Honorable0. B. Close opinion 100. 

### C-334 CountyAttorney Ochiltree.

County Rer Eospltal care of Indigent Perryton,Texas
Dear Mr. Closer

You request our opinion pn the above subjectmat& and eek the followingquertionst

tree County, Texas for indisent care? Can the 

### Ochiltree Jio8pltal District pay private physiclane for in-patientand.outpatient care o? .lndigente3.n Oohllt*eeC&My, ‘~ Texan? 

### (3) Your general opinion a8 to the scope of responsibil.Sty and authority of the Hospit& District under the existing circumstances

### regarding indigent 

### care?”

‘You state in your request that pursuant to Article

### 4494q4, Vernonfs Ciiil Statutes, a hoepi& districtwae created within the boundaries of Ochiltree County and.a bond electionhas been held, approving the Issuance of bonds 

### for the constructionof a hospltal.and.the

HospitalDistrict contemplatesthat the conetxuction of a hospital will be commenced within the year 

### 1965but It ~5.11 not be operationalfor 

### 801118 time. You 

### further state that at the present time there are no public hospitalsnithin the boundarlee of Ochlltree County and that the onI.. hospitalspresently operatingwithin the County are two privately owned hospitals.
Sect3.m 9 OS Article IX of the Constitutionof Texas

### provides for the creation of hospital districts, and provides in 

### Part a8 fo&lowar

II that after ita creation no other tnunicip.ilit~



### or political oubdlv$sion ohall have the power to levy taxes or ‘lame bonkle or other obligations

### for hospitalpurpoeea or for providingmedical care within the boundaries of the dietrict;

. , .I

-1588-**Hon. 0.**  R. ClOse,

Section 13 provide6 in part: page 

### 2 (C-334)

,

o? Article 4494q-4, Vernon~s Civil Statutes,

"Exceptas herein provided, no county that has been constituteda hospital district, and **no** city therein,&a31 thereafterlevy any tax **for** hospitalpurposes; and such hospital district shall be deemed to have assumed ?ull respcmslbility?or the ?urhishlng of medical and hospital care for the needy and Indigent perrronsresiding- in said hospital district from the date that We6 are collected for the hoepita1 distr’lct.” ~.
In kew'o? the facts &bxaltted in visions o? Sectlou 13 of Article 44g4q-4, ital District assumes.the same authority KS of tiedlcaI

and hospital care for the ne 603)s residing in the Xospltal District'as thereto?orepossessed by the Oommi66ioner6Court of Ochiltree Couuty; etlcle 4438, Vernon's Clvi~Statutes, provides:

*,I? ‘hers is a~regular **estebU6hed** puillc hoepital'in the count ; the 

### c&misdUner8 court shall provide ror.8e L the indigent sick o?

.the county to such hospital. If more than one such hospital exists In the county, the indigent patient 6haIl have 

### the right to select which one of theq he shall be sent to."

(1942), In Attorney General's Opinion6 O-2179 (1940 1 .and. 

### O-4633 it was held that the comi6eioners ccurt:o a county did not have authority to pay items of hospital treatment tar indigent sick to any hospital outside o? the county. .Theeeconclucrions were based upon the principle6 of law anuouuaedIn WilIacyl

, 29 S.W.2d 

### 456 (Tex.Clv.ApP.

"The power6 and duties of county commis6ioner61’court6, and the, obligatlon6 of the countlee to pauper6 are ?lxed by statute,and mg~z be enlargedupon by unnecessary impll-

. .Thesepowers and duties, in 60 far aa applicable,

here **are** de?lr.ed

in ,andrest icted by the provi6ion6o? Articles 2351 and 

### b43a Revised Statutes,

### 1925.

.In Article'2351 it'16
'i rovlded.

that each'

commibrloners~ court hell eubdivlslon11) ‘piovide for the support o? paupers Y * + residents **of** their **county, who** 
-1389-HOG. 0. R. Close, page 3 (C- 334)

are unable to support themselve.;', and (subdivision 12

1 'f'or the burial of paupers'. In Article 438 it is provided that 'if there is a regular establishedpublic hospital in the county, the commlssioners~Icourt shall provide Sor sending the indigent sick * l * to such hospital'. In the latter provision, the duty and the authority of the camnissionersl court to send the Indigent sick to hospitals is limited to public hospital6 within the county, which provision,by necessary implicationexcludes any duty or authority to send such person6 to privatehospitals, or to public hospitals without the county.&.EvenI? Barbosa was within the class.defined,as 'Indigentsick,' the commissioners8court-as a body, muchless the county judge-actingsingularly,we6 under no duty, and was denied the au&hority to send Barbosa to a hospital, either public or private, outside the county.
y+ iv* Under ,theprovision6 of Article 4438, the county was under no duty to send Rarbosa to any hospital, there being no public .' hospital in the county, and under the implied restrictionsof this provision it is doubtful if the county could be bound by the coeaaiasionersl court, certainlynot otherwise, to send him to a hospitalwithout the county, at public expense."

