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Sisters of St. Francis v. Groveland Township

AUGUST 28, 1972.




APPEAL from the Circuit Court of Tazewell County; the Hon. ARTHUR GROSS, Judge, presiding.


Rehearing denied September 29, 1972.

This case was heard by the circuit court of Tazewell County without a jury and upon a written stipulation as to facts and exhibits. No oral testimony was presented to the court. According to the stipulated facts a Janice Pearson was admitted to St. Francis Hospital (hereinafter referred to as the plaintiff) in Peoria on January 6, 1970. At the time of her admission Janice Pearson was in the advanced stages of pregnancy and in fact gave birth to a child on the same date. At the time of her admission the patient listed her address as being in Creve Coeur, Groveland Township, Tazewell County, Illinois. On January 8, 1970, the defendant Edward Giebelhausen as Supervisor of Groveland Township was notified of Janice Pearson's admission to the hospital when he received at his office an Illinois Department of Public Aid form No. 450. On January 9, 1970, Janice Pearson was discharged from the hospital and also on this date her child was placed for adoption with the Child & Family Service in Peoria. On January 13, 1970, the defendant Giebelhausen rejected the case on the basis that the application for payment of services rendered to the patient was not on township forms and that the birth expense was the responsibility of the Illinois Department of Public Aid. Application was then made by Janice Pearson on township forms but a rejection was again made on the basis that the case was one for the Department of Public Aid. The amount claimed for services provided by the plaintiff is $343.55.

The stipulated facts as to a Wanda Ragsdale are similar. She was first admitted to the plaintiff hospital on June 17, 1969, after she had been released from Wood River Township Hospital where she had been placed by the sheriff of Madison County for emergency medical treatment. She had arrived in Groveland Township on June 16, 1969, and was staying with a friend in Creve Coeur. The defendant Giebelhausen was on June 19, 1969, notified of her admittance in the hospital by receiving a form 450 which had been mailed to his office. He was further notified on June 23, 1969, of Wanda Ragsdale's release from the hospital which had occurred on June 22, 1969. The defendant Giebelhausen rejected the claim of Wanda Ragsdale on the grounds of lack of residence and because of the use of form 450 instead of making a personal application at his office where township forms were available. At this time the plaintiff's bill for services was in the amount of $296.55. She was again in the hospital on October 18, 1969, and on November 19, 1969. Similar applications were made for services provided as the result of each of these two admissions and these claims in the amount of $100.45 and $258.00 were also denied.

Action was brought by the plaintiff hospital under Article VII, Local Aid to the Medically Indigent, Ch. 23, Sec. 7-1 to Sec. 7-6, for charges for services rendered to Janice Pearson and Wanda Ragsdale. Judgment was entered for the plaintiff in the amount of $998.55 against the defendants Groveland Township and Edward C. Giebelhausen as its Supervisor. No judgment was entered against him individually. From the judgments entered the defendants prosecute this appeal.

The defendants raise a number of issues for review, the first of which is that the plaintiff hospital failed to prove that the patients Pearson and Ragsdale were medically indigent. This issue as presented to us presupposes that the plaintiff had a duty to make a determination as to whether or not the patients were medically indigent so as to be eligible for local aid as provided for in Ch. 23, Sec. 7-1 through Sec. 7-1.3, Ill. Rev. Stat. We do not believe that the plaintiff had the duty of making such a determination. In reaching this conclusion we were guided by the following statutory provisions:

"7-1.2 Need) The money, property, or other resources available to the person, including support available from legally responsible relatives, must be insufficient to meet the costs of necessary care, as defined by standards established in accordance with Section 7-2 of this Article. * * *." Ch. 23, Sec. 7-1.2, Ill. Rev. Stat.

"7-2. Amount of Aid — Standards) * * * The amount and nature of the care provided shall be determined in accordance with a uniform standard of eligibility established by the Illinois Department and its rules and regulations. The standard shall include provisions for determining what, if any portion of the income, property or other resources of an applicant or recipient is available to meet the cost of necessary care. However, a local governmental unit not receiving State funds for purposes of this Article may prescribe a uniform standard of eligibility according to local conditions. Such locally prescribed standards may be less, but not more, restrictive than the uniform standard of eligibility established by the Illinois Department. * * *." Ch. 23, Sec. 7-2, Ill. Rev. Stat.

• 1 Reading these two provisions in conjunction with each other it is quite obvious that our legislature has placed the function of determining indigency or non-indigency upon the Department of Public Aid and certain township officials.

In order to assist the proper officials in making this determination the Department had prepared and transmitted to various hospitals certain forms referred to as D.P.A. forms 450 which in effect are applications for assistance. These forms are quite detailed and solicit personal information concerning the applicant's source of income, property, and ability to pay for hospital services. The form does require the hospital to certify that it has determined the applicant's ability to pay a portion of the hospital costs or that it has determined that the applicant is unable to pay any of the costs which will be incurred. However, this certification by the hospital of its determination as to the applicant's degree of indigency is not conclusive of the question since Department of Public Aid regulations issued in the form of official bulletins specifically provide that the completed application shall be sent to the supervisor of General Assistance of a township within five days after the patient's initial hospital admission or date of service for which the hospital desires payment. The hospital's certification as to the degree of indigency can only be interpreted as an expression of an opinion derived from an analysis of the applicant's answers to the questions appearing on form 450. A portion of the form is entitled "disposition" where are located appropriate blanks for the recipient's signature, i.e., "the township supervisor", his determination of whether aid should be granted or denied and the reason for his action in the matter. This portion of form 450 is to be returned to its source, the hospital, within thirty days from its receipt by the township official.

We have set forth in detail the procedure to be followed when a determination is to be made as to the indigency or degree of indigency of an applicant for hospital and medical assistance since in doing so it becomes abundantly clear that the hospital performs the ministerial function of assisting the patient in completing the necessary forms provided by the Department of Public Aid. After this ministerial function is completed it becomes the duty of the township supervisor to take appropriate action. In the case now before us it was incumbent upon the defendant supervisor to reply to the request for aid contained in form 450 by making a determination as provided for in the rules and regulations of the Illinois Department of Public Aid. The record discloses that the township supervisor performed neither of the functions. He did not accept the forms nor did he accept or reject the case as being one of indigency, partial indigency or non-indigency. The defendant supervisor was not fulfilling his duty when he took the position that applicants for assistance must personally appear at his office in Creve Coeur, Tazewell County, for the purpose of making an application on forms which were specifically prepared and adopted by his township.

• 2 A question strikingly similar to the one we have been considering was presented to this court in Pekin Memorial Hospital v. Schilling, 121 Ill. App.2d 473, 257 N.E.2d 124, where the supervisor of Pekin Township raised the issue concerning the acceptance of form 450 of the Department of Public Aid as being the basis for an investigation by his office. This court after reviewing the applicable statutes stated:

"The claims of plaintiff were in proper form and should have been honored by defendant. It is therefore apparent that the court properly rejected the contention of the defendant that he is not subject to the regulations of the Illinois Public Aid Department."

In reaching the conclusion that the right of the plaintiff hospital to recover for the cost of services rendered is not dependent upon the hospital proving the indigency of the patient, we are fully aware of the case cited by the defendants, to-wit, Rockford Memorial Hospital Assn. v. Wells and Oregon Township, 89 Ill. App.2d 277, 231 N.E.2d 459. The holdings in the Rockford Memorial Hospital case are inapplicable since the question we have considered was never presented to the court but on the contrary the ...

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