Hospital Pitches Tougher Collecetion Policies to County Council

Fairfield Memorial Hospital may be getting more serious about collecting outstanding medical bills, as members of the hospital’s administration presented a proposal to County Council Monday night to consider garnishing the salaries of those who fail to settle their accounts. The hospital also put forward a proposal to place liens against property and other assets of those critically behind on their bills.

The proposal met with a mixed response from Council members, some of whom sympathized with a hospital trying to make ends meet, while other members were reluctant to put a further burden on the needy.

In addition to the new policies for collecting debts, Tim Mitchell, the hospital’s Chief Financial Officer, also offered a change to the hospital’s charity care program, which, he said, was more liberal than a similar policy administered by the State. The hospital’s policy, Mitchell said, has been strictly based on income. The proposed change would include assets as well as income, bringing it in line with the State’s policy. Mitchell also said that the hospital loses between $5 million and $6 million each year in free care, and some of that could be recouped from patients who may have the ability to pay some or all of their hospital bills, but simply aren’t doing so.

“I don’t think this penalizes any of our citizens who don’t have the ability to pay their hospital bill,” Mitchell said. “What (the new policies) do is tie up a loose end for those who do have the ability to pay by means of liquidating an asset or by tapping their savings account where they have money sitting. Right now, the current policies are based on income levels alone and are not taking into consideration any cash or savings they may have squirreled away for a rainy day. And an unforeseen medical expense is something we believe that cash should be spent on.”

Councilman Kamau Marcharia asked Mitchell if that approach redefined the word “charity.”

“I don’t think it redefines it, because we’re still providing care to those who don’t have the ability to pay for it,” Mitchell answered. “What it’s doing is, essentially, preventing people from abusing our policy and getting care at a discount or for free who have the ability to pay.”

Mitchell said the hospital would now take the same information that patients seeking free or discounted care provide on State forms and incorporate that data into the hospital’s charity care program.

“Only by collecting from people who have the ability to pay can we pay for services for those who are truly needy,” Mitchell said.

Hospital CEO Mike Williams said that the hospital’s emergency room has seen 907 more patients this year compared to last year, with many Fairfield residents using the emergency room as their source of primary care. This has helped put a strain on the hospital’s resources, he said, and it was essential that residents find a “medical home.”

Vice Chairman Dwayne Perry said the hospital in Allendale has adopted a similar method for collection with considerable success, more than doubling their collections.

“The taxpayers and the County support this hospital, and we want to make sure we are serving the folks who are the most needy,” Perry said.

But Council Chairman David Ferguson said he was less than comfortable with some parts of the new collection process.

“One of the things I do have a problem with is the garnishing of wages,” Ferguson said. “I agree with Mr. Perry that when services are rendered we need to make arrangements for those services to be paid for. But to go to an employment place and garnish wages, that’s a pretty drastic step. I’m not sure if I would be comfortable with doing that.”

Mitchell said the wage garnishing program would only attack debts over $300 and would be limited to a certain percentage of an individual’s income. In Allendale, that method has generated $500,000, Mitchell said.

“If the hospital goes out of business because they’re not making enough money, where are these people who are not paying going to go?” Councilman David Brown asked. “It’s working in Allendale County.”

While Council member Carolyn Robinson noted that Council actually had no legal authority to deny the hospital’s proposal, Ferguson said the new policies would be placed on the agenda for the Dec. 10 meeting for a formal vote.

“I would still like to see some details (of the collection program),” Ferguson said. “If it helps the hospital, that’s a great thing. If it helps the hospital on somebody’s back who can’t afford it, that’s a different thing.”

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