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 Application for Poor Relief SDCL & 32.4 Residency Requirement SDCL & Post- Secondary Student SDCL (6)(b) Veteran or Indian Health Services SDCL (5) Emergency vs. non-emergency admissions SDCL Ability to purchase Health Insurance SDCL (c)(d) Hospital must exhaust all avenues of payment SDCL ELIGIBILITY CHECKLIST

Household resources (SDCL )

Household Income (SDCL )

Determining person’s ability to pay (SDCL ) Household Factors contributions expenses discretionary income

Ability to purchase health insurance (SDCL )

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, $3,153, $2,543,429.05

County Jail Medical Expense 2010$2,470, $2,488, $2,786,048.93

Involuntary Alcohol and Mental Health 2010$1,861, $1,966, $2,543,429.05

Payments or reimbursement to counties Note: includes payments for non-medical items Client Payments Third Party Reimbursement Total 2010$830,475.49$213,084.47$1,043, $1,117,148.13$280,384.28$1,397, $920,516.56$208,702.53$1,129, Catastrophic Medical Pool ReimbursementsCounty Contributions $313,006.46$327, $418,895.95$306, $171,407.06$395,459.00

Sarah Petersen Codington County Welfare Director President SDACWO