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t , # EXHIBIT B Page 2 3. A determination that the patient is acutely ill or Injured and that hospitalization Is essential to the patient's treatment will be made for each recipient of hospitalization under this program by a physician, duly licensed to practice medicine in this State; 4, Authorizations for hospitalization under this program shall be made by the lnd;ni, h,vev County Health Department; • 5. Payments for hospitalization from the "hiAn— A—' County Indigent Hospitalization Fund" will be limited to the non-profit basic cost to the hospital for providing essential ho<pital care to the medically 6 IS indigent patient; 6. Payments for hospitalization from the " R-11' County Indigent Hospitalization Fund" will be made by this Board to the hospital providing essential hospital care to medically indigent and acutely ill or injured residents of(lutnrs Riven County whose hospitalization has been authorized under the provisions of this program by the li,41l,. R -ler' County Health Department, %. A record will be maintained by this Board of all expenditures made from the "(ru1;n ilwr' County Indigent Hospitalization Fund" and these records shall include; a. The patient's name, age, sex and race; and, if married, the full name of the patient's spouse. b. The parents' full names if the patient is a minor. c. Patient's address. d. Name of physician who diagnosed patient and certified hospitalization essential to his treatment. e. Physician's diagnosis. f. The calendar days of hospitalization received. g. A record of payment to this hospital; arid, BE IT FURTHER RESOLVED, that this Board will make all medical and financial records supporting direct expenditures from the " ��r,�,rt„ R.urr County indigent Hospitali- zation Fund" available for review by the State Board of Health, and this Board will submit at least monthly to the State Board of Health a certification Identifying hospitalized cases and the payments for the case of cacti made from the/P,vev County Indigent Hospitalization Fund," together with a statement of expenditures certifying that ail such payments were made in accordance with the provisions of Chapter 401, supra, and on the basis of such requisition this Board will request the State Board of Health to authorize direct payments to the b+Ct�rts•rrrr County Board of County Commissioners or other local official agency from 1-vidtni-s Rt, County's share of the State appropriation for this propgramm, less any charges that may have been paid to hospitals outside of 111(k(„ 11ive, County by the State Hoard of Health for necessary emergency treatment of indigent�tiver County residents; arid, BE IT FURTHER RESOLVED, that all payments received from the State of Florida through this program shall augment the "�yiwl, PN,vv r County Indigent Hospitalization Fund," and shall be expended in addition to County Funds herein appropriated in accordance with County Annual Budget Statute, Chapter 129, Florida statutes; and, BE IT FURTHER RESOLVED, that a certified copy of this Resolution be submitted /in to tile ti e �i� �,i %t'tK'o Medical Society, the I»�iit<;, ,,.rr County Health Department and the State Board of Health.