The question presented in this case mirrors one addressed in our decision in Wesley Med. Center v. City of Wichita,
In this appeal, we again must consider who must pay for medical treatment provided to an indigent offender for injuries sustained during an arrest—a law enforcement agency with physical custody of the offender (this time the Kansas Highway Patrol [KHP]) or a county where the offender is ultimately jailed while awaiting trial on felony charges. The issue arises anew because of the 2006 enactment of K.S.A. 22-4612, which addresses payment of medical expenses for indigent offenders in the custody of the KHP or several other governmental entities. The district court and the Court of Appeals in
Both courts considered a second issue that flows from that determination: Was the indigent offender in this case in KHP’s custody so as to trigger liability for the medical expenses at issue? Both the district court and the Court of Appeals determined that KHP had custody of the offender and was hable.
On petition for review from the Court of Appeals’ decision, we affirm the district court and Court of Appeals on both issues.
Facts and Procedural Background
The facts of this case are not in dispute. A KHP trooper stopped Wayne Thomas for speeding in Wyandotte County. When the trooper exited his patrol vehicle, Thomas sped away. An ensuing high-speed chase ended when Thomas crashed head-on into a tree. The trooper removed Thomas from his car, put him on the ground, handcuffed him, and formally placed him under arrest. Although the trooper called for an ambulance, Thomas initially refused any medical services.
After the trooper placed Thomas into his patrol vehicle and started filling out an arrest report, Thomas began complaining of pain and asked to be taken to the hospital. The trooper dren drove Thomas—who remained in handcuffs—to the emergency room at Kansas University Medical Center and escorted him inside. The trooper did not remove the handcuffs until the nurses began to examine Thomas. The trooper stayed at the hospital for about an hour until the nursing staff reported that they would be keeping Thomas overnight. Thereafter, the trooper instituted a “police hold” on Thomas, which meant that he wanted the hospital to call him before releasing Thomas.
The hospital called the trooper the next day, and he picked up Thomas and took him directly to the Wyandotte County Jail. No KHP officers guarded Thomas during his hospital stay, although there was an officer from the Kansas University Police Department in Thomas’ room when the trooper arrived to take Thomas to jail.
During the hospital stay, Thomas—whose indigence the parties do not challenge—incurred $23,197.29 in medical charges from the University of Kansas Hospital Authority and $2,311 from the Kansas University Physicians, Inc. (hereinafter collectively referred to as Hospital Authority). The Hospital Authority demanded payment from both the Unified Government of Wyandotte County/ Kansas City, Kansas, (County) and KHP. Both refused to pay the Hospital Authority for Thomas’ expenses, each claiming it was not liable under the law.
The Hospital Authority filed suit against both the County and KHP. As the case progressed, the Hospital Authority and KHP filed motions for summary judgment. Both argued the County was responsible for the expenses under the holding in Wesley. The County responded by citing K.S.A. 22-4612(a), which it argued abrogated Wesley and, through its plain language, imposed liability on KHP. The County prevailed in its arguments before the district court and Court of Appeals. We granted KHP’s petition for review. Both KHP and the Plospital Authority continue to argue the County should be liable for Thomas’ medical care.
Analysis
Issue 1: On what basis is a law enforcement agency liable for an indigent offenders reasonable medical expenses?
