Untitled Texas Attorney General Opinion ( 1978 )

The Attorney General of Texas
July 13, 1978
Honorable William W. Day Opinion No. H- 1208
Criminal District Attorney
Calhoun County Re: Authority of a county
211 So. Ann Street hospital to restrict admission of
Port Lavaca, Texas 779’79 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 resi-
dents who hnd moved into the State within the
qualifying period.
415 U.S. at 267.
With regard to lhr indig:cnl nonresident who presents himself for
treatment of a condition chnrrml~rized as an emergency, article 4438a,
V.T.C.S., provides:
P. 4846
. .
: _
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