AUSTIN. TrcxAs 787xa 

January 26, 1965 

Honorable James E. Barlow 

Criminal District Attorney 

Bexar County 

San Antonio, Texas 

Opinion No. C-382 

Re: Whether it would be constitutionally and statutorily sound 

for Bexar County Hospital District to admit patients who are 

neither needy nor indigent, 

and who are fully able to pay 

for any medical care rendered 

Dear Mr. Barlow: by the Hospital District. 

You have requested the opinion of this office as to 

whether It would be~‘constitutionally and statutorily sound for 

Bexar County Hospital District to admit patients to its,facilities who are neither needy nor indigent, end who are fully 

able to pay for any medical care rendered by the Hospital District. 

The Bexar County Hos ltal District is organized under 

the provisions of.Artlcle 4 fl $+n, Vernon’s Civil Statutes. This 

statute, enacted pursuant to the authority granted by,Article 

IX, Section 4, Texas Constitution, contains no specific grant 

of power to furnish care to anyone other than indigent and needy 

persons in Bexar County. However, Article ti*n, Section 14, 

does contain the following language: 

“Sec. 14. Whenever a patient has been 

admitted to the facilities of the Hospital Dlstrict from the county In which the District Is 

situated, the Administrator shall cause inquiry 

to be made as to his circumstances, and of the 

relatives of such oatlent leaallv liable for his 

support. If he f&da that s&h hatient or said 

relatives are liable to pay for his care and 

treatment in whole or in part, an order shall be 

made directing such patient, or said relatives 

to pay to the treasurer of the Hospital District 

for the support of such patient a specified sum 

-1810- 
Hon. James E. Barlow;. page 2 (C-382) 

per week, In proportion to their financial abillty, but such sum shall not exceed the actual per 

capita cost of maintenance. . . .'I (Emphasis 

supplied). 

Under Article 4478, Vernon's Civil Statutes, a county may 

establish a hospital for the care and treatment of all the ill 

persons in the county. A hospital district established under Article 4494n takes over the county system previously established under 

Article 4478, and the hospital district thenceforth carries out all 

the duties and obligations the county previously had for the care 

and treatment of "persons suffering from any illness, disease or 

injury." (Emphasis supplzed). 

The foregoing language indicates clearly that a patient 

should not be refused admittance to the hospital facilities simply 

because he may be able to pay for his care, either in whole or in 

part. The Administrator of the Hospital District has the affirmative duty of determining the extent of each patient's ability to 

pay, and-the further duty of collecting such sums as may be expended for-.a patient's care and maintenance, not to exceed the actual costs. 

It must be here noted that the primary function of the Hospital District is the furnishing of medical and hospital care for 

the indigent and the needy of the county, and that such function 

must take precedence over all others. It must also be noted that, 

when a patient has been admitted who is fully able to pay, the 

Administrator may not permit him to pay less than the full and 

actual cost of his care and maintenance. An excellent discussion 

of the effect of failure to charge the full and actual cdsts when 

a patient has been found able to pay may be found In Goodall vs. 

Brite, 54 P.2d 510 (Calif. D.C. App. 1936). Permitting pa- 

-s to pay less then the actual cost of their care would constitute a donation of public funds, In contravention of Article III, 

Section 51, Texas Constitution. 

SUMMARY 

A Hospital District organized under Article 

4494n, V.C.S., may admit patients to. Its facilities who are neither needy nor indigent, and 

who are fully able to pay for any medical care 

rendered them, provided that the Hospital District 

gives priority at all times to its primary function of rendering medical and hospital care to 

needy or indlgent.residents of the county. 

-1811- 
Hon. James E. Barlow, page 3 (c-382) 

Patients, who are fully able to pay for 

medical care, and are admitted to the facilities 

of.the Hospital District'inust be charged no less 

than the actual per capita cost of their medical 

care and maintenance. 

Yours very truly, 

;JAGGO*R CARR 

Attorney General 

MLQ:ms 

APPROVED: 

OPINION COMMITPEE 

-Ei%2&c*2 

Assistant' 

W. V. Geppert, Chairman 

R&old Kennedy 

Arthur S&ndlln 

W. 0. Shultz 

APPROVED F0R THE ATTORNEY GENERAL 

By: Stanton Stone 

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