Sioux Valley Hospital Ass'n v. Tripp County

SABERS, Justice

(dissenting).

I dissent.

County should be responsible for the medical bills from the date it received the notice of hospitalization until the date the patient was discharged from the hospital. In other words, although County is not responsible for the 15 days prior to notice, once it received notice of the hospitalization and did nothing to make substitute arrangements, nor did anything to inform Hospital that it was not going to pay for the hospitalization, it should be held responsible for the medical expenses incurred after notice, i.e., from September 7, 1984 through October 22, 1984.-

The statutes1 provide that it is not the hospital but rather the county which is *523responsible for the hospital expenses incurred on behalf of an indigent person. Instead of each county maintaining and operating its own hospital, a county has the option to have another hospital care for its indigent resident with the understanding that the county will reimburse the hospital for the actual costs of caring for that patient. SDCL §§ 28-13-28 through 28-13-32, inclusive. The purpose of SDCL 28-13-34 is to put the county on notice that one of its indigent residents is in the hospital, that the hospital intends to seek payment from the county for its services, and that the county has the option of obtaining alternate arrangements for hospitalization.2 Here, Hospital fulfilled this purpose when it notified County on September 7, 1984. By its actions, therefore, Hospital demonstrated substantial compliance and came within the “intent” of the notice statute even though “by a literal construction' [Hospital] may not be within its letter.” Application of Leo’s Bus Service, Inc., 342 N.W.2d 228, 230 (S.D.1984).

Although I recognize that generally es-toppel against the public is little favored, City of Rapid City v. Hoogterp, 85 S.D. 176, 179, 179 N.W.2d 15, 17 (1970), and then only when there has been some affirmative action by the party estopped, e.g., Missouri River Telephone Co. v. City of Mitchell, 22 S.D. 191, 116 N.W. 67 (1908), Tubbs v. City of Custer, 52 S.D. 458, 218 N.W. 599 (1928), I submit that the instant facts present precisely the type of “exceptional circumstances” necessary to estop County and prevent manifest injustice. Hoogterp, 85 S.D. at 179-180, 179 N.W.2d at 17. In Eden v. Board of Trustees of State University, 49 A.D.2d 277, 374 N.Y.S.2d 686 (1975), dismissed on other grounds, Eden v. State, 103 Misc.2d 461, 426 N.Y.S.2d 197 (1980), the court recognized that estoppels against the state are applicable only in truly exceptional cases and wrote: “But no branch [of government] is entirely immune from scrutiny. The courts must weigh the degree of manifest injustice against the effect, in the particular case, of intervention into public processes ... There is no rule of thumb.” Id. 374 N.Y.S.2d at 692.

Hospital argues that if it had been informed by County that the notice was untimely filed and that County was refusing to pay the bill, then Hospital would have had several options. First, Hospital could have dismissed the patient from its care and had the patient go to County for medical assistance. Second, Hospital could have released the patient for one day, then readmitted the patient, filed another notice of hospitalization which would have been within the fifteen-day period from the second admittance, and thus held County responsible for the second admittance. Obviously, neither one of these alternatives would have served the best interests of the patient.

There is no common law duty for the support of the poor; thus, any duty which lies is solely a creation of statute. Our code establishes the law of South Dakota and its provisions, as well as all proceedings thereunder, are to be liberally construed with a view toward effecting its objects and promoting justice. SDCL 2-14-12; Matter of Estate of Wolff, 349 N.W.2d 33, 35 (S.D.1984). County should be held responsible for the medical costs from the date of notice, September 7, 1984, until the date of discharge, October 22, 1984. This should be done on the basis of *524the intent, meaning, and purpose of the statute since Hospital complied with the underlying purpose of the notice requirement. SDCL 28-13-34 should be interpreted in the just and equitable manner for which it was intended, so that it fulfills its purpose and none other. That is the only statutory interpretation which is equally fair to Hospital,3 County, and indigent patients.

Accordingly, I would reverse and remand for trial.

. SDCL 28-13-1 states in part as follows:

"Every county shall relieve and support all indigent persons who have established residency therein, ...”

SDCL 28-13-16 states in part:

"The county commissioners in each county shall have the oversight and care of all poor persons in the county so long as those persons remain a county charge, and shall see that those persons are properly relieved and taken care of in the *523matter provided by law, and shall perform all the duties with reference to such poor persons that may be prescribed by law_”

SDCL 28-13-33 states in part:

"[W]henever hospitalization for an indigent person has been furnished by a hospital in any emergency case, the county where the indigent person has established residency shall be liable to the hospital as herein provided, ...”

. SDCL 28-13-35. Substitute arrangements for hospitalized indigent patient — County not liable to hospital after failure to cooperate. In any case of such hospitalization, when such county, ... makes a reasonable arrangement for adequate and suitable care and removal of such indigent person elsewhere and notifies the hospital thereof in writing, and the hospital unreasonably fails or refuses to extend cooperation to effect such changed arrangement, there shall be no liability on such county for any hospitalization, subsequent to such failure or refusal.

. The majority opinion attempts to bootstrap itself into the hearts and minds of the readers by claiming similarity with our recent cases involving St. Paul Ramsey Medical Center. See: St. Paul Ramsey v. Pennington and Moody Counties, 402 N.W.2d 340 (S.D.1987); St. Paul Ramsey v. Codington Co., 402 N.W.2d 345 (S.D.1987).

Substantial and real differences exist in these cases:
1.Sioux Valley Hospital is a South Dakota Hospital as required by South Dakota statute and St. Paul Ramsey is not.
2. Sioux Valley Hospital is a health care facility licensed by South Dakota authorities as required by South Dakota statute and St. Paul Ramsey is not.
3. Sioux Valley Hospital filed a statement of costs as required by South Dakota statute and St. Paul Ramsey did not.
4. The St. Paul Ramsey cases involve reciprocity between states and the Sioux Valley Hospital case does not.

For all of these reasons, recovery should be allowed here.