McGrath v. Crandall CA1/3 filed
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Filed 3/24/11 McGrath v. Crandall CA1/3 NOT TO BE PUBLISHED IN OFFICIAL REPORTS California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115. IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA FIRST APPELLATE DISTRICT DIVISION THREE KEVIN McGRATH, Plaintiff and Appellant, A127890 v. (Humboldt County Super. Ct. No. CV080924) PHILIP CRANDALL, as Director, etc., et al., Defendants and Respondents. Appellant Kevin McGrath appeals from a judgment dismissing his petition for writ of mandate against respondents Philip Crandall, as Director of the Department of Health and Human Services, Humboldt County, and Humboldt County Board of Supervisors (hereinafter also collectively referred to as the county) after the trial court granted the county s motion for judgment on the pleadings without leave to amend. Appellant correctly argues that his petition should be reinstated. Accordingly, we reverse the judgment and remand the matter for further proceedings. 1 FACTS1 A. Background On August 31, 2007, appellant was injured, rendered unconscious, and hospitalized in Nevada. He did not regain consciousness until September 1, 2007. After he regained consciousness, appellant applied in his county of residence, Humboldt County, for assistance to pay his medical expenses incurred in Nevada. On September 20, 2007, appellant initially applied for County Medical Services Program (CMSP) benefits to cover all of his Nevada medical expenses. On December 6, 2007, the county approved the application for medical expenses incurred in September 2007, the month of his application for those benefits. The county denied the application for medical expenses incurred on August 31, 2007, because appellant had not applied for CMSP benefits in that month, a requirement of the program. Appellant requested a hearing challenging the county s denial of coverage for the unpaid medical 1 Because appellant s petition was resolved by a motion for judgment on the pleadings, we set forth the relevant facts as alleged in the petition and the exhibit annexed to that pleading. (Barker v. Hull (1987) 191 Cal.App.3d 221, 224.) In the trial court, the county asked the court to take judicial notice of certain documents and regulations relating to the County Medical Services Program. The county also annexed to its motion papers certain sections of the Nevada Revised Statutes. Although both parties referred to these documents, regulations, and statutory law, the trial court did not explicitly rule on the county s request for judicial notice. In the absence of any objection by appellant, we will consider these documents, regulations, and statutory law, to the extent relevant to our evaluation of whether the county is entitled to judgment on the pleadings. Also, we deferred until this time the county s request that we take judicial notice of (a) the following documents and regulations not considered by the trial court: Humboldt County Indigent Medical Aid Standards of Care, published by the Humboldt County Board of Supervisors on September 22, 2009; and a letter dated September 15, 2008, addressed by the county to appellant s trial counsel; and (b) the following documents and statutes considered by the trial court: CMSP Letters No. 02-05 and 08-03 addressing retroactive coverage through County Medical Services Program and a pre-enrollment grace period for qualifying medical events; Eligibility Requirements of County Medical Services Program; and Nevada Revised Statutes sections 439B.260, 428.010 et seq., and 439B.300 et seq. Again, in the absence of any objection by appellant, we now grant respondents request for judicial notice, and have considered these documents and regulations to the extent they are relevant to our resolution of the appeal. 2 expenses incurred on August 31, 2007. On March 5, 2008, the county denied appellant s claim after a hearing held on February 20, 2008.2 Appellant then unsuccessfully applied on two occasions for payment of the unpaid medical expenses incurred on August 31, 2007, pursuant to the county s obligations as set forth in Welfare and Institutions Code section 17000.3 On June 9, 2008, the county denied appellant s first request stating that there was no retroactive coverage for CMSP benefits. On September 15, 2008, the county denied appellant s second request, again stating that [t]here was no retroactive eligibility available in the CMSP program for medical expenses incurred before a resident applied for such coverage. The county s September 15, 2008 letter did not mention section 17000, but noted that (a) appellant began application for a hardship program but failed to follow through; and (b) the Nevada hospital in which appellant had received his medical care had a payment plan that would allow a reduced payment for its services if appellant qualified for medically necessary services. B. Current Lawsuit