY $7,398.31 BEADLE $708.26DAY $85,025.56 HYDE $7,000.00 MC COOK $262.98HUTCHINSON $66,736.74 CHARLES MIX $6,313.67BEADLE $62,738.93 ROBERTS $4,573.60MC COOK $52,607.68 UNION $4,500.00TRIPP $47,450.07 AURORA $3,368.88HUGHES $42,952.15 HANSON $2,452.48TURNER $35,392.86 DEWEY $1,517.00SPINK $33,426.32 FALL RIVER $1,425.43KINGSBURY $32,684.07 HAND $1,366.36POTTER $32,244.54 BUTTE $1,245.21CODINGTON $29,405.48 CUSTER $817.03MARSHALL $27,731.92 JONES $600.00DEUEL $26,838.24 MEADE $270.91MINER $26,319.51JERAULD $25,999.30SANBORN $25,692.71GRANT $19,653.63EDMUNDS $19,375.78BRULE $15,987.64GREGORY $15,436.62SULLY $13,418.94

2011 Medical Expenses Health Insurance

County Total County Total County Total

Total $3,153,617.69 GREGORY $11,236.26 Total $152,516.21MINNEHAHA $781,276.00 LAWRENCE $10,738.92 MINNEHAHA $83,708.00BROWN $427,095.45 DEUEL $8,273.56 PENNINGTON $22,797.51DAVISON $356,024.45 FALL RIVER $5,159.09 BROWN $14,008.47MARSHALL $251,802.30 STANLEY $5,000.00 CODINGTON $8,072.41PENNINGTON $215,086.66 AURORA $2,287.16 MC COOK $7,423.84LINCOLN $128,373.55 LAKE $2,250.87 GRANT $7,284.65MOODY $105,318.06 TRIPP $2,049.00 LINCOLN $3,374.45BROOKINGS $99,034.97 WALWORTH $1,419.00 DEUEL $3,349.05BEADLE $85,546.55 ROBERTS $639.96 DAVISON $2,153.70POTTER $71,841.96 TODD $608.00 SPINK $344.13KINGSBURY $58,229.97 SULLY $471.33HUTCHINSON $55,406.17 BUTTE $384.73CHARLES MIX $49,608.21 UNION $62.50MINER $43,662.72 EDMUNDS $13.00CLARK $37,563.91MC COOK $33,566.51BRULE $33,242.43HUGHES $33,197.64SPINK $28,889.81DAY $27,384.41HANSON $26,037.27JERAULD $26,010.38CLAY $23,429.11CODINGTON $20,692.69TURNER $19,584.17MEADE $18,516.06MC PHERSON $17,725.19GRANT $17,594.70LYMAN $11,283.01

2012 Medical Expenses Health InsuranceCounty Total County

Total $2,543,429.05 Total $130,483.31MINNEHAHA $576,683.00 MINNEHAHA $63,114.00BROWN $460,016.82 PENNINGTON $21,964.77PENNINGTON $264,336.33 CODINGTON $10,865.91DAVISON $194,714.58 MC COOK $8,004.00BEADLE $137,512.79 LAKE $7,720.41BROOKINGS $123,028.38 BROWN $6,338.94EDMUNDS $77,369.22 DAVISON $3,906.00LINCOLN $64,560.97 LAWRENCE $2,667.00HUGHES $56,126.86 GRANT $1,841.40KINGSBURY $43,701.97 DEUEL $1,206.83GRANT $41,545.26 BEADLE $1,076.06CLARK $37,730.92 LINCOLN $901.02SPINK $34,907.40 SANBORN $567.89TURNER $33,814.00 SPINK $309.08LAKE $29,221.19HUTCHINSON $29,210.86HAAKON $28,956.94MINER $27,981.38MC COOK $26,516.69ROBERTS $25,940.27MC PHERSON $20,895.50GREGORY $20,312.60JERAULD $20,291.90DEUEL $17,460.54HAMLIN $17,302.00HANSON $15,039.79CODINGTON $14,131.83HARDING $13,122.23UNION $10,914.94WALWORTH $8,532.00

Sarah PetersenCodington County Welfare Director

President SDACWO

605-882-6286 e-mail

codwelfare@codington.org