Opinion
NOT TO BE PUBLISHED IN OFFICIAL REPORTS
Santa Clara County Super. Ct. No. CV016974
ELIA, J.In this action to recover medical expenses incurred by a police suspect, the court ruled that plaintiff San Jose Medical Center (SJMC) was entitled to reimbursement from the County of Santa Clara (County) for the period in which SJMC cared for the suspect, even though he had not yet been formally booked. The County appeals, contending that the trial court misapplied the applicable statute, Government Code section 29602. SJMC also appeals, challenging the reduction of its claim in the trial court's award of damages. We conclude that the County was not obligated to pay the medical expenses incurred by the suspect before he was booked into the county jail. Accordingly, we must reverse the judgment.
Background
Both the liability and damages phases of trial were conducted by the court, the parties having stipulated to the facts leading to the arrest and hospitalization of the suspect, Robert Markrell. At about 11:40 a.m. on June 5, 2003, Markrell was stopped by police for an infraction, operating a motorcycle with a passenger who was not wearing a helmet. The passenger dismounted, but Markrell fled on the motorcycle. He then abandoned the vehicle and ran into traffic, where he was struck by a car and severely injured.
The officers took Markrell to SJMC, where he remained hospitalized for nearly a month and underwent surgery to remove his spleen. After delivering Markrell to the hospital, the officers ascertained that he was a parolee at large and began the "paper booking" process. The state parole office, however, declined to lodge a parole hold for him, as he was not in physical custody at the jail. At 8 p.m. that day, the officers released Markrell pursuant to Penal Code section 849, subdivision (b), but they retained his clothing and impounded the motorcycle. They also asked the hospital to give them two hours' notice before it released Markrell.
The next day, June 6, 2003, the police submitted an application for a complaint to the district attorney, who approved a charge of violating Penal Code section 148 (resisting a public officer), a misdemeanor. An arrest warrant was issued that day, but it was not executed until the evening of July 3, when Markrell was about to be discharged from the hospital. The officers served the arrest warrant and "paper-booked" him into jail. It was approximately July 4 when he was ready to be physically transported from SJMC to the jail. On July 8, 2003, Markrell appeared in court and pleaded guilty to the complaint. He was sentenced to six days in jail with six days' credit for time served.
SJMC brought this action against the County in March 2004 to recover unpaid hospital charges for Markrell's care in the amount of $408,331.93. After summarizing the stipulated facts and receiving argument on liability, the trial court ruled that the County was responsible for the charges under its contract with SJMC and Government Code section 29602. The court then addressed the amount of damages and found that the charges that accrued after June 23 were not necessarily incurred, because the patient could have been transferred to the County-owned Valley Medical Center at that time. The court accordingly concluded that of the amount claimed, $167,414.20 was justified, and it entered judgment for SJMC in that amount. Both parties appeal.
Discussion
As Markrell was indigent and homeless, the expenses for his medical treatment at SJMC must be borne by SJMC under its contract with the County, unless the County was liable for those expenses under Government Code section 29602 (section 29602). As amended in 1992, section 29602 provides: "The expenses necessarily incurred in the support of persons charged with or convicted of a crime and committed to the county jail and the maintenance therein and in other county adult detention facilities of a program of rehabilitative services in the fields of training, employment, recreation, and prerelease activities, and for other services in relation to criminal proceedings for which no specific compensation is prescribed by law are county charges. However, nothing in this section shall preclude or prohibit the county from receiving reimbursement from a provider of medical insurance coverage for the provision of medical services to a prisoner or detainee received by or held in the county jail or other detention facilities, in those instances where the prisoner or detainee has private medical insurance coverage."
SJMC had been designated a trauma center. It had contracted with the County to provide services to victims of major trauma regardless of the victim's ability to pay. The contract included a statement that the County would not be liable for any expenses SJMC incurred in performing its contractual duties, including patient care for any patient "who would not have been treated by [SJMC] in the absence of this Agreement."
The statutory language at the core of the parties' dispute is the premise that the person supported have been "charged with or convicted of a crime and committed to the county jail." The County maintains that for it to be liable, the person must have been in custody—that is, he must have been booked into jail, either personally or on paper.
Both parties discuss the significance of Washington Township Hospital District v. County of Alameda (1968) 263 Cal.App.2d 272, where the First District, Division 2, applied section 29602 as it existed before the 1992 amendments. The Washington Township court held that Alameda County was obligated to pay for medical services provided to a suspect after he was arrested but before he was committed to jail. If the suspect is "ultimately arraigned" for a state or county offense, the court held, the county is liable. (Id. at p. 280.)
In ruling for SJMC in this case, the trial court determined that Markrell was initially arrested and he was not free to go while in the hospital, because the police were not going to allow him to be released from the hospital without taking him taken into custody. In the court's view, as Markrell was "ultimately arraigned, convicted, and committed to jail," the burden of the treatment expenses shifted to the County under Government Code section 29602.
