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The Attorney General of Texas
February 11, 1986
JIM MATTOX
Attorney General
Supreme Court Building Honorable Ray Farabee Opinion No. ~~-4.25
P. 0. BOX 12546 chairman
Austin. TX. 76711. 2548 State Affairs Committee Re: Whether a county may agree
512/475-2501 Texas State Senate to be a payor of last resort for
Telex 9101674-1367
Telecopier 512/475-0266
P. 0. Box 12068, Capitol Station medical services rendered to an
Austin, Texas 7Wll indigent child who resides out-
side the hospital district
714 Jackson. Suite 700
Dallas, TX. 75202-4506 Dear Senator Farabee:
214i742.6944
You have rc:questedour opinion regarding the authority of the
4624 Alberta Ave., Suite 160 Montague County Commissioners Court to pay for medical services
El Paso, TX. 799052793 rendered to an indigent who is a county resident, but who does not
915/533-3464 reside within an area served by a public hospital or a hospital
district. The in&lgent in this case is an eight-year-old girl who is
1001 Texas. Suite 700
scheduled to undergo a liver transplant. The commissioners court is
Houston, TX. 77W2~3111 willing'to pay al:1unpaid expenses up to a total of $25,000.
7132235866
Senate Bill No. 1, passed during the first called session of the
Sixty-ninth Legis Lature, enacted the Indigent Realth Care & Treatment
606 Broadway, Suite 312
Lubbock. TX. 79401.3479
Act, article 44Mf, V.T.C.S., which provides the following, in
6W747-5236 pertinent part:
Sec. 2.02. GENERAL PROVISIONS. (a) Each
4309 N. Tenth. Suite 6
county shall provide haalth care assistance as
McAllen. TX. 76501-1665
512/682-4547 prescribed by this title to each eligible resident
of that county who does not reside within the area
that a ,?ublichospital or hospital district has a
200 Main Plaza, Suite 4W legal obligation to serve.
San Antonio, TX. 762052797
5lZ2254191
(b) The county is the payor of last resort and
shall pr,ovide assistance only if other adequate
An Equal Opportunity/ public or private sources of payment are not
Affirmative Action Employer availab:.r:.
Acts 1985, 69th I>eg., 1st C.S., ch. 1, 92.02, at 8. Section 15 of
Senate Bill No. 1 provides that
[Slecticns 1 and 2 . . . take effect September 1,
1985, b>lt a county, public hospital, or hospital
district is not required to provide health care
assistance as prescribed . . . until September 1,
1986. . . . Health care assistance provided
p. 1948
.
Honorable day Farabee - Page 2 (JM-425)
before September 1, 1986, is governed by the law
and practice in effect at the time that the
assistance is provided. (Emphasis added).
Id. 115(a), at 46. The absence of a present legal requirement to pay
dots not negate the existence of legal power or authority to do so.
In Attorney General ClpinionMW-33 (1979). this office said that
Denton County was liable for its indigents' medical expenses which are
incurred at a joint city'-county hospital. The opinion relied on
section 11 of article 2351, V.T.C.S., which requires a county to
"[p]rovide for the support of paupers" who are "resideuts of their
county,I'and ou Monghon & !Sissonv. Van Zandt County, 3 Willson 240
(Tex. Ct. App. 1886), whi:h held that "support" as used in article
2351 means
all that is necmsary to bodily health and cou-
fort, and especis:Llydoes it include proper care,
attention and treatment during sickness.
See also Attorney General Opinion H-703 (1975).
Although there was a public hospital in Monghon & Sisson and in
Attorney General Opinion MI-33, neither opinion conditioned its answer
upon the existeuce of a Ilublic hospital, and we do not believe the
absence of a public hospital.is controlling in the situation you pose.
Moreover, section 7 of Senate Bill No. 1 repealed article 4438,
requiring commissioners to finance indigent health care "[IIf there is
a regular established pub:L:Lchospital in the county." Article 2351
makes no such distinction beetweenthe absence or presence of a public
hospital and, in any event, the legislature has manifested its intent
in Senate Bill No. 1 to abrogate any distinction based on whether a
person is a resident of an area served by a public hospital or a
hospital district. We conclude, therefore, that the Montague County
Commissioners Court is authorized to pay for medical services rendered
to an indigent who is a county resident but who does not reside within
an area served by a public hospital or a hospital district.
SUMMARY
The Montague County Commissioners Court is
authorized to pa:,for medical services rendered to
an indigent who is a county resident but who does
not reside within an area served by a public
hospital or a hospital district.
JIM MATTOX
Attorney General of Texas
p. 1949
Honorable Ray Farabee - Pa:3o3 (JM-425)
JACK HIGHTOWER
First Assistant Attorney General
MARY KELLER
Executive Assistant Attorney General
ROBERT GRAY
Special Assistant Attorney (General
RICK GILPIN
Chairman, Opinion Committee
Prepared by Rick Gilpin
Assistant Attorney General
p.,l950