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The care of all persons admitted to the several institutions enumerated herein under the provisions of Subsections (10) to (14), inclusive of Section 115, hereof, shall be billed to the City and County of San Francisco Employees' Retirement System.
(Added by Ord. 75-66, App. 4/11/66)
Every person who knowingly, fraudulently and designedly conceals or withholds any information concerning his financial condition or means or ability to pay or concerning other conditions, or who knowingly makes or causes to be made, either directly or indirectly or through any agency whatsoever, any false statement in writing, with intent that it shall be relied upon, respecting the financial condition or means or ability to pay of himself or any other person in whom he is interested, or for whom he is acting, for the purpose of gaining admission to and receiving care and treatment in the institutions, shall be guilty of a misdemeanor, punishable by a fine of not more than $500, or by imprisonment in the County Jail for not more than six months, or by both such fine and imprisonment.
Said person, in addition the penalties hereinabove set forth, shall be billed by the institution rendering said services for the full amount of the cost of such institutional care and treatment, thus fraudulently obtained, in accordance with the basic rates, legally established and determined therefor.
(Added by Ord. 75-66, App. 4/11/66)
Every person; except persons enumerated in Subsections (10) to (14) inclusive, and Section (17) of Section 115 hereof, and persons found to be exempt from liability for benefits under the provisions of Chapter 7 or Chapter 8, Part 3, Division 9 of the Welfare and Institutions Code of the State of California, who is given or shall receive aid directly or indirectly from public monies drawn through the Treasury of the City and County of San Francisco, shall be liable to the extent of his ability to pay as determined by Section 119 hereof, for the value of said aid so allowed, granted, or given, and if any of said aid granted to said person is for injury sustained by reason of an accident or wrongful act, the value of aid shall, if said person or other persons entitled to bring such action asserts or maintains a claim against another for damages on account of his or her injury or because of his or her death, constitute a lien upon the damages recovered, or to be recovered, either by judgment, settlement or compromise by said person, or by his or her heirs or personal representative in case of his or her death, or other persons lawfully entitled to a cause of action because of his or her death.
(Amended by Ord. 304-80, App. 6/27/80; Ord. 355-90, App. 10/17/90)
The actual cost of the aid shall constitute its value. The rates established by the Board of Super-visors pursuant to Section 128 and 128.1 hereof for aid granted or given to persons at the institutions or by the San Francisco Fire Department shall constitute prima facie evidence of the reasonableness of said charge and the resulting amount which shall be due to the City and County of San Francisco.
(Added by Ord. 75-66, App. 4/11/66; amended by Ord. 106-03, File No. 030624, App. 5/23/2003)
As a consideration for the allowing, granting or giving of aid, the officer, board, or commission shall take from every person receiving aid except for persons enumerated in Subsections (10) to (14), inclusive, and (17) of Section 115, hereof the following agreement:
"AGREEMENT TO REIMBURSE
"In consideration of the granting of aid to me by the City and County of San Francisco, I hereby pledge, promise and agree to reimburse and repay said City and County all sums of money actually expended in my behalf or aid granted or given by the City and County of San Francisco for my care and maintenance, provided I am able to pay for the same in whole or in part, and I further agree that if any of said aid consists of care and treatment for injury sustained by me by reason of accident or wrongful act, the value of such aid shall be, if I assert or maintain a claim against another for damages on account of said injury, a lien upon any damages recovered, or to be recovered, either by judgment, settlement or compromise by myself, or by my heirs or personal representative in case of my death.
"I further agree that if and when I enter Laguna Honda Hospital or Hassler Hospital as a patient therein, I shall deposit in the Home Trust Fund an amount not less than the sum fixed for payment by toward cost of such institutional care as determined by my ability so to pay, and which sum I hereby expressly agree to pay; and I further agree that a direct charge against my Home Trust Fund account in that amount may be made by the said hospital at the completion of each month or portion of a month during the time I remain therein to discharge this obligation to pay, as aforesaid.
