### ATTORNEY GENERAL OFTEXAS GREG ABBOTT

The Honorable Frank .I.Carte Jr. Chair, Committee on Defense Affairs and Opinion No. GA-0467 State-Federal Relations Re: Whether the East Coke County Hospital Texas House of Representatives District is authorized to operate a long-term Post Office Box 2910 health care facility and levy taxes for its Austin, Texas 78768-2910 maintenance and operation (RQ-0467-GA) Dear Representative Corte: You ask the following question:

Does the East Coke County Hospital District have the authority to operate along-term health care facility and levy taxes to maintain and operate said facility?’ The East Coke County Hospital District (the “ECCHD”) was created pursuant to article IX, section 9 of the Texas Constitution, which permits the legislature to provide for the creation and operation ofhospital districts and to authorize them to levy taxes or issue bonds. Hospital districts created pursuant to this constitutional provision assume responsibility for providing medical and hospital care to indigent residents. See TEX. CONST.art. IX, 59. In 1969 the legislature adopted House Bill 1462, a special law creating the ECCHD within part of Coke County and authorizing it to levy atax, subject to approval by the voters. See Act of May24,1969,61stLeg., R.S., ch. 444,§§ l-3,1969Tex. Gen.Laws 1485,amendedbyActofMay 12, 1977, 65th Leg., R.S., ch. 249, § 1, 1977 Tex. Gen. Laws 662, 663 (authorizing district to contract with physicians, professional associations providing health care, and nonprofit medical corporations). House Bill 1462 vested management and control of the ECCHD in its board of directors and charged the district with establishing ahospital or ahospital system to furnish care to

‘Letter from Honorable Frank J. Carte Jr., Chair,~Committee on Defense Affairs and State-Federal Relations, Texas House of Representatives, to’Honorable Greg Abbott, Attorney General of Texas, at 1 (Mar. 14,2006) (on file with the Opinion Committe,e, also available af http:ilwww.oag.state.tx.us). See Letter from Mr. Edward M. Cumbie, President, Board of Directors, East Cqke County Hospital District, to Honorable Greg Abbott, Attorney General of Texas, at 1(Feb. 16,2006) (on file with the Opinion Committee, also mailable athttp:ii~.oag.state.tx.us, submitted as part of request letter giving additional information about request).The Honorable Frank J. Carte Jr. - Page 2 (GA-0467)

the district’s residents, including indigent residents ofthe district. See Act ofMay 24, 1969, 61st Leg., R.S., ch. 444, 5s 1-3, 1969 Tex. Gen. Laws 1485,1485. Weconsider whether the ECCHD may operate along-term health care facility and levy taxes to maintain and operate the facility? The board’s authority is to be determined from the plain meaning ofthe statutory language. SeeFitzgeraldv.AdvancedSpineFixationSys.,Inc.,996S.W.2d 864,865-66 (Tex. 1999). The board must exercise its authority over the hospital district consistently with Texas Constitution article IX, section 9 and with other law defining the district’s powers and duties. House Bill 1462 sets out the district’s authority to levy a property tax. The election approving the district’s creation authorized the district to levy atax “not to exceed 75 cents on each $100 valuation, upon all taxable property situated within said district
. for all hospital district purposes.” Act ofMay24,1969,6lstLeg., R:S., ch. 444, §4(c), 1969 Tex. Gen. Laws 1485,1486. “The board ofdirectors shall annually levy a,tax” topay the interest on and create asinking fund for bonds and other obligations itmay have issued, provide for the operation and maintenance of the hospital district and the hospital system, and make further improvements and additions to the hospital system. Id. 3 13, at 1490-91. The ECCHD thus may levy taxes “for all hospital district purposes,” expressly including “improvements and additions” to the hospital system. Id. $54(c), 13,at 1486,149@-91. House Bill 1462 gives the ECCHD board “complete discretion as to the type ofbuildings, both asto number and location, required to establish and maintain anadequate hospital system.” Id. § 10,at 1490. “The hcspital system may include facilities for domiciliary care ofthe sick, wounded, and injured, facilities for outpatient clinic or clinics,
. facilities for geriatric domiciliary care, convalescent home facilities, and any other facilities deemed necessary for hospital care by the directors.” Id. The ECCHD thus has broad statutory authority to provide for the facilities of a hospital system. Pursuant to this authority the district board may, in the exercise of reasonable discretion, determine that a long-term health care facility is necessary for hospital care and may spend taxes tomaintain and operate that facility. SeegenerallyTex.Att’y Gen. Op.No. JM-2 (1983) (Corrigan Hospital District, established by special law, may build and operate anursing home to provide geriatric care). Ageneral law also authorizes the ECCHD to operate along-term health care facility. Health and Safety Code section 285.101 provides that certain hospitals, hospital districts, and authorities may “construct, acquire, own, operate, enlarge, improve, furnish, or equip
. . [various types ofl facilities or services for the care ofthe elderly or disabled,” including “anursing home or similar long-term care facility.” TEX.HEALTH & SAFETY

CODE ANN.§285.101(b)(l)(A) (Vernon2001).

‘Abrief raises additional questions about the district’s provision of indigent care. See Letter from Tom and LouAnna Peters,

toOpinion

Committee, Office ofthe Attorney General, at l-2 (Apr. 1,2006) (on file with the Opinion Committee). Government Code sections 402.042 and 402.043 identify the state and local officials who are authorized to request attorney general opinions, and section 402.045 provides that the attorney general may not give a written opinion to a person who is not an authorized requestor. See TEX.GOV'T CODEANN. $5 402.042, ,043, ,045 (Vernon 2005). Accordingly, we do not address the questions raised in the brief.The Honorable Frank J. Carte Jr. - Page 3 (GA-0467)

A hospital district created by special law under article IX ofthe Texas Constitution that is located in acounty with apopulation of35,000 orless isamong the entities that may exercise this authority. See id. 5285.101(a)(l). The ECCHD is ahospital district created by special law under article IX, section 9 and located in a county with a population well under 35,000.3 Accordingly, section 285.101 authorizes the ECCHD to operate along-term health care facility. A long-term health care facility established by section 285.101 serves a“hospital district purpose” for which the district may levy and spend taxes. See Act of May 24, 1969,61st Leg., R.S., ch. 444, §4(c), 1969 Tex. Gen. Laws 1485, 1486.

‘The population ofCoke County was 3,864 in 2000. See BUREAUOFTHECENSUS,U.S. DEP’TOFCOMMERCE, 2000 CENSUSOFPOPULATION,available ai h~p://quickfacts.census.gov/qfdistates/4~/48081 .html (State and County Quick Facts) (last visited Sept. 14, 2006).The Honorable Frank J. Corte Jr. - Page 4 (GA-0467)

SUMMARY The East Coke County Hospital District, created by special law under article Ix, section 9ofthe Texas Constitution has authority to operate a long-term health care facility and to levy taxes to maintain and operate this facility.

RENT C. SULLIVAN First Assistant Attorney General ELLEN L. WJTT Deputy Attorney Generai for Legal Counsel NANCY S. FULLER Chair, Opinion Committee Susan L. Garrison Assistant Attorney General, Opinion Committee