JOHN 1. HILL 

Attorney General 

The Attorney General of Texas 

December 12, 1978 

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Honorable Robert E. Owen 

Coke County Attorney 

Robert Lee, Texas 76945 

Opinion No. PI- 12 7 g 

Re: Whether a county located 

in a hospital district may provide 

ambulance service. 

Dear Mr. Owen: 

You ask whether Coke County may provide ambulance service for its 

citizens. Part of Coke County is included in the West Coke County Hospital 

District, Acts 1963, 58th Leg., ch. 315, at 825, while the rest of the county is 

included in the East Coke County Hospital Dmtrict, Acts 1969, 61st Leg., ch. 

444, at 1485. Roth hospital districts were created pursuant to article IX, 

section 9, of the Texas Constitution, which provides in part: 

[Alny district so created shall assume full responsibility for providing medical and hospital care for its 

needy inhabitants. . . . [Alfter its creation no other 

municipality or political subdivision shall have the 

power to levy taxes or issue bonds or other obligations 

for hospital purposes or for providing medical care 

within the boundaries of the district. . . . 

Similar language appears in the enabling statutes of each hospital 

district. See Acts 1969, 61st Leg., ch. 444, S 3, at 1485; Acts 1963, 56th Leg., 

ch. 3l5, m, 19, at 825. You suggest that ambulance service constitutes 

“medical care” within the Constitution and enabling acts, so that the county 

may not levy taxes or issue obligations of indebtedness in order to provide it. 

See Attorney General Opinions H-454, H-367 (1974). 

We believe your question has been answered by Attorney General 

Opinion M-385 (1969). That opinion concluded that the Terry County Hospital 

District, created under the authority of article IX, section 9, could operate an 

ambulance service in cooperation with Terry County and a city within the 

district. It found provision of an ambulance service to be an auxiliary 

function of a hospital district and determined that a district could undertake 

it, but did not have the exclusive duty to do so. See Attorney General 

Opinion C-759 (1966). The operation of an ambulance &&ice by the hospital 

p. 5056 
Honorable Robert E. Owen - Page 2 (H-1279) 

district did not preclude a similar undertaking by another political subdivision 

within the district cr the cooperative effort inquired about. 

We believe Attorney General Opinion M-385 reached the correct result. See 

Attorney General Opinion H-976 (1977). More recent authorities support x 

conclusion by characterizing the provision of ambulance service as not solely a 

hospital or medical function. In m 507 S.W.2d 324 

(Tex. Civ. AIID. - Corous Christi 1974. no writ) the court described ambulance 

service as “k%dred to ihe police or fire service.” It stated that this “service is 

incident to the police power of the state: i.e. to protect the health, safety, and 

general welfare of its citizens” We relied on the views of the Ayala court in 

Attorney General Opinion H-562 (1975), which determined that rural fire prevention 

districts, established pursuant to article 3, section 48d of the Constitution, could be 

given statutory authority to provide emergency ambulance service. See also 

Attorney General Opinion M-231 (1968) (operation of emergency ambulance service 

by firemen). 

Consequently, we do not believe that the establishment of hospital districts in 

Coke County divests the county of its authority to provide ambulance service 

within the district. See V.T.C.S. art. 4418f; Attorney General Opinions H-976 

0977); M-806 (197B; M-385 (1969); C-772, C-759 (1966). 

SUMMARY 

A county, wholly, included within hospital districts 

established pursuant to article IX, section 9 of the Texas 

Constitution, may provide ambulance service. 

Attorney General of Texas 

.~ 

ad 

C. ROBERT HEATH. Chairman 

Opinion Committee 

Ml 

p. 5057