Gary Community Mental Health Center, Inc. v. Indiana Dept. of Public Welfare

Decision Date28 May 1987
Docket NumberNo. 45A03-8610-CV-304,45A03-8610-CV-304
Citation507 N.E.2d 1019
PartiesGARY COMMUNITY MENTAL HEALTH CENTER, INC. and Nineteen (19) Cases, Petitioners-Appellants, v. INDIANA DEPARTMENT OF PUBLIC WELFARE and Lake County Department of Public Welfare, Respondents-Appellees.
CourtIndiana Appellate Court

Douglas M. Grimes, Gary, for petitioners-appellants.

Maria Luz Corona, Karen P. Pulliam-Willis, Gary, for respondents-appellees.

GARRARD, Presiding Judge.

Facts

In 1977, Gary Community Mental Health Center (GCMHC) entered into an agreement with St. Mary Medical Center (medical center) whereby GCMHC established an inpatient psychiatric facility within the medical center building. Pursuant to this agreement, GCMHC leased a wing of the medical center building and assumed sole responsibility and authority to administer and implement the mental health inpatient treatment program. The medical center's role was that of lessor of the hospital wing. (See Record, p. 45).

Nineteen mental patients who had received treatment at the GCMHC inpatient facility within the medical center submitted applications to Lake County Department of Public Welfare (LCDPW) for payment for such services under the Hospital Care for the Indigent Act, IC 12-5-6-1 et seq. The LCDPW refused to consider the nineteen applications because the facility which administered the treatment, namely GCMHC, was not a hospital as defined by IC 16-10-1-6(a). 1 GCMHC and the nineteen applicants appealed the decision of the LCDPW to an administrative law judge and subsequently to the Indiana Department of Public Welfare (IDPW), each of whom affirmed the decision of the LCDPW.

On May 19, 1986, GCMHC and the nineteen applicants filed a verified petition for review in the Lake Superior Court. Both the IDPW and the LCDPW (the departments) filed responses. The trial court affirmed the departments' decisions denying review under the Act. GCMHC and the nineteen applicants now appeal to this court.

Issues

The following issues are presented by this appeal:

I. Whether medical services eligible for payment under the Act must be provided "by a hospital" rather than merely "in a hospital."

II. Whether the eligibility requirements under the Hospital Care for the Indigent Act violate the equal protection and due process guarantees of the Indiana and United States Constitutions.

We affirm.

Discussion
I.

Initially GCMHC contends that the departments' refusal to consider the nineteen applications of the mental patients was based on an improper application of the Hospital Care for the Indigent Act, IC 12-5-6-1 et seq. The specific provision at issue sets forth the criteria for eligibility under the Act and provides:

"Eligibility for assistance

Sec. 2.1(a) A resident of Indiana who meets the income and resource standards established by the state department of public welfare under subsection (c) is eligible for assistance to pay for any part of the cost of care provided in a hospital in Indiana that was necessitated after the onset of a medical condition that manifested itself by symptoms of sufficient severity that the absence of immediate medical attention would probably result in:

(1) placing the person's life in jeopardy;

(2) serious impairment to bodily functions; or

(3) serious dysfunction of any bodily organ or part."

IC 12-5-6-2.1 (West Supp.1986-87) (our emphasis). GCMHC argues that the language "in a hospital in Indiana" does not require that the medical care for which financial assistance is sought be rendered by the hospital itself. Instead, GCMHC claims, the phrase "in a hospital" is locational and merely requires that the medical care be provided within the physical structure of a hospital. GCMHC concludes that since the mental treatment which the nineteen applicants received was rendered inside the physical confines of a hospital, then review of the nineteen applications for financial assistance under the Act should have been granted.

The departments respond, however, that the eligibility requirements under the Act and the language "in a hospital" must be read in conjunction with other sections of the Act. The departments urge that an appropriate reading of the statute as a whole reveals that the legislature intended that for eligibility under the Act, the medical treatment must be for physical injury or disease and must be provided "by" the hospital itself rather than merely within its walls. We agree.

If the language of a statute is clear and unambiguous it is not subject to judicial interpretation. Indiana Department of State Revenue v. Estate of Smith (1984), Ind.App., 460 N.E.2d 1263, 1265. Where the statutory language is reasonably susceptible to more than one construction, we will construe the statute to determine the apparent legislative intent. Frame v. South Bend Community School Corp. (1985), Ind.App., 480 N.E.2d 261, 263. However, a statute is to be interpreted as a whole, giving common and ordinary meaning to the words used and not overemphasizing a strict literal or selective reading of individual words. Foremost Life Insurance Co. v. Department of Insurance (1980), 274 Ind. 181, 409 N.E.2d 1092, 1096. Interestingly, both GCMHC and the departments claim that the Act is clear and unambiguous. Nevertheless, we find the parties' argument illustrative of the Act's susceptibility to two or more constructions. Thus, judicial interpretation of the Act and, specifically, the language "in a hospital" is warranted.

A brief examination of several sections of the Act reveals the legislature's intent that medical care within the Act be rendered "by a hospital" and for physical injury, disease or defect. For example, IC 12-5-6-5, which governs investigation procedures for the determination of eligibility, provides in pertinent part:

"Investigation; determination of eligibility

Sec. 5(a) A county department of public welfare, upon receipt of an application of a patient admitted to a hospital, shall promptly investigate to determine the patient's eligibility under this chapter. The hospital rendering medical care to the patient shall provide information which it has which would assist in the verification of indigency of a patient and if a hospital provides such information it is immune from civil and criminal liability for divulging that information."

(our emphasis). Similarly, IC 12-5-6-11, which governs the responsibility for medical costs in a county with a health and hospital corporation, provides in relevant part:

"[H]owever, the hospital providing treatment shall transfer the patient to a hospital operated by the health and hospital corporation as soon as the attending physician determines that the patient's medical condition permits such a transfer without injury to the patient. If a hospital owned by the health and hospital corporation is unable to care for or otherwise treat a patient at the time a transfer is requested by the hospital initiating treatment, such hospital may continue to treat the patient until his discharge, and the costs of treatment shall be borne by the county department of public welfare of the county."

(our emphasis). The language in these sections clearly indicates that the Indiana legislature intended that medical care within the Act be rendered "by a hospital" rather than simply "in a hospital." We hold that the departments properly applied the Act and correctly denied review of the nineteen applications. 2

II.

GCMHC also asserts that the departments' refusal to review the nineteen applications violated the equal protection and due process guarantees of the Indiana and United States Constitutions. 3 Specifically, GCMHC claims that the departments' denial of benefits under the Act discriminated against a suspect class, indigents suffering from mental illness, and impinged on the applicants' fundamental right to medical treatment. Our finding that the departments' application of the Act was correct converts GCMHC's argument into a direct constitutional challenge to the Act's eligibility requirements. In any case, GCMHC's constitutional claims are simply contrary to law and must fail.

Fundamental rights are those rights either ...

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