The Attorney General of Texas
November 25, 1980
Honorable Henry Wade Opinion No. MW-279
District Attorney
Condemnation Section Re: Treatment of crippled children
6th Floor, Records Building under the provisions of article 4419c
Dallas, Texas 75202
Dear Mr. Wade:
On behalf of the Dallas County Hospital District, you have requested
our opinion as to whether the Crippled Children’s Division of the Texas
Department of Health may compensate the hospital district for services
rendered to crippled children under article 4419c, V.T.C.S. You advise that
compensation is available if a crippled child is treated at a private hospitaL
Article 4419c created the Crippled Children’s Division and empowered
it to procure medical service for children who are eligible under the criteria
set forth therein. Section 4 provides that:
No child shall be entitled to the care and treatment
provided in this Act unless the Texas Department of
Health determines that every person who has a legal
obligation to provide care and treatment for the child
is financially lolable to provide for said care and
treatment.
Section 4A(b) states that:
A child is not eligible to receive services provided by
this Act to the extent that the child or a person who
has a legal obligation to support the child is eligible
for some other benefit that would pay for the service
or part of the service provided by this Act.
“Other benefit” is defined in section 4A(a) as:
. . .a benefit to which a person is entitled other than
a benefit under this Act for payment of the costs of
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Honorable Henry Wade - Page Two (MW-279)
medical care and treatment. . . including but not limited to the
following:
. . . .
(F) a public program created by federal law, state law, or the
ordinances or rules of a municipality or political s&division of
the state. . . .
Hospital districts, which are tax-sipported entities, exist pursuant to article IX,
section 4 of the Constitution of Texas and the enabling act, article 4494n, V.T.C.S.
They are responsible for providing medical and hospital care and treatment to indigent
or needy county inhabitants, although they may also admit patients who are financially
able to pay for treatment. Attorney General Opinion C-382 (1965). See also Attorney
General Opinions H-703 (1975); M-1154 (19’72). Section 14 of article 4494n provides that
when a patient is admitted to the facilities of a hospital district, the administrator
must ascertain the ability of the patient and any relatives who are legally liable for his
support to pay for treatment. To the extent that the patient and/or his relatives are
unable to bear the expenses involved, “the same shall become a charge lpon the
Hospital District.”
From the foregoing provisions, it is apparent that the total cost of treating a
crippled child in a hospital district facility will be borne by the child’s relatives and by
the district. As we have observed, a child is ineligible for services under article 4419c
if anyone with a legal obligation to pay for his treatment is financially able to do so,
and he is also ineligible to the extent that he is entitled to some “other benefit” that
would pay for such services, including benefits available under “a public program
created by. . . state law.” V.T.C.S. art. 4419c, §4A(a)(l)(F). If a hospital district is
deemed to be such a public program, a crippled child treated in a district facility is
ineligible for services under 4419c, because the total cost of his treatment will be
assumed by his relatives and/or by the district. It follows, moreover, that if a child Is
ineligible for services under article 4419c, the Crippled Children’s Division may not
reimburse the hospital district for services rendered to said child.
When a statutory provision is ambiguous, it is permissible to resort to legislative
intent as an aid in construing said provision. Huntsville Ind. School District v.
McAdams, 221 S.W. 2d 546 (Tex. 1949). In our opinion, the portions of the statutes
quoted above indicate that the legislature clearly intended article 4419c to be used
only to assist eligible children who have no alternative means of assuming the costs of
treatment. We hwe noted that hospital districts have a constitutional and statutory
duty to assume that portion of the costs of caring for a crippled child which those
responsible for the child’s sipport are unable to bear, and we do not think the
legislature intended that funds earmarked for children with no outside financial
sources may be diverted to reimburse a hospital district for costs which it is obligated
by law to assume and which will be covered by taxes levied by the district. We
therefore conclude that the term “public program” was intended to include hospital
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. .
Honorable Henry Wade - Page Three (NW-279)
districts and, accordingly, that the Crippled Children’s Division may not, consistent
with article 4419c, V.T.C.S., reimburse the Dallas County Hospital District for services
rendered to crippled children.
SUMMARY
Article 4419c, V.T.C.S., does not permit the Crippled
Children’s Division of the Texas Department of Health to
reimburse a hospital district for expenses incurred in treating
crippled children.
MARK WHITE
Attorney General of Texas
JOHN W. FAINTER, JR.
First Assistant Attorney General
RICHARD E. GRAY III
Executive Assistant Attorney General
Prepared by Jon Bible
Assistant Attorney General
APPROVED:
OPINION COMMlTTEE
Susan L. Garrison, Acting Chairman
Jon Bible
Rich Gilpin
Barbara Marquardt
p. 895
Untitled Texas Attorney General Opinion
Combined Opinion