KMC wins mental health tab appeal

The Idaho Supreme Court on Friday said a local judge was wrong to limit how much money Bonner County must pay to cover mental health care for an indigent woman who checked herself into a hospital.

A unanimous state Supreme Court decision written by Chief Justice Roger Burdick appeared to put the Bonner County commissioners on the hook for $26,000 in health care costs presented to the county by Kootenai Medical Center of Coeur d’Alene, which treated an indigent Bonner County woman twice for psychiatric issues.

After KMC made several requests for payment, rejected by Bonner County, the county commissioners agreed to cover roughly a sixth of the costs and paid $4,285.25, court documents show. First District Court Judge John Mitchell denied KMC’s suit to be granted full payment.

“I think the Supreme Court may have missed this entirely,” John Topp, civil attorney for Bonner County, said Friday.

Topp argued the county’s position before the state’s five Supreme Court justices when they visited Coeur d’Alene in October. He argued that state statutes require patients to be involuntarily committed to psychiatric hospitals before taxpayers pick up the bill.

“The taxpayers of the state of Idaho should not have to pay continuous indigent claims for individuals who believe they are a danger to themselves or others and voluntarily admit themselves to psychiatric hospitals,” Topp said. “Our position is there needs to be some oversight on the part of the hospitals – an evaluation – to say these individuals are a danger to themselves or others.”

If the person is determined to pose a threat, they should be involuntarily admitted for treatment. If not, the state should not have to pay for treatment, Topp said.

Burdick disagreed in his decision: “The Idaho Supreme Court … failed to find a reason why Kootenai Medical Center should have refused admission to this patient.”

The justices appear to say that KMC’s hands are tied by state statute. Once the woman committed herself for voluntary psychiatric care, the hospital had no authority to hold her against her will unless the woman asked to leave and staffers determined she posed a danger to herself or others.

Since the woman never asked to be released until her treatment was finished, the hospital could not declare here an involuntarily committed patient, Burdick wrote, adding the Bonner County argument “inconsistent with the statute.”

Hospital officials could not be reached for comment Friday.