AUSTIN. TrcxAs 787xa January26, 1965

Honorable James E. Barlow CriminalDistrictAttorney Bexar County SanAntonio, Texas OpinionNo. C-382 Re: Whether it would be constitutionally and statutorilysound for Bexar County HospitalDistrict 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 HospitalDistrict.

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 topay for any medical care rendered by the HospitalDistrict. The Bexar County Hos ltal District is organizedunder the provisions of.Artlcle4 $+n, fl Vernon’s Civil Statutes.This statute, enactedpursuant to the authority granted by,Article IX, Section 4, Texas Constitution,containsno specificgrant 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 facilitiesof the HospitalDlstrict from the county In which the District Is situated, theAdministrator 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 suchpatient, or said relatives to pay to the treasurer of the Hospital District for the support of suchpatient a specified sum -1810-Hon. James E. Barlow;. page 2 (C-382)

per week, In proportion to their financialabillty, but such sum shallnot exceed the actual per capita cost of maintenance.

. . .'I(Emphasis supplied). Under Article 4478, Vernon's Civil Statutes,a countymay establisha hospital for the care and treatmentof all the ill persons in the county. A hospital district establishedunderArticle 4494n takes over the county systempreviously establishedunder Article 4478, and the hospital district thenceforthcarries out all the duties and obligations the county previouslyhad for the care and treatment of "persons suffering from any illness,disease or injury." (Emphasissupplzed). The foregoing language indicates clearly that a patient shouldnot 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 ofmedical 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 admittedwho is fully able topay, the Administratormay not permit him to pay less than the full and actual cost of his care and maintenance. An excellentdiscussion 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 Goodallvs. 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 ofArticle III, Section 51, Texas Constitution. SUMMARY A HospitalDistrict organizedunder 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 HospitalDistrict gives priority at all times to its primary function of renderingmedical and hospital care to needy or indlgent.residentsof the county.

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### Hon.James E. Barlow,page 

### 3 (c-382)

Patients, who are fully able topay for medical care, and are admitted to the facilities of.the HospitalDistrict'inust be chargedno less than the actual per capita cost of theirmedical care and maintenance.Yours very truly, ;JAGGO*R CARR Attorney General

MLQ:ms APPROVED: OPINION COMMITPEE 

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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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