Opinion
As Modified March 26, 1974.
Opinion on pages 998-1005 omitted.
REHEARING GRANTED
For Opinion on Hearing, see 128 Cal.Rptr. 374.
Charles R. Baumbach, Cecilia D. Lannon, Legal Aid Society of Marin, San Rafael, and Burton Danziger and David B. Bryson, Cooperative Legal Service Center, San Francisco, Norman S. Nayfach, Legal Aid Society of Santa Cruz, Santa Cruz, for plaintiffs-appellants.
Evelle J. Younger, Atty. Gen. by N. Eugene Hill, Deputy Atty. Gen. Sacramento, Daniel V. Blackstock, County Counsel, Oroville, Douglas J. Maloney, County Counsel, San Rafael, Howard E. Gawthrop, County Counsel, Santa Cruz, for defendants-respondents.
REGAN, Associate Justice
In this action Alice filed a petition for a writ of mandate and a complaint for declaratory relief on behalf of herself and a class of plaintiffs consisting of all female minors '(a) over the age of 15 years, living separate and apart from their parents, and managing their own financial affairs so as to be emancipated within Civil Code § 34.6; and (b) eligible for medical assistance and Medi-Cal benefits under the Aid for Families with Dependent Children program (hereinafter AFDC since they are needy and deprived within the meaning of applicable federal and state statutes and regulations; and (c) being denied access to urgently needed medical care and attention by defendants who rely on the certain state welfare policies and procedures more particularly described below to deny the class eligibility for medical assistance and Medi-Cal. Such class may be divided into: (i) those women whose urgent medical and surgical need is for termination of pregnancy pursuant to the Therapeutic Abortion Act; and (ii) those whose pregnancy will not be terminated and whose urgent need is for prenatal care to protect their health and safety and that of their unborn children.'
The fictitious names 'Alice,' 'Sharon,' and 'Barbara' have been used by stipulation of the parties, and continued by this court in lieu of the normal party designations, to protect the actual identities of the petitioners.
Barbara and Sharon sought leave to and were granted permission to intervene as members of the class.
The answering defendants are the State Department of Social Welfare (SDSW) (the agency charged with administration of the welfare laws including the AFDC program), the Director of the State Department of Social Welfare, Marin County Department of Public Services and Butte County Department of Social Welfare.
Department of Social Welfare has been changed to Department of Benefit Payments.
At trial, judgment was for defendants.
FACTS
Alice, Barbara and Sharon each applied in their respective counties for AFDC assistance, specifically for medical attention with respect to their pregnancies. Each of them was an unmarried minor over the age of 15 living apart from her parents, and managing her own affairs, so as to be emancipated under Civil Code section 34.6. Each was refused medical assistance (Medi-Cal) in connection with her AFDC application for the reason that she refused to consent to contact being made with her parents by the county welfare authorities informing the parents of her pregnancy. Two of the girls, Alice and Bardara, sought medical aid for a therapeutic abortion and each had qualified for such under the abortion laws. The other girl, Sharon, had not yet determined whether or not she qualified for a therapeutic abortion, but she sought AFDC medical aid to so determine and for prenatal care if she was not certified as qualified for an abortion. None of the girls sought cash grants under AFDC for their general maintenance and support, but only for medical assistance relative to pregnancy under the Medi-Cal program. It is undisputed that they would have been eligible for such aid but for their refusal to give consent to parental contacts by the welfare authorities.
The trial court found that Alice, Barbara and Sharon have raised questions in this action of common and general interest to the class they represent as a whole, and that the interests of Alice are identical to those of the other members of the class.
[112 Cal.Rptr. 732]Upon the filing of the instant action, a temporary restraining order was issued which required that Alice and others in her class of emancipated minors, who appeared on the basis of their initial applications to be eligible, should be given immediate Medi-Cal assistance without informing their parents. However, upon final decision of the case in 1972, the trial court upheld the practice of the state and various county welfare departments of contacting parents and revealing pregnancies where deemed necessary and of refusing Medi-Cal aid to such applicants who refuse to agree or consent that such parental contact may be made where deemed necessary by the welfare authorities. The practice approved by the trial court was based upon a directive of the SDSW contained in a letter, signed by Robert Martin then the director of SDSW, and dispatched to the county welfare directors. This directive set forth 'guidelines' or requirements to be followed with respect to cases of the class with which we are here concerned. The applicable portion of the directive required the counties to do the following:
'Determine what contribution the minor is in fact receiving from her parents and the unborn child's natural father. Evaluate the amount in light of their ability to provide support. Determine ability to support in the manner specified for use in stepfather or absent parent cases, using information supplied by the daughter.
