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09/06/83 LUTHER HOSPITAL v. EAU CLAIRE COUNTY

September 6, 1983

LUTHER HOSPITAL, A WISCONSIN CORPORATION, AND MIDELFORT CLINIC, LTD., PLAINTIFFS-APPELLANTS,
v.
EAU CLAIRE COUNTY, WISCONSIN, A MUNICIPAL CORPORATION, DEFENDANT-RESPONDENT



Appeal from a judgment of the Circuit Court for Eau Claire County: Thomas H. Barland, Judge.

Petition to Review Denied.

Foley, P.j., Dean and Cane, JJ.

The opinion of the court was delivered by: Cane

Luther Hospital and Midelfort Clinic, Ltd., appeal from a judgment dismissing their complaint for payment by Eau Claire County (county) of the emergency medical service costs for Harold E. Gorman. The trial court concluded that Gorman was not a dependent as defined by sec. 49.01(4), Stats., and therefore the county was not liable for the cost of his care. Because we conclude that Gorman's right to apply for a veteran's emergency relief grant did not constitute "other means" by which he could "presently obtain" money to provide emergency medical services for himself, we reverse the judgment and remand this matter to the trial court with directions.

Gorman was admitted to Luther Hospital on May 24, 1981, with chest pains diagnosed as a possible heart attack. He was treated by a physician from Midelfort Clinic and released on May 27. On May 26, a Notice of Emergency Hospitalization and/or Inpatient Treatment signed by the attending physician was sent to the Eau Claire County Department of Human Services. The notice was intended to satisfy the procedural requisites to county liability for the cost of Gorman's care under sec. 49.02(5), Stats., *fn1 and indicated that Gorman was a veteran of United States military service.

The Eau Claire County Veteran's Service office was also notified of the emergency hospitalization. This office in turn notified the Wisconsin Department of Veteran's Affairs (department), in an attempt to secure an emergency grant for health care aid pursuant to Wis Admin Code § VA 2.01 (1979). *fn2 Such aid was not obtained, however, because Gorman did not submit the necessary application forms for certification of his eligibility.

Section 49.02(5) makes local governments liable for the expense of hospitalization and medical care of persons entitled to general relief under ch. 49, Stats. To be entitled to relief under ch. 49, a person must meet certain criteria, the only one at issue on this appeal being whether Gorman was a dependent. A dependent is defined in sec. 49.01(4), Stats., as:

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 [including medical, surgical, and hospital care] . . . .

The trial court concluded, as a matter of law, that Gorman's right to apply for a veteran's emergency grant for health care aid constituted "other means by which the same can be presently obtained," making him nondependent and not entitled to relief under ch. 49, thus relieving the county of liability for the cost of his care. The interpretion of a statute is a question of law to be independently decided by this court without deference to the trial court's Conclusion. Nelson v. Union National Bank, 111 Wis. 2d 313, 315, 330 N.W.2d 225, 226-27 (Ct. App. 1983).

As a veteran, Gorman could have applied to the Wisconsin Department of Veteran's Affairs for an emergency grant for health care aid to cover the expense of his hospitalization under Wis. Admin. Code § VA 2.01 (1979). The department requires that sufficient evidence be submitted, and in some cases investigated, before an application for an emergency grant will be acted upon. Wis. Admin. Code § VA 2.01(9) (1983). The required evidence should include information demonstrating that the veteran "has insufficient resources to cover the cost of health care . . . and . . . insufficient income to enable the . . . to repay a loan, the proceeds of which could be used for the purpose of providing necessary health care." Wis. Admin. Code §§ VA 2.01(2), (3) and (9) (1983). If the veteran is eligible and follows the proper procedure, a grant may be authorized for emergency medical care already rendered if the department receives prompt notice of the treatment. See Wis. Admin. Code § VA 2.01(6) (1983). The department apparently received notice of the treatment, but Gorman never applied for a grant.

The trial court found "that Harold E. Gorman at the time he received the medical service was eligible for reimbursement of those expenses through his veterans rights and that he failed to date to apply for those rights." In order to receive such reimbursement, however, Gorman must first apply to the department, which must then make its own determination of his eligibility. A veteran's grant would thus require action by Gorman subsequent to his hospitalization. A hospital's right to recover the cost of emergency medical care under sec. 49.02(5) "should not be conditioned upon the recipient's subsequent action or inaction." Mercy Medical Center of Oshkosh, Inc. v. Winnebago County, 58 Wis. 2d 260, 266, 206 N.W.2d 198, 200 (1973); St. Michael Hospital v. Milwaukee County, 98 Wis. 2d 1, 6-7, 295 N.W.2d 189, 193 (Ct. App. 1980). A grant would also be dependent upon the department's future determination of Gorman's eligibility. This potential future eligibility does not fall within the clear intent of the statutory scheme of ch. 49 to provide needed relief for persons without present available money or "other means" by which to obtain it. See St. Michael Hospital, 98 Wis. 2d at 6, 295 N.W.2d at 192-93.

The trial court incorrectly concluded that this case is not controlled by Mercy Medical Center and St. Michael Hospital. The supreme court, in Mercy Medical Center, 58 Wis. 2d at 268-69, 206 N.W.2d at 201, held that a recipient of emergency medical care was a dependent within the meaning of sec. 49.01(4) in spite of her refusal to subsequently apply for general relief. In refusing to condition the county's liability on subsequent action or inaction by the recipient, the court stated:

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 . . . demands that emergency service by doctors and hospitals shall be promptly rendered to those in need without regard for immediate payment or security therefor.

Id. at 266, 206 N.W.2d at 200. We find this concern applies as well to veterans whose eligibility for an emergency ...


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