SOMERVELL COUNTY INDIGENT HEALTHCARE PROGRAM P.O . Box 851 102 N.E. Vine Street Glen Rose, Tx. 76043 Telephone: 254-897-2322 Fax: 254-897-7314 December 5, 2012 REPORT FOR THE MONTH OF DECEMBER 2012 To: Judge Mike Ford County Auditor, Darrell Morrison Commissioner Zach Cummings, Precinct 1 Commissioner John Curtis, Precinct 2 Commissioner Lloyd Wirt, Precinct 3 Commissioner James Barnard, Precinct 4 From: Pat Schneider, Indigent Care Administrator Attached please find the following reports: Somervell County Fiscal Year to Date and Precinct Report State Form 105, Vendor Report, Current Month Dashboard/Source Totals Report Note: The Fiscal Year for Indigent Healthcare is September 1 through August 31.
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SOMERVELL COUNTY INDIGENT HEAL THCARE PROGRAM
PO Box 851 102 NE Vine Street Glen Rose Tx 76043 Telephone 254-897-2322 Fax 254-897-7314
December 5 2012
REPORT FOR THE MONTH OF DECEMBER 2012
To Judge Mike Ford County Auditor Darrell Morrison Commissioner Zach Cummings Precinct 1 Commissioner John Curtis Precinct 2 Commissioner Lloyd Wirt Precinct 3 Commissioner James Barnard Precinct 4
From Pat Schneider Indigent Care Administrator
Attached please find the following reports
Somervell County Fiscal Year to Date and Precinct Report State Form 105 Vendor Report Current Month
DashboardSource Totals Report
Note The Fiscal Year for Indigent Healthcare is September 1 through August 31
SOMERVELL COUNTY INDIGENT HEALTH CARE PROGRAM
PO Box 851 102 NE Vine Street Glen Rose Tx 76043 Telephone 254-897-2322 Fax 254-897-7314
Fiscal Year 90112012 - 83112013
Month Total Year to Date September 2012 $ 3418257
October 2012 $ 2897724 November 2012 $ 7339482 December 2012 $ 4426286 January 2013 $ February 2013 $
March2013 $ April 2013 $ May 2013 $ June 2013 $ July 2013 $
August 2013 $
Year to Date $ 18081749
Current Month Clients by Precinct
Precinct No Number 1 15 2 14 3 13 4 9
Total 51
Form 105
COUNTY INDIGENT HEALTH CARE PROGRAM MONTHLY FINANCIAL REPORT
County Name Somervell Report for (MonthYear) or
Amendment of the Report for (MonthYear)
122012
I REIMBURSABLE EXPENDITURES during This Report Month
Physician Services 1 $622345
Prescription Drugs 2 $693056
Hospital Inpatient Services 3 $1782717
Hospital Outpatient Services 4 $13219 67
LaboratoryX-Ray Services 5 $62 01
Skilled Nursing Facility Services 6 $000
Family Planning Services 7 $000
Rural Health Clinic Services 8 $000
State Hospital Contracts 9 $000
Optional Health Care Services 10 $000
Total Expenditures (Add 1 through 10) 11 $4426286
Reimbursements Received (Do not include State Assistance) 12 ( $000 )
6 Eligibility System Review Findings ($ in error) 13 ( $000 )
Total to be Deducted (Add 12 + 13) 14 ( $000 )
Applied to State Assistance EligibilityReimbursement (11 minus 14) 15 $4426286
II EXPENDITURE TRACKING for State Assistance Funds EligibilityReimbursement
TOTAL EXPENDITURES for Current State Fiscal Year (91 - 831) $ 18081749
GRTL $ 1045671800
6 of GRTL $ 62740308
8 of GRTL $ 83653744
PAT SCHNEIDER 12052012 Signature of Person Submitting Form 105 Date
CIHCP 05-5 September 2005
70
Active Clients by Program for Eligibility Dates 09012012 through 12052012
Denied - IHe 2 Indigent 68
Total Clients By Program
90
80
70
60
50
40
30
20
10
0
Active Clients by PrOiraft
Denied - I Indigent
Appointments Scheduled by Type for Appointment Dates 09012012 through 12052012
New App-102 o Renewal-102 o
Total Appointments Scheduled o
copyIHS Dashboard Report Issued 121052012 Somervell County Indigent Healthcare
Source Totals for Batch Dates 09012012 through 120512012