Essentially, the parties’ arguments present us with an either/or question of law: Either the County is liable for Thomas’ medical bills under Wesley or KHP is responsible under K.S.A. 22-4612(a). Our review of this question is unlimited. See University of Kansas Hosp. Auth. v. Board of Wabaunsee County Comm’rs,
1.1 Wesley and K. S.A. 22-4612(a)
To add specifics to our previous summary oí Wesley, in that case Wichita police officers attempted to arrest a man and a “gun battle” ensued, resulting in injuries to the offender. Wesley,
This court recognized a statutory duty to treat prisoners with humanity, meaning the governmental entity with custody of a prisoner must provide the prisoner with necessary medical care. Wesley,
As the district court and Court of Appeals recognized, if Wesley controls this case, Wyandotte County would be liable to pay for Thomas’ medical expenses because Thomas was arrested and charged with a violation of state law. University of Kan. Hosp. Auth.,
Under K.S.A. 22-4612(a):
“Except as otherwise provided in tills section, a county, a city, a county or city law enforcement agency, a county department of corrections or the Kansas highway patrol shall be liable to pay a health care provider for health care semices rendered to persons in the custody of such agencies the lesser of the actual amount billed by such healdr care provider or the [M]edicaid rate.” (Emphasis added.)
1.2 KS.A. 22-4612(a) abrogates Wesley
Throughout these proceedings—from those before the district court to those before this court—both the Hospital Authority and KHP have argued that K.S.A. 22-4612(a) merely addresses the rate of reimbursement that applies if an entity bears the legal responsibility
As their arguments suggest, tire fundamental goal of statutory-construction is to ascertain the intent of the legislature. State v. Williams,
Upon examination of the language of K.S.A. 22-4612(a), we conclude—as did the district court and Court of Appeals—that the statute does two things. First, it specifies a test for determining who is responsible for paying for the medical expenses by saying that KHP or one of the other listed agencies “shall be liable to pay a health care provider for health care services rendered to persons in the custody of such agencies.” (Emphasis added.) Second, it defines the method for calculating the amount that can be charged in such situations. K.S.A. 22-4612(a).
This plain-language reading of K.S.A. 22-4612(a) finds reinforcement in the language of K.S.A. 22-4613(a), which the legislature enacted along with K.S.A. 22-4612. L. 2006, ch. 183, secs. 1-2. K.S.A. 22-4613(a) provides: “A law enforcement officer having custody of a person shall not release such person from custody merely to avoid the cost of necessary medical treatment while the person is receiving treatment from a health care provider,” except under specified circumstances. Through this legislation, the Kansas Legislature clearly adopted custody as the trigger for payment liability when an indigent offender receives medical care.
Although KHP and the Hospital Authority present five arguments in an attempt to convince us that K.S.A. 22-4612(a) is ambiguous and does not designate custody as a liability trigger, they do not succeed. The legislature clearly conveyed its intent to base liability on custody, which effectively adopted the custody test that the Wesley court rejected. As we will discuss in the next issue, however, there remains a long-existing ambiguity in this area of law regarding when a person is in “custody” for liability purposes. Before reaching the meaning of custody, however, we will address KHP’s and the Hospital Authority’s five arguments that attempt to persuade us the legislature did not change the Wesley holding.
First, KHP suggests the statute is ambiguous because it could be read to obligate either the County or KHP to pay for Thomas’ medical expenses. But there is no ambiguity—an agency is liable for the medical expenses of a person in its custody. K.S.A. 22-4612(a). If Thomas was in KHP’s custody, tiren KHP would be liable. If Thomas was in the County’s custody, then the County would be liable.