(1940): Likewise, It was held in Attorney General's Opinion 0-2633

"You are thereforerespectfullyadvised that it is the opinion of this department that if the commissioners~court determines that an

. indigent is a pauper it may furnishmedical aid and medicines to him as such, regardlessof nhether or not he has been placed upon the pauper roll of the county, inasmuch 11sthere~is no statutory requirementfor the making up of a county pauper roll. It is the furthc:r opinion of this department that the commissiol;ers' court has the authority to aid 'indigentsick',who may or may not be 'paupers', by sending such 'indigentsick' to 'public'hospitalswithin :.he county. The question of 'indigency'is also a question of fact to be determinedby the commissioners'court."Ron. C. R. Close, page 4 (C-334)

In Attorney General’s Opinion C-246 (1964),‘it was polnted out:
“Somewhatsimilar to the preceding queetlon, your sixth question also concerns the contractualpower and authority of the ComniselonereCourt **of** Tarrant County. **Ae** etated In answeringyour 

### first question, where a duty is Imposed or e **power** conferred upon a commiesloners court, then the commlssioncrecourt hae implied authority to exercisebroad discretion to ecccmplieh the purporee intended. When the 

### comleelonere courtr were expreealy given the power end duty ‘toprovide for the rupport of peupers,t **by** necessary implication they **were** clothed with the authority to do all the **lnci** dental thinga necessary to provide for their support. Thus, while the commlsnionere court Is 

### not under e duty to place lndigente In a prlvet8 iecilitya County v. Valley (T Ci A ltB%s,l~tpi gents whom it placea in e .prlvate facilifiy.

Here, of couree, the contractual term miust not be such es to amount to a donation **by** the County to 

### the Individual **or** corporation

### providing the care, nor can the contractprovide for payment.8 by the County out of future 

### revenuem.”
,Itwae pointed out in Attorney 

### Gcneral’e OpinionC-246 that: “Your first end second questions can be answered together. Under the provlefonrrof Section 11, Article 2351, Vernonls Civil Statutes, the Conunlseloncre~ Court has the duty to:
“‘11. Provide for the support of paupers and such idiots and lunatics aa cannot be admltted Into the lunatic asylum, residents of their county, who are unable to eupport themeelvce. I

. . .‘While it Is true that the Comieeioners8 Court is a court of limited juriediction,it Is also true that where a duty Is imposed or a power conferredby statute upon e commiseioners court within the boundaries of power which the Constitutionhas created, then the commlseloners

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c Hon. G. R. Close, page 5 (C-334)

court has impliedauthority to exercisebroad ( discretion to accomplishpurposfs Intendedby such statute. El Paso County v. Elam, 106 S.W. 26 393 Q

Tex.Clv.App. 19 :TEGon v. Marshall, 11
Orror d3r S.W.2d 621 (Te%.vw938,
152 

### s.w.Et' * Anderson v. Wood, 137 Tex. 201,



### 684-(pSl)

. "Under the provisionsof Section 11, Artlcle 2351, a duty to provide

### for the support of paupers, which Includes the Indigentaged, Is lmposed'uponthe CommissionersCourt.'

In view of the foregoing, if the Indigent care referred to In your request constitutes the support of paupers within the meaning of Section 11 of Artlcle.2351,Vernon's Civil Statutes, the Hospltal.Distrlct, under theauthority of Section 

### 13 of Article 4494q-4,ma make payments to private hos ltals within OchlltreeCounty -#ttorneyGeneral's Opinion C-24 8 themedical care or Indigents does not constitute $196417. If the support of paupers" within the meaning of Section 11 of Article 2351, the HospitalDistrictmay not make payments to privets hospitals within Ochlltree County,but such care must be limited to.such hospital treatmentas authorizedby Article 4438, Vernon's Civil Statutes, In public hospitals. Wlllacy County v. Valley Baptist Hospital,29 S.W.2d 456 (Tex.Clv.App.I-930).

SUMMARY

A hospital district created under the provisions of Article tig%-4, Vernon's Civil Statutes, assumes the same responsibility 

### for the medical care of indigentswithin said district 

### as that previously Imposed on the ccmmlssloners court under the provisions of Section 11 of Artlcle 2351, Vernon's Civil Statutes and Article 

## 4438, Vernon'sCivil Statutes.

Yours very truly,
WAGGONER CARR Attornc\y

General

JR:ms 

### . ,:4-:&& By/rd’ yc) ,;' 

### ,1’ -John Reeves Assistant

-1592-HOG: 0. R. Close, page 6 (c-334)

APPROVED:
OPINION COMMITTEE W. V. Geppert,Chairman Malcolm ,Quick George Black Ralph Rash
APPROVEDFORTIB ATTORNEXQENERAL BY: Roger Tyler

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