Compilation of Rules and Regulations of the State of Georgia
Department 111 - RULES OF DEPARTMENT OF COMMUNITY HEALTH
Chapter 111-3 - MEDICAL ASSISTANCE
Subject 111-3-12 - RULES AND REGULATIONS FOR HOSPITAL CARE FOR THE INDIGENT
Rule 111-3-12-.04 - Method of Local Administration
Universal Citation: GA Rules and Regs r 111-3-12-.04
Current through Rules and Regulations filed through March 20, 2024
(1) Supervision of Local Program:
(a) The governing authority of the county
shall have the following Program role:
1. to
determine whether the Program should be activated in the county and to
establish the local budget needed;
2. to review and to adopt the County Program
Plan;
3. to make an annual review
of Program performance and to determine whether the Program is to be continued
in its county.
(b) The
County Board of Health shall have the following Program role:
1. to bear responsibility for the proper
administration of the Program in its county;
2. to develop or supervise the development of
a County Program Plan;
3. to adopt
local policies necessary to Program administration;
4. to delegate administrative Program
functions as it deems desirable.
(c) The County Board of Health, except as
indicated in paragraph (a) above shall represent the county in official
negotiations with the Division of Hospital Services, Georgia Department of
Community Health.
(2) County Program Plan:
(a) Annually, the County
Board of Health shall prepare a County Program Plan which contains the
following elements:
1. a selection of
hospitals to be used by the County in accordance with
111-3-12-.04(3);
2. resolutions from the medical staff and the
governing board of each selected hospital stating acceptance of participation
in the local Program;
3. a policy
or standard for determining indigency and medical indigency in accordance with
111-3-12-.05;
4. a policy or method for determining the
need for hospitalization in accordance with
111-3-12-.06;
5. a policy or method relating to
out-of-county hospital care in accordance with
111-3-12-.06(3);
6. a method or procedure for the payment of
funds in accordance with
111-3-12-.03(3);
7. a statement defining the area of
responsibility for any agency to which the county has delegated administrative
Program responsibility in accordance with
111-3-12-.04(4).
(b) The County Program Plan shall be prepared
so as to provide a logically interrelated set of policies for the local
Program.
(c) The County Program
Plan shall be submitted for review and approval to the governing authority of
the county and to the Georgia Department of Community Health.
(3) Selection of Participating Hospitals:
(a) The County Program Plan shall
contain the selection of a reasonable number of Participating Hospitals so that
geographic Program Coverage will conform, in General, with the pattern of
medical care for the area.
(b) In
the selection of Participating Hospitals to be used by the local Program,
consideration should be given to the probable needs of individual patients, the
necessity for referrals between hospitals, the geographic convenience of
patients, and the desires of local practicing physicians.
(c) To the fullest degree consistent with
sound local Program management, the local selection of Participating Hospitals
should be limited to general hospitals providing medical and surgical
services.
(d) The Eugene Talmadge
Memorial Hospital shall not be selected for inclusion in any County Program
Plan; however, emergency or highly specialized hospital care may be authorized
at this hospital.
(e) In an
emergency wherein the medical condition of the patient prevents utilization of
a selected participating hospital, hospitalization may be authorized in any
Participating Hospital without reference to the County Program Plan.
(f) The county may amend its selection of
Participating Hospitals by written notice to the Georgia Department of
Community Health.
(4) Local Program Administration:
(a) The County
Board of Health shall have authority to administer the local Program, including
the following areas:
1. to make the necessary
investigation for the final determination of indigency and medical
indigency;
2. to make the final
determination of the need for hospitalization;
3. to authorize and to approve payments for
hospital care;
4. to maintain
Program records and to prepare reports of its activities;
5. to properly account for funds made
available to the local Program;
6.
to maintain liaison with public and private agencies interested in the
Program.
(b) The County
Board of Health may delegate definable aspects of local Program administration
to a governmental official, an agency, or an organization which perform a
public and necessary governmental function. Any delegation must be on an annual
basis and does not relieve the County Board of Health of its total Program
responsibility.
(c) The County
Board of Health, at its option, may elect to establish a Screening Committee to
advise in local program administration.
1. The
Act specifies that a Screening Committee, created by a County, should be
delegated the function of making determinations and certifications relative to
the indigency of persons applying for assistance under this Program.
2. Such a Screening Committee should consist
of three responsible and public-minded local citizens. At least one member of a
Screening Committee must be designated by the local medical society.
Ga. L. 1933, p. 7; O.C.G.A. § 31-8-1et seq.
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