"For valuable consideration, I hereby assign to the San Francisco General Hospital the amount equal to the total cost of care rendered to me (or the total amount due to me if the amount thus due be less than the total amount of the cost of care rendered to me) from any monies due or to become due to me under my insurance policies, including any hospital benefits payable from the California State Disability Program or any private carrier in lieu thereof, and hereby authorize you to make such payment directly to said San Francisco General Hospital.
"This agreement is binding upon myself, my heirs, executors, administrators and assigns.
"The foregoing agreement is executed on the express condition, and with the understanding that it shall be binding on the applicant only in the event that he (or she) is found to be exempt from liability for such benefits under the provisions of Chapter 7 or Chapter 8, Part 3, Division 9, Welfare and Institutions Code of the State of California and that it shall be null and void if the applicant is found to be exempt from liability for such benefits.
Dated this ____________ day of 197____________
Witness ____________
Witness ____________
Signature of Applicant in full
____________"
The Controller of the City and County of San Francisco shall prescribe the procedure governing the evaluation of institutional care at the Laguna Honda Hospital, the auditing, accounting, reporting and collecting of all obligations arising under Sections 124 to 124.4, inclusive, hereof in accordance with the provisions of Section 64 and 75 of the Charter.
(Added by Ord. 75-66, App. 4/11/66)
Any lien created by the provisions of Section 124 of this Article upon damages recovered, or to be recovered by a recipient of aid, shall be referred to the Bureau of Delinquent Revenue for collection pursuant to the provisions of Chapter 10, Article V, of the San Francisco Code.
(Amended by Ord. 155- 68; App. 6/13/68; Ord. 386-89, App. 10/25/89)
(a) As used in this section:
(1) "Recipient" means any person who has received medical care or hospitalization or will be provided medical care or hospitalization rendered by the San Francisco Department of Public Health or the San Francisco Fire Department because of an injury for which another person may be liable. This term includes the recipient's guardian, conservator, other personal representative, estate, or survivors, including any heir, as defined in California Code of Civil Procedure Section 377, who is a party in a cause of action arising out of the death of the person who received the medical care or hospitalization.
(2) "Action" means any cause of action demanding payment of damages filed in any court, or with any public agency, including but not limited to any application for compensation under the Workers Compensation Act of the California Labor Code, or with a private adjudicator, including but not limited to a private arbitrator or mediator, arising out of the injuries that resulted in the medical care or hospitalization of the recipient. This term also includes any cause of action arising out of the death of the recipient from such injuries.
(3) "Claim" means any demand by the recipient for damages against another, including but not limited to any written demand by the recipient for payment under the provisions of any insurance contract providing for payment to injured persons, including payment from the recipient's insurance carrier or the third party's insurance carrier or both carriers.
(b) When any recipient, as defined in Subsection (a)(1) of this section, asserts an action or claim for damages against a third party or insurance carrier based upon an injury requiring medical care, the cost of the medical care shall constitute a lien in favor of the City and County of San Francisco upon any such recovery received by the recipient.
(c) When any recipient who has been billed for the cost of medical care rendered by the San Francisco Department of Public Health or the San Francisco Fire Department fails to pay in full for such care and asserts an action or claim for damages against a third party or insurance carrier, the recipient's attorney retained to assert the action or claim shall provide written notice of such action or claim by personal delivery or first-class mail to the Bureau of Delinquent Revenue Collection in the Office of the Treasurer-Tax Collector within 10 days of asserting such action or claim. Such notice by the retained attorney to the Bureau of Delinquent Revenue Collection shall adequately identify the recipient, and his or her action or claim, including the name of the insurance carrier against which claim has been made, or the court or state or local agency in which the action or claim is asserted, in order to allow the Bureau of Delinquent Revenue Collection to prepare and file the lien as authorized by Subsection B of this section. In addition, if the recipient as defined in Subsection (a)(1) of this section does not retain an attorney to assert the action or claim, he or she shall give the same notice as described in this subsection. A mailed billing statement sent by the San Francisco Department of Public Health, the San Francisco Fire Department or the Bureau of Delinquent Revenue Collection to the address of the recipient as given on the medical records shall constitute prima facie evidence of knowledge by the recipient of such billing for medical care.
