Lutheran Hospital of Ft. Wayne, Inc. v. Department of Public Welfare of Allen County
| Decision Date | 06 December 1979 |
| Docket Number | No. 3-776A178,3-776A178 |
| Citation | 397 N.E.2d 638 |
| Parties | LUTHERAN HOSPITAL OF FORT WAYNE, INC.; Parkview Memorial Hospital, Inc. of Fort Wayne, Indiana; St. Joseph's Hospital, Inc. of Fort Wayne, Indiana, Appellants (Plaintiffs Below), v. DEPARTMENT OF PUBLIC WELFARE OF ALLEN COUNTY, Indiana, Appellee (Defendant Below). |
| Court | Indiana Appellate Court |
Paul C. Raver, Sr., Richard D. Robinson, Rothberg, Gallmeyer, Fruechtenicht & Logan, Fort Wayne, for appellants.
Philip H. Larmore, Adair, Perry, Beers, Mallers, Scott & Larmore, David A. Stewart, Miller & Stewart, Fort Wayne, for appellee.
This is an appeal from a judgment of the trial court declaring that three Fort Wayne hospitals are entitled to reimbursement from the Allen County Department of Public Welfare (Department) for emergency medical treatment rendered to indigents suffering from alcoholism, drug addiction or emotional illness but not for services associated with normal pregnancies.
On July 8, 1975, an action for a declaratory judgment was filed in Allen Superior Court by Lutheran Hospital, Inc.; Parkview Memorial Hospital, Inc.; and St. Joseph's Hospital, Inc. (collectively referred to as "Hospitals") requesting a declaration of their rights with respect to IC 1971, 12-5-1-1 through 12-5-1-17 (Burns Code Ed.) hereinafter referred to as the "Hospital Commitment Act." Specifically, Hospitals petitioned for a determination that the Department was responsible under the act for paying the necessary medical, surgical and hospital expenses incurred in the emergency treatment of indigents suffering from the following disorders:
"(a) Persons afflicted by ills associated with the ingestion of alcoholic beverages;
(b) Persons suffering from mental illness and depression and emotionally related illnesses;
(c) Persons afflicted by ills associated with the use of narcotic drugs as well as all and any drugs taken in excess; and
(d) Persons who are pregnant and in need of hospital care for the delivery of children or other hospital care associated with pregnancy."
On December 8, 1975, the court entered judgment as follows:
"1. That the plaintiff hospitals are corporations organized pursuant to the laws of the State of Indiana and that said plaintiff hospitals are not conducted for profit.
2. That the plaintiff hospitals are open to the public without discrimination of race, color, or religious belief.
3. That the plaintiff hospitals are 'public hospitals' within the meaning of I.C. 12-5-1-1 Et seq.
4. That the Allen County Department of Public Welfare of Allen County, Indiana, has a Hospital Commitment Program adopted pursuant to I.C. 12-5-1-1 through 12-5-1-17 and that the said Program commenced on January 1, 1975 at which time the said Department had a duty to accept application and make investigation pursuant to the said statutes in regards to the following three categories of illnesses which are included within 'diseases, defects or deformities' as set forth in the aforementioned statutes:
a. Those persons afflicted by ills associated with the ingestion of alcoholic beverages;
b. Those persons suffering from mental illness and depression and emotionally related illnesses;
c. Those persons afflicted by ills associated with the use of narcotic drugs as well as all and any drugs taken in excess.
5. That the aforementioned statutes require the said Department to accept application in the aforementioned three categories and to make investigation as to financial eligibility and further that the said Department should pay for the treatment rendered if the said person or persons are otherwise financially eligible.
6. That the aforementioned three excluded categories all fall within the definition of I.C. 12-5-1-1, Et seq. and are either a 'disease', 'defect', or 'deformity'."
