Texas Attorney General Opinion: GA-0552 Page: 2 of 4
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The Honorable Richard Clark - Page 2
263.041(a). The county commissioners court and the hospital board of managers may exercise
only those powers that the law expressly confers upon them and those powers that may be
necessarily implied from the express powers. See City ofSan Antonio v. City ofBoerne, 111 S.W.3d
22, 28 (Tex. 2003) (commissioners court); cf Mascarenhas v. Meridian Hosp. Auth., 560 F.2d 683,
685 (5th Cir. 1977) (quoting Tri-City Fresh Water Supply Dist. No. 2 v. Mann, 142 S.W.2d 945, 946
(Tex. 1940)) (hospital authority created under Health and Safety Code chapter 262); Jackson County
Hosp. Dist. v. Jackson County Citizens for Continued Hosp. Care, 669 S.W.2d 147, 154 (Tex.
App.-Corpus Christi 1984, no writ) (citing Tri-City Fresh Water Supply Dist. No. 2, 142 S.W.2d
at 946; Mascarenhas, 560 F.2d at 685) (hospital district created by special law).
Nothing in chapter 263 expressly prohibits a county hospital from operating a clinic in an
adjacent county if the two counties have not entered an agreement, but nothing expressly permits it
either. See, e.g., TEX. HEALTH & SAFETY CODE ANN. 263.001(a) (Vernon 2001) (permitting two
adjacent counties to join together to construct a hospital or health care facility); 263.028(a)
(permitting a county that does not have a municipality with a population over 10,000 to contract with
an adjacent county for the care of county residents); 263.080 (requiring a hospital superintendent to
admit a person from an adjacent county if, among other things, "the adjacent county has contracted
with the board of managers for the care and treatment of' county residents).
But in our opinion, section 263.022(c), together with a board of managers' general power to
manage hospital facilities, personnel, and patients, implicitly provides the authority you seek.4 Under
section 263.022(c), a commissioners court may "purchase or lease real or personal property, or both,
in an adjacent county if the court considers the purchase or lease necessary for hospital purposes."
TEX. HEALTH & SAFETY CODE ANN. 263.022(c) (Vernon 2001). Section 263.022(c) on its face
permits the County to acquire property in an adjacent county if the court finds the acquisition
"necessary for hospital purposes," without indicating that the adjacent county's consent is required.
Id. Hospital purposes may include the establishment or enlargement of a "medical or other health
facility" as authorized by section 263.021(a), which we interpret to include a clinic. See id.
263.021(a). Because determining whether a particular acquisition is necessary for hospital
purposes requires the resolution of fact questions, the commissioners court must make the
determination in the first instance, subject to judicial review for abuse of discretion. See Wichita
County v. Bonnin, 182 S.W.3d 415, 420 (Tex. App.-Fort Worth 2005, pet. denied) (indicating that
a commissioners court's decisions are subject to judicial review for abuse of discretion); see also
Tex. Att'y Gen. Op. No. GA-0446 (2006) at 18 ("Questions of fact are not appropriate to the opinion
process."); cf Tex. Att'y Gen. LO-97-068, at 3-4 (summarizing attorney general opinions
considering whether particular activities served hospital purposes consistent with article IX, section
9 of the Texas Constitution, which pertains to hospital districts). Similarly, before the
commissioners court may order an expenditure of county funds to own or operate a medical clinic
4We do not consider in this opinion whether any other legal impediment to the project exists, such as limitations
in the commissioners court's order establishing the hospital or a contract with County voters. See, e.g., Taxpayers for
Sensible Priorities v. City of Dallas, 79 S.W.3d 670, 676 (Tex. App.-Dallas 2002, pet. denied) (stating the
"elementary" principle that "the proceeds of bonds voted by the people must be expended for the purposes for which they
were voted" (quoting Lewis v. City of Fort Worth, 89 S.W.2d 975, 978 (Tex. 1936))).
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Texas. Attorney-General's Office. Texas Attorney General Opinion: GA-0552, text, June 25, 2007; (https://texashistory.unt.edu/ark:/67531/metapth275448/m1/2/: accessed June 24, 2021), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.