'If the daughter refuses to provide the necessary information, or refuses to give her consent to allow the county to contact her parents or the child's father regarding their obligation to provide support, advise the unwed pregnant minor that she is ineligible for AFDC because she does not meet the conditions set forth in Regulation Sections 44-103.212 and 44-103.23 (Exploration of Income Potentials, Applicant and Recipient Responsibility).' The letter in question was prefaced by a statement correctly making it clear that the AFDC referred to can include Medi-Cal eligibility relating to pregnancy and the unborn child. (See Welf. & Inst.Code, §§ 14005, 14005.1.)
The reference to Regulation Sections 44-103.212 and 44-103.23 are to Eligibility and Assistance Standards (EAS). The two references are to provisions requiring the county to explore potential income to an applicant and providing that the applicant is responsible 'for taking all actions necessary to obtain unconditional available income' and that an applicant is ineligible for aid if refusing to accept unconditionally available income. The concept here of course is that the parents or parent of the unwed minor would be contacted to determine their financial ability to assist in support of the unwed pregnant minor.
Alice contends that the procedure or policy of parental contacts applied to her violates Welfare and Institutions Code section 14010. That section of the code was enacted by the Legislature in 1971, a few months after the 1970 directive of the SDSW referred to hereinabove.
Section 14010 reads as follows: 'Notwithstanding any other provision of law, the parent or parents of a child under 21 years of age shall not be held financially responsible, nor shall financial contribution be requested or required of such parent or parents for health care or related services to which the child may consent without the need for parental consent under any express provision of law.'
It is to be noted that a 'child,' such as Alice, who was an unmarried pregnant minor, had previously been authorized by the Legislature in statutes enacted in 1953 and in 1968, to consent to medical and surgical care related to her pregnancy. (Civ.Code, §§ 34.5, 34.6.) It is undisputed by any party that a minor may consent to an abortion without parental contact or consent. (See Ballard v. Anderson (1971) 4 Cal.3d 873, 878, 95 Cal.Rptr. 1, 484 P.2d 1345.)
The record discloses that prior to the SDSW directive ti was not incumbent upon the counties to require the consent of persons in Alice' circumstances to a parental contact. Thus, at that time this was not one of the conditions of eligibility and Alice could have qualified for medical care without being requested to, or giving, her consent to contact her mother. The trial [112 Cal.Rptr. 733] court stated that section 14010 did not apply because as long as Medi-Cal benefits were tied to AFDC, the applicant's resources must be explored, and one of the possible resources is the parents.
Alice does not contend that the welfare departments are prohibited by section 14010 or any other law from contacting an emancipated, pregnant minor's parents when such contact is necessary to determine whether she receives or has available financial support from them. Alice agrees that consent to contact parents may properly be requested of an applicant for medical aid in specific instances where the information supplied by the applicant regarding her eligibility is incomplete, unclear or inconsistent. This is in conformance with federal welfare law as to which the state must comply, and also with state rules. (See 45 C.F.R. 206.10(a)(12) iii; 45 C.F.R. 206.10(a)(12)(iii)(a); EAS 40-157.33]; EAS 40-157.4.) But even though Medi-Cal for Alice was a part of AFDC, there is no requirement in any federal or state law, or regulation, rule or standard which would require parental contact in an Alice case, because the information Alice supplied was not incomplete, unclear or inconsistent as to her parents. She stated in writing that her father was dead; that her mother was ill and on both welfare support aid and Medi-Cal. She also gave her mother's address.
Defendants and respondents explain the SDSW directive as requiring an applicant for any aid (including Medi-Cal abortion aid) to be a needy person and that the consent to check with the parents of the Alice class was for the purpose of determining need. They further claim that section 14010 does not change the AFDC requirements which apply equally to minors and adults, i. e., to be eligible for any aid (including Medi-Cal abortion) they must be eligible for support whether or not it is sought. Defendants and respondents conclude parental contact is essential to determine any income potential for welfare purposes.
Alice's position on appeal in light of the foregoing, and particularly in reference to section 14010, is that the SDSW directive requirements of consent to parental contacts as a condition of medical aid where no support money is requested or needed are contrary to the spirit of section 14010. Her reasoning is that (1) she has requested 'health care or related services' within the meaning of section 14010; (2) her parents are not liable for any financial contribution to such services under that section; (3) there is a specific prohibition against the parents even being 'requested' to pay or contribute for such services; and (4) it follows that under section 14010 her consent is at most an idle act and the effect of the rule set forth in the SDSW directive is to harass persons in Alice' position into not completing their applications because of fear or shame of having an ill or impoverished parent know of her condition. There is evidence in the record that this is the actual effect of the directive and that some severe medical problems and traumas have resulted from application of this directive. There was expert testimony of sometimes devastating effects resulting from lack of medical attention, including attempts at self-abortion.
