Request By:
Mr. James S. Secrest
Allen County Attorney
Box 35
210 W. Main Street
Scottsville, Kentucky 42164
Opinion
Opinion By: Steven L. Beshear, Attorney General; By: Charles W. Runyan, Assistant Deputy Attorney General
Your questions relate to the county's responsibility for paying medical expenses of a county prisoner who is charged with, and committed to jail for, violating state statutes.
The facts were stated as follows:
"(a) On 7/21/82, Roger Brooks was committed to jail for 180 days on three charges of public intoxication and 1 charge of disorderly conduct. See attached PRISONER REVIEW chart. Allen District Court - 81 M 081, 82 M 034, 146, 165.
"(b) He was committed to hard labor pursuant to a Standing Order of the Allen District Court dated 3/19/82, a copy of which is attached. Note that the labor performed under the provisions of the order shall be at the discretion of and under the supervision of the Allen County Judge/Executive.
"(c) While working with the county road crew - and while in the process of using the chain saw - Roger Brooks was injured when the saw cut his knee. He was taken to the Bowling Green Medical Center and admitted on 11/4/82 - released on 11/8/82. The total bill to the Medical Center was $2,318.64. Being an indigent, the Kentucky Medical Assistance Program paid the Medical Center the sum of $1,089.00, the maximum computed at 4 days at $272.25 per day. See KRS 441.010(3)(b).
"(d) The Medical Center has billed Allen County for the balance due.
"(e) For all practical purposes Allen County is 'broke' and I have asked Bob Purdom how we go about declaring 'bankruptcy'. (We have at least been able to keep our jail open and operating - and will continue to do so until the bureaucrats in Frankfort close us down - even though our jail was the most modern in the area when constructed in 1965)."
Question No. (1) reads:
"(1) Since Brooks was incarcerated on a state charge and since KRS 441.010(3) provides that if an indigent prisoner needs medical care under such circumstances the state shall pay it, and, since KRS 441.010(3)(b) provides that such medical payments shall not exceed the maximum allowed under the Ky. Medical Assistance Program (which has been paid), to what extent, if any, is Allen County responsible to the Medical Center for the balance of this bill?"
While KRS 441.010(3) requires Allen County to pay for the indigent prisoner's medical expenses, the amount of the medical payments from the county is expressly limited to the maximum payments permitted under the Kentucky Medical Assistance Program. Since that maximum payment has already been paid by the Kentucky Medical Assistance Program, the county has no authority for paying out county money in excess of that which has already been paid by the KMA program. The total medical bill was $2,318.64. The KMA program paid the Medical Center $1,089.00, which we assume was the maximum permissible. The sum of $2,318.64 less $1,089.00, leaves a balance of $1,229.64. However, the county is authorized to pay only $1,089.00 of that remaining balance, because of the express and ordinary meaning of the language of KRS 441.010(3)(b). Old Lewis Hunter Distillery Co. v. Kentucky Tax Commission, 302 Ky. 68, 193 S.W.2d 464 (1946).
Question No. (2):
"(2) Does the fact that the prisoner was working for the Allen County Road crew at the time he was injured (pursuant to an order of the district court) make any difference as to the responsibility of the county?"
The answer is "no". The prisoner was committed to the county jail, regardless of the conditions of increaceration, including the work program. Note that under KRS 441.068(6) the participation in a county work program shall not be deemed employment for any purpose. See also KRS 431.130 and 431.140, relating to working a county prisoner.
Question No. (3) reads:
"(3) If Allen County does not have the funds available to pay the Medical Center the balance of the bill, what then?"
Our view is that the fiscal court must pay the $1,089.00 of the total hospital bill under the express language of KRS 441.010. The responsibility rests with the county, even though county money for that purpose may not presently be available. In the meantime it would be subject to a lawsuit by the hospital in the event the $1,089.00 is not paid.
Question No. (4) reads:
"(4) Would the magistrates be personnally responsible for this claim if it is not a legitimate claim against the county?"
Under the facts given, the amount of the medical bill of $1,089.00 involving an indigent or needy prisoner is strictly a legitimate obligation of the county. Therefore their authorizing the payment of the claim in the amount of $1,089.00 would be strictly an official act, pursuant to KRS 441.010. Here your facts indicate the county's obligation to pay the medical expenses of the county prisoner, with the statutory limitations above indicated. Leslie County v. Keith, 227 Ky. 663, 13 S.W.2d 1012 (1929).