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Millions of medical care dollars for indigents


The medically indigent, a group traditionally underserved with health care, can obtain some needed free services from Hill-Burton facilities. These facilities (hospitals, nursing homes, clinics, and agencies) received Hill-Burton funds for their building programs and have, as a result, an obligation to provide a certain amount of uncompensated medical care to a defined medically indigent population.

Health systems agencies (HSAS) or other interested agencies and groups can play an integral role in highlighting the Hill-Burton Program and helping the medically indigent obtain free care, This paper describes the Hill-Burton Program and explains how one HSA identified the Hill-Burton facilities in its area, determined the extent of their obligations, obtained allocation plans, and publicized and promoted the available health care services. From the interest shown by the community it was apparent that the HSA had provided a much needed and appreciated service that could be duplicated across the country by HSAS or other community groups.

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  1. 1.

    Public Law 725. Hospital Survey and Construction Act, 1946.

  2. 2.

    Public Law 93-641. Health Planning and Resources Development Act, 1975.

  3. 3.

    CSA Poverty Income Guidelines. Fed. Reg. 46, March 5, 1981.

  4. 4.

    Medical Facility Construction and Modernization; Requirements for Provision of Services to Persons Unable to Pay and Community Service by Assisted Health Facilities. Fed. Reg. 44, May 18, 1979.

  5. 5.

    Hill-Burton Project Register, Vol. I. Projects Approved Under Title VI of the Public Health Service Act. July 1, 1974–June 30, 1971. DHEW Pub. No. (HRA) 76-4010, 1976.

  6. 6.

    Hill-Burton Project Register, Vol. II. Listing of Grant, Loan, and Loan Guarantee Projects for Hospitals and Other Health Care Facilities, July 1, 1971–June 30, 1974. DHEW Pub. No. (HRA) 76-4011, 1976.

  7. 7.

    Facilities Obligated Under the 20-Year Uncompensated Services Assurance Where Obligation Began September 1959 and Later. DHEW Bureau of Health Facilities Financing, Compliance, and Conversion, 1979.

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Additional information

Lillian Emmons, Ph.D., R.D., Nutrition Consultant. James E. Burnett is Chief of Industrial Programs, National Aeronautical and Space Administration. Ruth Finkelstein, M.A., Planning Associate, Metropolitan Health Planning Corporation. Bernice Frieder, M.A., is Senior Associate Planner, Metropolitan Health Panning Corporation. Gail Long, M.S.S.A., is Assistant Director, Merrick Settlement House. Dennis Lettenauer Attorney-at-Law, is with the Legal Aid Society. Cynthia Miller is President, C.B. Miller Funeral Home. Paper presented on November 2, 1981, at the Annual Meeting of the American Public Health Association, Los Angles, Ca.

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Emmons, L., Burnett, J.E., Finkelstein, R. et al. Millions of medical care dollars for indigents. J Community Health 9, 30–48 (1983).

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  • Public Health
  • Health Care
  • Health System
  • Medical Care
  • Nursing Home