CHAPTER 217

FORMERLY SENATE BILL NO. 418

AS AMENDED BY

SENATE AMENDMENT NO. 2

AND

HOUSE AMENDMENT NO. 1

AN ACT TO AMEND TITLE 29, CHAPTER 79, DELAWARE CODE, BY PROVIDING FOR A UNIFORM METHOD OF CHARGING AND COLLECTING FEES FOR CERTAIN SERVICES PROVIDED BY THE DEPARTMENT OF HEALTH AND SOCIAL SERVICES AND ALLOWING FOR THE DISCLOSURE OF INCOMES OF PERSONS HAVING OBLIGATIONS TO THE DEPARTMENT.

WHEREAS, it is in the public interest to assure proper treatment of persons with chronic illness, mental disorders, contagious diseases such as tuberculosis, chronic pulmonary diseases, and other health deficiencies; and

WHEREAS, it is in the public interest to assure that facilities are available for the care of elderly and for the care of the mentally retarded; and

WHEREAS, it is also in the public interest to assure that persons who accept such services• as may be provided by the State and who have the ability to pay all or some part of the costs, or whose relatives have such ability, should be expected to do so; and

WHEREAS, the failure of those able to pay for services rendered by the State restricts the financial resources of the State in providing these services for others less fortunate.

NOW, THEREFORE,

Be it enacted by the General Assembly of the State of Delaware:

§ 7940. Financial liability of persons served by the Department

(a) Any person committed to or accepting the services of any hospital, home, clinic or other facility of the Department and his spouse, parents, or children in the order named, except for persons committed to a prison or correctional institution, shall at all times be jointly and severally liable for the full cost of the care and/or treatment provided him, except as may be specifically set forth in this section. No person other than the patient shall be required to pay all or any part of the cost of care of any patient if such patient shall have attained the age of twenty-one years and shall have been a patient in one or more of the institutions served by the Department for a period of five years.

(b) The "cost of care and/or treatment" per diem for an in-patient facility such as, but not limited to, a hospital or home shall be deemed to mean the total disbursements made by or on behalf of such facility during a fiscal year divided by the number of patient-days during such fiscal year; such cost shall be computed on the experience of the previous fiscal year and the revised rate shall be charged beginning on the first day of the fourth month following the end of said fiscal year. In the event the in-patient facility has not been operational during the previous fiscal year, the "cost of care and/or treatment" shall be the amount determined by the Department within the guideline of available appropriations and anticipated patient-days. In the event an in-patient facility provides services that have substantially different costs, and such different costs may be reasonably identified, the Department may determine the "cost of care and/or treatment" based upon the particular service provided. In the case of out-patient or clinic services, the "cost of care and/or treatment" shall be determined by the Department based upon the most recent available experience of actual cost.

() The Department is authorized and empowered to accept partial payments from any person committed to, or accepting the services of, any hospital, home, clinic or other facility of the Department, or from any other person liable for the cost of such person, in an amount less than the full cost of care and/or treatment based upon the financial ability of such person or persons as determined by the Department. In determining financial ability to pay, the Department shall take into account the assets, liabilities, income, expenses, number of dependents of the

entire family, and any other relevant factors. The Department shall also promulgate such rules and regulations under subsection (i) hereof as may be necessary to insure that the enforcement of this obligation shall be as uniform as possible.

(d) Except in cases committed by order of the courts of the State of Delaware, the Department may require, before or after the patient is admitted or treated, the written agreement of those persons to receive or receiving care and/or treatment from the Department, and of those other persons who are liable under the provisions of this section, concerning the payments required by this section. Such agreements may be reviewed from time to time at the request of the Department or the person liable and in any event shall be automatically reviewed at least once every two years and may be amended if the cost of care and/or treatment has changed or if the ability to pay of person liable has changed in the judgment of the Department. The Department may require the person to receive or receiving care and/or treatment or from persons liable for the cost of care and/or treatment under this section such evidence of ability to pay as copies of Federal Income Tax Returns, tax withholding forms, and statements of bank accounts and property holdings; failure to provide such evidence may be grounds to refuse or terminate such care and/or treatment. Except in the case of the Delaware Home and Hospital for the Chronically Ill at Smyrna, such evidence of ability to pay shall not be required of liable persons if they agree to pay the full cost of care and/or treatment and so long as such payments are timely rendered.

