When a Georgia juvenile is held at a Department of Juvenile Justice facility before being formally committed to DJJ, who pays for emergency medical care, the state or the county?

Plain-English summary

The Commissioner of the Department of Juvenile Justice asked the Attorney General to settle a recurring fight with the counties: when a juvenile is held in a DJJ detention facility before a juvenile court formally commits the youth to DJJ custody, and that juvenile needs emergency medical care beyond what the facility can provide, who pays the hospital bill, the state or the county? Several counties had refused to pay, with the result that some hospitals were turning away DJJ-held juveniles.

Attorney General Thurbert Baker concluded that the cost belonged to the county, not the state. The opinion's logic ran in three steps.

First, Georgia's Juvenile Code distinguishes "commitment" from "detention." Under O.C.G.A. §§ 15-11-66 and 15-11-67, a juvenile court formally "commits" an adjudicated delinquent or unruly child to the Department's legal custody. By contrast, O.C.G.A. § 15-11-48(a)(3) and § 15-11-65 contemplate temporary "detention" of juveniles at a DJJ facility before any final disposition; in that period the court retains legal custody and DJJ has only physical custody. The Uniform Juvenile Court Rules even keep the two on different forms (JUV-13 for detention, JUV-15 for commitment).

Second, the statute that gives DJJ a duty to provide medical care is O.C.G.A. § 49-4A-7(b), which is triggered only when a child is in DJJ's legal custody. Until the court signs a JUV-15 commitment order, that duty has not attached.

Third, O.C.G.A. § 15-11-8(a)(5) makes "the expense of . . . transportation, subsistence, and detention of the child" a charge on county funds, on certification by the juvenile court. The AG read "subsistence" broadly to include necessary medical care, citing the Code's own use of the word in defining a "deprived child" and pulling in supporting authority from a Kansas case (Shelter Mut. Ins.) and a Georgia Court of Appeals deprivation case (In re M.L.G.).

The opinion also pointed to a 2002 legislative episode that confirmed the conclusion: the General Assembly amended House Bill 642 to shift these costs onto DJJ, and the Governor vetoed the bill (Veto No. 11 of 2002), explicitly noting that "[c]urrently the cost of such temporary commitment is borne by the child's county of domicile" and that the amendment would have cost DJJ over $3.7 million per year. Both branches treated existing law as putting the bill on the county. If the law already saddled DJJ, the amendment would have been pointless.

The county does have a backstop. Under O.C.G.A. § 15-11-8(b), after a hearing, the juvenile court can order the parents (or other persons legally obligated to support the child) to pay these costs up front or to reimburse the county. So the county pays first when the bill is urgent, then chases the parents.

Currency note

This opinion was issued in 2002. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here.

In particular, Georgia's Juvenile Code was substantially rewritten in 2013 (HB 242), and many of the section numbers cited here (§§ 15-11-1, 15-11-2, 15-11-8, 15-11-46, 15-11-48, 15-11-65, 15-11-66, 15-11-67) have been recodified. The substantive distinction between detention and commitment may still hold, but anyone trying to allocate a hospital bill in 2026 should look at the current Juvenile Code and any subsequent AG opinions before relying on the 2002 conclusion.

Common questions

Q: Why does it matter whether DJJ has "legal custody" or just "physical custody"?
A: Because the statute that requires DJJ to pay for medical care (§ 49-4A-7(b) at the time) was triggered only when DJJ had legal custody. Physical custody alone meant DJJ was just holding the youth on the court's behalf. The AG drew that line carefully to keep the medical-care duty tethered to a formal commitment order.

Q: What counts as "subsistence" in § 15-11-8(a)(5)?
A: The opinion read it broadly. The word is not defined in the Code, so the AG used the dictionary definition ("the minimum (as of food and clothing) necessary to support life," New Merriam-Webster Dictionary 714 (4th ed. 1989)) and the Code's use of "subsistence" in the deprived-child definition. Cases recognizing medical neglect as a basis for a deprivation finding (In re M.L.G.) and a Kansas case treating medical care as part of "care and custody" (Shelter Mut. Ins. Co. v. Williams) reinforced that medical expenses fall within the term.

