Montana Deaconess Medical Center V.

No. 8 8 - 9 1
IN THE SUPREME COURT OF THE STATE OF MONTANA
1988
MONTANA DEACONESS MEDICAL CENTER,
a non profit corporation,
Plaintiff and Respondent,
-vs-
CARL E. JOHNSON,
Defendant and Respondent,
and
CITY OF GREAT FALLS, MONTANA,
Defendant, Third-Party Plaintiff
and Appellant,
-vs-
COUNTY OF CASCADE, MONTANA,
Third-Party Defendant and Respondent.
APPEAL FROM: District Court of the Eighth Judicial District,
In and for the County of Cascade,
The Honorable Joel Roth, Judge presiding.
COUNSEL OF RECORD:
For Appellant:
David V. Gliko, City Attorney, Great Falls, Montana
For Respondent:
Sharon M. Anderson, Great Falls, Montana
Patrick L. Paul, County Attorney, Great Falls, Montana
For Amicus Curiae:
David J. Patterson, (MACO), Missoula, Montana
James T. Harrison, Jr., (Sheriffs), Helena, Montapa
Jim Nugent, (MT League of Cities & Towns), Missoula,
Montana
Submitted on Briefs: May 26, 1 9 8 8
Decided: July 7, 1988
Filed:
luc 7 -
f w r".lC -.xPL%r-s.c'
~ Clerk
@
Mr. Justice John C. Sheehy delivered the Opinion of the
Court.
In this case we are asked to determine whether the City
of Great Falls (City) or the County of Cascade (County) is
ultimately responsible for medical costs incurred by a person
in the custody of City Police Officers as a result of a
felony arrest. The District Court of the Eighth Judicial
District, Cascade County, determined that the controlling
factor was the City's custody over Johnson at the time the
medical expenses were incurred and issued an order dismissing
the City's third party complaint against the County. We
reverse.
The facts, as stipulated by the parties, are as follows:
1. On January 4, 1987, Johnson was arrested by
City Policemen.
2. The officers immediately determined Johnson's
life was in jeopardy as a result of his ingestion
of a quantity of prescription pills.
3. The officers requested an ambulance which
arrived at the scene of the arrest and transported
Johnson to Montana Deaconess Medical Center
(Deaconess).
4. Deaconess was advised Johnson was under arrest
when Johnson arrived.
5. Johnson incurred reasonable medical charges
from January 4, 1987, until his release on January
5, 1987, in the amount of $2,193.13, after two days
in Deaconess's Intensive Care Unit.
6. Deaconess made demand for full payment to
Johnson and Third Party Plaintiff City, and to
Third Party Defendant County.
7. The City and County have refused to pay said
bill.
8. Johnson admits liability for Deaconess's claim
but he is indigent and has no present or future
means to pay the charges.
9. Johnson was "booked in" in absentia at the
Police Department on January 4, 1987.
10. Johnson was released by Deaconess on January
5, 1987, and transported to the City Police
Department.
11. Johnson was detained at the City Police
Department until his initial appearance on January
6, 1987, before the County Justice of the Peace and
subsequently detained in the County Jail. The
County Jail is operated and managed by the County
Sheriff's Department.
12. Initial charges of aggravated assault,
aggravated kidnapping and sexual intercourse
without consent, all felony offenses under the
Montana Criminal Code, were filed in the County
Justice of the Peace Court (later transferred to
the District Court) and accepted by the County
Attorney. No misdemeanor or felony charges of any
kind were filed with the City Court.
Generally, persons under official detention have a
constitutional right to adequate medical care, regardless of
their ability to pay. City of Revere v. Massachusetts
General Hospital (1983), 463 U.S. 239, 103 S. Ct. 2979, 77
L. Ed. 2d 605 (due process demands that persons detained by
government agencies receive adequate medical care;
responsibility for costs is a matter of state law).
Consistent with the mandate of the United States Supreme
Court, the Montana Legislature has adopted legislation
providing for the care of prisoners. Section 7-32-2222, MCA,
provides :
Health and safety of prisoners. (1) When a county
jail or building contiguous to it is on fire and
there is reason to believe that the prisoners may
be injured or endangered, the sheriff, jail
administrator, or private party jailer must remove
them to a safe and convenient place and there
confine them as long as it may be necessary to
avoid the danger.
(2) When a pestilence or contagious disease breaks
out in or near a jail and the physician thereof
certifies that it is likely to endanger the health
of the prisoners, the district judge may by a
written appointment designate a safe and convenient
place in the county or the jail in a contiguous
county as the place of their confinement. The
appointment must be filed in the office of the
clerk and authorize the sheriff, jail
administrator, or private party jailer to remove
the prisoners to the designated place or jail and
there confine them until they can be safely
returned to the jail from which they were taken.
