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Beverly Carol Fuchino v. Ann Edwards-Buckley

June 27, 2011

BEVERLY CAROL FUCHINO, PLAINTIFF AND APPELLANT,
v.
ANN EDWARDS-BUCKLEY, AS DIRECTOR, ETC., ET AL., DEFENDANTS AND RESPONDENTS.



APPEAL from a judgment of the Superior Court of Sacramento County, Lloyd G. Connelly, Judge. (Super. Ct. No. 34200980000177CUWMGDS)

The opinion of the court was delivered by: Hoch , J.

CERTIFIED FOR PUBLICATION

Reversed with directions.

Appellant Beverly Carol Fuchino petitioned the superior court for a writ of mandamus to, among other things, compel Sacramento County to cover the cost of emergency ambulance services provided to her in Monterey County. She claimed that Sacramento County was required to pay for her out-of-county emergency ambulance services pursuant to Welfare and Institutions Code section 17000.*fn1 The trial court denied this portion of her petition. We reverse.

FACTUAL BACKGROUND

The underlying facts are not in dispute. Fuchino is an indigent Sacramento County resident with severe diabetes. She enrolled in and has received medical care under the County Medically Indigent Services Program (CMISP), the program through which Sacramento County endeavors to fulfill its statutory obligations under the Welfare and Institutions Code. The medical care she has received under CMISP includes medication and a diet regimen. She has no co-pay requirement.

On April 21, 2007, Fuchino was in Monterey County, California, with her daughters to celebrate her 63rd birthday. It was Fuchino's first and only trip to Monterey County. She took her normal four insulin injections that day and watched her diet as usual. Late at night, she went into diabetic shock and became unconscious. Her daughters called an ambulance to the hotel.

An ambulance from Westmed Ambulance Inc. (Westmed) transported Fuchino to Community Hospital of Monterey Peninsula. In transit, ambulance personnel administered glucagon and dextrose to Fuchino. Once at the hospital, she was treated in the emergency room.

Some time later, Fuchino received a bill from Westmed totaling $1,391.04 for the ambulance services provided on April 21, 2007. Fuchino submitted the bill to her Sacramento CMISP worker and requested coverage. Fuchino's request was denied for the stated reason that "[p]ayment of ambulance services is not within the scope of services provided by CMISP." Fuchino submitted a letter to Sacramento County to appeal CMISP's denial of coverage for the ambulance bill. In a letter response, Sacramento County concluded that "Fuchino's expenses in Monterey County are not the responsibility of Sacramento County CMISP." Sacramento County also sent a letter to Fuchino informing her that her administrative appeal was denied. The letter ended with the following statement: "The Decision On Your Request Is The Final Decision. There Is No Further Appeal Recourse Available To You Within The Department Of Health and Human Services."

Consequently, Fuchino submitted a request to Monterey County to cover the cost of the ambulance services. Monterey County denied her request. The written denial, signed by a Monterey County representative, states in pertinent part: "I cannot find that [] Fuchino has ever been a county resident. She therefore is not eligible for services provided by our county including ambulance services."

PROCEDURAL HISTORY

On February 27, 2009, Fuchino filed a verified petition for writ of mandamus in the Sacramento County Superior Court.*fn2 The petition sought both a writ of administrative mandamus (Code Civ. Proc., § 1094.5) to compel Sacramento County to issue a decision covering the cost of her ambulance bill and a traditional writ of mandamus (Code Civ. Proc., § 1085) to compel Sacramento County to establish new policies for its CMISP. The new CMISP policies sought were: (i) coverage for medically necessary emergency ambulance services without requiring prior authorization; (ii) coverage for medically necessary care received outside of Sacramento County by CMISP beneficiaries who are out of county when the need for care arises and the person is unable to return to Sacramento for treatment; (iii) coverage for medically necessary emergency care provided by non-contracted providers; and (iv) appeal rights, including a formal appeal, when services are denied for falling outside the scope of CMISP's coverage.

The trial court heard the matter and granted in part and denied in part Fuchino's petition. The judgment states in pertinent part: "Petitioner's claims for payment by the Sacramento CMISP of the costs of emergency ambulance services received by petitioner in Monterey County while a Sacramento County resident eligible for CMISP services are denied. As explained in City of Lomita v. County of Los Angeles (1983) 148 Cal.App.3d 671, 673, and City of Lomita v. Superior Court (1986) 186 Cal.App.3d 479, 481-482, a county has a duty to provide and pay for emergency ambulance services needed by an indigent person who is permanently or temporarily within the county."

Fuchino timely filed a notice of appeal from the judgment denying her petition.*fn3

DISCUSSION

This appeal involves the interpretation and application of statutory language, raising questions of law subject to our independent review. (Sisemore v. Master Financial, Inc. (2007) 151 Cal.App.4th 1386, 1411 ["The interpretation and application of a statute involve questions of law subject to de novo review"].)

On appeal, Fuchino argues that under section 17000 Sacramento County is financially responsible for her out-of-county emergency ambulance bill. ...


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