Kilkenny, Carton and Fulop. The opinion of the court was delivered by Carton, J.A.D.
This action was instituted by the City of East Orange to determine the respective responsibilities of the city, the County of Essex, the Essex County Welfare Board and the State of New Jersey, for paying the costs of hospital care*fn1 of persons covered by certain public assistance programs. Originally brought in the Superior Court, Law Division, it was determined that the action in part constituted an attack upon certain rules and regulations of a state administrative agency properly to be heard, pursuant to R.R. 4:88-8 and 4:88-10, in the Appellate Division. A motion to consolidate the remainder was granted and the entire case brought here on an agreed statement in lieu of record.
Involved herein is the interrelationship of those statutory programs of public assistance administered by the welfare board of each county and those administered and paid for at the municipal level. Because the county programs
embrace only individuals coming within certain defined categories -- e.g., the aged, the blind, dependent children -- they are commonly referred to as "categorical assistance." The municipal responsibility is broader in scope for it covers all aid to the needy not otherwise provided, and hence has been designated "general public assistance."
Specifically, the city contends that hospital care rendered to persons eligible for aid under categorical assistance should be paid for by the county rather than by the municipality under general public assistance. The city advances as a secondary argument that if it is deemed responsible for providing hospital care to these persons, the Legislature has mandated that the State reimburse it for a certain percentage of the actual cost of such care. On this basis the city contends that the regulation of the Department of Institutions and Agencies limiting reimbursement to a percentage of $10 per day for a period of 30 days is invalid. The validity of these contentions turns upon the proper interpretation of the statutory provisions establishing and implementing these various programs.
Defendants are the Commissioner of the Department of Institutions and Agencies, overseer of New Jersey's welfare programs; the State Treasurer; the county, bearer of financial responsibility for categorical assistance; the Welfare Board, administrator for categorical assistance; and two voluntary hospitals which have provided care to certain dependent children. All defendants except the hospitals deny that categorical assistance includes provision for hospital care for those covered by the programs and, therefore, that such care remains the responsibility of the city under general public assistance. The hospitals are neutral on this issue; they are concerned, however, that the costs due them be paid by some level of government. The hospitals support the city's attack on the limiting regulation, while the county and the Welfare Board take no position on that point.
A brief introduction to the complex statutory scheme of both general and categorical public assistance is necessary to a resolution of the issues before us. First, it must be recognized that the primary duty for furnishing public assistance has since early times been cast upon the municipalities of this State. The Legislature has incorporated this underlying principle as a declaration of its public policy in the General Public Assistance Law:
"44:8-109. Public policy regarding assistance to needy persons
It is hereby declared to be the public policy of this State that every needy person shall, while in this State, be entitled to receive such public assistance as may be necessary, and that the furnishing of such public assistance is primarily the duty of the municipalities and of civic and charitable organizations but that all needy persons not otherwise provided for under the laws of this State shall hereafter receive public assistance pursuant to law and the provisions of this act."
Those responsibilities imposed on the municipalities under this basic policy are delineated in N.J.S.A. 44:8-107 et seq.
The areas or categories of county assistance, on the other hand, are found under several headings in Title 44 of the Revised Statutes, and each represents a new sphere of responsibility at the county level and thus an area carved out of the municipal burden. The first of these categorical programs in point of time was old age assistance, N.J.S.A. 44:7-1 to 37 (1936), providing aid to needy persons over 65. This was followed by disability assistance, N.J.S.A. 44:7-38 to 42 (1951), providing aid to disabled persons between 18 and 65; assistance for dependent children, N.J.S.A. 44:10-1 et seq. (1959), aiding needy children; assistance to the blind, N.J.S.A. 44:7-43 to 50 (1962), assisting those over 18 and blind; and medical assistance for the aged, N.J.S.A. 44:7-76 to 84 (1962), entitling residents over 65 to medical assistance.
All of these categorical assistance programs are linked together by cross-reference to the original program, old age assistance. Since the newer statutory designs simply designate and define the newly-included categories and provide by reference that these forms of aid shall be administered pursuant to the provisions of the old age assistance program, it is that law that is of primary concern, although old age assistance itself is not at issue here. See N.J.S.A. 44:7-39, 44 and 79, and 44:10-2 (the cross-reference provisions of the newer programs).
The city takes the position, generally, that when each of these newly included categorical assistance programs was adopted, the Legislature implicitly cast upon the State and the Welfare Board the responsibility of providing for all of the needs of these persons, including medical services and hospital care, and thus removed this area of public assistance from the domain of the local municipality.
The city arrives at its conclusion that categorical assistance includes medical services (and therefore hospital care as a phase of medical services) by reason of the interpretation which it avers must be placed upon the language of N.J.S.A. 44:7-12, the statutory section defining and describing the extent of relief provided under all forms of categorical assistance. Its entire case rests upon the validity of this position.
That section, in pertinent part, reads as follows:
"The county welfare board * * * shall extend to those persons found to be eligible * * * assistance adequate to provide for their reasonable maintenance and well-being. * * * [A]ssistance shall be granted in the form of cash or check. Necessary medical and health services and supplies may be granted in addition thereto in accordance with the regulations of the State division [Department of Institutions and Agencies]. * * * Such assistance shall be provided for the recipient only while living in his own or some other suitable family home or approved institution * * *." (Emphasis added)
In particular, the city asserts that the italicized sentence was not designed, as defendants insist, to ...