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South Dakota Supreme Court
The case underscores the question of who is responsible for emergency health care costs of migrant workers in South Dakota and other states where thousands of permitted seasonal workers are on farms and ranches.

S.D. Supreme Court: County Right To Deny Poor-Relief

PIERRE, S.D.  — Sully County wasn’t required to pay for the emergency medical care that a nonresident person who was indigent received at Avera St. Mary’s Hospital in Pierre, according to the South Dakota Supreme Court.

The justices unanimously ruled for Sully County in a decision that was publicly released on Thursday. Justice Scott Myren wrote the opinion.

In a KELO story, it was reported J.R., a Mexican national, was working in Sully County on a seasonal work visa in 2014 when he suffered appendicitis. According to the opinion, he was taken by someone he knew to the hospital in Pierre, where he received emergency treatment. He later returned to Mexico without paying some $75,000 in medical bills.

Avera St. Mary’s then sought payment from Sully County under South Dakota’s county poor-relief laws. Sully County turned to a 1918 decision by the South Dakota Supreme Court known as Roane v. Hutchinson County and refused to pay. In Roane, multiple emergency surgeries were performed on nonresidents, and ultimately concluded there was no statute in state law for emergency cases.

Justice Myren stated that Sully County’s application of the law was correct.

“J.R. was an indigent who was not a Sully County resident. He received medical care at Avera St. Mary’s Hospital in Hughes County. Sully County did not become aware of J.R.’s illness until the notice of hospitalization was sent after J.R. had received emergency services and was hospitalized in Hughes County,” Justice Myren wrote.

He continued, “As in Roane, Sully County had no chance to investigate whether J.R., a nonresident, was ‘lying sick’ in its county or ‘in distress’ and to provide ‘such temporary relief as the nature of the case may require’ before Avera provided emergency services to J.R. In these circumstances, where temporary relief had already been administered to the nonresident indigent by a third party in another county, Sully County had no statutory obligation to reimburse Avera for J.R.’s emergency medical services.”

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