Untitled Texas Attorney General Opinion

Honorable 0. B. Close opinion 100.C-334
County Attorney
Ochiltree.County Rer Eospltal care of Indigent
Perryton, Texas
Dear Mr. Closer
You request our opinion pn the above subject mat& and
eek the following quertionst
tree County, Texas for indisent care?
Can the Ochiltree Jio8pltal District pay
private physiclane for in-patient and.out-
patient care o? .lndigente3.nOohllt*ee C&My, ‘~
Texan? (3) Your general opinion a8 to the
scope of responsibil.Sty and authority of the
Hospit& District under the existing circum-
stances regarding indigent care?”
‘You state in your request that pursuant to Article 4494q-
4, Vernonfs Ciiil Statutes, a hoepi& district wae created with-
in the boundaries of Ochiltree County and.a bond election has been
held, approving the Issuance of bonds for the construction of a
hospltal.and .theHospital District contemplates that the conetxuc-
tion of a hospital will be commenced within the year 1965 but It
~5.11not be operational for 801118time. You further state that at
the present time there are no public hospitals nithin the boun-
darlee of Ochlltree County and that the onI..hospitals presently
operating within the County are two privately owned hospitals.
Sect3.m 9 OS Article IX of the Constitution of Texas pro-
vides for the creation of hospital districts, and provides in
Part a8 fo&lowar
II
that after ita creation no other
or political
tnunicip.ilit~ oubdlv$sion ohall
have the power to levy taxes or ‘lame bonkle
or other obligations for hospital purpoeea
or for providing medical care within the
boundaries of the dietrict; . , .I
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Hon. 0. R. ClOse, page 2 (C-334)
,
Section 13 o? Article 4494q-4, Vernon~s Civil Statutes,
provide6 in part:
"Except as herein provided, no county
that has been constituted a hospital district,
and no city therein, &a31 thereafter levy any
tax for hospital purposes; and such hospital
district shall be deemed to have assumed ?ull
respcmslbility ?or the ?urhishlng of medical
and hospital care for the needy and Indigent
perrrons residing- in said hospital district from
the date that We6 are collected for the hoe-
pita1 distr’lct.” ~.
In kew'o? the facts &bxaltted in
visions o? Sectlou 13 of Article 44g4q-4,
ital District assumes.the same authority
KS of tiedlcaIand hospital care for the ne
603)sresiding in the Xospltal District'as thereto?orepossessed
by the Oommi66ioner6 Court of Ochiltree Couuty; etlcle 4438,
Vernon's Clvi~Statutes, provides:
*,I? ‘hers is a~ regular estebU6hed puillc
hoepital'in the count ; the c&misdUner8 court
shall provide ror.8e L the indigent sick o?
. the county to such hospital. If more than one
such hospital exists In the county, the indigent
patient 6haIl have the right to select which one
of theq he shall be sent to."
In Attorney General's Opinion6 O-2179 (1940 .and.O-4633
(1942), it was held that the comi6eioners ccurt:o 1 a county did
not have authority to pay items of hospital treatment tar indi-
gent sick to any hospital outside o? the county. .Theee conclu-
crions were based upon the principle6 of law anuouuaed In WilIacyl
, 29 S.W.2d 456 (Tex.Clv.ApP.
"The power6 and duties of county commis-
6ioner61’court6, and the, obligatlon6 of the
countlee to pauper6 are ?lxed by statute, and
mg~z be enlarged upon by unnecessary impll-
. .These powers and duties, in 60 far aa
applicable,here are de?lr.edin ,andrest icted
by the provi6ion6 o? Articles 2351 and b43a
Revised Statutes, 1925. . In Article'2351 it'16
rovlded.that each'commibrloners~ court hell
eubdivlslon 11) ‘piovide for the support o?
'i
paupers Y * + residents of their county, who
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HOG. 0. R. Close, page 3 (C-334)
are unable to support themselve.;', and (sub-
division 12 'f'orthe burial of paupers'.
In Article 1438 it is provided that 'if there
is a regular established public hospital in
the county, the commlssioners~ Icourtshall
provide Sor sending the indigent sick * l *
to such hospital'. In the latter provision,
the duty and the authority of the camnissionersl
court to send the Indigent sick to hospitals
is limited to public hospital6 within the county,
which provision, by necessary implication ex-
cludes any duty or authority to send such per-
son6 to private hospitals, or to public hospi-
tals without the county.&.Even I? Barbosa was
within the class.defined,as 'Indigent sick,'
the commissioners8 court-as a body, muchless
the county judge-acting singularly, we6 under
no duty, and was denied the au&hority to send
Barbosa to a hospital, either public or pri-
vate, outside the county.
y+ iv* Under ,theprovision6 of Article
4438, the county was under no duty to send
Rarbosa to any hospital, there being no public .'
hospital in the county, and under the implied
restrictions of this provision it is doubtful
if the county could be bound by the coeaaiasion-
ersl court, certainly not otherwise, to send
him to a hospital without the county, at public
expense."
