Evening star., 1949-01-12
Ruling
Opens Hospitals
To Non-Paupers
West Clears Way
For D. 6. to Set
Income Limits

The question OF what District
residents can be eligible as indi-
gents for private hospital care at
District expense was back in the
hands Of the Commissioner today.
The path for action on the con-
troversial issue, after a more than
six-month delay, was cleared yes
terday by an opinion from Cor
poration Counsel Vernon E. West.
Congress gave the city $500, 900
last July to pay nine private hos
pitals for treating emergency "in-
digent" victims who are residents
and would be eligible for care at
tax-supported Gallinger Hospital.
At present, the District pays the
hospitals only for treating patients
whose incomes are so low they
are not expected to pay anything
toward their hospital bills.
Need Not Be Pauper.
Mr.. Vests opinion ruled that a
resident does not have to be a
pauper in order to be considered
INDECENT.
It said the Commissioners should
decide the maximum amount of
money a person can earn and the
maximum amount Of property he
can own-according to the number
of dependents he has-and still be
considered INDECENT.
Persons who fall below the maxi
mum standards in income and
property ownership then should be
entitled to care at District expense,
under the ruling. But if the Health
Department decides they can afford
to pay some part of their expenses,
based on Individual investigation,
that amount should be collected, it
added.
At the same time the opinion
defined an INDECENT as a person who
is wholly unable" to pay hospital
expenses after providing for the
normal necessities of life for him.
self and his family.
A corporation counsel official said
the definition should be used only
as "a general rule" however, estab-
fishing the assumption that these
groups are wholly unable" to pay
anything. Those who can pay, he
said, should.
Range Set for Gallinger.
At the root of the indigency def
milton mixup is a Commissioner
order which lists income ranges for
different-sized families to determi.
nation eligibility for care at GAL
linger.
Families whose incomes are at the
low end of the range are considered
INDECENT and can get free care at
Gallinger. Those above the higher
end are disqualified. Those within
the range are considered "semi-in-
digents" and are expected to pay
what they can afford toward the
bills.
Health Officer George c. Rutland
proposed that this table be applied
also to the private hospital patients.
Mr. Vests opinion said this could
not be because Congress has author
lied Gallinger to accept "semi-indi-
gents" But those at the private
hospitals, it said, must be "indi-
gents"
The effect of the ruling is that
the Gallinger table could be used
simply by making the maximum in
come range determine indigency-
not the minimum, as 1t does at CAL
linger.
Then, the opinion declared, lower
ranges of the table could be used
as a guide to negotiate part-pay
payments for those who can
afford it.
Cannot Set Standards.
The corporation counsel said he
could not define standards that de-
termine whether a person is an indi-
gent "in the practical sense" be-
cause he had no way of knowing
the income below which a certain
sized family would not normally be
able to afford hospital expenses.
When the Commissioners reach a
decision on the question, meanwhile,
the Hospital Permit Bureau of the
Health Department, which approves
payments to the private hospitals,
may be faced with the job OF re-
viewing many claims turned down
from the hospitals during the last
several months.
In his opinion, Mr.. West urged
that his ruling be sent to Auditor
A. r. Pilkerton for study. He also
suggested that, If the auditor de-
sired, the opinion be forwarded to
the United States controller gen.
eral for approval.
Mr.. Pilkerton said he saw no rea-
son for sending the opinion further,
however, and added that he thought
he could get rid of it in a couple
of days"
Marlboro Plans Pool