The Board of Aldermen will gather at a public hearing tonight to discuss issues surrounding Yale-New Haven Hospital’s charitable care and debt collection policies following the hospital’s decision to clear 18,000 patients’ debts.

Hospital officials announced Friday that patients who incurred debt for medical care before Oct. 1, 2003, no longer needed to submit applications to have their debts cleared. But members of the aldermanic Human Services Committee said they were still concerned about the underlying system that led to the original debts.

At tonight’s hearing, the board will discuss an investigative report the committee released on Oct. 10 on the availability of free-care funds, which Yale-New Haven provides in addition to Medicare to help uninsured patients pay their medical bills.

Ward 10 Alderman Edward Mattison, chair of the Human Services Committee, said the committee has invited a number of outside experts to speak on the committee’s recommendations and to offer advice. He said he expected members of the community to be part of the audience and to make their voices heard.

Yale-New Haven spokesman Vincent Petrini said the hospital began modifying its debt collection procedures, including implementing a sliding fee scale based on ability to pay for care, when community organizations first raised questions about the procedures two years ago. He said Friday’s decision to close all debt cases opened before Oct. 1, 2003, without requiring an application was an extension of this process.

“We are now in the process of closing more than 18,000 accounts,” he said. “Most date from between 1999 and 2003.”

Mattison said that although the closure of the past accounts was a positive step, it serves as an indicator that the hospital’s methods for giving charitable care need an overhaul.

“It’s a great thing that they did it, but what it shows is that their system needs some fixing,” he said.

Daniel Livingston, the lawyer for the class action lawsuit funded by the Service Employees International Union that represented those patients before their debts were recently canceled, said pressure must be maintained on Yale-New Haven to change its policies. He said a pending lawsuit is intended to recover funds for patients who he said should never have had to pay them.

“It shows what the community and the legal system can accomplish when they work together,” Livingston said. “But there is tremendously more that can be done.”

In the previously released report, the aldermanic committee made three proposals for the overhaul of Yale-New Haven’s free-care fund policies, including establishing a program of “provisional eligibility” under which all patients are assumed eligible for coverage until proven otherwise, Mattison said. He said the report also suggested eliminating all unnecessary paperwork and adopting an independent oversight board to review the hospital’s charitable care policies.

The oversight committee proposed by the report would be composed of impartial members of the community who would make general policy decision and serves as a board of appeals for patients, Mattison said.

“It would also be a sounding board for the hospital in trying to figure out what to do next, he said. “The process is too introverted, this is an idea to open it up a little bit.”

Following the release of the report, Yale-New Haven published a response questioning the purposes of the oversight board and the practical implications of the provisional eligibility program, explaining their current one-page application process for free-care funds.

“In general, our most significant frustration is the patient that ignores or makes no attempt to pursue financial assistance, then takes no financial responsibility for their debt, including not returning telephone calls or completing applications for assistance,” Yale-New Haven Senior Vice President William Gedge said in the report.

Petrini said he was concerned about the potential complications inherent in having an oversight committee with authority over the hospital’s policies and noted that the hospital has already sat down with many concerned members of the community. He also expressed concern about the potential role of the SEIU, the organization that is trying to unionize hospital workers at Yale-New Haven, in the proposed oversight board.

“We’ve solicited community input,” he said. “We don’t want to have it caught up the unionization scandal.”

SEIU spokesman William Meyerson said the union provided information to the committee as part of the Hospital Debt Justice project. Mattison said that although the SEIU did participate in the hearings that preceded the report by providing information, unionization concerns are separate from the medical debt collection issues.

The public hearing to discuss the report will begin at 6 p.m. tonight in the aldermanic chambers of City Hall.