ATTORNEY GENERAL OF TEXAS 

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 a long-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 of hospital 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, 5 9. 

In 1969 the legislature adopted House Bill 1462, a special law creating the ECCHD within 

part of Coke County and authorizing it to levy a tax, 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 a hospital or a hospital 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 at http: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 of the district. See Act of May 24, 1969, 61st 

Leg., R.S., ch. 444, 5s 1-3, 1969 Tex. Gen. Laws 1485,1485. 

We consider whether the ECCHD may operate a long-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. See Fitzgeraldv. AdvancedSpine Fixation Sys., Inc., 996 S.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 a tax “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 of directors shall annually levy a,tax” to pay the interest on and create a sinking fund for 

bonds and other obligations it may 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. $5 4(c), 

13, at 1486,149@-91. 

House Bill 1462 gives the ECCHD board “complete discretion as to the type of buildings, 

both as to number and location, required to establish and maintain an adequate hospital system.” Id. 

§ 10, at 1490. “The hcspital system may include facilities for domiciliary care of the 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 to maintain and operate that facility. See generally Tex. Att’y Gen. Op. No. JM-2 (1983) 

(Corrigan Hospital District, established by special law, may build and operate a nursing home to 

provide geriatric care). 

A general law also authorizes the ECCHD to operate a long-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 of the elderly or disabled,” including “a nursing home or similar 

long-term care facility.” TEX. HEALTH & SAFETY CODE ANN. § 285.101(b)(l)(A) (Vernon 2001). 

‘A brief raises additional questions about the district’s provision of indigent care. See Letter from Tom and 

LouAnna Peters, to Opinion 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 CODE ANN. $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 of the Texas Constitution that is located 

in a county with a population of 35,000 or less is among the entities that may exercise this authority. 

See id. 5 285.101(a)(l). The ECCHD is a hospital 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 a long-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 of Coke County was 3,864 in 2000. See BUREAU OF THE CENSUS, U.S. DEP’T OF COMMERCE, 

2000 CENSUS OF POPULATION, 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 9 of the 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