Likewise, It was held in Attorney General's Opinion 0-2633
(1940):
"You are therefore respectfully advised
that it is the opinion of this department that
if the commissioners~ court determines that an
. indigent is a pauper it may furnish medical aid
and medicines to him as such, regardless of nhe-
ther or not he has been placed upon the pauper
roll of the county, inasmuch 11sthere~is no statu-
tory requirement for the making up of a county
pauper roll. It is the furthc:ropinion of this
department that the commissiol;ers'court has the
authority to aid 'indigent sick', who may or may
not be 'paupers',by sending such 'indigent sick'
to 'public' hospitals within :.hecounty. The
question of 'indigency' is also a question of
fact to be determined by the commissioners' court."
Ron. C. R. Close, page 4 (C-334)
In Attorney General’s Opinion C-246 (1964),‘itwas polnt-
ed out:
“Somewhat similar to the preceding quee-
tlon, your sixth question also concerns the
contractual power and authority of the Com-
niselonere Court of Tarrant County. Ae etated
In answering your first question, where a duty
is Imposed or e power conferred upon a commie-
sloners court, then the commlssioncre court hae
implied authority to exercise broad discretion
to ecccmplieh the purporee intended. When the
comleelonere courtr were expreealy given the
power end duty ‘to provide for the rupport of
peupers,t by necessary implication they were
clothed with the authority to do all the lnci-
dental thinga necessary to provide for their
support. Thus, while the commlsnionere court
Is not under e duty to place lndigente In a prl-
vet8 iecility a
County v. Valley
(T Ci A
ltB%s,l~tpi
gents whom it placea in e .prlvatefacilifiy.Here,
of couree, the contractual term miustnot be
such es to amount to a donation by the County
to the Individual or corporation providing the
care, nor can the contract provide for payment.8
by the County out of future revenuem.”
,It wae pointed out in Attorney Gcneral’e Opinion C-246
that:
“Your first end second questions can be
answered together. Under the provlefonrr of
Section 11, Article 2351, Vernonls Civil Stat-
utes, the Conunlseloncre~Court has the duty to:
“‘11. Provide for the support of paupers
and such idiots and lunatics aa cannot be admlt-
ted Into the lunatic asylum, residents of their
county, who are unable to eupport themeelvce.
. . .I
‘While it Is true that the Comieeioners8
Court is a court of limited juriediction, it
Is also true that where a duty Is imposed or a
power conferred by statute upon e commiseioners
court within the boundaries of power which the
Constitution has created, then the commlseloners
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i
b
c
Hon. G. R. Close, page 5 (C-334)
court has implied authority to exercise broad (
discretion to accomplish purposfs Intended by
such statute. El Paso County v. Elam, 106
S.W. 26 393 Tex.Clv.App. 19 :TEGon v.
Marshall, 11Q S.W.2d 621 (Te%.vw938,
* Anderson v. Wood, 137 Tex. 201,
152 s.w.Et'
Orror d3r 684-(pSl) .
"Under the provisions of Section 11, Artl-
cle 2351, a duty to provide for the support of
paupers, which Includes the Indigent aged, Is
lmposed'upon the Commissioners Court.'
In view of the foregoing, if the Indigent care referred
to In your request constitutes the support of paupers within the
meaning of Section 11 of Artlcle.2351, Vernon's Civil Statutes,
the Hospltal.Distrlct,under theauthority of Section 13 of
Article 4494q-4, ma make payments to private hos ltals within
Ochlltree County ttorney General's Opinion C-248 $196417. If
themedical care -#or Indigents does not constitute the support
of paupers" within the meaning of Section 11 of Article 2351,
the Hospital District may not make payments to privets hospitals
within Ochlltree County, but such care must be limited to.such
hospital treatment as authorized by Article 4438, Vernon's Civil
Statutes, In public hospitals. Wlllacy County v. Valley Baptist
Hospital, 29 S.W.2d 456 (Tex.Clv.App. I-930).
SUMMARY
A hospital district created under the pro-
visions of Article tig%-4, Vernon's Civil Stat-
utes, assumes the same responsibility for the
medical care of indigents within said district
as that previously Imposed on the ccmmlssloners
court under the provisions of Section 11 of Artl-
cle 2351, Vernon's Civil Statutes and Article
4438,Vernon's Civil Statutes.
Yours very truly,
WAGGONER CARR
Attornc\yGeneral
. ,:4 -:&&
By/rd’
,1’ yc)
,;'-John Reeves
JR:ms Assistant
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HOG: 0. R. Close, page 6 (c-334)
APPROVED:
OPINION COMMITTEE
W. V. Geppert, Chairman
Malcolm ,Quick
George Black
Ralph Rash
APPROVEDFORTIB ATTORNEXQENERAL
BY: Roger Tyler
..
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