The Attorney General of Texas 

July 13, 1978 

Honorable William W. Day 

Criminal District Attorney 

Calhoun County 

211 So. 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 a one year 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 to be valid. 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. 

415 U.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, 

P. 4846 
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Honorable William W. Day - Page 2 (H-1208) 

Section 1. No officer or employee of a general hospital 

supported with public funds may deny a person diagnosed by 

a licensed physician on the staff of that hospital as seriously 

ill or injured emergency services customarily provided at the 

hospital because the person is unable to establish his ability 

to pay for the se.rvices. 

Sec. 2. An officer or employee of a hospital who violates 

the provisions of Section 1 of this Act is guilty of a Class C 

misdemeanor and on conviction’is subject to a fine not 

exceeding $200. 

Sec. 3. Nothing in this Act shall be construed to relieve a 

person of his obligation to pay for services provided by a 

hospital. 

The definition of an unmistakable emergency involves a difficult question of 

fact which has been addressed by treatises on the subject. “While persons who are 

not within the statutory classes hnve no right of admission, hospitals owe a duty 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 is that if an emergency is found to exist, 

a hospital with emergency facilities is required to render 

service. No completely satisfactory definition of an 

emergency has been formulated. In general, an emergency 

is an injury or acute medical condition liable to cause death, 

disability, or serious 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 a county 

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<!c of :esinence. 

.,Vcry truly yours. 

Attorney General of Texas 

P. 4847 
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Honorable Williflm W. Ihy - I’cqy R (II-1208) 

APPROVED: 

C. ROBEKT HEATH, ‘chairman 

Opinion Committee 

jsn 

P. 4848