Mercy Medical Center of Oshkosh, Inc. v. Winnebago County

• Decision Date: 20 April 1973
• Docket Number: No. 356,356
• Citation: 58 Wis.2d 260,206 N.W.2d 198
• Court: Wisconsin Supreme Court
• Parties: MERCY MEDICAL CENTER OF OSHKOSH, INC., Plaintiff-Appellant, v. WINNEBAGO COUNTY, Defendant-Respondent.

Page 198

206 N.W.2d 198

58 Wis.2d 260

MERCY MEDICAL CENTER OF OSHKOSH, INC., Plaintiff-Appellant, v. WINNEBAGO COUNTY, Defendant-Respondent.

No. 356.

Supreme Court of Wisconsin.

April 20, 1973.

Rehearing Denied June 29, 1973.

Nolan, Engler, Yakes & Curtis, Oshkosh, for plaintiff-appellant.

Edward J. Salzsieder, Asst. Corp. Counsel, Oshkosh, for defendant-respondent.

HALLOWS, Chief Justice.

The issue raised is whether a county must reimburse a hospital for emergency care given to a patient who does not want public assistance (although she is unable to pay for the hospital services) and refuses to cooperate with county officials in charge of public assistance so as to allow the county to charge back any public assistance given to the place of the patient's legal settlement.

The facts are not in dispute. In the early morning hours of January 3rd, 1970, Linda K. Wilkinson was admitted to the hospital suffering from a self-induced incomplete abortion and requiring immediate and indispensable hospitalization and care. Miss Wilkinson at the time was unemployed, had no health insurance or liquid assets, and had approximately $5 in cash in her purse. She had driven with friends into Oshkosh from Green Bay, but the place of her residence is not clear in the record.

The hospital served the county with a written notice of Miss Wilkinson's injury and treatment pursuant to the requirements of sec. 49.02(5), Stats. ¹ The bill amounted to $528.87. Having received the notice, Dan MacArthur, an employee of the county's department of social services, visited Miss Wilkinson at the hospital. She told him she did not desire any welfare and wished to be left alone, as she intended to pay the bill herself. On the basis of this information, the county denied liability. Thereafter, the hospital commenced an action against Miss Wilkinson and on June 1, 1971, took a judgment against her, which remains unsatisfied. The hospital then commenced this suit against the county.

At the trial Miss Wilkinson, in testifying as to her financial status, stated that prior to the entry into the hospital she was a go-go dancer earning from $150 to $400 per week depending upon the type of act. After her discharge from the hospital she concluded her personal problems stemmed from this line of work and decided not to resume dancing. She was unsuccessful in obtaining other employment but she did work sporadically cleaning houses or as a part-time baby sitter. She lived with a boy friend who provided room and board and occasionally she received some money from an aunt in Indiana who was caring for her child. In spite of her financial condition, Miss Wilkinson refused to make an application for general welfare.

Under sec. 49.02(5), Stats., a county is liable for the hospitalization and care rendered by a physician or surgeon to a person entitled to relief under ch. 49, Stats., without previous authorization when in the reasonable opinion of the physician immediate and indispensable care or hospitalization is required and authorization therefor cannot be obtained without delay likely to injure the patient. This section also provides that there is no liability for care or hospitalization beyond what is reasonably required, and liability shall not exist unless within seven days of furnishing the first care or hospitalization written notice by the hospital or surgeon giving required information is mailed to the county. There is no dispute that an emergency existed, Miss Wilkinson needed immediate hospitalization, there was no previous authorization of the service by the county, and a proper notice of the rendering of the service was given to the county. The issue is what is meant by the words in the statute, 'a person entitled to relief under this chapter.'

Although the trial court stated the statute contemplated a situation 'of emergency treatment required for an individual receiving public assistance in accordance with the provisions of chapter 49,' we take this to mean not that the person must actually be receiving public assistance but rather that the person must be determined eligible in order to receive general assistance subsequent to the rendering of emergency relief. Thus we construe sec. 49.02(5), Stats., to authorize emergency relief without the county's previously authorizing the same for a person not then receiving general assistance. But the question is whether that person must subsequently apply for general relief under ch. 49 or whether the liability of the county for such relief is excused when the person otherwise meeting the requirements of the statute for general relief refuses to make an application therefor.

In sec. 49.01(7), Stats., 'eligible' or 'eligibility' is defined as 'a dependent person who has continuously resided for one whole year in this state immediately prior to an application for relief except that temporary assistance including medical care may be granted during the initial year to meet an emergency situation . . .' By sec. 49.01(4) a 'dependent person' or 'dependent' is defined as 'a person without the present available money or income or property or credit, or other means by which the same can be presently obtained, sufficient to provide the necessary commodities and services specified' as 'relief,' one item of which is hospital care.

The county takes the position that a person is not entitled to relief until his eligibility is determined and that it has no duty to determine entitlement unless the person makes an application for general relief and gives sufficient information to allow the county giving the care or hospitalization to charge back the cost thereof to the municipality of the person's legal settlement. Since Miss Wilkinson refused to make such an application, the county takes the position she is not 'a person entitled to relief' and it has no liability for the hospital emergency service furnished her.

This section can mean one of two things for the purpose of emergency medical relief: (1) That a person is eligible if the facts show she would receive general relief if she would make the application, or (2) the more strict rule of interpretation, that the person must actually be receiving or subsequently receive relief after her entitlement has been determined for the purpose of granting general relief. We find no requirement in sec. 49.02(5), Stats., that an application must be made or the information on legal settlement must be given as a condition precedent to the liability of the county for emergency hospital relief. See Holland v. Cedar Grove (1939), 230 Wis. 177, 282 N.W. 111, rehearing denied, 282 N.W. 448; Davis v. Town of Scott (1884), 59 Wis. 604, 18 N.W. 530; McCaffrey v. Town of Shields (1882), 54 Wis. 645, 12 N.W. 54. The only express condition precedent to the county's liability is a notice to be given to it within seven days after furnishing hospitalization. The hospital's right to recover under this section should not be conditioned upon the recipient's subsequent action or inaction or even refusal to apply under ch. 49 for general relief which she does not want.

Availability of hospital emergency service may well be at stake. A hospital should not be put in the position of negotiating over payment for its services as a condition precedent to rendering emergency services. Our health-conscious society and the government's interest in extensive health care for young and old alike demands that emergency service by doctors and hospitals shall be promptly rendered to those in need without regard for immediate payment or security therefor. The best traditions of the medical and hospital professions have recognized this. It is quite true...