Q: Why did the AG cite a vetoed bill?
A: Vetoed bills do not become law, but they tell you what people in the building thought the existing law said. House Bill 642 (2002) attempted to shift the cost from counties to DJJ; the Governor's veto message expressly described existing law as charging the cost to the county. Both the legislature's effort to change the rule and the Governor's reason for blocking it confirm the AG's reading.

Q: Can the county recover the cost from someone else?
A: Yes. Under O.C.G.A. § 15-11-8(b), after a hearing, the juvenile court could order the parents (or others legally obligated to support the child) to pay or reimburse for the expenses. The county fronts the money in an emergency, then seeks reimbursement.

Q: What happens after a juvenile is formally committed?
A: Once a court signs an order of commitment under §§ 15-11-66 or 15-11-67, DJJ has legal custody, and the duty under § 49-4A-7(b) attaches: DJJ has both "the right and duty" to provide or obtain medical care. From that point forward, the bill is the state's.

Q: What about a juvenile picked up on a warrant and held overnight at a DJJ facility before any adjudication?
A: That juvenile is in detention only, not commitment. Under the AG's reading, the cost of any necessary medical care during that interim window is a county charge, certified by the juvenile court that has jurisdiction.

Background and statutory framework

Georgia's Juvenile Code, codified at O.C.G.A. §§ 15-11-1 through 15-11-177, sets up a two-track system for juveniles in custody. A juvenile may be held at a Department of Juvenile Justice facility temporarily, before any final disposition (under § 15-11-48(a)(3) for delinquent or unruly children, and under § 15-11-65 for the period between adjudication and disposition, with possible extensions). Or, after a final disposition under §§ 15-11-66 or 15-11-67, the juvenile court can "commit" the youth to DJJ's legal custody.

These two tracks have different statutory consequences. The Department's care obligation (then codified at O.C.G.A. § 49-4A-7(b)) is keyed to legal custody, not physical custody. And for the pre-commitment phase, O.C.G.A. § 15-11-8(a) sets out what counts as a county charge: "the expense of . . . transportation, subsistence, and detention of the child, and other like expenses incurred in the proceedings under this chapter."

The Uniform Juvenile Court Rules ratify the same distinction. Form JUV-13 ("Order for Detention") keeps the child in court custody. Form JUV-15 ("Order of Commitment") transfers legal custody to DJJ. The AG used these forms as concrete evidence that the General Assembly had drawn a clean line between detention and commitment.

Under the in pari materia canon (the rule that statutes on the same subject must be read together) the AG harmonized the Juvenile Code's detention and commitment provisions with Chapter 4A of Title 49 (DJJ's powers and duties) so that the two regimes did not collide. The result lined up DJJ's care duty with formal commitment, and county fiscal responsibility with the pre-commitment detention period.

Citations and references

Statutes:
- O.C.G.A. § 15-11-8(a) and (a)(5) (county charge for transportation, subsistence, detention)
- O.C.G.A. § 15-11-8(b) (juvenile court may order parental reimbursement)
- O.C.G.A. § 15-11-48(a)(3); § 15-11-65; § 15-11-66; § 15-11-67 (detention vs. commitment)
- O.C.G.A. § 15-11-2(8) (definition of "deprived child")
- O.C.G.A. § 49-4A-7(b); § 49-4A-8 (DJJ duty to provide medical care upon commitment)
- O.C.G.A. § 1-3-1; § 1-3-1(b) (statutory construction principles)
- Uniform Juvenile Court Rule 3.8 (Form JUV-13 and JUV-15)

Cases:
- Board of Trustees v. Christy, 246 Ga. 553 (1980)
- Butterworth v. Butterworth, 227 Ga. 301 (1971)
- Ryan v. Comm'rs of Chatham County, 203 Ga. 730 (1948)
- City of Jesup v. Bennett, 226 Ga. 606 (1970)
- City of Roswell v. City of Atlanta, 261 Ga. 657 (1991)
- Risser v. City of Thomasville, 248 Ga. 866 (1982)
- In Re M.L.G., 170 Ga. App. 642 (1984)
- Shelter Mut. Ins. Co. v. Williams, 788 P.2d 1344 (Kan. Ct. App. 1990) (Kansas authority on "care and custody")
- Moss v. Moss, 135 Ga. App. 401 (1975)
- Webb v. Echols, 211 Ga. 724 (1955)
- Houston v. Lowes of Savannah, 235 Ga. 201 (1975)
- Buice v. Dixon, 223 Ga. 645 (1967)
- Asberry v. State, 220 Ga. App. 40 (1996)
- State v. Camp, 189 Ga. 209 (1939)

Legislative material:
- House Bill 642 (2002), vetoed by the Governor (Veto No. 11 of 2002)

Source

• Landing page: https://law.georgia.gov/opinions/2002-6
• Original PDF: not linked from landing page

