Carpenter v. Twin Falls County

• Decision Date: 07 November 1984
• Docket Number: No. 14389,14389
• Parties: Clarence CARPENTER and St. Alphonsus Hospital, Plaintiffs-Respondents, v. TWIN FALLS COUNTY, Idaho and its Board of County Commissioners, Defendants-Appellants.
• Court: Idaho Supreme Court

Page 1190

691 P.2d 1190

107 Idaho 575

Clarence CARPENTER and St. Alphonsus Hospital, Plaintiffs-Respondents, v. TWIN FALLS COUNTY, Idaho and its Board of County Commissioners, Defendants-Appellants.

No. 14389.

Supreme Court of Idaho.

Nov. 7, 1984.

Rehearing Denied Dec. 28, 1984.

Lloyd J. Webb, Twin Falls, for defendants-appellants.

Phillip S. Oberrecht and Glenna M. Christensen (argued), of Moffatt, Thomas, Barrett & Blanton, Chartered, Boise, for plaintiffs-respondents.

BISTLINE, Justice.

Elva Carpenter was hospitalized at St. Alphonsus Hospital in Boise with a terminal illness on April 21, 1980. Upon her death on May 4, 1980, a total hospital bill of $10,614.09 was rendered by the hospital to her surviving husband, Clarence Carpenter. While Mrs. Carpenter was in the hospital, Mr. Carpenter, using a county-printed form which he obtained from a county secretary, partially completed an "Application for County Assistance." Carpenter would later testify that on or about May 8, 1980, he personally delivered the application, which was neither signed nor sworn to, to Merle Leonard, then Chairman of the Board of County Commissioners; that he had not signed it because he knew his signature had to be "notarized" by someone; that Mr. Leonard stated that the application was "all right." Tr., pp. 10, 12. Mr. Leonard would later testify that he did not recall ever suggesting to Mr. Carpenter that the application was all right even though it was not signed, but that he just took the application. Tr., p. 32.

By letter of May 27, 1980, the Commissioners advised Mr. Carpenter that the application was incomplete and did not meet the requirements of I.C. § 31-3404. The letter suggested that additional data be supplied concerning the treatment involved and the dates and costs thereof. The letter concluded with the statement "we can do nothing but consider that no formal written application ... has been filed." The letter, which was addressed to Elva Carpenter at the residence specified in the application--519 Wiseman Street, Hansen, Idaho--was returned undelivered. A second letter sent to Clarence and Elva Carpenter, Route 1, Kimberly, Idaho, was also returned undelivered. This letter was from attorney Lloyd J. Webb, informing the Carpenters that the County Commissioners had directed him to inform them that the incomplete application was rejected. A second paragraph added: "Under the law, you have a right to hearing before the Board of County Commissioners to review this denial. If you wish a hearing, please advise either me or the County Commissioners in writing within the next 20 days so that we can schedule the appropriate procedures." A third letter of rejection was sent to Carpenter at Route No. 12, Box 199, Gooding, Idaho, and that letter was ultimately delivered.

Prior to the delivery of the third letter, the Commissioners received a certified letter from counsel for the Hospital, dated August 19, 1980, requesting a redetermination hearing. ¹ Enclosed with the letter was an itemized statement for the services that had been rendered. A hearing was duly scheduled for November 21, 1980.

At the hearing and prior to the taking of any testimony, three exhibits were stipulated into evidence; these included the application, the hospital records of services and charges, and a bankruptcy court notice which declared that Mr. Carpenter had filed a petition for bankruptcy on July 21, 1980. There ensued a colloquy between counsel for the Hospital and independent counsel representing the Commissioners. When asked why the Commissioners initially denied the Carpenter application, counsel for the County responded: "I suppose the answer, counsel, to your question has to be because we simply felt we lacked information upon which to act. ... [T]he denial was merely to avoid getting caught in a trap of letting the application sit without action ...." Tr., p. 7. (I.C. § 31-3505 provides that "[i]f the board of county commissioners fails to act upon an application within sixty (60) days from the receipt of said application, it shall notify the applicant in writing, or upon its failure to give notice within said time, the application shall be deemed approved ....")

The first letter from the Commissioners suggests that the information to which counsel appears to have been referring was data concerning the treatment received by Mrs. Carpenter, the dates and cost thereof. ² The county's application form, however, provided no place for the insertion of such information. The form utilized is captioned APPLICATION FOR COUNTY MEDICAL INDIGENT ASSISTANCE. Paragraph 2 of the form is structured so that the form can be used in emergency and non-emergency situations. Basically it is a statement that the applicant is without assets or without average monthly income from which he or she could reasonably be expected to pay necessary hospitalization costs. Paragraph 5 provides a financial statement to be filled out. Mr. Carpenter did so, including therein with his statement of Total Monthly Expenses that his wife "is presently in intensive care in Boise, had extensive surgery--with several Drs. Also estimate 3 weeks yet in intensive care--will be considerable skin grafts done." This information, although not requested by the county's form, appears to be in compliance with all of the various provisions of I.C. § 31-3504. ³

As is discussed infra, an application for certification of medical indigency status is made to the clerk of the Board of County Commissioners, and not in the first instance to the Board. The clerk has the further duty to investigate the claim of indigency, or cause it to be investigated, and thereafter report his findings to the Board--who will then approve or deny the application. Where the application precedes medical or hospital treatment, initially the only question before the clerk, and in the Board, is determination of the asserted status. In emergency situations the person claiming or on whose behalf claim of medical indigency is made is obligated to make application for the status determination only--leaving for later, presumably at the termination of services, the validity of the monetary claim which will be submitted to the Commissioners for their action.

The legislature has required a timely application for certification as to medical indigency status, but has not required the same alacrity regarding the submission of claims. For instance, I.C. § 31-3509 provides that "Hospitals making claims for the hospitalization of medically indigent persons shall make all reasonable efforts to determine liability for the account so incurred from any available insurance or other sources ... prior to submitting the bill to the county for payment." I.C. § 31-3508 refers to a bill "submitted for payment pursuant to section 31-3405, Idaho Code," but I.C. § 31-3405 merely provides that "the bill for such hospitalization or expenditure shall be presented to the board of county commissioners, duly verified under oath," without specifying who has the obligation to present the bill or at what time.

The statutory scheme as written and scattered haphazardly in the various sections is confusing. At least one thing is clear however, and that is that there is no requirement that the indigent applicant include the hospital bill with his application. This makes sense; if the application is for non-emergency assistance, there will be no bill at the time the application is filed, and the same situation will also occur in some cases in which the application is for emergency medical benefits because of the time restrictions on the filing of an application. Under the circumstances, it appears that it would be clearly inappropriate for county commissioners to deny an application for medical indigency assistance on the sole ground that information regarding the medical bill had not been submitted, without ever notifying an indigent applicant that he or she was expected to provide such information.

We hold that the application clearly complied with the requirements of I.C. § 31-3504. As the lower court pointed out, I.C. § 31-3404 excepts from its provisions medical indigency petitions filed under I.C. § 31-3504, which specifically deals with the medically indigent receiving emergency services. We agree. Hence, there was no requirement of Mr. Carpenter that he subscribe and swear to a petition, which he submitted on behalf of his hospitalized wife.

At the hearing on November 21, 1980, Carpenter testified that at the time the debt in question was incurred and at the time the application for assistance was filed, he was employed by a farmer who paid him $750 a month plus housing. Carpenter further testified that he quit this job because his daughter did not want him living alone and his son-in-law needed help on his farm. At the time of the hearing Carpenter was living with his daughter's family and working for his son-in-law for his room and board plus some occasional spending money. Carpenter testified that it was "possible" that employment as a farm laborer would be available to him if he wanted to return to that sort of work. He also testified at the hearing that he had virtually no assets and a total outstanding indebtedness of $25,797.71, including the bill from the hospital for $10,614.09. At the hearing the Commissioners were made aware of the fact that on or about July 22, 1980, Carpenter had filed a voluntary petition in bankruptcy and that the hospital's claim was among those inventoried in the bankruptcy petition.

Upon completion of the hearing, the matter was taken under advisement by the Commissioners. On January 9, 1981, the Commissioners reaffirmed their earlier rejection of the Carpenter claim on the basis of: (1) The lack of filing of a properly executed claim; (2) The lack of notice of emergency medical indigent treatment as required by I.C. § 31-3504; ⁴ (3) The lack of medical indigency; (4) The applicant's lack of any...