. THE ATTORNEY GENERAL 

OF TEXAS 

Hon. John A. Menefee 

County Attorney 

Upton County Courthouse 

Rankiti, Texas 79778 

Dear Mr. Menefee: 

opitiion’ NO. M-870 

Re: Liability of a county for 

a medical bill of an indigent ~prlsoner whose 

residence is located in 

the county of his lncarceration and in the local 

county hospital district-, 

but who was treated outside the county and in 

another hospital district. 

Your recent letter requesting the opinion of this office 

concerning the referenced matter states, in part, as follows: 

*I herewith request an opinion as to the 

liability of Upton County for the medical bill 

and expenses'of an indigent prison& whose residence is in a hospital district in Upton County 

created under the provision of House Bill Number 

816, 60th Legislature, Re 

Ann.CXv.St. Article b&g&& Y 

lar Session (Vernon's 

in accordance with 

Article 9, Section 9 of the Con,stitution of,the 

State of Texas. This indigent'prlsoner~ was 

treated and cared for In a hospital not located 

In Upton County, Texas. 

"The facts and background of the matter are 

as follows:. . . 

"Now in view of the foregoing, please answer 

the following questions: 

"1. Is Upton County~llable for the bill 

for medical treatment and hospital care of the 

Indigent prisoner, Francis William Dalgleish? 

"In the event the answer to the foregoing 

Is yes, please answer this question: 

-4239- 
Hon. John A. Menefee, page 2 (M-870) 

n2. Can the County place in Its budget an 

item 'for medical care and hospltallzatlon of 

slck,prlsoners in county Jails' and levy a tax 

therefor? 

“3. In the event the answer to the question 

number one (1) is no, does the liability for the 

'medical bill lie with the McCamey County Hospital 

District?" 

Your letter relates that the area of Upton County I: 

coextensive with the area of two hospital districts, the McCar 

County Hospital District and the Rankin County Hospital Dlstr: 

each of these districts comprise a portion of Upton County. 

Your letter, also, in regards to the factual sltuat 

states that the indigent prisoner was taken by the Sheriff of 

Upton County, who had him in his custody, to a doctor for an 

examination, and that 

4, .*. . the doctor informed the sheriff that 

the prisoner was suffering from a blockage of the 

kidneys and that if he was not immediately removed 

to a hospital having proper facilities, this man 

would moat likely die in his cell. The doctor 

informed the sheriff that the Rankin County 

Hospital District did not have the facilities 

and would not admit him or accept hlm as a 

patient. In the meantime. . .(t)he sheriff . 

then called (another) doctor. . . and he was 

Informed that the McCamey County Hospital District did not have the facilities in the hospital 

to treat this patient and that he would not be 

able to admit him because of the lack of facilities 

there for the proper treatment. Whereupon, the 

sheriff made inquiries and was Lnformed that the 

Ode&a Medical Center Hospital In Odessa, Texas 

(located in Eotor County) had the facilities and 

would accept him. The sheriff of Upton County 

secured an order from the County Judge of Upton 

County to transfer the prisoner to the Odessa 

Medical Center Hospital in Odessa.' 

You further state that the medical bill Incurred 

indigent prlisoner at the Odessa hospital was approximately 

-4240- 
Hon. John A..Menefee, 

At the time 

a resident of McCamey 

page 3 (M-870) 

of his arrest, the Indigent prisoner was 

in Upton County, and of the McCamey County 

Hospital Mstrict. When arrested, he was taken to the Upton County 

Jail, located in Rankin, Texas, and within the Rankin County Hospital District. His illness was contracted while incarcerated in the 

County Jail. 

Section 9 of Article IX of the Constitution of Texas, as 

enacted‘in 1962, provides, in part, that: 

"The Legislature may by law provide for the 

creation, establishment, maintenance and operation 

of hospital districts. . ., providing that any 

district so created shall assume full responsibility 

for providing medical and hospital care for its 

needy Inhabitants. . .; providing that after its 

creation no:other'munic~pallt 

aivision shall h ave the powerYt?lety t '~a 

P litI 1 

s" ' 

b 

axe3 or 

Issue bonds or other obllgatlons for hospital purposesor for providing medical care within the 

boundaries of the district; . ;"' (Emphasis added.) 

Your letter states that the indigent prisoner was a 

resident of the McCamey County Hospital District. This District 

was created by Acts 60th Legislature, Re 

&" 

lar Session, 1967, 

Chapter 183, 

Statutes). 

Page 384 (which Is Article 494s note, Vernon's Civil 

The Act creating the Hospital District provzdes, in '. 

part, as follows: 

(Emphasis added.) 

Article 1037, Texas Code of Criminal Procedure 

that: 

', provides 

"Each county shall be liable for all expense 

Incurred on account of prisoners confined in jail 

k t d d t prlscners brought 

~ome~no~~e~c~~~y'f~rxc~~fe keeping, or on 

-4241- 
Hon. John A. Menefee, page 4 (M-870) 

habeas corpus or change of venue; In which cases 

the county from which the prisoner is brought 

shall be liable for the expense of his safe 

keeping." (Emphasis added.) 

Article 1040, Texas Code of Criminal Procedure, provides, 

In part, that: 

"For the safe keeping, support and malntenance of prisoners confined in Jail or under 

guard, the sheriff shall be allowed the following 

charges : 

'I 

. . . 

