Request By:
Mr. Bill Stephens
Supervisor
County Fee Systems
Department for Administration
Division of County and Municipal
Accounting
Capitol Annex
Frankfort, Kentucky 40601
Opinion
Opinion By: Steven L. Beshear, Attorney General; By: Charles W. Runyan, Assistant Deputy Attorney General
You have written that the 1982 session of the General Assembly in the budget bill clarified KRS 441.010, which deals, with medical care of indigent prisoners in county jails. Included in an appropriation for jailer's fees is $150,000 each fiscal year for state payment of medical expenses for indigent prisoners in county jails pursuant to KRS 441.010. The budget bill adds this statement:
Notwithstanding other statutory provisions to the contrary, it is the intent of the General Assembly that payment be provided only for emergency medical services for indigents which cannot be postponed until after the period of confinement without hazard to the needy person. Such emergency medical services will include an initial examination only after which hospitalization or extensive medical care is required and certified.
You request that we issue an opinion to specifically define the legislative intent of "extensive medical care" , as stated in the budget bill, H.B. No. 295, 1982 regular session.
It is first our opinion that the above quoted statement in the budget bill about emergency medical services and the phrase "extensive medical care" should be disregarded as not being a constitutional part of the budget bill. The statement at best is in no way necessary or germane to the budget or appropriations concept. It merely attempts to deal with legislative intent in connection with qualifying applications of the money appropriated for indigent prisoners in county jails. The language transcends that language appropriate to identify state budget appropriations. Thus the budget bill, to that extent, relates to a subject other than budget. Section 51 of the Kentucky Constitution provides that no law enacted by the General Assembly shall relate to more than one subject. The purpose of that section is to require that the title to an act should give to interested persons fair and reasonable notice of the nature of the provisions contained in the act.
Burton v. Mayer, 274 Ky. 245, 118 S.W.2d 161 (1938) 165. H.B. 295 is described in the title as "An Act relating to appropriations for the operation, maintenance, support, and functioning of the government of the Commonwealth of Kentucky and its various officers, cabinets, departments, boards, commissions, institutions, subdivisions, agencies, and other state supported activities." The title gives no clue to nor intimation of the statutory interpretational statement cited above.
Since the interpretational statement must be disregarded, we must look to KRS 441.010 to discover the legislative intent in the administration of the indigent prisoner medical fund. Thus you must resort to KRS 441.010(3) in administering the fund. Under that subsection, which treats the matter at some length, a licensed physician, upon an initial examination of the indigent, determines whether medical care is needed and whether medical care can be postponed without hazard.
Next, you ask whether or not convalescent care falls within the provisions of KRS 441.010?
Even where the licensed physician determines that medical care cannot be postponed until after the period of confinement without hazard to the indigent, under KRS 441.010(3)(a) it is required that the physician or physicians attending the indigent prisoner certify, under oath, that the prisoner's condition was such that medical care could not be postponed until after the period of confinement without hazard, "and that medical procedures were limited to those necessary to preserve the life or health of the prisoner, " and that they were not of an elective nature except for the initial examination by the physician to determine whether medical care is needed. (Emphasis added).
The answer to your last question is that the medical care afforded the indigent does not extend to convalescent care, where such convalescent care is not necessary to preserve the health or life of the prisoner.
If you feel that KRS 441.010 still does not prescribe sufficient and reasonable standards in terms of the spending of state money, you will have to present it to the legislature.