Hiller v. Adams County
Hiller v. Adams County
Opinion of the Court
Joanne Hiller appeals from an order affirming a decision of the Adams County Social Services Board which denied her application for general relief in order to meet recently-incurred extraordinary medical expenses.
The issue is whether the guidelines adopted by the county to determine eligibility for general relief — -which are based on an applicant's income — are invalid because, as applied to the facts of this case, they fail to require consideration of Hiller's undisputed need for medical
The facts are not in dispute and may be briefly stated. Hiller, an unmarried, employed adult living in Adams County, developed a medical problem that involved expensive testing and a course of extensive and expensive treatment. During a three-month period in early 1989, she incurred expenses of approximately $32,000.
Hiller applied to Adams County for general relief for the sole purpose of assisting in the payment of these medical expenses. At the time of her application she was earning $506.34 ($422.26 net) per month. The county Department of Health and Social Services denied the application because Hiller's income exceeded the county's general relief medical benefit eligibility guideline of $298 per month. The board sustained the denial for the same reason and Hiller sought certiorari review in circuit court.
Hiller argued to the circuit court that it was error to deny her application based solely on the county's income guidelines because it ignored her "level of need" — that is, the $32,000 in medical expenses she had accumulated in the preceding months. The court affirmed the board's decision, holding that adoption of the income standard was within the authority delegated to the county by sec. 49.02(9), Stats.,
Hiller expands upon the argument here, and she begins by referring to two statutes. First, she turns to the provisions in sec. 49.02(lm), Stats., stating that "[e]very county shall furnish general relief to all eligible dependent persons within the county." (Emphasis added.) She then looks to the definition of "dependent person" in secs. 49.01(2) and (5m) as "an individual without the presently available money, income, property, or credit . . . sufficient to provide . . . food, housing, clothing, fuel, light, water, medicine, medical, dental and surgical treatment (including hospital care). . .." From this language, Hiller draws the following syllogism: because eligible dependent persons are entitled to general relief; and because a person without funds to provide medical treatment — that is, a person whose medical "needs" are not being met — is within the definition of "dependent persons," it follows that an applicant's "level of need" for medical treatment must be considered to determine whether he or she meets that definition and is thus entitled to the relief sought. As a result, Hiller asserts that an applicant's "level of need" must be considered on an equal basis with his or her finances and assets in determining eligibility for medical payments through general relief, and that rejection of her application solely on the basis that her income exceeded the cutoff level was improper and illegal.
Beyond that, Hiller contends that the supreme court's decision in State ex rel. Sell v. Milwaukee County, 65 Wis. 2d 219, 222 N.W.2d 592 (1974), controls and mandates reversal. The Sell court invalidated a Milwaukee County regulation requiring general relief applicants to dispose of automobiles as a condition of receiving assistance. The court held that, "rather than
We agree with the county that Sell is inapposite. First, the case did not involve a request for non-emergency medical payments as general relief, as is the situation here. Second, the statute at issue in this case, sec. 49.02(9), Stats., was enacted after Sell was decided and it was designed to apply specifically to requests for non-emergency medical care as general relief. Given those distinctions, we see Sell as being of little value to the disposition of this appeal.
As to Hiller's statutory argument, sec. 49.02(9), Stats., authorizes counties to "limit [their] liability for medical . . . care furnished as general relief ... by adopting income and resource limitations which are not more restrictive than those set forth under s. 49.06." And that is just what Adams County has done. It has adopted an income limitation in order to limit its general relief medical care liability, as the statute authorizes it to do. The only question, then, is whether the limitation adopted is more restrictive than permitted by sec. 49.06; and it is not.
Section 49.06(1), Stats., sets limits on the type and value of a general relief applicant's assets, and the
And we see nothing in that statute — or in any other statute material to this appeal — to support Hiller's argument that the standards applicable to evaluation of applications for medical assistance under sec. 49.47 have been incorporated into sec. 49.02(9). Indeed, we believe sec. 49.02(9) is plain and unambiguous in authorizing counties to adopt income standards designed to limit their liability for payment of medical expenses as general relief as long as certain conditions are met. Where, as here, the governing statute is plain on its face, our task is to apply it, not to interpret it into something it is not. Section 49.02(9), Stats., is a law dealing specifically with the type of relief Hiller has requested, and Adams County has exercised the authority granted it by that law to limit its liability for that type of assistance.
We realize the result seems harsh in this instance. We also realize that given the blanket authority granted
By the Court. — Order affirmed.
Section 49.02(9), Stats., provides in pertinent part that:
[a]ny county may limit its liability for medical. . . care furnished as general relief... by adopting income and resource limitations . . ..
Dissenting Opinion
(dissenting). This appeal presents an important question in the administration of general relief by counties: Does sec. 49.02(9), Stats., permit a county to deny general relief-medical benefits to a person whose income exceeds a determined level, without considering that person's need for medical relief? I conclude that it does not and therefore respectfully dissent. Section 49.02(9), Stats., provides:
Any county may limit its liability for medical or dental care furnished as general relief, including emergency care provided under sub. (5), by adopting income and resource limitations which are not more restrictive than those set forth under s. 49.06. This limitation applies only to medical or dental care furnished as general relief on or after the date the county acts to limit its liability.
