STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

In re: The matter of the billing ) submitted to Gadsden ) County by Tallahassee )

Memorial Hospital ) CASE NO. 78-523 concerning the patient )

Savanah McGriff )

)

RECOMMENDED ORDER

Pursuant to notice, the Division of Administrative Hearings, by its duly designated Hearing Officer, G. Steven Pfeiffer, held a final hearing in this case on June 2, 1978, in Quincy, Florida.

The following appearances were entered: John D. Buchanan, Tallahassee, Florida, for Tallahassee Memorial Hospital of Tallahassee; and John Shaw Curry, Quincy, Florida, for Gadsden County, Florida.

On April 28, 1978, Gadsden County, Florida filed a petition and request for hearing. The County alleged that the Tallahassee Memorial Hospital had submitted a bill to it with respect to medical services rendered to Savanah McGriff. The hospital contends that Ms. McGriff is an indigent resident of Gadsden County, that the hospital performed emergency treatment for her, and that Gadsden County is liable for payment of a portion of the bill in accordance with the provisions of the Florida Health Care Responsibility Act (Florida Statutes 154.301 et seq.). The County contends that Ms. McGriff was not indigent within the meaning of the Act.

A pre-hearing conference was conducted on April 7, 1978, and all pending motions have been resolved. The final hearing was scheduled by notice dated May 16, 1978. At the final hearing the hospital called the following witnesses: Connie Barrett, a financial counsellor employed by the hospital; Kenneth M. Martin, the hospital's Director of Patient Accounts; Charlie Anderson, the patient's husband; and George Hamilton, the Chief Deputy Property Appraiser for Gadsden County. The County called James G. Fletcher, an Assistant Service Officer employed with the Gadsden County Veterans Service Office; and recalled Charlie Anderson. Hearing Officer's Exhibit 1, TMH Exhibits 1 and 2, and County Exhibits 1 and 2 were received into evidence at the final hearing. The parties have submitted Post-Hearing Legal Memoranda.

FINDINGS OF FACT

1. Savanah McGriff was, until her death, a resident of Gadsden County. The parties have stipulated that on November 1, 1977 she was admitted to the Tallahassee Memorial Hospital in an emergency medical condition, and that the treatment performed by the hospital was of an emergency nature. The parties have further stipulated that the Tallahassee Memorial Hospital is a regional referral hospital within the meaning of 154.304(4), Florida Statutes (1977).

   
   

2. Savanah McGriff was admitted to the Tallahassee Memorial Hospital on November 1, 1977. She died on November 3, 1977 while she was still a patient at

   the hospital. The total bill for services was $683.85. The hospital submitted a bill to Gadsden County in the amount of $253.58 for the services, which is the amount permitted to be billed in accordance with the Florida Health Care Responsibility Act. Gadsden County has refused to pay the bill, contending that the patient was not indigent within the meaning of the Act. The bill has not been otherwise paid.

   
   

3. Savanah McGriff was married to Charlie Anderson. During the six months preceding the hospitalization of Savanah McGriff, she and her husband resided together in their home. During that period Mr. Anderson received a monthly disability check of $74.70, and Social Security benefits in the amount of

   $116.10. Ms. McGriff had received Veterans benefits in the amount of $50.40. They had no other income. Their average monthly income for the six months prior to the hospitalization was thus $241.20.

   
   

   CONCLUSIONS OF LAW

   
   

4. The Division of Administrative Hearings has jurisdiction over the parties to this action and over the subject matter, Sections 120.57(1), 154.312, 154.314, Florida Statutes (1977).

   
   

5. The burden of proof in an administrative proceeding lies with the party asserting the affirmative of an issue before an administrative tribunal. Tropical Park v. Ratliff, 97 So.2d (Fla. 1957). In the instant matter it is the hospital which is seeking to impose the bill upon the County, The hospital thus has the affirmative of the issue, and the burden of proof lies upon it.

   
   

6. Section 154.308 imposes upon the Department of Health and Rehabilitative Services the duty of promulgating standards for determining indigency of persons admitted to regional referral hospitals in accordance with the Florida Health Care Responsibility Act. The Department originally promulgated emergency rules, and these have been superseded by permanent rules. Chapter 10C-26 Florida Administrative Code. Under both the emergency rules and the permanent rules, a family unit with two persons must have an average monthly income during the six months preceding hospitalization of $225 or less. In the instant case the average monthly income of the patient's family unit exceeded this amount. No provisions have been cited which would support a conclusion that Social Security benefits, disability payments, or Veterans allowances would not be includable as gross income, and none have been found. The patient is therefore not indigent within the standards promulgated by the Department of Health and Rehabilitative Services.

   
   

7. Gadsden County is not liable to pay the Tallahassee Memorial Hospital for services rendered by the hospital to Savanah McGriff.

RECOMMENDED ORDER

Based upon the foregoing Findings of Fact and Conclusions of Law, it is, RECOMMENDED:

That a final order be entered rejecting the bill submitted by the Tallahassee Memorial Hospital for medical services performed for Savanah McGriff.

RECOMMENDED this 17th day of July, 1978, in Tallahassee, Florida.

G. STEVEN PFEIFFER Assistant Director

Division of Administrative Hearings Room 101, Collins Building Tallahassee, Florida 32301

(904) 488-9675

COPIES FURNISHED:

John Shaw Curry, Esquire Post Office Box 706 Quincy, Florida 32351

John D. Buchanan, Esquire Post Office Drawer 1049 Tallahassee, Florida 32302

Mr. Ben S. Duncan Chairman

Board of County Commissioners Gadsden County Courthouse Quincy, Florida

Docket for Case No: 78-000523

Orders for Case No: 78-000523