After the county s second denial of his claim for coverage for his unpaid medical bills pursuant to section 17000, appellant filed this petition against the county. In the first cause of action appellant applied for a writ of administrative mandamus (Code Civ. Proc., § 1094.5) seeking payment for his unpaid medical bills incurred on August 31, 2007, in Nevada. In the second cause of action appellant applied for a writ of traditional mandamus (Code Civ. Proc. § 1085) seeking to require the county to provide medical coverage pursuant to its section 17000 obligations to indigent county residents. In the 2 Although appellant was informed he could petition the superior court if he was not satisfied with the county s decision, there is no allegation in the petition that either he sought such review or he did not seek such review. 3 All further unspecified statutory references are to the Welfare and Institutions Code. Section 17000 reads: Every county and every city and county shall relieve and support all incompetent, poor, indigent persons, and those incapacitated by age, disease, or accident, lawfully resident therein, when such persons are not supported and relieved by their relatives or friends, by their own means, or by state hospitals or other state or private institutions. 3 petition s request for relief, appellant sought a writ of administrative mandamus (a) directing respondent Crandall to reverse the county s decision and find that appellant was eligible for payment of his unpaid medical expenses incurred in August 2007; and (b) directing respondent Board of Supervisors to provide residual county medical coverage to indigent county residents not otherwise medically supported. After filing its answer, the county moved for judgment on the pleadings, which was opposed by appellant. The court granted the motion without leave to amend, and entered a judgment dismissing the petition. This timely appeal ensued. DISCUSSION The motion for judgment on the pleadings performs the function of a general demurrer. Therefore, it admits all material and issuable facts pleaded. [Citation.]. [T]he facts alleged in the pleading must be accepted as true, and the court may also consider matters subject to judicial notice. [Citation.] (Baillargeon v. Department of Water & Power (1977) 69 Cal.App.3d 670, 676.) [W]e do not review the validity of the trial court s reasoning but only the propriety of the ruling itself. [Citations.] This court is not bound by the trial court s construction of the [petition] . . . . (Wilner v. Sunset Life Ins. Co. (2000) 78 Cal.App.4th 952, 958.) Treating as true all material facts properly pleaded, and facts that may be implied or inferred from those expressly alleged, we determine de novo whether the factual allegations in the petition are adequate to state a cause of action under any legal theory, regardless of the title under which the factual basis for relief is stated, or even if appellant is not entitled to the requested relief. (Blank v. Kirwan (1985) 39 Cal.3d 311, 318.) In the first cause of action appellant seeks review of the county s several denials of his requests, pursuant to section 17000, for coverage of his unpaid medical bills incurred on August 31, 2007, in Nevada.4 In the trial court, the county challenged this cause of 4 After the petition s heading FIRST CAUSE OF ACTION, appellant alleges and incorporates the earlier allegations in the petition setting forth his various attempts to secure a decision on his request for coverage pursuant to section 17000 for his unpaid August 31, 2007, medical bills, and then the petition specifically refers to the county s 4 action on the grounds that (1) a writ of administrative mandamus did not lie because appellant was not seeking review of a quasi-judicial decision; and (2) appellant failed to allege facts showing he had a beneficial interest in the outcome of the case because he did not set forth the amount of medical expenses at issue or the basis for any charges he was seeking to recover from the county. As we now discuss, the county s contentions fail. First, the fact that appellant may have invoked the wrong mandamus statute is insufficient to support the grant of the motion for judgment on the pleadings. (See County of San Diego v. State of California (1997) 15 Cal.4th 68, 109 (County of San Diego).) California . . . [has] entirely rejected the doctrine of theory of the pleading as incompatible with the fundamental code principle of abolition of forms of action. (4 Witkin, Cal. Procedure (5th ed. 2008) Pleading § 413, p. 551.) Consequently, a party cannot be thrown out of court merely because he may have misconceived the form of relief to which he is entitled. (Ibid.) Second, the allegations in the first cause of action are sufficient to show appellant has a beneficial interest in coverage for his unpaid medical expenses incurred on August 31, 2007, in Nevada. It was alleged that appellant requested