Pursuant to this section, Adams County has provided that general relief will not be used to pay medical expenses of a person whose anticipated annual income exceeds a level determined by family size. In this case, for a single person, the eligibility level is anticipated annual income of $3,576 or $298 per month. JoAnne Hiller's anticipated income exceeds that level. She contends that the county erroneously denied her medical relief by relying solely upon the income-eligibility stan
Section 49.02(lm), Stats., provides: "Every county shall furnish general relief to all eligible dependent persons within the county . . .." Section 49.01(2) defines a "dependent person" to mean "an individual without the presently available money, income, property or credit, or other means . . . sufficient to provide the necessary commodities and services specified in sub. (5m)." Section 49.01 (5m), Stats., defines "general relief" to mean "such services, commodities or money as are reasonable and necessary under the circumstances to provide . . . medical, dental, and surgical treatment . . .." The last sentence of sec. 49.01 (5m) provides: "The general relief furnished, whether by money or otherwise, shall be at such times and in such amounts, as will in the discretion
Did the legislature in sec. 49.02(9), Stats., intend to repeal the requirement that the general relief official or agency determine whether medical relief furnished will meet the needs of the recipient and protect the public? I conclude that it did not.
Section 49.02(9), Stats., as construed by the county, would permit it to virtually eliminate its responsibility to provide medical relief to dependent persons. The county has set the income-eligibility limitation for one person at an anticipated annual income of $3,576. Because under its construction of the statute the county need not consider need, there is no reason why the county could not set the eligibility limit at a figure which would eliminate virtually all dependent persons. This is an unreasonable construction of sec. 49.02(9) and we must reject it. Dickie v. City of Tomah, 160 Wis. 2d 20, 25, 465 N.W.2d 262, 264 (Ct. App. 1990) (citing Maxey v. Racine Redevelopment Authority, 120 Wis. 2d 13, 20, 353 N.W.2d 812, 816 (Ct. App. 1984)).
Plainly, however, the legislature did not intend to do an inutile act when it enacted sec. 49.02(9), Stats. The guiding principle of statutory construction is to determine the intent of the legislature. State v. Vonesh, 135 Wis. 2d 477, 482, 401 N.W.2d 170, 173 (Ct. App. 1986). When a statute is ambiguous, a reviewing court may resort to extrinsic aids to determine legislative intent. Id. at 483, 401 N.W.2d at 173. "One of the most valuable extrinsic aids of judicial construction is legislative history." Id. (quoting Milwaukee Co. v. LIRC, 113 Wis. 2d 199, 204, 335 N.W.2d 412, 415 (Ct. App. 1983)).
Section 49.02(9), Stats., was created by sec. 1011, 1983 Wis. Act 27 [1983 Senate Bill 83] to read:
*1047 Any municipality or county may limit its liability for medical or dental care furnished as general relief, including emergency care provided under sub. (5), by adopting income and resource limitations. This limitation applies only to medical or dental care furnished as general relief on or after the date the municipality or county acts to limit its liability.
1983 Senate Bill 83 was the executive budget bill. The bill made extensive statutory changes to the medical assistance and general relief standards. The Legislative Reference Bureau's analysis of the bill includes the following:
This bill requires that general relief-administering agencies establish written criteria for determining eligibility for benefits and establish written standards of need to be used to determine the type and amount of relief to be furnished . . .. The bill also enables a relief agency to establish standards to determine what is reasonable care for the purpose of reimbursement and to establish resource and income limitations for eligibility for medical care similar to those used for medical assistance. [Emphasis added.]
The resource and income limitations for eligibility of medically indigent persons for medical assistance affected by 1983 Wis. Act 27 were contained in sec. 49.47(4), Stats. Paragraph (b) established resource limitations and para, (c) established income limitations. Paragraph (c)2 provided:
Whenever an applicant has excess income, no certification [of eligibility] shall be issued until such time as the excess income above the applicable limits has been expended for medical care or for any other type of remedial care recognized under state law or*1048 for personal health insurance premiums or both.1
Paragraph (c)2 of sec. 49.47(4), Stats., is the so-called "spend-down" provision under which an applicant is not automatically ineligible for medical assistance if he or she has income in excess of the eligibility standard. The spend-down provision simply requires that the applicant spend excess income for medical care before becoming eligible for assistance.
I conclude that when the legislature enacted sec. 49.02(9), Stats., it intended to allow counties to adopt resource and income limitations similar in kind to those contained in sec. 49.47(4), Stats. In the 1985 legislative session, however, the legislature enacted income and resource limitations specifically applicable to general relief. The legislature repealed and recreated sec. 49.06, Stats., to expand the general relief resource and asset limitations contained therein.
Any municipality or county may limit its liability for medical or dental care furnished as general relief, including emergency care provided under sub. (5), by adopting income and resource limitations which are not more restrictive than those set forth under s. 49.06. [Emphasized language added by amendment.]
Section 962, 1985 Wis Act 29.
The majority concludes that Adams County's $298-per-month income limitation is not more restrictive
I would reverse and remand to the circuit court with directions that it order the county department to determine Hiller's eligibility for medical relief under secs. 49.01(2), (5m), 49.02(lm) and 49.06, Stats.
Section 49.47(4)(c)2, Stats., has been amended in respects not material to the issue before us.
Prior to the 1985 repeal and recreation, sec. 49.06, Stats. (1983-84) exempted home equity, and life insurance having a value of $300.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.