ATTORNEY GENERAL OF TEXAS

The Honorable Vince Ryan Harris County Attorney 10 19 Congress, 15th Floor Houston, Texas 77002

DearMr. Ryan: GREG ABBOTT

April 1,2011
Opinion No. GA-0854 Re: AuthorityoftheHarris CountyDepartmentof Educationto operate an on-sitehealth 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 yourrequest to section 22.004. As aresult, we constrain ouranalysis 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 TeacherRetirement System's ("TRS")healthbenefitprograms. 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 ofcoverages under Chapter 1579, Insurance Code, is implemented. TEX. EDUC. CODEANN. §22.004(i) (West Supp. 2010). Youexplainthatin additionto participating in the TRS program, the Department "desires to offer an on-site health clinic to its employees," which "wouldbe an optional, available service for employees to use ifthey so desire." 

### Id. at 2. The

'Letterfrom Honorable Vince Ryan, Harris County Attorney, to Honorable Greg Abbott, Attorney General of Texas at 1 (Oct. 26, 2010) (on file with the OpinionCommittee, also available athttp://www.texasattorneygeneral.gov) [hereinafter Request Letter].The Honorable Vince Ryan

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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). RequestLetter, supra note 1, at 1. Yourquestionrequires us to determine whetherthe 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. AdvancedSpine 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 ofa clinic. The clinic, as you describe it, would provide direct careto employees. Sucha clinic wouldprovidehealthcare itself, nothealthcare coverage. As you describe it, the clinic would "supplement employees' available healthcare options," which is distinctfrom supplementalhealthcareinsurancecoverage. RequestLetter, supranote I, at2. Based onthe facts describedintheletter, theoperation ofan on-site clinicthatprovides optionalhealthcare services to employees does not meet the definition of group health coverage under subsection 22.004(i).

### The Honorable Vince Ryan

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### 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 toits employees, Offeringdirecthealthcare services doesnot 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