# The Attorney General ofTexas July 13, 1978

Honorable William W. Day Criminal District Attorney Calhoun County 211So.Ann Street Port Lavaca, Texas 779’79 Opinion No. H- 1208 Re: Authority of a county hospital to restrict admission of nonresidents. Dear Mr. Day: You have requested an opinion regarding the validity of a county hospital regulation restricting admission to those who meet a one year durational residency requirement. You also ask whether the fact that a person needs emergency care would alter the result. Your question is prompted by concern “over the 

### growing losses incurred by the hospital, particularly as a result of the nonpayment for emergency room services rendered to nonresidents of Calhoun County.” The United States Supreme Court held aoneyear residency requirement for an indigent’s admission to a county hospital in Arizona was an unconstitutional impingement on the right of travel. Memoria! Hospital v. Maricopa County, 415 U.S. 250 (1974). With regard to nonresidents, the Supreme Court, in dicta, considered regulations barring nonresidents from public hospitals tobevalid. The court said:

A mere residence requirement would accom.plish the objective of limiting the use of public medical facilities to bona fide residents of the County without sweeping within its prohibitions those bona fide residents who hnd moved into the State within the qualifying period. 415U.S. at 267. With regard to lhr indig:cnl nonresident treatment of a condition chnrrml~rized as an V.T.C.S., provides: who presents himself for emergency, article 4438a,

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Honorable William W. Day - Page2 (H-1208)

Section 1. No officer or employee of a general hospital supported with public funds may deny aperson diagnosed by alicensed physician onthe staff of that hospital asseriously ill or injured emergency services customarily provided at the hospital because the person isunable to establish hisability topay for the se.rvices. Sec. 2. An officer oremployee of ahospital whoviolates the provisions of Section 1of this Act isguilty of aClass C misdemeanor and on conviction’is subject to a fine not exceeding $200. Sec. 3. Nothing inthis Act shall beconstrued to relieve a person of his obligation to pay for services provided by a hospital. The definition of an unmistakable emergency involves adifficult question of fact which hasbeen addressed by treatises onthe subject. “While persons who are not within the statutory classes hnve no right of admission, hospitals owe aduty to exercise reasonable care to those who present themselves for assistance and are in need of immediate attention.” Health Law Center, Problems in Hospital Law, 2d Ed. 5’7(1974). The general rule isthat if an emergency isfound toexist,

a hospital with emergency facilities is required to render service. No completely satisfactory definition of an emergency has been formulated. In general, an emergency isan injury or acute medical condition liable to cause death, disability, orserious injury. G. Annas, The Rights of Hospital Patients 37 (1975). If an emergency exists, a public hospital must treat the nonresident. SUMMARY A one year residency requirement for admission to acounty hospital is unconstitutionnl, although a nondurational rcside!lcy reqrlire:rwrl!~ ma\, tic valid. Emergeficy pa:k?nts must he treated rcg’““llttss of twi:. p;n<!cof :esinence. .,Vcry truly yours.

Attorney General ofTexas

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Honorable Williflm W.Ihy - I’cqy R (II-1208)

APPROVED:

C. ROBEKT HEATH, ‘chairman Opinion Committee jsn

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