Over time, her husband's business prospered and expanded, enabling Mary Elizabeth to take an active role in supporting numerous and varied charitable causes.

Mary Elizabeth started the State Crippled Children's Program using her dining room as an office.

In addition, she started the first tuberculosis diagnosis and treatment program in the region; and also purchased the first equipment used to test the hearing and vision of schoolchildren.

The foundation focused on funding public school programs, establishing libraries and constructing recreational facilities.

[5] In 1953, she helped to establish the Hilltop Hospital which treated tuberculosis patients and eventually serving five years as the chairman of its board.

[1] The Texas State Historical Association lists the many awards Butt has received over the years for her philanthropic activities: