In the summer of 2000, the Universal Health Care Action Network (UHCAN) Ohio’s free care committee conducted a survey of the ten non-profit acute-care hospitals in Columbus. The results will appear in a report to be issued in December (check the uhcanohio website for a copy of the report). UHCAN Ohio has already met with administrators of several hospitals, all of whom indicated a willingness to collaborate with the community group on instituting improvements recommended in the report.

The group wanted to find out how easy it is for individuals to get information about free care. The concern was not that the hospitals aren’t providing free care, but rather that hospitals do not take steps necessary to inform patients and the public that free care is available to those in need. Thus, people are not seeking needed care because they don’t know – and can’t easily find out — about free care.

Free care is care provided by a hospital to low-income, uninsured people for which the hospital does not expect to be paid. For people who have no health insurance and little money, free care is often the only way they can get necessary medical treatment.

Hospitals have an obligation to provide free care, derived from several sources outlined in the report. A major source is Ohio’s statutory Hospital Care Assurance Program (HCAP), which requires all hospitals to provide medically necessary hospital-level services free to individuals whose incomes are at or below the federal poverty level.

Among the report’s findings:

• Information about the availability of HCAP and other hospital free care programs is difficult to obtain.

• Written information about free care programs and hospital policies is not readily available or prominently displayed.

• Although all of the hospitals had at least some of the required signs describing HCAP, the signs were in English only, and they were often difficult to find, read, or understand.

• Callers were generally discouraged from applying for free care in advance of receiving services.

The report contains a set of recommendations for individual hospitals, including:

First, hospitals should reach out and actively seek to qualify individuals for Medicaid, HCAP, and their own free care programs.

Second, hospitals should collaborate with each other and with community members to improve access.

Third, hospitals should collect and report HCAP and free care data in a standard format.

Fourth, the Ohio Department of Job and Family Services should expand its monitoring of the HCAP program and collect and report data on free care, by patient income, excluding hospital bad debt.

Policymakers and the public need more specific data on hospital free care, by patient income, in order to assess the need for policy change, including expanded coverage for the uninsured.

For more information, or for help in doing a similar survey in another community, contact Cathy Levine, in the Columbus office.

UHCAN Ohio keeps an eye on Ohio health legislation. For more information on pending bills, either check our website or call the policy director, Cathy Levine, in our Columbus office, (614)253-4340. Full texts and summaries of bills are available on the state’s website: www. legislature.state.oh.us.