Marion County Dept. of Public Welfare v. Methodist Hosp. of Indiana, Inc.

Decision Date03 June 1982
Docket NumberNo. 2-1081A339,2-1081A339
Citation436 N.E.2d 123
PartiesMARION COUNTY DEPARTMENT OF PUBLIC WELFARE, Appellant (Defendant below), v. METHODIST HOSPITAL OF INDIANA, INC., Appellee (Plaintiff below).
CourtIndiana Appellate Court

Robert F. Gammon, Indianapolis, for appellant.

D. L. Hardamon, Dillon, Hardamon & Cohen, Frank E. Spencer, Indianapolis, for appellee.

SHIELDS, Judge.

On July 9, 1980, Willie J. Dixon was admitted to Methodist Hospital (Hospital) in Indianapolis for emergency medical treatment. Dixon, an indigent unable to pay for the care furnished, incurred medical costs valued at $1001.55. The Hospital notified the Marion County Department of Public Welfare (Department) that Dixon had been admitted for emergency care and, pursuant to the Hospital Commitment Act, I.C. 12-5-1-1-15-5-1-17 (Burns Code Ed., Repl. 1981) (now repealed), 1 demanded repayment for the services rendered. The Department denied the request for reimbursement and the Hospital initiated the present action.

The only issue addressed by the trial court was a question of law, i.e., whether the Department, under stipulated facts, is financially responsible for emergency medical care furnished an indigent. Both parties moved for summary judgment. Following a hearing, judgment was entered in favor of Hospital in the amount of $1001.55. The Department appeals. The sole issue presented for our review is

whether the trial court erred as a matter of law when it held the Department is liable under the Hospital Commitment Act for the value of emergency medical services rendered by Hospital to an indigent.

According to I.C. 12-5-1-1, 2 all county welfare departments, except those in counties which maintain a health and hospital corporation under I.C. 16-12-21-1 et seq. (Burns Code Ed.), shall admit to a public hospital any indigent county resident "suffering from a disease, defect or deformity which may be benefited by treatment in such hospital." The term "shall" used in the statute is presumed to be used in its imperative and mandatory sense. City of Indianapolis v. Ingram, (1978) Ind.App., 377 N.E.2d 877. In those counties where a health and hospital corporation (HHC) exists pursuant to I.C. 16-12-21-1 et seq. the county welfare department may in its discretion make the commitment to a public hospital upon application by the indigent.

Marion County is the only county in the state which has an HHC under I.C. 16-12-21-1 et seq. The Marion County HHC is responsible for the operation of Wishard Hospital in Indianapolis. The HHC and Wishard Hospital are charged with the mandatory duty of providing medical care for indigent residents of the county. I.C. 16-12-21-28 states in pertinent part that the HHC:

"(4) ... shall furnish medical care to the indigent within the county other than to those for whom such medical care is furnished by the department of public welfare under the laws of this State." (emphasis added)

Therefore, when an indigent resident of Marion County is in need of hospital care he shall be treated at a hospital operated by the HHC unless the Department exercises its discretion and agrees to reimburse a public hospital for the services rendered. 3

In the present case, however, Dixon was not admitted to the hospital pursuant to an application made in advance with the Department as contemplated under I.C. 12-5-1-1. He was in need of emergency medical treatment. I.C. 12-5-1-15 is the relevant section of the Hospital Commitment Act governing the department of public welfare's financial responsibility for indigents accorded emergency medical care at a public hospital. It provides:

"Whenever any person is admitted to any hospital operated by the trustees of Indiana University or to any other public hospital on an emergency basis with the expectation that the county department of public welfare shall be responsible for necessary charges and expenses, the hospital authorities shall notify promptly such county department of public welfare who shall investigate immediately and determine the eligibility or ineligibility of such person for hospitalization at the expense of the county department of public welfare and shall promptly notify the proper hospital authority of such determination. When any person is committed on an emergency basis subject to the later determination of eligibility, the necessary investigation, determination of eligibility or ineligibility, and notification of hospital authorities of such determination, shall be made promptly. If ineligible, the hospital authorities shall make collection directly from the patient or persons responsible for him or from other resources available to him or from other responsible public authorities. If the county department of public welfare has participated in the original emergency commitment subject to a later determination of eligibility, upon a determination of ineligibility, the liability of the county department of public welfare shall cease in any event, whenever such emergency is over and the patient can be moved from such hospital without injury as determined by medical authority." (emphasis supplied)

This section generally states when an indigent is admitted to a "public hospital" for emergency care the department of public welfare of the relevant county shall be promptly notified. This notification triggers the language of the statute mandating a prompt investigation and determination of eligibility of such person for hospitalization at the expense of the county department of public welfare.

The Department argues I.C. 12-5-1-1-12-5-1-17 must be read in its entirety. It alleges whether a patient is eligible for hospitalization at the expense of the county department of public welfare depends upon the standards established under I.C. 12-5-1-1. It claims because the Department is vested with broad discretion under that section in admitting indigents to public hospitals where application is made in advance, the same unfettered discretion may be exercised in deciding whether to reimburse public hospitals in emergency cases. According to the Department, the question is not whether the patient is eligible for hospitalization at public expense but whether the expense should be borne by the county department of public welfare as opposed to some other public agency. Toward this end the Department points out that upon a determination of ineligibility the hospital may make collection from other parties, including "other responsible public authorities." 4

We find the Department's contention untenable. I.C....

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