"3. For necessary medical bill and reasonable extra cosipansatlon for attention to a 

The foregoing Art&es 1037 and 1040 are found in Chapter 104 of 

the Texas Code of Criminal Procedure, whioh Chapter Is styled 

"Costs Paid by Counties." 

Several prior Opinions of this Office have held that a. 

county Is liable for the necessary and reasonable medical expenses 

lncurred:by a prisoner during sickness , and that the proper amount 

of'the charges for such medical treatment'ls to be determined by 

the commissioners 'court and paid by the county. Attorney 

General's Opinions Nos. 

and O-4708 (1942). 

c-538 (lg65), ww-1509 (19%;; i%j4 (19%. 

None of these or any other Opinion of this Offlc! 

or any decision of any appellate court of this State of which we are 

aware, has considered the liability of.a county for Its indigent 

rlsoners where a hospital district comprising ~the whole or a part 

!&-tTi- e county and having the powers under consideration, exists. 

Attorney General's Opinion No. M-171 (1967) held that a 

hospital district, created pursuant to Section 9 of Article IX of 

the Constitution of Texas, quoted supra, has the full responslbilltY 

for providing medical and hospital care for indigent residents of 

such district and that, when the hospital district cannot adequately 

1 barge its responslbillty to such Indigent inhabitant because of 

a i:ck of sufficient hospital facllltles, it may send the indigent 

-4242- 
Hen, John A. Menefee, page 5 : (M-870) 

to-a hospital outside the district -and legally pay for such.outof-district expenses. 

Attorney General's Opinion No, C-334 (1964) held that 

a hospital district oreated pursuant to the foregoing constitutional provision assumes the responsibility for medical care of 

Indigents within Its district that'was theretofore imposed on 

the county commissioners court pursuant to Articles 2351 and 

Vernon's Civil Statutes. 

4438, 

Attorney General's Opinion No, c-646 (1966) held that 

Section 9 of Article II of the Constitution of Texas does not 

permit a county in which a hospital district Is created pursuant 

thereto to expend tax monies for med.loal and hospital services. 

We are of the opinion that, under the circumstances set 

forth in your letter, the prov@$ons of Articles 1037 and 1040 of 

the Texas Code of Criminal Procedure, supra, relating to the 

llablllty of a county for medical bills of prisoners, must yield 

to the express broad Zanguage of Section 9 of Article IX of the ' 

Constitution of Texas which is undersoored, supra, and to the 

underscored langua e of the Act oreatlng the McCamey County 

Hospital District 

mpra). 

7 Article 4494q,,note, Vernon's Civil Statutes, 

The language covers lndlgents and needy Inhabitants, 

whether or not they are prlsoneys. 

While a county may, by statute, be given authority In 

certain areas, this authority may, by constitutional provision, 

be delegated to another entity. 

NO. c-334 (1964), supra. 

See Attorney General's Opinion 

Accordingly, you are advised that, under the particular 

circumstances set forth in your letter, the McCamey County Hospital 

District, the district of the residence of the indigent prisoner, 

1s liable for the medical bills incurred in his treatment, notwithstanding the fact that he was a prisoner In the custody of 

the county sheriff, and further notwithstanding the fact that he 

was treated outside the boundaries of that Hospital District. 

Attorney General's Opinion No. M+171 (1967), supra. 

As your first question has been answered in the negative, 

we do not deem It necessary to consider your second question. 

Your third question 1s answered in the'affirmatlve. 

-4243- 
Hon.'John A. Menefee, page 6 t ,,.-' : (M-870) 

SUMMARY:. 

Under the facts presented, and pursuant to 

Section 9 of Article IX-of the Constitution of 

Texas, the hospital dlstrlct.of'whlch an indigent 

prisoner held by the Sheriff of the county is's 

resident Is liable for the medical bills Incurred 

In treating the prisoner, when that hospital dlstrlct did not have adequate facilities for treating him, and the treatment had to be administered 

In a hospital without the boundaraes of the hospital 

'district. 

Under the facts presented, the provisions of 

Articles 1037 and 1040 of the Texas Code of Criminal 

Procedure relating" to ccunty responsibility for the 

med~cal~bllis of prisoners must yield to the broad 

.~ language of the foregoing constitutional provision, 

and of the.Act creating the.hospital district (Article 

449&q note, .Vernoti's~Ci.vil Statutes) that was enacted 

.pursuant to 'such constltutlonal provision. 'Its 

language IS comprehensive enough to -include;.all 

needy and indigent -Inhabitant ressdents, whether. . '. 

'or not they are prisoners.. 

n 

. . 

neral of Texas 

Prepared'by~ Austin C. Bray, Jr. 

Asslstant.Attorney General. 

APPROVED:. -. 

OPINION COMMITTKR .' 

Kerns Taylor, ChaIrman 

W. E. Allen, Co-Chairman 

Jim Swearlngen 

John Hanks 

Fisher Tyler 

Sam McDaniel 

.,. 

-4244- 
Hon. John A. Menefee; p+ge,,7~ 

MEXDE F. GRIFFIN 

StaPf Legal Assistant 

ALFFBDWALm 

Executive Assistant 

NOLA WIiI!I'E 

First Assistant 

-4245-