The trial court concluded that the consent to parental contact required by the directive was not being sought for the purpose of requesting or requiring any payment for Medi-Cal health or related services as contemplated by the language of section 14010. The court concluded that Medi-Cal benefits, as tied in with eligibility for AFDC, required that the consent to parental contact be sought to determine whether the parents could or would become financially supportive of their daughter. We disagree with the trial court and note that the court has not limited its consideration of the directive and of section 14010 to the exact facts of the Alice situation, to wit, a situation where there is no question but that no support money had been requested, and full information provided.
The Alice class and its definitive fact situation have been carefully and clearly [112 Cal.Rptr. 734] delineated hereinabove. It should be added that even if the directive did not violate the letter or spirit of section 14010, it is not by its own terms applicable to the fact situation of the class with which we are here concerned. The letter directs that the welfare department determine what, if any, contribution the minor is receiving from her parents, and to evaluate this in light of the parents' ability to provide support, using information supplied by the daughter. It is only if the daughter refuses to supply such information or refuses to consent to parental contact, that the county is required by the SDSW directive to contact the parents. Thus, in the instant case, when Alice gave the necessary information to determine that her parents could in no way contribute to her support, there was no requirement, or even any authority, in the directive for the county to ask Alice for consent to contact her parents. This rather obvious construction of the SDSW directive seems to have escaped the trial court, but it is buttressed by the coexisting regulation of the department contained in EAS 40-157.3.32, which provides that: 'When needed in the evidence gathering process, and as evidence of the applicant's consent thereto, a specific consent form, signed by the applicant . . . shall be obtained for each such contact.' (Emphasis added.) Under the facts consent was not needed in Alice' case pursuant to the express language of both the directive and the rule referred to above. Accordingly, whenever under such factual circumstances as obtain in her case, a consent is required, it is unlawful.
Alice correctly contends there was no authority under which to deny Medi-Cal when she applied in the manner she did. The welfare laws do not require such consent as demanded by the department. They simply exist in conjunction with section 206 of the Civil Code, which requires parents to 'maintain' children under certain circumstances. Section 206 provides as follows: 'It is the duty of the father, the mother, and the children of any person in need who is unable to maintain himself by work, to maintain such person to the extent of their ability. The promise of an adult child to pay for necessaries previously furnished to such parent is binding. A person who is receiving aid to the aged shall be deemed to be a person in need who is unable to maintain himself by work.' This support statute is not in conflict with section 14010 of the Welfare and Institutions Code which removes any possibility that health care costs, including medical abortion, are 'maintenance' or support. (See County of San Mateo v. Boss (1971) 3 Cal.3d 962, 971, 92 Cal.Rptr. 294, 479 P.2d 654; County of San Bernardino. v. Simmons (1956) 46 Cal.2d 394, 398-400, 296 P.2d 329; Welf. & Inst. Code, §§ 14008.5, 11350; 45 C.F.R. 234; EAS 43-117, 43-119.) Therefore, the judgment in this case denying the petition for writ of mandate to prohibit application of the SDSW directive to Alice and her class is erroneous and shall be reversed.
Alice raises two contentions involving alleged violations of constitutional rights in the denial of Medi-Cal assistance to her and the class represented by her and by Barbara and Sharon.
We shall not decide the constitutional issues raised by plaintiffs herein for a very fundamental reason. Since we have arrived at a decision to reverse based on a nonconstitutional ground, we are foreclosed by long-established policy and principle set by both the United States and California Supreme Courts that when a decision has been reached to reverse on other grounds an appellate court will not decide a constitutional question raised in the appeal. (Palermo v. Stockton Theatres, Inc. (1948) 32 Cal.2d 53, 65-66, 195 P.2d 1.)
The judgment is reversed and the trial court is directed to enter judgment granting the premptory writ and declaratory judgment as prayed for in the complaints [112 Cal.Rptr. 735] filed in this action, and in conformity with this decision.
We emphasize that this decision has no bearing on any case in which an emancipated, unwed, pregnant minor applies for AFDC support or maintenance aid in addition to medical aid related to her pregnancy.
RICHARDSON, P. J., concurs.
JANES, J., concurs in the result.