The sole issue posed by Hospitals' appeal is whether the trial court erred in excluding the emergency treatment of indigents for normal pregnancies from the coverage of the Hospital Commitment Act. In its cross-appeal, the Department has interposed these objections to the trial court's ruling:
(1) whether responsibility for the payment of hospital care rendered to indigents is that of the township trustee or the Department;
(2) whether responsibility for the payment of hospital care rendered to indigents suffering from alcoholism, drug addiction or mental illness is that of the Indiana Department of Mental Health;
(3) whether Hospitals are "public hospitals" within the meaning of the Hospital Commitment Act;
(4) whether the Hospital Commitment Act is unconstitutional;
(5) whether Hospitals have standing to bring this suit;
(6) whether Hospitals failed to join indispensable parties;
(7) whether the trial court erred in granting a motion for involuntary dismissal tendered by the Indiana State Department of Public Welfare;
(8) whether the trial court erred in finding that alcoholism, drug addiction and mental illness were included within the terms "disease, defect or deformity" because no competent medical evidence was introduced to support that finding; and
(9) whether the trial court erred in failing to specify within which of the terms "disease, defect or deformity" the categories of alcoholism, drug addiction and mental illness fall.
Hospitals' only contention is that the trial court erred in excluding emergency treatment for normal pregnancies from the scope of the Hospital Commitment Act. IC 1971, 12-5-1-1 provides generally that the Department is empowered to commit to certain hospitals any indigent who appears to be suffering from a disease, defect or deformity which may be benefited by treatment in those hospitals. IC 1971, 12-5-1-15 contains an emergency admissions procedure applicable to the act.
Hospitals suggest that the clause "disease, defect or deformity which may be benefited by treatment" should be broadly construed in order to encompass normal pregnancies. Several recognized principles of statutory construction offer guidance in resolving this controversy. Paramount among these rules is to ascertain the intent of the Legislature. State v. Gilbert (1966), 247 Ind. 544, 219 N.E.2d 892. Moreover, unnecessary strain should not be placed on words in order to give effect to the interpreter's preconceived meaning. Specific words in a statute ought not to be enlarged when it is apparent that they were not intended to be given such construction. Adams et al. v. Slater, Administrator etc. (1961), 132 Ind.App. 105, 175 N.E.2d 706. Further, where the terms are not technical in nature, they should be interpreted according to their plain and ordinary meaning. Bowen v. Review Bd. of Ind. Emp. Sec. Div. (1977), Ind.App., 362 N.E.2d 1178.
Considering these terms in their plain and ordinary meaning, a reasonable approach dictates that treatment for normal pregnancies is not within the scope of the Hospital Commitment Act. The following definitions extracted from Black's Law Dictionary (4th ed. 1968) provide a useful summary of the meaning of these words:
Pregnancy is the existence of the condition beginning at the moment of conception and terminating with delivery of the child. State ex rel. Leffingwell v. Grant Sup. Ct. 2 (1974), 262 Ind. 574, 321 N.E.2d 568. Additionally, the consensus of judicial opinion in this country indicates that pregnancy is a normal physiological function of women. Banti v. State (1956), 163 Tex.Cr. 89, 289 S.W.2d 244; Newmon v. Delta Air Lines, Inc. (N.D.Ga.1973), 374 F.Supp. 238; Crees v. California State Board of Medical Exam. (1963), 213 Cal.App.2d 195, 28 Cal.Rptr. 621; Rasicot v. Royal Neighbors of America (1910), 18 Idaho 85, 108 P. 1048; Commonwealth v. Porn (1907), 196 Mass. 326, 82 N.E. 31; Lee v. Metropolitan Life Ins. Co. (1936), 180 S.C. 475, 186 S.E. 376.
Thus, it is evident that a normal pregnancy does not fall within the rubrics of "disease, defect or deformity". To hold otherwise would place an unreasonable strain upon the language of the statute.
In an effort to obviate this conclusion, Hospitals maintain that the Hospital Commitment Act evinces a clear legislative purpose to provide a broad and comprehensive scheme for rendering medical assistance to all indigents. It is argued that the 1974 amendment to IC 1971, 12-5-1-1 shifted the responsibility for indigent medical care from the township trustee to the county department of public welfare. Contrary to this assertion, the 1974 amendment did not fully supplant the township trustee's duty to provide medical assistance to the poor. Prior to 1974, the Department was permitted but not required to commit indigents "suffering from a disease, defect or deformity, which may be benefited by treatment" under the act. With the 1974 enactment, the Department's responsibility became mandatory.
Unless an indigent can meet the statutory criteria of "disease, defect or deformity which may be benefited by treatment", the Department is not mandated to commit him or pay for his care. If the General Assembly had intended to shift all indigent medical care to the Department, it could easily have done so. Instead,...
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