The Attorney General of Texas
Sept:ember9. 1986
JIM MATTOX
Attorney General
Supreme Court Building Honorable Chester V. Hines Opinion No. JM-540
P. 0. 80x 12548 County Attorney
Austin. TX. 79711.2548 Houston County Courthouse Re: Whether a county hospital dis-
512,47&2501
Crockett, Texas 75835 trict is liable for emergency health
Telex 910(874-1367
Telecopier 512/4750256
care administered in a hospital in
another county to an indigent resi-
dent of the hospital district
714 Jackson. Suite 700
Dallas, TX. 75202-
Dear Mr. Hines:
2141742-8944
You inquire wlwther a hospital district is liable for emergency
4824 Alberta Ave., Suite 160 health care admin::stered to an indigent resident. of the hospital
El Paso, TX. 79905-2793 district in a cornty public hospital of another county prior to
91515353484 September 1, 1986. Section 15(a) of the Indigent Health Care and
r‘ Treatment Act, codified as article 4438f. V.T.C.S., provides, among
I Texas. Suite 700
other things, that health care assistance provided before September 1,
Houston, TX. 770023111 1986, is governed 1,~’the law in effect at the time the assistance was
713,2235&M provided.
You advise us that an indigent resident of Nacogdoches County
606 Broadway, Suite 312
Lubbock, TX. 79401-3479
required emergency medical treatment which was supplied by a county
00617476239 public hospital o:i another county that does not have a hospital
district. It is our opinion that the Nacogdoches County Hospital
District is liable for such medical treatment.
4309 N. Tenth. Suite B
McAllen. TX. 78501.1585
512/682-4547
The Nacogdochw County Hospital District, composed of the entire
county, was created by chapter 431, 60th Legislature, 1967, in
accordance with tha!provisions of article IX, section 9 of the Texas
200 Main Plaza, Suite 400 constitution. Article IX, section 9 provides, in part, that a
San Antonio. TX. 782C52797
hospital district c,reatedthereunder
51Z2254191
shall assume full responsibility for providing
An Equal OpportunityI medical and hospital care for its needy
Affirmative Action EmplOyer inhabitartts.. . .
Chapter 431, section 19 of the 60th Legislature states that the
Nacogdoches County Hospital District
shall aswme full responsibility for the operation
of all hospital facilities for the furnishing of
f-
p. 2488
Honorable Chester V. Hines -.Page 2 (m-540)
medical and hospital care for its needy
inhabitants. . .
The language of chapter 431, section 19 does not does not reduce the
responsibility of the hospital district for the care of its needy
inhabitants that is mandated by article IX, section 9, of the
constitution.
Prior opinions of t:his office have dealt with similar
responsibility of hospital districts. Attorney General Opinion M-171
(1967) held that a hospital district, created pursuant to section 9 of
article IX of the Texas Cons~titution,has the full responsibility for
providing medical and hospital care for indigent residents of the
district and that, when the hospital district cannot adequately
discharge its responsibility to an indigent inhabitant because of a
lack of sufficient hospital :Eacilities,it may send the indigent to a
hospital outside the district and pay for such out-of-district
expenses. Attorney GeneraIl Opinion M-870 (1971) advised that the
hospital district of the residence of an indigent prisoner is liable
for the medical bills incurred in his treatment, notwithstanding the
fact that the treatment was administered in a hospital outside the
boundaries of the hospital district. Attorney General Opinion H-703
(1975), citing Attorney Gewral Opinion M-870, reiterated the opinion
that where a prisoner is an indigent resident of a hospital district,
the hospital district of his residence was constitutionally
responsible for his care anmiwas liable therefore. See also Attorney
General Opinion JM-487 (1981j:l(following opinions M-171. M-870, H-703
and concluding that hospital districts of the residence of indigent
prisoners are liable for thc:Lrmedical bills regardless of the county
in which treatment was received). Cf. Attorney General Opinion JM-257
(1984) (citing prior opinions in~oting that in fulfilling its
constitutional duty to aswme full responsibility for medical and
hospital care for its needy inhabitants, a hospital district has
authority to pay the medixl expense incurred in sending a needy
inhabitant to a medical facility outside the district because of lack
of .facility); Attorney General Opinion M-1154 (1972) (citing prior
opinions upholding right of hospital district to pay private hospital
for care rendered to needy and indigent persons of the district where
it was not practical to tre,%l:
such persons in the hospital district's
own facilities).
Hence, it is our opinion that the Nacogdoches County Hospital
District is liable for the aemergency health care administered to an
indigent resident of that district in a county public hospital of
another county.
p. 2489
Honorable Chester V. Hines -.Page 3 (JM-540)
SUMMARY
A hospital district created under article IX,
section 9 of the ?:t:xas
Constitution, is liable for
emergency health care administered prior to
September 1, 1986, to an indigent resident of the
hospital district in a county hospital of another
county.
JIM MATTOX
Attorney General of Texas
JACK HIGHTOWER
First Assistant Attorney General
MARY KELLER
Executive Assistant Attorne:rGeneral
RICK GILPIN
Chairman, Opinion Committee
Prepared by Nancy Sutton
Assistant Attorney General
,-
p. 2490