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 

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