ATTORNEY GENERAL OF TEXAS 

The Honorable Vince Ryan 

Harris County Attorney 

10 19 Congress, 15th Floor 

Houston, Texas 77002 

Dear Mr. Ryan: 

GREG ABBOTT 

April 1,2011 

Opinion No. GA-0854 

Re: Authority of the Harris County Department of 

Education to operate an on-site health clinic for its 

employees (RQ-0928-GA) 

On behalf of the Harris County Department of Education (the "Department"), you ask 

whether a school district may "provide an on-site health clinic to its employees" without violating 

Education Code subsection 22.004(i).1 At the outset, we note that you limit your request to section 

22.004. As a result, we constrain our analysis to the Department's compliance with that section and 

do not evaluate whether the Department has general authority to operate an on-site clinic. 

Education Code subsection 22.004(a) provides that school districts "shall participate in the 

uniform group coverage program established under Chapter 1579, Insurance Code." TEX. EDUC. 

CODE ANN. § 22.004(a) (West Supp. 2010). You tell us that pursuant to this provision, the 

Department participates in the Teacher Retirement System's ("TRS") health benefit programs. See 

Request Letter, supra note 1, at 1-2. Education Code subsection 22.004(i) provides: 

Notwithstanding any other provision of this section, a district 

participating in the uniform group coverage program established 

under Chapter 1579, Insurance Code, may not make group health 

coverage available to its employees under this section after the date 

on which the program of coverages under Chapter 1579, Insurance 

Code, is implemented. 

TEX. EDUC. CODE ANN. § 22.004(i) (West Supp. 2010). You explain that in addition to participating 

in the TRS program, the Department "desires to offer an on-site health clinic to its employees," 

which "would be an optional, available service for employees to use if they so desire." Id. at 2. The 

'Letter from Honorable Vince Ryan, Harris County Attorney, to Honorable Greg Abbott, Attorney General of 

Texas at 1 (Oct. 26, 2010) (on file with the Opinion Committee, also available at http://www.texasattorneygeneral.gov) 

[hereinafter Request Letter]. 
The Honorable Vince Ryan - Page 2 (GA-0854) 

Department "does not intend for its health clinic to replace or circumvent the TRS health coverage 

program but rather, merely supplement employees' available healthcare options." Id. You ask 

whether the District may operate the on-site health clinic without violating subsection 22.004(i). 

Request Letter, supra note 1, at 1. Your question requires us to determine whether the on-site health 

clinic would be considered "group health coverage" under the statute. 

The phrase "group health coverage" is not defined in the Education Code. When a word is 

not defined by statute, we look to its plain meaning, beginning with the commonly understood 

definition. See Fitzgerald v. Advanced Spine Fixation Sys., Inc., 996 S.W.2d 864,865 (Tex. 1999). 

The common understanding of "coverage" is the "inclusion of a risk under an insurance policy." 

BLACK'S LAW DICTIONARY 422 (9th ed. 2009); see also AMERICAN HERITAGE COLLEGE 

DICTIONARY 329 (4th ed. 2002) (defining "coverage" to mean "inclusion in an insurance policy"). 

It does not include the separate operation of a clinic. The clinic, as you describe it, would provide 

direct care to employees. Such a clinic would provide healthcare itself, not healthcare coverage. As 

you describe it, the clinic would "supplement employees' available healthcare options," which is 

distinct from supplemental healthcare insurance coverage. Request Letter, supra note I, at 2. Based 

on the facts described in the letter, the operation of an on-site clinic that provides optional health care 

services to employees does not meet the definition of group health coverage under subsection 

22.004(i). 
The Honorable Vince Ryan - Page 3 (GA-08S4) 

SUMMARY 

By operating an on-site healthcare clinic, the Harris County 

Department of Education does not propose to offer healthcare 

insurance, but rather it proposes to provide optional healthcare 

services to its employees, Offering direct healthcare services does not 

implicate Education Code subsection 22.004(i), which prohibits 

districts from offering group healthcare coverage. 

DANIEL T. HODGE 

First Assistant Attorney General 

DAVID J. SCHENCK 

Deputy Attorney General for Legal Counsel 

JASON BOATRIGHT 

Chair, Opinion Committee 

Virginia K. Hoelscher 

Assistant Attorney General, Opinion Committee