Terrell County v. Albany/Dougherty Hosp. Authority
| Decision Date | 28 January 1987 |
| Docket Number | No. 43764,43764 |
| Citation | 256 Ga. 627,352 S.E.2d 378 |
| Parties | TERRELL COUNTY v. ALBANY/DOUGHERTY HOSPITAL AUTHORITY. |
| Court | Georgia Supreme Court |
Joe C. Bishop, Collier & Bishop, Dawson, for Terrell County, georgia.
C. Richard Langley, Perry, Walters & Lippett, Albany, Michael J. Bowers, Atty. Gen., William C. Joy, Sr. Asst. Atty. Gen., for Albany/Dougherty Hosp. Authority, d/b/a Phoebe Putney Memorial Hosp.
The dispute here involves the county's obligation to pay for services extended to its indigent pregnant residents by a hospital in another county. Terrell County contests the constitutionality of the statute which requires such payment. The trial court found for the Albany/Dougherty Hospital Authority and we affirm.
The Hospital Care for Pregnant Women Act (OCGA § 31-8-40, et seq.) is the target of the constitutional attack. OCGA § 31-8-42 requires certain hospitals to provide emergency care to pregnant women in labor and the Albany/Dougherty Hospital falls in that group. OCGA § 31-8-43(c) allows the hospital affording the services to make a claim for reimbursement of a portion of the costs from the county of residence of the patient if the patient is found to be indigent. The mechanics for asserting the claim involve several steps. The hospital shall notify the Health Care Advisory officer of the patient's county of residence of the claim. Not later than sixty days after notification the health care advisory officer of the county must notify the hospital of his determination as to the indigency of the patient. "If the health-care advisory officer determines that the patient meets the indigency standard or if the health-care advisory officer of a county fails to respond to a request for determination of indigency from a hospital providing health care for such patient within the time limitation provided by this subsection, the county of residence of the patient shall be liable for the payment of cost of care of such patient in each hospital rendering ... emergency services."
The Albany/Dougherty Hospital Authority (the hospital) made claims against Terrell County for services to five Terrell County residents. Determinations of indigency were made by the Health Care Advisory officer of Terrell County. The demand for payment by the hospital was refused. The present litigation followed. Summary judgment was granted to the hospital and Terrell County appealed. As outlined by Terrell County, the issues involved in the case are: (1) Whether OCGA § 31-8-40 is constitutional; (2) whether there is any genuine issue of material fact; (3) whether the hospital or individuals waived any rights under OCGA § 31-8-40 by the execution, delivery and acceptance of promissory notes; (4) whether there has been an effective payment and release; (5) whether the hospital's claims were properly presented to Terrell County as provided by OCGA § 36-11-1; (6) whether the claims of the hospital were for appropriate emergency services.
1. In its constitutional attack on the statute, the county complains that the legislation could force a political subdivision to incur obligations without submitting new debt to the voters for approval in violation of Art. IX, Sec. V of the Georgia Constitution of 1983. The county asserts that the statute is violative of Art. IX, Sec. IV, Para. 1 in that it might result in taxation to pay bills for residents who are not truly indigent if the health care advisory officer fails to process the hospital's claim within the time required by the statute. The county also attacks the statute as conflicting with Art. IX, Sec. IV, Para. 2 (), Art. IX, Sec. II, Para. 1 () and Art. IX, Sec. III, Para. 1 (). The county's argument in support of its position is that it might have a contract with the hospital to provide services and be forced to buy a claim under OCGA § 31-8-43 as well, thus paying the same bill twice. All of the above constitutional arguments rely on hypothetical facts which are not properly before the court. "The delicate power of pronouncing an Act of Congress unconstitutional is not to be exercised with reference to hypothetical cases...." United States v. Raines, 362 U.S. 17, 22, 80 S.Ct. 519, 523, 4 L.Ed.2d 524 (1960). Similarly, this court will not decide the constitutionality of an act of the legislature where the attack is made by a party whose rights have not been affected. Northeast Factor & Discount Company v. Jackson, 223 Ga. 709, 157 S.E.2d 731 (1967).
2. Another constitutional attack made by the county is that OCGA § 31-8-42 is violative of Art. IX, Sec. II, Para. III(b)(1) which prohibits a county from exercising certain enumerated powers inside the boundaries of any municipality or other county except by contract with the entity affected. Terrell County argues that since it has no contract with the political subdivision within which the hospital is located, it cannot constitutionally pay the claims of the hospital. However, the constitutional prohibition is prefaced by the words "unless otherwise provided by law." This exception applies to a general law such as OCGA § 31-8-43.
3. Terrell County also raises a variety of other issues. The first of these is that the complaint fails to state a claim upon which relief can be granted. The basis of this allegation is that the complaint fails to set forth the statute under which the claim is made. The county's answer, however, shows on its face that the complaint was sufficient to make defendant aware of the nature of the claim against it and the statutory authority for that claim. The trial court did not err in this respect.
4. OCGA § 31-8-43 mandates the adoption of statewide standards of indigency by the Commissioner of Human Resources. In compliance with this statute, the Commissioner promulgated standards which appear at § 260-4-5-.05, Official Compilation, Regulations of the State of Georgia. The county takes the position that these standards are arbitrary, capricious, or otherwise unreasonable and enumerates as error the failure of the trial court to so hold....
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