EonorableMark 8.Dettman Midland CountyAttorney P. 0. Box 2559 Midland,Texas 79702 OpinionNo. ~~-643
Re: Liability of a county for medical care of indigent inmates of a county jail
DearMr. Dettman:
You inquireabout liabilityformedical treatment fornonresident Indigent prisoners incarcerated in the Midland County jail. Specifically,you askwhether the term "welfarepatient" as used in the act creating the Midland County Hospital District includes nonresident indigentprisoners indarceratedin thecounty jailwhen theprisoners' residences are in areas not served by a hospital district. We conclude that responsibility for medical treatment for a "welfare patient

u incarceratedin the county jailwhose residence isnot within a hospital district is determined by article 104.002 of the Code of CriminalProcedure. The Midland County Hospital District is created under authority of article IX, section 9. of the Texas Constitution,by chapter 112, Sixty-fifthLegislature, 1977. SeeV.T.C.S. art. 4494q. The district includes all of Midland County. Section 19 of that act provides principally for liabilityfor care and treatmentof apatient residing within thathospital districtwho has been admitted to the district's facilities. It also contains the followingprovision:

If awelfarepatient is admitted to the district's facilitiesand is not a resident of the district, the district may seek reimbursement from the countyof the residencyof thepatient andmay sue for reimbursement.
Acts 1977. 65thLeg., ch. 112, 519.at 242. The section-by-sectionanalysis of the bill creating the Midland County Hospital District includes the following analysis of section 19: Section 19. Board to inquire into patient's

ability topaywith recourseaswell to relatives. Inability to pay will cause the patient to become a charge on the District. Disputes, hearings, appeals. Board may seek reimbursement from

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indigentshome county (indigentdefinedas welfare patient). May sue. See Bill Analysis to S.B. No. Intergovernmental Affairs, 1210 prepared for House Committee on filed in Bill File to S.B. No. 1210, Legislative Reference Library. Hence, it seems clear that the legislature intends "welfare patient" in that act to be synonymous with "indigentpatient." Expenses forprisoners confined In a county jail are the subject of article 104.002 of the Code of Criminal Procedure, which provides that: (a) Except as otherwise provided by this

article, a county Is liable for all expenses incurred in the safekeeping of prisoners confined in the county jail or kept under guard by the county. If a prisoner is transferred to a county from another county on a change of venue. for safekeeping, or for a habeas corpus hearing. the county transferringtheprlsoner'is liable for the expensesdescribedby this article. Article 104.002 is a recodification of several procedural statutes, including articles 1037 and 1040 of the Code of Criminal Procedure (Vernon 19251, which governed the liability of a county for the medical care and treatment of indigent prisoners. Article 1037 provided that:

Each County shall be liable for all expenses incurred on account of the safe keeping of prisoners confined in jail or kept under guard, except prisoners brought from another county for safe keeping, or on habeas corpus or change of venue; in which cases, the county from which the prisoner is brought shall be liable for the expense of his safekeeping. (Emphasisadded). Article 1040provided inpart as follows:

For the safekeeping,supportandmaintenance of prisoners confined in jail or under guard, the sheriff shallbe allowed the following charges:

. . . . 3. For necessary medical bill and reasonable extra compensation for attention to a prisoner during sickness, such an amount as the commissioners court of the countywhere the prisoner is confined may determine to be just and proper. (Emphasisadded).

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Article IX, section 9, of theTexas Constitution,underwhich the Midland CountyHospital Authority is created,provides, in part, that a hospitaldistrict created thereunder

shall assume full responsibility for providing medical and hospital care for its needy inhabitants.
. . . On several occasions, this office has considered the liability of a county for medical servicesprovided to indigentpersons incarcerated in county jailswhen theperson is a residentof a hospital district. Those opinions concluded that the hospital district of which an indigentprisoner Is a resident, rather than the county of incarceration, is liable for the medical care and treatment of an indigent prisoner. See Attorney General Opinions JM-487 (1986);H-703 (1975); M-870 (1971r The rationale for that conclusion is that articles 1037 and 1040 of the Code of Criminal Proceduremust yield to the express broad language in article IX, section 9, of theTexas Constitution. Subject to constitutionalprovisions, the liability for care and treatment of indigentpersons and Indigent prisoners is now governed by article 104.002of the Code of Criminal Procedure and the Indigent Health Care and Treatment Act. codified as article 4438f, V.T.C.S. Under the IndigentHealth Care Act, (1) a county is liable for health care assistance of its eligible residents who do not reside in an area served by a public hospital or hospital district, (2) a public hospital is responsible for health care assistance to eligible residents of the area served by the hospital, and (3) a hospital district is liable for.health care services as provided by the Texas Constitutionand the statutecreating thehospitaldistrict. The Indigent Health Care Act does not expressly amend or repeal any part of articles 1037 and 1040. A repeal of statutesby implication is never favored or presumed. It has long been well established that a repeal by implicationwill be adjudged only if that result is inevitable or is plainly intended by the legislature. See Texas 6 N.O. Railway Co. v. Kelso Building Material Co., 250 S.W.2d426, 430 (Tex.Civ.App. - Galveston 1952,writ ref'dn.r.e.); Berry V. State, 156 S.W. 626, 635 (Tex.Grim. App. 1913);ParshallV. State, 138 S.W. 759. 765 (Tex. Grim. ADD. 1911). Statutes which deal with the same general subject and ha-& the same general purpose are considered as inpara materia and must be construed together and harmonized. if possible, so as to give effect to both statutes, with a special statutegoverninga general statute in the eventof any conflict. See Lingnerv.,

Haley, 277 S.W.2d 302, 306 (Tex.Civ.App. - Amarillo 1954, writ dism d); Hines V. State, 515 S.W.2d 670, 675 (Tex. Crim. App. 1974). The IndigentHealth Care Act, article 4438f. is a broad statute providing for the expenses of health care for indigent persons in general. Article 104.002 of the Code of Criminal Procedure deals specifically with expenses incurred in the safekeeping of prisoners

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confined in a county jail. A general law will not ordinarilybe held to have repealed by implication a particular or special law although both relate to the same subject. The more particular law usually is construed as constituting an exception to the general law. American Canal Co. of Texasv. Dow Chemical Co., 380 S.W.2d 662, 666 (Tex.Civ. APP. - Houston 1964.writ dism'd).
We conclude that article 104.002,which provides that the county of incarceration is liable for all expanses includingmedical care of an indigentprisoner, constitutes an exception to the Indigent Realth Care Act for an indigent person who is not a resident of a hospital district. It follows that the provision of the Midland County Eospital District Act which authorizes the hospital district to sue for reimbursement from the county of residence of an indigentpatient who is not a resident of the Midland County Eospital Dfstrict is not applicable to an indigent prisoner in the Midland County jail whose residence is in an area not within a hospitaldistrict and,hence, not governedby article IX, section 9,of the Texas Constitution.
SUMMARY Medical care and treatment for a nonresident indigent prisoner in a county jail who is a resident of an area within a hospital district is the responsibility of the hospital district, as provided by article IX, section 9. of the Texas Constitution. Medical care and treatment for a nonresident indigent prisoner In a county jail whose residence is not within a hospital district is the responsibility of the county of incarceration, as provided by article 104.002 of the Code of Criminal Procedure. Very

Ll trulyyours,

A JIM MATTOX AttorneyGeneral ofTexas
JACK HIGHTOWKR First AssistantAttorney General
MARY KELLER ExecutiveAssistantAttorney General
RICK GILPIN Chairman,Opinion Committee Prepared by Nancy Sutton AssistantAttorney General

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