. Second, KHP attempts to circumvent the statute’s plain language by arguing that under Frick v. City of Salina,
Frick is also distinguishable from the instant case because it involved the interplay between precedential judicial interpretation of a particular statutory phrase and the legislature’s subsequent enactment of a statute using the same phrase. See Frick,
Third, the Hospital Authority seeks to circumvent the clear meaning of K.S.A. 22-4612(a) by arguing that we must construe a statute designed to protect the public in light of legislative intent and interpret it to fully carry out the public purpose. See Blue Cross & Blue Shield of Kansas, Inc. v. Praeger,
The Hospital Authority cites nothing to suggest that public interest statutes uniquely permit us to consider legislative history in the face of unambiguous statutory language. State v. Tague,
Fourth, despite unambiguous statutory language, KHP and the Hospital Authority argue various canons of construction allow us to infer legislative intent; they again suggest tire legislature intended to retain the holding in Wesley. “But if a statute is plain and unambiguous, this court will not speculate about legislative intent or turn to canons of construction.” State v. Reese, 300 Kan. 650, 653,
Fifth, the Hospital Authority argues the district court’s and Court of Appeal’s reading of K.S.A. 22-4612(a) conflicts with K.S.A. 19-1910(b)(l), which imposes liability on KHP for medical bills in the limited circumstance of a KHP officer injuring an offender. The Hospital Authority cites the rule of in para materia, asking us to construe K.S.A. 22-4612(a) in workable harmony with K.S.A. 19-1910(b)(l). We have held that even when various statutory provisions are independently unambiguous, we will construe them in para materia. Northern Natural Gas Co. v. ONEOK Field Services Co.,
The legislature used limiting language in drafting K.S.A. 19-1910(b)(1). But in enacting K.S.A. 22-4612(a)—with presumed knowledge of K.S.A. 19-1910, which it had enacted the previous legislative session—the legislature chose not to use the same limiting language. We presume that difference to have been intentional. Further, the circumstances described in K.S.A. 19-1910 and K.S.A. 22-4612(a) are not mutually exclusive: KHP can be responsible for expenses when its officers injure an individual, even if the individual is not in KHP’s custody when treatment is sought, and it can be responsible if an indigent offender is in its custody when medical treatment is rendered, even if a KHP officer did not injure the individual.
In summary, K.S.A. 22-4612(a) clearly states that any of the listed agencies, including KHP, “shall be liable to pay a health care provider for health care services rendered to persons in the custody of such [agency]” (Emphasis added.) The Hospital Authority and KHP fail to argue how we can construe the statutory language of K.S.A. 22-4612(a) to mean anything other than what it says. We, therefore, conclude the Court of Appeals and the district court were correct in holding that K.S.A. 22-4612(a) abrogated Wesley. See Wabaunsee County,
Issue 2: Did KHP have custody of Thomas for liability purposes?
KHP claims that it did not have custody of Thomas even if K.S.A. 22-4612(a) potentially imposed liability on it. But KHP concedes that a KHP trooper arrested Thomas. Plus, the trooper handcuffed Thomas and placed him in the back of a patrol car, gaining physical custody over Thomas.
Elsewhere in chapter 22, the legislature defined “custody” as “the restraint of a person pursuant to an arrest or the order of a court or magistrate.” (Emphasis added.) K.S.A. 22-2202(9). Similarly, “arrest” is “the taking of a person into custody in order that the person may be forthcoming to answer for the commission of a crime.” (Emphasis added.) K.S.A. 22-2202(4). At the least, under the plain meaning of the statutes, a person is in custody when under arrest. Wabaunsee County,
Nevertheless, KHP argues that Thomas was not in its custody when the Hospital Authority treated him because the KHP trooper had removed Thomas’ handcuffs before treatment and did not guard him throughout the hospitalization. KHP essentially contends that a person is in custody for liability purposes only so long as an agency physically restrains the person.
KHP’s argument reflects the ambiguity we previously mentioned: What did the legislature mean when it used the word “custody”
In the earliest of these cases—Mt. Carmel Medical Center—a prisoner injured himself when he escaped by jumping out of a courthouse window. With agreement from a sheriff s deputy, the prisoner was taken to the hospital by ambulance, and once discharged from the hospital was allowed to stay with his parents while recovering. The sheriff posted no guards. Despite the fact the prisoner was not in die county’s physical custody throughout the hospital stay—i.e., when the hospital treated him—and was not immediately returned to custody when discharged from the hospital, the Court of Appeals found the county liable for the medical expenses, making at least two points important to our analysis. First, the court identified “[t]he determinative factor is whether [the prisoner] was in custody when the decision was made to transport [him] to the hospital.” Additionally, the court found physical custody during the hospitalization to be immaterial: “[Ojnce the duty to furnish medical care attaches, the hospital’s claim cannot be defeated by the sheriff s failure to carry out his sworn duties due to the lack of manpower.”
