In a unanimous decision released yesterday, the Court of Appeal, ordered Sacramento County to pay Beverly Fuchino’s ambulance bill, incurred when Ms. Fuchino went into diabetic shock while visiting Monterey County. The Sacramento County Medical Indigent Services Program (CMISP) is a program of last resort designed to meet the basic health care needs of individuals who cannot afford the cost of their care after meeting the basic necessities of life and are not otherwise eligible for healthcare programs such as Medi-Cal, Medicare or private health insurance.

This case arose when Ms. Fuchino, who was then enrolled in CMISP, was taken by her daughters to Monterey County to celebrate her 63rd birthday. Ms. Fuchino took medication for her diabetes through CMISP, and followed a strict blood sugar testing and dietary regimen, according to her doctor’s instructions. Despite her taking these precautions, late on the night of her visit to Monterey, Ms. Fuchino went into diabetic shock and became unconscious. She had to be transported to the Community Hospital of the Monterey Peninsula emergency room by ambulance to receive life-saving medical treatment. When Ms. Fuchino later received the $1391.04 ambulance bill, she submitted it to Sacramento’s CMISP for payment. But Sacramento County refused to pay the bill because the expense was incurred in another county.

Legal Services of Northern California and Western Center on Law & Poverty filed a lawsuit on Ms. Fuchino’s behalf in February, 2009. A Sacramento County Superior Court judge ruled last year that Monterey County, not Sacramento, was responsible for paying Ms. Fuchino’s bill, but the Court of Appeal reversed. Justice Andrea Hoch, writing for the Court, stated, “Fuchino has not been relieved of th[e] medically necessary cost [of emergency ambulance services] by any other means nor can she herself afford the bill. We conclude that Sacramento County, her county of residence and ‘last resort,’ is obligated . . . to relieve her of this cost.”