The parties continue to debate the meaning of the statutory phrase "charged with or convicted of a crime and committed to the county jail." The County insists that because the paper-booking process was never completed and the police released Markrell under Penal Code section 849, he was not under arrest and in custody between June 6 and July 3, 2003. SJMC adheres to its position that Markrell was in fact arrested on June 5 and "in all effect," remained arrested during his entire stay at the hospital. SJMC discounts the significance of the formal release, as the police not only retained Markrell's clothing and vehicle but obtained an arrest warrant the next day. In SJMC's view, consonant with the trial court's, "The police were not letting Markrell go without a criminal prosecution. Markrell was never a free man. The police were confident, based on the [doctor's report], that Markrell was not going anywhere." Thus, according to SJMC, because the patient was under a valid arrest from June 5 until his discharge from the hospital, the County was responsible for his medical expenses under section 29602 during this entire period.
After the parties completed their appellate briefs, the Fourth District, Division 1, issued its decision in Sharp Healthcare v. County of San Diego (2007) 156 Cal.App.4th 1301. In Sharp, the County of San Diego announced that it would no longer pay for medical care of arrestees who had not yet been booked or otherwise "committed" to county jail. A group of hospitals sued for declaratory relief and both parties moved for summary adjudication. The trial court granted the plaintiffs' motion, but the appellate court reversed, holding that the 1992 amendments to both section 29602 and Penal Code section 4015 evidenced the Legislature's intent "that county liability would extend only to persons who have been booked into the jail." (Id. at p. 1313.) The reference to commitment to jail must be actual, not constructive, ultimate, or contemplated. Thus, "[e]ven though the arrestee would have been booked into the county jail if not for his or her illness or injury, the Legislature's enactment of a provision allowing delayed booking of an arrestee who needs immediate medical care evinces a clear legislative intent to permit a county to delay accrual of its duty to provide care until the arrestee receives the needed medical attention and is actually committed to the jail." (Id. at pp. 1311-1312.)
The County submitted a supplemental brief in which it argued that the reasoning in Sharp suggests a comparable result in the case before us. SJMC responded, disagreeing with the Fourth District's analysis and urging departure from Sharp on the facts presented here. We find Sharp persuasive, however. The 1992 amendment of section 29602 added language emphasizing that a county's duty to support and maintain persons "charged with or convicted of a crime and committed to the county jail" does not prohibit that county from obtaining reimbursement for medical services from the prisoner or detainee's private health insurance provider. The 1992 additions to Penal Code section 4015 make it clear that the county sheriff is not obligated to receive a suspect who is in need of immediate medical care; instead, the sheriff may decline to book the arrestee into jail until those medical needs have been addressed. Subdivision (c) explicitly focuses on the medical expenses of such persons arrested by city law enforcement personnel, emphasizing that the city is not obligated to pay for medical services before the arrestee is booked. The Legislature expressed its intent in amending the statute to ensure that the arrestee's private medical insurance bear the costs associated with the arrestee's care. (Pen. Code, § 4015, subd. (d).)
We agree with the Sharp court that the addition of these provisions to Penal Code section 4015, together with the concurrent amendment of section 29602, indicate that a county should not be held liable for medical care costs before an arrestee is committed to jail. Thus, even if Markrell was arrested initially and "in all effect" remained under arrest while hospitalized at SJMC, he was undisputedly not actually committed to jail, by booking or arraignment, at the time he received his care. That he was "ultimately" arraigned, convicted, and committed to jail after being discharged from the hospital is not sufficient to meet the objectives of section 29602 and Penal Code section 4015. The County therefore was not responsible for the medical expenses incurred by Markrell before the evening of July 3, 2003, when he was paper-booked, or booked "in absentia," in the County jail. (Sharp, supra, 156 Cal.App.4th at p. 1313.) In light of this conclusion, we need not address the contention raised in SJMC's appeal, that the amount it was awarded as damages was insufficient and based on an incorrect criterion. To the extent that Markrell received any further treatment after he was booked at 5:02 p.m. on July 3 but before leaving the hospital on July 4, the trial court will have an opportunity to revisit the question of how much SJMC should recover, if any, for the care provided during this short period.
The Sharp court further discussed the alternative holding of Washington Township, in which it relied on language in section 29602 making counties liable "for other services in relation to criminal proceedings for which no specific compensation is prescribed by law." In Sharp the court rejected this phrase as an alternative basis for county liability. (Sharp, supra, 156 Cal.App.4th at p. 1313.) Although the County raises the issue on appeal, we need not address it, since SJMC does not argue that the quoted phrase and the alternative holding of Washington Township are dispositive here.
Disposition
The judgment is reversed. The matter is remanded for the purpose of recalculating the amount to which SJMC is entitled to recover for medical care provided to Markrell, if any, between 5:02 p.m. on July 3 and July 4, 2003. The judgment shall then be amended accordingly. The parties shall bear their own costs on appeal.
WE CONCUR: RUSHING, P. J., PREMO, J.