() Any court of this State committing a person to the jurisdiction of the Department, may, in its discretion, order said person, and such other persons liable for the payment of costs under this section over which the court has jurisdiction, to pay for the cost of care and/or treatment in such amounts as may be fixed by the Department under the provisions of the act.

(a) The Department, after full investigation of collectibility and/or reasons for nonpayment, shall proceed for the recovery of the monies owed for such care and/or treatment in an action to be brought in any court of the State in the name of the Department, where such action is deemed justified. The Department of Justice of the State of Delaware shall represent the Department in such cases and any costs to the State arising from such action shall be

paid by the State Treasurer from monies in the General Fund not otherwise appropriated.

(g) The Department may partially or totally waive liability for persons receiving services from a facility such as, but not limited to, a clinic when the Department determines that the cost of computing ability to pay and making collection would exceed the sums to be collected or when the Department determines that such liability would jeopardize the health of the community.

(h) In the event any person, juvenile or adult, is committed to a prison or correctional institution, and in the event a court of this State has not ordered payment of the full cost of care, the Department may require such payments from such juvenile or adult while on a work release or similar program as it may deem appropriate provided that the total payment shall not exceed the actual cost of care while on the work release program.

() The Delaware Home and Hospital for the Chronically Ill at Smyrna and any similar facility of the Department may continue, as heretofore, to refuse admission to persons adjudged to have adequate resources, either personally or from others legally liable for them, to secure such services from private facilities.

(a) The Secretary of the Department shall have the power to promulgate any rules and regulations not contrary to the laws of the State of Delaware which he deems necessary to carry out the provisions of this section and such rules and regulations shall have the full force and effect of law.

(b) If it appears to the satisfaction of the Department that a person to receive or receiving care and/or treatment will be institutionalized for a long period of time and that the expected income of such person from all sources (including any portion of the cost of care to be paid by legally liable relatives) will be insufficient to pay for the full cost of care, the Department may require that all or part of the assets of such person be transferred and conveyed to the State of Delaware to be applied to his cost of care as the same shall come due, any balance thereof to be returned to such person or his estate upon his discharge or death. In carrying out this provision, the Department may bring suit in any court having jurisdiction to require the transfer of such assets,

and may also apply for the appointment of a guardian or trustee of such person, and if the Court, after giving appropriate notice and after hearing the evidence, shall enter such order as it deems appropriate.

(1) Nothing herein contained shall be construed to prevent the Department from refusing to admit or from discharging any patient who, for reasons other than nonpayment of cost of care, in the opinion of the Department, does not qualify for admission under the law or who will not benefit from the treatment available, or whose presence in any such institution will be detrimental to others.

(m) In the event that any person feels aggrieved by any decision of the Department with respect to the payment of fees, refusal of admission or discharge for other than medical reasons, he may appeal to a special appeals committee consisting of the chairmen of the respective advisory councils on Mental Retardation, Mental Health, Delaware Home and Hospital, and Physical Health by petition in writing stating the substance of the decision appealed from, the facts in support of the appeal and the relief sought. The Department shall reply within ten (10) days after which the committee shall hold a hearing within sixty (60) days and render its decision promptly which shall be final and binding. No formal rules of evidence shall be applicable at such hearing and the committee may establish its own rules not inconsistent herewith.

§ 7941. Disclosure of income

, Notwithstanding the provisions of Section 1241, Title 30, Delaware Code, the Secretary of Finance shall, upon the written request of the Secretary of the Department of Health and Social Services, provide the Secretary with the gross and net income, as defined in Chapter II of said Title 30, and all other available financial data concerning those persons who are liable under the provisions of this section for payments for the care and/or treatment of any persons in facilities operated by the Department of Health and Social Services and who are not paying the full cost of such care and/or treatment monthly. The Secretary shall certify that information so received shall be used only for the purpose of collecting sums due the State of Delaware and any employee of the Department guilty of disclosing such information for any

other purpose shall be subject to the same penalties as provided in Section 1241, Title 30, Delaware Code.

Section 2. Any provisions of the Delaware Code inconsistent with the provisions of this Act are hereby repealed to the extent of such inconsistency.

Section 3. The provisions of this Act are severable and any such provision determined to be unconstitutional shall be null and void and all other provisions shall continue in full force and effect.

Approved July 5, 1971.