Evening star., 1949-01-12
Ruling
Opens Hospitals
To Non-Paupers
West Clears Way
For D. c. 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 Commissioners TODAY.
The path for action on the con-
troversial issue, after a more than
slx-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
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.
1t 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
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-
llshlng the assumption that these
groups are wholly unable" to pav
anything. Those who can pay, he
said, should.
Range Set for Gallinger,
At the root of the indigencv def
milton mixup is a Commissioner,
order which lists income ranges fo,
olHerent-s1zed families to determi
nation eligibility for care at Gal
linger.
Families whose incomes are at the
low end of the range are considere,
lndigent and can get free care
Gallinger. Those above the highe
end are disqualified Those With,
the range are considered "semi-in
digents" and are expected to pa,
what they can afford toward tn,
bills.
Health onicer George c. Ruhlan
proposed that this table be apple
also to the private hospital patient
Mr.. Vests opinion said this coul
not be because Congress has author
lied Gallinger to accept "semi-indj
gents" But those at the privat
hospitals, it said, must be lind;
gents"
The effect of the ruling is ths
the Gallinger table could be use
simply by making the maximum in
come range determine indigency-
not the minimum as it does at Cal
linger.
Then, the opinion declared lowe
ranges of the table could be use
as guide to negotiate part-ps
payments for those who ca:
afford it.
Cannot Set Standards.
The corporation counsel said r
could not define standards that dc
termlne whether a person is an ind
gent lin the practical sense" be
cause he had no way of KNOWN
the income below which a certa;
sized family would not normally /
able to afford hospital expenses.
When the Commissioners reach
decision on the question, meanwhil.
the Hospital Permit Bureau of tt
Health Department, which approve
payments to the private hospital
may be faced with the job of re
viewing many claims turned dow
from the hospitals during the la
several months.
In his opinion, Mr.. West urge;
that his ruling be sent to Audito
A. R. Pilkerton for study. He ais.
suggested that, if the auditor de-
sired, the opinion be forwarded t
the United States controller gen
eral for approval.
Mr.. Pilkerton said he saw no rea
son for sending the opinion furthe,
however, and added that he though
ne could get rid of it in a coupl
of days.