(d) When the Bureau of Delinquent Revenue Collection has perfected a lien upon a judgment, award, or settlement in favor of a recipient against any third party or third-party insurance carrier for an injury for which the recipient has received medical care from the San Francisco Department of Public Health or the San Francisco Fire Department, the Bureau of Delinquent Revenue Collection as lien claimant shall be entitled to foreclose its lien against any proceeds from such judgment, award, or settlement to enforce payment of the lien against the third party or third-party insurance carrier, with interest at the legal rate. If the amount of such judgment, award, or settlement so recovered has been paid to the recipient, as defined in Subsection (a)(1) of this section, or to his or her attorney retained to assert the action or claim, the Bureau of Delinquent Revenue Collection shall be entitled to foreclose its lien against the proceeds received by such recipient, recipient's agent, recipient's transferee, or against the retained attorney if he or she has received such payment, to the extent of the San Francisco Department of Public Health's or the San Francisco Fire Department's or the Bureau of Delinquent Revenue Collection's lien, with interest at the legal rate.
(e) The failure by the attorney retained by the recipient, as defined in Subsection (a)(1) of this section, to give notice to the Bureau of Delinquent Revenue Collection in the Office of the Treasurer-Tax Collector regarding the recipient's action or claim for damages against a third party or insurance carrier after the recipient has received a billing for medical care from the San Francisco Department of Public Health, the San Francisco Fire Department or the Bureau of Delinquent Revenue Collection shall constitute fraud and deceit by the retained attorney. Likewise, the failure by any recipient, as defined in Subsection (a)(1) of this section, to give such notice as described in this subsection after receiving a billing for medical care from the San Francisco Department of Public Health or by the recipient. In addition, either the recipient or the recipient's attorney retained to assert such action or claim who receives any payment from the third party or insurance carrier resulting from the assertion of such action or claim and who fails to apply such payment toward the satisfaction of the outstanding bill for medical care shall be liable as a constructive trustee for all damages that may be awarded by any court to the City and County of San Francisco for breach of constructive trustee duties and responsibilities.
(f) Commencing 30 days after the enactment of this ordinance, the affected medical facilities of the San Francisco Department of Public Health and the San Francisco Fire Department shall make every reasonable effort where feasible to include a statement in English, Spanish, and Chinese with every billing setting out the notice requirement, as described in Subsection (c) of this section, imposed on the recipient's retained attorney, or if there is no retained attorney, imposed on the recipient, regarding any action or claim for recovery asserted against a third party or insurance carrier. The statement shall read:
"IMPORTANT: If your attorney or you alone demand money from another person or insurance company because of your injuries and you have not paid this bill in full, your attorney or you must notify: The Bureau of Delinquent Revenue Collection, City Hall, Room 107, San Francisco, California 94102. Failure to notify the Bureau within 10 days of making your demand may result in civil liability for your attorney or you. S.F. Health Code Section 124.5."
(Added by Ord. 355-90, App. 10/17/90; amended by Ord. 106-03, File No. 030624, App. 5/23/2003)
When adequate facilities are not available in any of the institutions enumerated in Section 111 of this Article, the Chief Administrative Officer may contract with other hospitals for the admission and care of persons enumerated in Section 115 of this Article, for in-patient or out-patient care. The Chief Administrative Officer shall not enter into any such agreement until after the Board of Supervisors has made an appropriation to provide funds for the payment to such hospitals, and the rates agreed to be paid such hospitals in any such agreement for in-patient care shall not exceed the cost of maintaining and caring for like classes of person at the San Francisco General Hospital. In any such agreement for out-patient care other than psychiatric care the rates agreed to be paid each hospital shall not exceed said hospital's actual costs or $12, whichever is the lesser as determined and approved by the Controller of the City and County of San Francisco. In any such agreement for out-patient psychiatric care the rates agreed to be paid each hospital shall not exceed said hospital's actual costs or $16, whichever is the lesser as determined and approved by the Controller of the City and County of San Francisco.
(Amended by Ord. 149-66, App. 6/22/66)
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