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California: County Not Liable For Precommitment Arrestees' Medical Costs

by John E. Dannenberg

The California Court of Appeals held that San Diego County was not financially responsible for medical care for precommitment arrestees who received medical care at community hospitals prior to being booked into county jail.

Sharp Healthcare (Sharp) and other healthcare providers sued San Diego County to recover medical costs associated with treatment of freshly arrested persons, but before they were booked into county jail. Of course, many persons arrested are, as a result of the cause of their arrest, in need of emergency medical care and are first rushed to the nearest hospital. San Diego County does not dispute their liability for medical care after booking, but complained that under 1992 revisions to California Penal Code (PC) § 4015 and Government Code (GC) § 29602, they were no longer liable for such care prior to booking.

Sharp had won summary judgment in the Superior Court in 2004 declaring that they were entitled to recover from San Diego County. Sharp had argued that based upon long-standing law, the county was liable for medical care rendered to arrestees before they were booked into jail. The county had countered that pre- booking liability had been eliminated by the 1992 revisions to PC § 4015 and GC § 29602. In a accommodating policy overlooking this change, the county - prior to July 2003 - had booked medically needy arrestees "in absentia" and then accepted their medical bills. But thereafter, the county told the hospitals that they would no longer do this and not to bill the county. After the superior court ruled in Sharp's favor, the parties entered into a stipulated judgment providing that the county must reimburse for pre-arraignment detainees' medical care, but allowed that judgment to be appealed.

The appellate court construed the pre-1992 and post-1992 statutory language. Prior to the 1992 amendments, the same question had been decided favorably to the medical care providers in Washington Township Hosp. Dist. v. County of Alameda (1968) 263 Cal.App.2d 272. Washington had interpreted the language of § 29602 and committed to county jail" broadly to include those enroute to such commitment, but in need of emergency medical treatment first.

The 1992 amendment to § 4015 expressly provided that a county "sheriff need not receive an arrestee in need of immediate medical care," which had the effect of removing the lynchpin from the Washington rule. § 4015 was also amended to require emergency treatment to be covered by the arrestee's private medical insurance. Thus, under the current amended statutes, an arrestee in need of urgent medical care cannot be classified as a "person charged with ... a crime and committed to the county jail" because the sheriff has the legal authority to delay booking until after the care has been administered. Although the "in absentia" policy used by the sheriff until mid- 2003 favored Sharp, it could not be translated into a duty to continue to do so.

Accordingly, the appellate court concluded that the 1992 amendments controlled, reversed the stipulated judgment below, and ordered the superior court to enter summary judgment for the county. See: Sharp Healthcare v. County of San Diego, 156 Cal.App.4th 1301 (2007).

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Related legal case

Sharp Healthcare v. County of San Diego