Healthcare Entitlement: 2014 Policies: Amendment

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A decision made 20 June 2014:

Decision Reference: MD-HSS-2014-0025
Decision Summary Title :	2014 Entitlement to healthcare amendment		Date of Decision Summary:	June 19th 2014
Decision Summary Author:	Assistant Director – Policy, Communications & Ministerial Support		Decision Summary: Public or Exempt?	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:
Written Report Title :	2014 Entitlement To Health Care (“The Policy”) – Amendment To Emergency Care Definition		Date of Written Report:	June 19th 2014
Written Report Author:	Assistant Director – Policy, Communications & Ministerial Support		Written Report : Public or Exempt?	Public
Subject: Amendment to the Health and Social Services Residents and Non-Residents Charging Policy, defining the provision of Emergency treatment to non-residents. The amendment to be effective from June 23rd 2014.
Decision(s): The Minister for Health and Social Services approved the amendment to Section 1: Emergency Care of the Residents and Non-Residents Charging Policy, effective from June 23rd 2014
Reason(s) for Decision: To align the provision of emergency treatment to non-qualified residents and non-RHA visitors (under the provision of health care in the Residents and Non-residents Charging policy) with restrictions universally implemented in other jurisdictions, including the UK. Continued implementation of the current HSS policy (Section 1 Emergency Treatment), which automatically extends emergency treatment provision, is very likely to have a significant impact on the Hospital budget and, could be considered unfair, in light of the requirement for residents and visitors to meet other strict criteria for eligibility to access free health care.
Resource Implications: None
Action required: Amended Residents and Non-residents Charging Policy to be published, effective June 23rd 2014
Signature:		Position: Assistant Minister for Health and Social Services
Date Signed:		Date of Decision (If different from Date Signed):

Healthcare Entitlement: 2014 Policies: Amendment

Health and Social Services

Minister’s Decision Report

2014 Entitlement to health CARE (“THE pOLICY”) – AMENDMENT TO EMERGENCY CARE DEFINITION

Purpose of Report

To recommend the Minister for the Health and Social Services Department approves the amendment to the Health and Social Services Residents and Non-Residents Charging Policy, defining the provision of Emergency treatment to non-residents. The amendment to be effective from June 23rd 2014.

Background

The existing Health and Social Services Residents and Non-Residents Charging Policy came into effect on June 18th 2014, amended from the former Overseas Patients Policy to align with new legislation under the Control of Housing and Work (Jersey) Law 2012 and regulations which came into effect in 2013, and the Long-Term Care (HSS Charges)(Jersey)Law 201-.

Introduction

In drafting the Residents and Non-Residents Charging Policy (effective June 18th 2014) the Health and Social Services Department undertook a protracted review exercise on appropriate revisions to the former policy relating to charges for health care and services (Overseas Patients Policy)

Following Ministerial approval of the revised Policy, further discussions have highlighted significant issues being raised around the financial implications of amendments to the provision of emergency treatment.

Further consideration of restrictions that exist within the UK, confirm that ‘Emergency treatment’ for patients who would not ordinarily qualify for access to free health care, is restricted to care and treatment provided within the Emergency Department.

Continued implementation of the current HSS policy (Section 1 Emergency Treatment), which automatically extends that provision further, is very likely to have a significant impact on the Hospital budget and, could be considered unfair, in light of the requirement for residents and visitors to meet other strict criteria for eligibility.

It is recognised that there may be individual cases where exception to this policy may be deemed appropriate. In such circumstances, the Hospital Managing Director may approve an exemption to charges, or a patient may wish to appeal against the ruling on their liability for charges.

The Charges Appeals Policy makes provision for any patient to submit an appeal against charges, for consideration and ruling by the Charges Appeals Panel.

The HSS Residents and Non-Residents Policy has been implemented to meet the needs of the Health and Social Services Department while a detailed review and drafting of a comprehensive States “Entitlement to Services Policy” – being led by the Central Policy Unit in the Chief Minister’s Department – is completed.

The Central Policy Unit Review and the drafting of a States “Entitlement to Services Policy” is likely to take several years to come to fruition and, as such, it is incumbent on the department to have in place an appropriate interim provision for dealing with issues relating to charging for services.

It is important to note that these policies are neither legal nor statutory documents and there is currently no legal foundation for the charges that have been put in place. However, like all Ministers, The Minister for Health and Social Services is mandated to make policy for charging for services within the department and, as such, these policies have been developed to support Ministerial direction on charging.

The following Policy document id attached to this report:

 Residents & Non-residents Charging Policy – effective June 23rd 2014

Key area of change

AMENDMENT TO RESIDENTS AND NON-RESIDENTS CHARGING POLICY
SECTION 1: EMERGENCY TREATMENT
Objective	To clarify the definition of emergency treatment (where charging for non-eligible patients begins)
What	Emergency care: defines the limitations of ‘emergency care’ Non-eligibility for treatment beyond emergency care is clarified
Why	Determining where charging should begin has cause considerable confusion and has been difficult to address, in that there are widely varying view around what constitutes ‘emergency care’. The issue of cost to the Department is also critical and an amendment is required to ensure the provision of free emergency care to non-qualified patients is both fair and sustainable. The amendment to the Policy brings the HSSD policy on the provision of ‘Emergency Care’ in line with UK practice The amendment defines that ‘emergency treatment’ will be considered as treatment and care for an acute episode within the Emergency Department. Further urgent care for visitors covered by a current RHA is restricted to the provisions made within the individual agreement A visitor not covered by an existing RHA is classified as a non-resident and not eligible to free care beyond ‘emergency treatment’ as defined above.

Recommendation

It is recommended that the Minister of Health and Social Services approves the amendment to the Residents and Non-Residents Charging Policy: Section 1: Emergency Treatment, and publication of the amended policy, effective from June 23rd 2014.

Reason for Decision

The Policy has been amended to accommodate necessary changes to the rules governing the provision of emergency treatment to non residents, and meets the needs of the Health and Social Services Department while a detailed review and drafting of a comprehensive States “Entitlement to Services Policy” – being led by the Central Policy Unit in the Chief Minister’s Department – is completed.

Resource Implications

None

Consultation and Approval

The revision to the Residents and Non-Residents Charging Policy has been subject to internal consultation with the Hospital Director and Finance Department, and approved by the Executive (Corporate Directors) Board.

Report author : Assistant Director – Policy, Communications & Ministerial Support	Document date : June 19th 2014
File name and path: WR - 2014 Entitlement to Healthcare - Emergency Care Amendment - 190614.doc