Original opinion text

This responds to your request for my opinion on the issue of whether emergency medical expenses are to be borne by the Department of Juvenile Justice (hereinafter "the Department") or by the county of residence of a juvenile when the Department must seek emergency medical treatment for a juvenile detainee who is in the legal custody of a juvenile court, but in the physical custody of the Department (hereinafter "court detainees"). I understand that the Department provides basic medical services to all youths held by the Department, but that there are instances when youths held, including court detainees, require medical attention beyond the capabilities of the Department. I further understand that a disagreement exists between the Department and several counties over this issue which has resulted in some medical care providers refusing to provide service to juveniles being held by the Department. After a careful review of the relevant statutes, I conclude that the expense of emergency medical care for a juvenile who has not yet been committed to the Department under O.C.G.A. §§ 15-11-66 or 15-11-67 is appropriately charged to the funds of the county upon certification of the expense by the juvenile court having jurisdiction over the court detainee. Georgia's Juvenile Code, codified at O.C.G.A. §§ 15-11-1 through 15-11-177, provides that juveniles who are adjudged delinquent or unruly may be "committed" by a juvenile court to the legal custody of the Department. See O.C.G.A. §§ 15-11-66(a); 15-11-67; 49-4A-8. Once the Department has been given legal custody of a child or youth under Georgia's Juvenile Code, the Department has "the right and duty to provide or obtain for a child or youth medical, hospital, psychiatric, surgical, or dental care or services as may be considered appropriate and necessary." O.C.G.A. § 49-4A-7(b). Thus, the sole issue to be resolved is when does the Department obtain legal custody, as contrasted with mere physical custody, of a child or youth? In addition to providing for "commitment" to the Department, the Juvenile Code provides for youths to be temporarily detained at a Department facility prior to final disposition hearings under O.C.G.A. §§ 15-11-66 or 15-11-67. For example, O.C.G.A. § 15-11-48(a)(3) allows for the detention of alleged delinquent or unruly children "in a detention home or center for delinquent children which is under the direction or supervision of the court or other public authority " (emphasis added). Further, O.C.G.A. § 15-11-65 permits the juvenile court to order that delinquent or unruly juveniles may be detained for up to 30 days between the adjudicatory hearing and the disposition hearing, and further permits the court to extend this period if necessary. It is my understanding that many youths are in the care of the Department under this Code section. Thus, the statutory scheme makes clear that the General Assembly envisioned and specifically provided for pre-commitment detention of juveniles by the Department when so ordered by a juvenile court. See, e.g., O.C.G.A. § 15-11-46. In all interpretations of statutes the courts shall look diligently for the intention of the General Assembly, keeping in view at all times the old law, the evil, and the remedy. O.C.G.A. § 1-3-1. Further, Georgia courts have long recognized that in the construction of a statute the legislative intent must be ascertained from a consideration of the statute as a whole. The construction of language and words used in one part of the statute must be made in light of the legislative intent as found in the statute as a whole. Board of Trustees v. Christy , 246 Ga. 553, 554-55 (1980). "[A] statute must be construed in relation to other statutes of which it is a part, and all statutes relating to the same subject matter, briefly called statutes 'in pari materia,' are construed and harmonized wherever possible, so as to ascertain the legislative intendment and give effect thereto." Butterworth v. Butterworth , 227 Ga. 301, 303-04 (1971), quoting Ryan v. Comm'rs of Chatham County , 203 Ga. 730, 731 (1948). Accordingly, Georgia's Juvenile Code must be read in pari materia with Chapter 4A of Title 49, setting forth the powers and duties of the Department of Juvenile Justice (formerly known as "the Board of Children and Youth Services"). The cardinal rule for the construction of statutes is to ascertain the intent of the General Assembly and the purpose in enacting the law, then give it that construction which will effectuate the legislative intent and purpose. City of Jesup v. Bennett , 226 Ga. 606 (1970); City of Roswell v. City of Atlanta , 261 Ga. 657 (1991). Reading O.C.G.A. §§ 15-11-46, 15-11-48, 15-11-65, 15-11-66, 15-11-67, 49-4A-7(b), and 49-4A-8 in pari materia , the statutes clearly differentiate between formal commitment to the Department and temporary detention by the Department. This distinction is further clarified by referral to the Uniform Juvenile Court Rule 3.8, which identifies two separate forms – the "ORDER FOR DETENTION" (designated as Form JUV-13) and the "ORDER OF COMMITMENT" (Form JUV-15). The uniform "ORDER FOR DETENTION" reads in relevant part: "It is therefore ordered that said child be detained in the custody of the court until further order of the court or until released by a person duly authorized by the court." Uniform Juvenile Court Rule 3.8 (Form JUV-13)(emphasis added). Thus, the Department does not obtain legal custody of a court detainee until the court, under the authority granted to it by O.C.G.A. §§ 15-11-65 or 15-11-66 and in conjunction with O.C.G.A. § 49-4A-8, has issued an order of commitment. How expenses are to be handled while a matter is pending before a juvenile court is codified at O.C.G.A. § 15-11-8, entitled "Expenses charged to county; payment by parents on court order." That Code section specifically empowers the juvenile courts to assess costs by providing that certain enumerated categories of expenses "shall be a charge upon the funds of the county upon certification thereof by the court." O.C.G.A. § 15-11-8(a). Included in these enumerated expenses is "the expense of . . . transportation, subsistence , and detention of the child, and