dissenting:
The majority holds that the DOC’s definition of the term “indigent” contained in section 415.30(g)(3) of its regulations governing inmate health care (20 Ill. Adm. Code §415(g)(3) (2005)) conflicts with section 3 — 6—2(f) of the Unified Code of Corrections (730 ILCS 5/3 — 6— 2(f) (West 2004)) because the DOC’s definition, together with its rule that an inmate must authorize the DOC to deduct the co-payment from present or future funds means that, contrary to the mandate of the statute, the inmate is always subject to the co-payment, irrespective of his financial ability to afford it. Because I do not believe the regulation conflicts with the statute and that the DOC’s definition of indigent is not unreasonable, I dissent.
Section 3 — 6—2(f) provides that the Department shall require committed persons receiving nonemergency medical or dental services to pay a $2 co-payment, but that a committed person who is indigent is exempt from the co-payment and is eligible to receive nonemergency medical or dental services on the same basis as a committed person who is financially able to afford the co-payment. 730 ILCS 5/3 — 6—2(f) (West 2004). Section 3 — 6—2(f) does not define the term “indigent.”
To implement section 3 — 6—2(f), the DOC promulgated section 415.30(g), which provides that adult offenders who require nonemergency medical or dental services shall authorize the Department to deduct a $2 co-payment from present or future funds in his or her trust fund account. 20 Ill. Adm. Code §415.30(g) (2005). Subsection (3) further provides that “[a]n offender who is found to be indigent shall be exempt from the co-payment. An offender shall be considered indigent if during the entire term of his or her incarceration the offender is without funds to pay the $2.00 co-payment.” 20 Ill. Adm. Code §415 (g)(3) (2005). If the inmate has no funds, or insufficient funds, at the time the nonemergency medical or dental services are requested, the inmate’s account is debited, resulting in a negative balance. The inmate remains liable for the co-payment for the entire term of his incarceration, only becoming eligible for the indigence exclusion at discharge.
The majority concludes that the term “indigent” as used in section 3 — 6—2(f) is ambiguous because the statute is unclear as to whether the inmate’s financial ability to afford the co-payment should be judged by his account balance on the day services are requested, or by some other measure. The majority acknowledges the well-settled rule that where an agency is charged with the administration and enforcement of a statute, courts will give deference to the agency’s interpretation of any statutory ambiguities and will not substitute its own interpretation where the agency’s interpretation does not conflict with the statute or is not unreasonable. Church v. State of Illinois, 164 Ill. 2d 153, 161-62 (1995). The majority finds the DOC’s definition of indigent to be in conflict with the statute because section 413.30(g)’s requirement that an inmate’s account be charged for the co-payment at the time nonemergency medical or dental services are provided, irrespective of whether he has any funds in his account, means that he is not “exempt” from the co-payment as required by the statute. The majority’s argument is unpersuasive.
The conflict between section 3 — 6—2(f) and regulation 415.30(g) arises only because the majority interprets the statute as meaning that an indigent inmate cannot be charged the co-payment. If section 3 — 6—2(f) is so interpreted, then the majority is correct. If, however, section 3 — 6—2(f) is interpreted as meaning that the inmate is not required to pay the co-payment, then no conflict arises because an inmate who never acquires the funds to pay the co-payment never has to pay it. Contrary to the majority’s assertion, the former interpretation is not dictated by the definition of “exempt.” An inmate who is charged the co-payment but who never acquires the funds to pay the co-payment and therefore never has to pay is no less free from its operation.
Alternatively, because section 3 — 6—2(f)’s requirement that an indigent inmate is exempt from the co-payment is subject to multiple interpretations — being charged the co-payment as opposed to being required to pay it — it is ambiguous. The DOC, which is charged with resolving any statutory ambiguities, has implicitly chosen the latter interpretation, and this court should defer thereto. Moreover, as the DOC correctly observes, such an interpretation is clearly consonant with the legislature’s intent, as demonstrated by the exchange between Representative Pugh and Representative Bost, one of the sponsors of the legislation which added the co-payment requirement and the indigence exemption to section 3 — 6—2(f).
I also dissent because I believe that the majority’s suggestion that an inmate’s ability to afford the co-payment could be determined by examining his account over some reasonable period of time before and after nonemergency medical or dental services are requested is inconsistent with the reasoning behind the majority’s conclusion that section 415.30(g)(3) conflicts with section 3 — 6—2(f).
The DOC argues that the purpose of the co-payment program is to teach inmates financial responsibility and to deter abuse of health-care services. The DOC maintains that its definition of “indigent” supports these goals by deterring abuse of the system by inmates. If indigence is determined only at a point in time, inmates could spend down their trust fund accounts with commissary purchases prior to requesting services, or seek such services immediately before an expected deposit.
The majority acknowledges the potential for abuse and the legitimacy of the DOC’s concerns in this regard. The majority responds by suggesting that assessing an inmate’s ability to afford the co-payment could include reviewing the inmate’s account activity during some reasonable period of time immediately prior to or after the date nonemergency services are requested. However, this suggestion is clearly inconsistent with the majority’s determination that charging an inmate’s account for the co-payment if he does not have the funds to pay it denies the inmate the statutorily mandated exemption.
The majority’s suggestion also leads to the questions of what constitutes a “reasonable” period of time and who should make that determination. The answer to the second question is clear. Because the statute is ambiguous as to how an inmate’s financial ability to pay is determined, it would be the responsibility of the DOC, the agency charged with implementing the statute, to determine what “reasonable” period of time should be used. I submit that the DOC has already made this determination.
In sum, there is a “conflict” between section 415.30(g)(3) and 3 — 6—2(f) only because the majority construes these sections in such a manner as to create one. I would defer to the DOC’s interpretation of the term “indigent,” an interpretation which is both reasonable and consonant with the intent of the legislature. Therefore, I respectfully dissent.
CHIEF JUSTICE THOMAS joins in this dissent.