Board of Trustees, University of Ark. v. Pulaski County

• Decision Date: 01 July 1958
• Docket Number: No. 5-1643,5-1643
• Citation: 229 Ark. 370,315 S.W.2d 879
• Parties: BOARD OF TRUSTEES, UNIVERSITY OF ARKANSAS, Appellants, v. PULASKI COUNTY et al., Appellees.
• Court: Arkansas Supreme Court

Page 879

315 S.W.2d 879

229 Ark. 370

BOARD OF TRUSTEES, UNIVERSITY OF ARKANSAS, Appellants, v. PULASKI COUNTY et al., Appellees.

No. 5-1643.

Supreme Court of Arkansas.

July 1, 1958.

Rehearing Denied Sept. 29, 1958.

Bruce Bennett, Atty. Gen., Roy Finch, Jr., Chief Asst. Atty. Gen., Ray Trammell, Fayetteville, of counsel, for appellants.

William M. Lee, Clarendon, H. B. Means, Malvern, Reed Thompson, North Little Rock, J. Frank Holt, John T. Jernigan, Joseph C. Kemp and Gardner A. A. Deane, Jr., Little Rock, for appellees.

GEORGE ROSE SMITH, Justice.

By this suit the appellees, six counties and two cities, seek a declaratory judgment holding that the Medical Quota Act (Act 568 of 1957) is unconstitutional. The defendants compose the Board of Trustees of the University of Arkansas and govern the University Medical Center at Little Rock. The chancellor declared the act to be invalid and enjoined the defendants from attempting to enforce it.

By its preamble the act declares that the Medical Center is a state institution, supported by state-wide taxation, and that the use of its facilities by certain counties and municipalities has been disproportionate to comparative population. To correct this situation the act assigns quotas to each county and to each city of more than 10,000 people. Residents of the various counties and cities who are unable to pay for medical care may be treated at the state's expense within the limits of the assigned quotas, but each county or city must pay the actual cost of charitable treatment rendered to its residents in excess of its quotas. If any city or county fails to pay within thirty days after it is billed, the sum due may be deducted from state funds that the city or county would otherwise receive.

For the most part the appellees' attacks upon the validity of the act require little discussion. The counties' contention that the statute infringes upon the county court's constitutional power to control county finances has been rejected in a number of cases, the most recent being Campbell v. Arkansas State Hospital, Ark., 306 S.W.2d 313, which is not dissimilar on this point to the case at bar. An allied contention, that the financial burden upon these appellees will be so great as in effect to destroy their local governments, is sufficiently answered by that provision of the act which empowers each county judge and the chief administrative officer of each city to certify the eligibility of each resident applicant for free medical care. If the charges now assertedly due from these appellees appear to be unduly great, it is because they have failed to exercise their option to control admissions to the Medical Center.

A number of contentions are based on the fact that the quotas assigned to the various counties and cities are based solely on comparative population. Before these points can be discussed it is necessary to describe the quota system in some detail.

The act provides two different quotas for each of the seventy-five counties (and for the city of Marked Tree, as we shall explain later on) and for each of the twelve cities having more than 10,000 residents. The first quota represents the number of patient-days in the hospital that are allotted annually to each county and city. Arkansas county, for example, is allowed 1,728 patient-days a year at state expense, Ashley county 1,872, and so on down the list. The various separate quotas total 140,604 patient-days a year. In like manner the act assigns to each county and city an annual quota for emergency and clinic visits to the Medical Center. These various separate quotas total 100,000 visits a year.

The act itself does not state just how these numerical quotas were determined, except that it does declare parenthetically that they are apportioned pro rata according to population. The system is explained in detail, however, in the answer filed by the appellants. It is there asserted that the Medical Center hospital has 450 beds, which can be utilized at 85 per cent of their full capacity for 365 days a year. This leads to a total of 139,613 patient-days a year (85% of 450X365). This total was allocated among the counties and cities in proportion to their population as shown by the 1950 federal census. (That the actual total in the act comes to 140,604 instead of 139,613 is due in a negligible degree to the rounding off of fractions and, principally, to an obvious mathematical error by which Woodruff county was assigned 1,000 more patient-days than its relative population calls for. We assume that a mere mathematical error of this kind can be judicially corrected. See Murphy v. Cook, 202 Ark. 1069, 155 S.W.2d 330.) When a county contained a city having more than 10,000 people the city's population was subtracted from that of the county in fixing their separate quotas. In the same way the Medical Center's annual capacity to take care of 100,000 emergency and clinic visits was apportioned on the basis of the 1950 census.

In addition to pleading the method of allocation in their answer the appellants offered testimony to show that the quotas were in fact determined in the manner just stated. This proof is a part of the record, though the chancellor ruled it incompetent. Perhaps the testimony would not be admissible to show what was in the minds of the legislators when the act was passed, but we see no reason why it would not be competent as tending to support the appellants' assertion that there is a sound factual basis for the quotas allotted to the counties and cities. We need not explore this issue, however, for we can determine the method of allocation without reference to the pleadings or the proffered proof. We take judicial notice of the federal census figures, Street Imp. Dist. Nos. 481 and 485 v. Hadfield, 184 Ark. 598, 43 S.W.2d 62, and it is a simple matter to demonstrate to a mathematical certainty that the various quotas were based upon comparative population as shown by the 1950 federal census.

It is first insisted that a classification based upon relative population alone is so unreasonable and arbitrary as to invalidate the act on the ground that it is local or special legislation. Ark.Const. Amendment 14. On this point the appellees insist that the residents of counties and cities geographically near the Medical Center will inevitably use its facilities more frequently than will citizens living far away. Hence, it is said, the assigned quotas should take into account relative distances as well as relative population.

This argument overlooks the basic purpose of the act, which is to distribute the burden of maintaining the Medical Center equitably among the several counties and cities. A quota system based upon population appears to us to be an altogether fair method of accomplishing the legislative purpose; certainly it is not so unreasonable as to warrant a holding that comparative population has nothing to do with the purpose of the act. See the Hadfield case, supra. The appellees' position really narrows down to the contention that, merely because they happen to be near the Medical Center, they should not be required to pay their fair share toward maintaining the institution. This position is obviously without merit.

A further contention is that the distinction between cities having more than 10,000 people...