medical coverage for August 2007 as a medically indigent county resident based on the county s obligations under section 17000 to support the indigent. To establish appellant s beneficial interest in the matter, there is no requirement that the petition include the amount of medical expenses at issue or the basis for any charges appellant was seeking to recover. A pleading need only set forth the ultimate facts constituting the cause of action, not the evidence by which the plaintiff proposes to prove those facts. (Committee on Children s Television, Inc. v. General Foods Corp. (1983) 35 Cal.3d 197, 212.) Thus, as appellant argues, if writ relief is granted he will gain the direct benefit of being relieved of the debt of his unpaid medical bills, and if the writ is denied he will suffer the detriment of unpaid medical bills he cannot afford to pay. Contrary to the county s suggestion, at this March 5, 2008, written decision denying his claim after a hearing. The March 5, 2008 written decision indicates that at the hearing appellant s counsel referred to the county s obligations pursuant to section 17000. 5 procedural stage of the case appellant is not required to provide this court with evidentiary proof in support of his allegations that he is an eligible indigent county resident who is entitled to coverage for unpaid medical expenses incurred on August 31, 2007, in Nevada, pursuant to section 17000. (See People v. Superior Court (Jayhill Corp.) (1973) 9 Cal.3d 283, 288.) Nor do we see any merit to the county s appellate argument that the petition lacks factual allegations establishing that appellant s unpaid medical bills are not recoverable in Nevada. If [the county] require[s] further specifics in order to prepare [its] defense, such matters may be the subject of discovery proceedings. (Ibid.) The county conceded in the trial court that traditional mandamus was appropriate to address the allegations in the second cause of action which challenges the county s failure to provide coverage for medical services incurred by indigent residents pursuant to section 17000. Nevertheless, the county argues this cause of action fails because appellant has failed to establish his right to pursue such a cause of action in that (1) there are no facts in the petition that would establish appellant was eligible for benefits under section 17000; and (2) appellant has not shown he has standing under the public right/public duty exception to the requirement that a petitioner be beneficially interested in the matter. Additionally, the county contends the petition should be dismissed on the substantive ground that appellant failed to establish that the county s section 17000 obligation encompasses the payment for emergency medical services incurred by residents injured in another state. As we now discuss, the county s contentions fail. Code of Civil Procedure section 1085 authorizes a trial court to issue a writ of mandate to compel the performance of an act which the law specifically enjoins . . . . Mandamus is brought upon verified petition of a beneficially interested party. (Code Civ. Proc., § 1086.) (Timmons v. McMahon (1991) 235 Cal.App.3d 512, 517 (Timmons); see Madera Community Hospital v. County of Madera (1984) 155 Cal.App.3d 136, 143 (Madera Community Hospital) [ ordinarily the writ of mandate will be issued only to persons who are beneficially interested ].) However, [a]s to the beneficially interested requirement, our Supreme Court has recognized an exception to the general 6 rule where a public right is at stake and the purpose of the mandamus action is to procure enforcement of a public duty. In this situation, the relator need not show that he has any legal or special interest in the result, since it is sufficient that he is interested as a citizen in having the laws executed and the duty in question enforced. (Timmons, supra, 235 Cal.App.3d at p. 518, quoting Green v. Obledo (1981) 29 Cal.3d 126, 144, quoting Bd. of Soc. Welfare v. County of L.A. (1945) 27 Cal.2d 98, 100-101; see Doe v. Saenz (2006) 140 Cal.App.4th 960, 999 (Doe).) We need not address the county s argument as to whether appellant will be able to establish he is entitled to benefits under section 17000 because the public right/public duty exception to the requirement of beneficial interest applies here. (Timmons, supra, 235 Cal.App.3d at p. 518; see Doe, supra, 140 Cal.App.4th at p. 999; Gresher v. Anderson (2005) 127 Cal.App.4th 88, 114; Madera Community Hospital, supra, 155 Cal.App.3d at pp. 141-145.) Appellant sufficiently demonstrated his public right/private duty standing in that in the second cause of action it is alleged that the county s provision of medical services to indigent county residents is a matter of public right pursuant to section 17000 (County of San Diego, supra, 15 Cal.4th at p. 101), and appellant is seeking to procure the enforcement of a public duty to provide such benefit under the