Similarly, in Dodge City and Allen Memorial the Court of Appeals, at least implicitly, focused on tire point in time when the decision was made to transport an indigent individual to the hospital. In Allen Memorial, sheriff s officers took an intoxicated person into protective custody and placed him in the county jail overnight. During the night, the man experienced a seizure that prompted the jailer to call an ambulance. The court found the man to be in the sheriffs custody for liability purposes even though he was never under arrest and had no obligation to return to jail after receiving the medical treatment.
In Dodge City, a sheriffs deputy shot a burglar and then summoned an ambulance. The burglar was not arrested or guarded during his 3-week stay at the hospital. Nevertheless, the court noted that the sheriff would have pursued the burglar if he fled the hospital. As well, the doctors were to advise the sheriff before releasing the burglar. The doctors did so, and the sheriff arrested the burglar at his release. Ultimately, the court held:
“Where a suspect is apprehended in the commission of a felony, felled by an officer’s gunshots, and taken to a hospital by the sheriff, the suspect is ‘in custody’ while hospitalized for the purpose of determining the county’s liability for his medical expenses even though he has not been formally arrested or kept under guard.”6 Kan. App. 2d 731 , Syl. ¶ 2.
The focus of these cases on the point in time when medical care is initiated is consistent with this court’s recognition that the obligation to provide medical care is rooted in the government’s duty to treat prisoners with humanity. Wesley Med. Center v. City of Wichita,
Here, because Thomas was under arrest and in the KHP trooper s custody, he had no ability to seek medical care on his own. He was wholly dependent on the trooper. Under the law discussed in past Kansas appellate decisions, this means a governmental entity became liable for Thomas’ medical care since he was both a prisoner and indigent. Nothing in K.S.A. 22-4612(a) alters this past approach, and we presume that the legislature understood the law when it enacted K.S.A. 22-4612(a).
Consistent with these past authorities, we hold that under K.S.A. 22-4612(a) tire obligation of one of the statutorily specified governmental entities, such as the KHP, to pay for the medical expenses of an indigent criminal offender is triggered by the entity having custody of the indigent offender at the time the decision is made to obtain medical treatment for the offender. Because the KHP trooper had placed Thomas under arrest and took Thomas into physical custody, KHP is that governmental agency in this case and is liable. See K.S.A. 22-2202(4), (9); University of Kansas Hosp. Auth. v. Board of Wabaunsee County Comm’rs,
Given that Thomas was under arrest, we need not discuss the outer parameters of what might constitute custody. We do note, however, that arrest might not always be necessaiy.
KHP also suggests that liability can shift if custody transfers to another entity. It then contends that Thomas was actually in custody of the Kansas University (KU) Police Department when he received treatment. We need not resolve this legal issue because the necessaiy factual basis was not established in KHP’s motion for summary judgment; nor has it argued that summaiy judgment is precluded because the facts on this point are controverted. See Parish,
Also, KHP takes issue with the Court of Appeals’ citation to K.S.A. 22-4613(a), arguing that tire Court of Appeals improperly shifted the burden to KHP to prove it was not liable for Thomas’ medical expenses. Although we do not read the Court of Appeals decision as burden shifting, K.S.A. 22-4613(a) does not apply in this case under our holding. Thomas was in the KHP officer’s custody when tire decision was made to seek treatment.
Conclusion
Thomas was under arrest and in KHP’s custody at the time he was taken to the hospital for treatment. Based on that custody, KPIP was liable for Thomas’ reasonable medical expense under K.S.A. 22-4612(a), which superseded the holding in Wesley. The district court correctly granted the Hospital Authority’s motion for summary judgment, and the Court of Appeals correctly affirmed the district court’s resolution of the case.
Affirmed.
