. 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 requestingthe opinion of this office concerningthe referencedmatter states, in part, as follows:

*I herewith request an opinion as to the liabilityof Upton County for the medical bill and expenses'ofan indigentprison& whose residence is in a hospital district in Upton County createdunder the provision of House Bill Number 

## 816, 60th Legislature,

Re Ann.CXv.St.Article b&g&& Y lar Session (Vernon's in accordancewith 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 backgroundof the matter are as follows:.

. . "Now in view of the foregoing, please answer the followingquestions: "1. Is Upton County~llable for the bill for medical treatmentand hospital care of the Indigentprisoner,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 'formedical 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 liabilityfor 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 hospitaldistricts,the McCar County Hospital District and the Rankin County HospitalDlstr: each of these districts comprisea portion of Upton County.

Your letter, also, in regards to the factual sltuat statesthat the indigentprisonerwas taken by the Sheriff of Upton County, who had him in his custody, to a doctor for an examination,and that

4, .*.
. the doctor informedthe sheriff that the prisonerwas sufferingfrom a blockage of the kidneys and that if he was not immediately removed to a hospitalhaving 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 facilitiesin 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 inquiriesand was Lnformed that the Ode&a Medical Center Hospital In Odessa,Texas (located in Eotor County)had the facilitiesand 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 indigentprlisoner

at the Odessa hospitalwas approximately

-4240-Hon. John A..Menefee,

At the time a resident of McCamey page 

## 3 (M-870)

of his arrest, the Indigentprisonerwas in Upton County, and of the McCamey County HospitalMstrict. 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 incarceratedin the County Jail.

Section 9 of Article IX of the Constitution of Texas, as enacted‘in1962, provides, in part, that:

"The Legislature

may by law provide for the creation,establishment, maintenanceand operation of hospitaldistricts.

. ., providing that any district so created shall assume full responsibility for providingmedical and hospital care for its needy Inhabitants.

. .; providing that after its creation no:other'munic~pallt aivision shall have the powerYt?lety t '~a P litI 1 s" '

b axe3 or Issue bonds or other obllgatlonsfor hospitalpurposesor for providingmedical care within the boundariesof the district;

. ;"' (Emphasis added.) Your letter states that the indigentprisonerwas 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 Districtprovzdes, in '. part, as follows:

(Emphasisadded.) 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 prlscnersbrought ~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 prisonersconfined in Jail or under guard, the sheriff shall be allowed the following charges

: 'I

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

The foregoingArt&es 1037 and 1040 are found in Chapter 104 of the Texas Code of Criminal Procedure, whioh Chapter Is styled "Costs Paid by Counties."

Severalprior Opinions of this Office have held that a. county Is liable for the necessaryand reasonablemedical expenses lncurred:by

a prisonerduring sickness , and that the proper amount of'the charges for such medical treatment'lsto be determined by the commissioners

'court and paid by the county. Attorney General'sOpinionsNos. 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 rlsonerswhere a hospitaldistrict comprising~the whole or a part !&-tTi- e county and having the powers under consideration, exists. AttorneyGeneral'sOpinion No. M-171 (1967)held that a hospitaldistrict,createdpursuant to Section 9 of Article IX of the Constitution

of Texas, quoted supra, has the full responslbilltY for providing

medical and hospital care for indigentresidentsof such districtand 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 hospitaloutside the district-andlegallypay for such.outof-district

expenses. Attorney General'sOpinionNo, C-334 (1964) held that a hospitaldistrict oreatedpursuant to the foregoingconstitutional provisionassumes the responsibility for medical care of Indigents

within Its district that'was theretoforeimposed on the county commissioners court pursuant to Articles 2351 and Vernon'sCivil Statutes. 4438,

Attorney General'sOpinion 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 llabllltyof 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 underscoredlangua e of the Act oreatlng the McCamey County HospitalDistrict mpra). 7 Article 4494q,,note, Vernon's Civil Statutes, The language covers lndlgentsand needy Inhabitants, whether or not they are prlsoneys.

While a county may, by statute,be given authority In certainareas, this authoritymay, by constitutional provision, be delegatedto another entity. NO. c-334 (1964), supra. See AttorneyGeneral'sOpinion

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 indigentprisoner, 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 boundariesof that Hospital District. AttorneyGeneral'sOpinionNo. M+171 (1967), supra.

As your first questionhas been answered in the negative, we do not deem It necessary to consideryour 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 Constitutionof Texas, the hospitaldlstrlct.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 hospitaldlstrlct did not have adequate facilitiesfor treating him, and the treatmenthad to be administered In a hospitalwithout the boundaraesof the hospital 'district. Under the facts presented, the provisionsof Articles 1037 and 1040 of the Texas Code of Criminal Procedurerelating" to ccunty responsibility for the med~cal~bllis

of prisonersmust yield to the broad
.~ language of the foregoingconstitutional 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.

. '. 'ornot 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 ExecutiveAssistant NOLA WIiI!I'E First Assistant

-4245-