(3) If in the opinion of the sheriff, jail
administrator, or private party jailer any
prisoner, while detained, requires medication,
medical services, or hospitalization, the expense
of the same shall be borne by the agency or
authority at whose instance the prisoner is
detained when the agency or authority is not the
county wherein the prisoner is being detained. The
county attorney shall initiate proceedings to
collect any charges arising from such medical
services or hospitalization for the prisoner
involved if it is determined the prisoner is
financially able to pay.
Although the City contends that 5 7-32-2222 (3), MCA,
when viewed in its entirety, indicates that persons charged
with violations of state law occurring within a county are
the financial responsibility of that county, we do not find
the statute to be controlling. By its terms, 5 7-32-2222(3),
MCA, is not triggered until such time as "the sheriff, jail
administrator, or private party jailer" determines that a
detained person requires medical care. In addition, the
statute, when read as a whole, assumes incarceration in the
county jail at the time the need for medical care arises.
Such is clearly not the situation in the instant case.
Moreover, § 7-32-2222 (3), MCA, is obviously designed to
fix financial responsibility for medical costs on the agency
for which the prisoner is being detained in the county jail.
This section recognizes that frequently county jails in
Montana are used to house federal prisoners or persons held
for violations of municipal laws.
When confronted with the issue now before us, the courts
of other jurisdictions have split along two lines of
reasoning. Under the minority "custody and control"
approach, the financial responsibility for medical costs is
determined on the basis of which agency had custody at the
time the treatment is provided. See e.g. Sisters of the
Third Order of St. Francis v. Tazewell County (111.App.
1984), 461 N.E.2d 1064. "[If] physical control is
[subsequently] transferred [during the course of the
treatment] the responsibility is transferred along with it
and the cost of care [is] prorated." Cuyahoga County
Hospital v. City of Cleveland (Ohio App. 1984), 472 N.E.2d
757, 759. Few jurisdictions have followed the lead of the
Ohio and Illinois courts, however.
The majority "nature of the crime" approach determines
financial responsibility not on the basis of which agency
first takes a person into custody, but rather on the basis of
the crime ultimately charged. See Wesley Medical Center v.
City of Wichita (Kan. 1985), 703 P.2d 818; L. P. Medical
Specialists v. St. Louis County (Minn. App. 1985), 379 N.W.2d
104; Zieger Osteopathic Hospital v. Wayne County (Mich. App.
1984) , 363 N.W.2d 28; Albany General Hospital v. Dalton (Or.
App. 1984), 684 P.2d 34; St. Mary of Nazareth Hospital v.
City of Chicago (Ill. App. 1975), 331 N.E.2d 142; Washington
Township Hospital District of Alameda County v. County of
Alameda (1968), 263 Cal. App. 2d 272, 69 Cal. Rptr. 442. After
carefully considering the arguments and authority supporting
both positions, the Supreme Court of Kansas recently held:
... We have concluded that a city is not
responsible for the payment of medical expenses
incurred by an indigent person who is arrested by
city police and subsequently charged with a
violation of state law and who, before being
physically transferred to the county jail, is taken
to a hospital for necessary medical treatment. We
hold that so long as an offender is arrested for
violation of a state law and in due course is
charged with a state crime and delivered to the
county jail for confinement, the medical and other
incidental expenses incurred as a consequence of
and following his arrest, and until his transfer to
such facility, are chargeable to the county. We
further hold that a county's liability for charges
and expenses for safekeeping and maintenance of the
prisoner, including medical expenses, does not
depend on which police agency happens to be called
to the scene of the alleged crime or whether such
expenses were incurred before or after he is placed
in a county jail. The controlling factor is that
the prisoner was arrested and subsequently charged
with violation of a state law.
Wesley Medical Center, 703 P.2d at 824. We agree.
A county is the largest subdivision of the state.
Section 7-1-2101, MCA. Consequently, the county is vested
with the primary responsibility of enforcing the laws of the
state and maintaining facilities in furtherance of that task.
See, S S 7-4-2716, 7-32-2201, MCA. Sound reasoning dictates
that the performance of the county's task necessarily
includes the assumption of the associated financial burden.
We, therefore, hold that the county is financially
responsible for medical costs incurred by a detained person
ultimately charged with a violation of state law but who is
unable to pay. The judgment of the District Court is
reversed and remanded for proceedings consistent with this
Opinion.
, A & - e &A-
Justice
W e Concur: 'A
Chief ' J u s t i c e