other like expenses incurred in the proceedings under this chapter." O.C.G.A. § 15-11-8(a)(5) (emphasis added). In all statutory interpretation, "words in a statute should be given 'their ordinary and everyday meaning.'" Risser v. City of Thomasville , 248 Ga. 866 (1982) (quoting O.C.G.A. § 1-3-1(b)). The word "subsistence" is not defined anywhere in the Georgia Code; however, elsewhere in the Juvenile Code "subsistence" is used in the definition of a "deprived child." Under O.C.G.A. § 15-11-2(8) (emphasis added), deprived child means "a child who is without proper parental care or control, subsistence , education as required by law, or other care or control necessary for the child's physical, mental, or emotional health or morals." Cases seeking termination of parental rights due to deprivation of a child have cited medical neglect as important evidence justifying a finding of deprivation. For example, in In Re M.L.G. , the Georgia Court of Appeals "agree[d] with the juvenile court that M.L.G. was a deprived child because of the parents' failure to provide the special care required by the child's . . . medical condition." 170 Ga. App. 642, 646-47 (1984).1 The legislative intent to include medical care as a component of "subsistence" is further supported by juvenile law decisions from other states. For example, in construing the statutory language "care and custody" of a juvenile, the Kansas Court of Appeals held "we are of the opinion that, arguably, expenses of the care and custody of a juvenile offender would include such expenses as the cost of food, shelter, education, and ordering medical care . . . . " Shelter Mut. Ins. Co. v. Williams , 788 P.2d 1344 (Kan. Ct. App. 1990); see KAN. STAT. ANN. § 38-1616 (2001). Finally, it must be remembered that "[t]he Juvenile Court Code of Georgia 'is to be liberally construed toward the protection of the child whose well-being is threatened.'" Moss v. Moss , 135 Ga. App. 401, 405 (1975) ( citing former GA. CODE ANN. § 24A-101, now codified at O.C.G.A. § 15-11-1). Bearing in mind the General Assembly's explicit emphasis on the well-being of the juvenile, it must be concluded that, when providing in O.C.G.A. § 15-11-8 for the expenses of subsistence and detention of a court detainee, the General Assembly implicitly included necessary medical care. Additional support for this conclusion is found in an attempt to change the law in this regard during the 2002 session of the General Assembly. House Bill 642, as initially introduced, was concerned with discovery in juvenile cases. It was amended during the legislative process to include a requirement that the cost of care and support of a child temporarily placed in the Department's custody be borne by the Department. The Governor vetoed House Bill 6422, but the attempted enactment into law is significant. The courts have stated that "it may be presumed that the General Assembly did not undertake a meaningless act" when the wording of an existing statute is altered. Webb v. Echols , 211 Ga. 724 (1955); see also Houston v. Lowes of Savannah , 235 Ga. 201, 204 (1975). "It is well settled in this jurisdiction that all statutes are presumed to be enacted by the legislature with full knowledge of the existing condition of the law and with reference to it." Buice v. Dixon , 223 Ga. 645, 647 (1967); see also Asberry v. State , 220 Ga. App. 40 (1996); State v. Camp , 189 Ga. 209, 210 (1939). Clearly, both the General Assembly in passing the legislation and the Governor in vetoing it understood that the counties are primarily liable for these medical costs. If the counties were not liable for the medical expenses incurred on behalf of a court detainee, the amendment to HB 642 would have been superfluous. It is important to point out that the juvenile courts are authorized under paragraph (b) of O.C.G.A. § 15-11-8, following a hearing, to order the parents or other persons legally obligated to care and support the child either to pay these costs up front or to reimburse the county or other public care providers for all such expenses incurred on behalf of the child. "Unless otherwise ordered, payment shall be made to the clerk of the court for remittance to the person or agency, including the Department of Human Resources, to whom compensation is due or, if the costs and expenses have been paid by the county, to the appropriate officer of the county." O.C.G.A. § 15-11-8(b). Thus, if the parents or other legally obligated persons are financially able, all pre-commitment expenses incurred on behalf of the child are ultimately to be borne by those persons, upon order of the court. Because the need for medical care is sometimes an emergency, it is likely that the county would be required to pay those expenses initially and then seek reimbursement through the procedures established in paragraph (b) of O.C.G.A. § 15-11-8. For all of the reasons set forth above, it is my official opinion that all costs related to subsistence and detention, including emergency medical costs, incurred on behalf of juveniles held in Department facilities prior to a formal commitment to the Department are properly assessed to the counties. However, the juvenile court having jurisdiction over the juvenile should certify those costs before county funds can be charged. Prepared by: MARK J. CICERO Assistant Attorney General 1 The inclusion of medical care as a component of "subsistence" as used in the Juvenile Code is supported by the dictionary definition of the term, which is "the minimum (as of food and clothing) necessary to support life." New Merriam-Webster Dictionary 714 (4th ed. 1989). 2 In Veto Number 11 (2002), the Governor noted that "an unrelated amendment was added which would shift the cost to the Department of Juvenile Justice of care and support of a child temporarily placed in or committed to the custody of the Department. Currently the cost of such temporary commitment is borne by the child's county of domicile. The estimated cost to the Department for this amendment is in excess of $3.7 million per year and no budgetary provision has been made for such costs. Therefore . . . I VETO House Bill 642 and encourage the General Assembly to reenact it without costly riders."