facts as alleged in the petition, namely for emergency medical services incurred by an indigent resident while in another state. (Green, supra, 29 Cal.3d at p. 145.) Our conclusion that appellant has standing to pursue his second cause of action is supported by our decision in Union of American Physicians & Dentists v. County of Santa Clara (1983) 149 Cal.App.3d 45 (Union of American Physicians & Dentists). In that case, individual doctors and their representative union filed a complaint for declaratory relief and petition for writ of mandate to compel the county to consider and compensate the doctors for the reasonable value of emergency medical services provided to those persons allegedly eligible for county services under section 17000. (Id. at p. 47.) Petitioners sought compensation for emergency medical services rendered to indigent residents. (Id. at p. 48.) In rejecting the compensation claim, we noted: The trial court, at an early stage in the proceedings, afforded physicians a broad hint that the ultimate 7 validity of the causes of action now before us lay not in seeking to compel monetary compensation under quasi-contract theories, but in seeking, as interested citizens, to compel the County s compliance with Welfare and Institutions Code section 17000. We agree; if a county fails to perform its duty, the remedy is not to impose liability for individual claims, but to require it to fulfill its obligations to the indigent, who are the class of persons benefited under section 17000. [Citations omitted.] The fact remains that physicians here have sought to compel reimbursement. The question whether a writ of mandate should issue, on the facts presented, to compel the County s compliance with section 17000 is not before us. (Union of American Physicians & Dentists, supra, 149 Cal.App.3d at pp. 52-53.) As noted by appellant, in his second cause of action he seeks a writ of mandate . . . on the facts presented, to compel the County s compliance with section 17000, which is the proceeding that we contemplated could be maintained in Union of American Physicians & Dentists. 5 The purpose of a standing requirement is to ensure that the courts will decide only actual controversies between parties with a sufficient interest in the subject matter of the dispute to press their case with vigor. [Citations.] The purpose is met when, as here, [appellant] possess[es] standing to have the underlying controversy adjudicated and the desired relief granted after a trial on the merits . . . . (Common Cause v. Board of Supervisors (1989) 49 Cal.3d 432, 439-440.) In dismissing the petition, the court did not rule on the substantive issue presented in the second cause of action. The court stated only that the county had no duty to reimburse Nevada State medical providers for their expenses in providing services to indigent residents of Humboldt County. However, this is not a case in which a Nevada State medical provider is seeking reimbursement for medical expenses incurred by a indigent resident of Humboldt County. The issue is whether an eligible indigent county resident is entitled to county payment of unpaid medical bills for emergency medical services incurred out of state pursuant to the county s obligation under section 17000. 5 While the county cites to our holding in Union of American Physicians & Dentists, supra, 149 Cal.App.3d 45, it relies on isolated portions of the decision that are not relevant to the resolution of this appeal. 8 Additionally, since the trial court s decision the county has issued new standards governing the provision of medical services to indigent residents pursuant to section 17000. The parties do not agree on the effect of the new standards or their applicability to appellant s claims. Under these circumstances, we deem it appropriate to remand the matter to the trial court to resolve the substantive issues raised in the second cause of action in the first instance. In sum, we conclude the trial court erred in granting the county s motion for judgment on the pleadings without leave to amend. Given the procedural posture of this case, our decision should not be read as an expression of the ultimate merits of any of appellant s claims. We hold only that appellant is not barred as a matter of law from pursuing his claims against the county based on the facts alleged in his petition. Accordingly, we reverse the judgment of dismissal and remand the matter for further proceedings. DISPOSITION The judgment of dismissal is reversed. On remand the trial court shall vacate its order granting respondents motion for judgment on the pleadings without leave to amend, and enter a new order denying respondents motion for judgment on the pleadings. Petitioner is awarded costs on appeal. _________________________ Jenkins, J. We concur: _________________________ Pollak, Acting P. J. _________________________ Siggins, J. 9
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