Texas Attorney General Opinion: GA-0552 Page: 3 of 4
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The Honorable Richard Clark - Page 3
in an adjacent county, it must determine that the expenditure serves a legitimate county purpose.5
See TEX. CONST. art. III, 52(a) (prohibiting the expenditure of public funds for private purposes);
id. art. VIII, 9(b) (permitting a county to levy taxes for four constitutional purposes only); Tex.
Att'y Gen. Op. No. GA-0059 (2003) at 3 (stating that county funds may be used for county purposes
only). Once the County has made the requisite determinations and acquired the property, the hospital
board of managers has express authority to manage the facility, personnel, and patients consistently
with legal requirements. See TEX. HEALTH & SAFETY CODE ANN. 263.046(a) (Vernon 2001).
Finally, while other sections of chapter 263 appear to require a contract between counties
before a county hospital may serve residents of another county, we do not believe those sections limit
the exercise of a county's authority under section 263.022(c). Section 263.028 authorizes the
commissioners court of a county that does not have a municipality with a population of more than
10,000 (such as Gaines County) to "contract with ... an adjacent county for the care of residents of
the county who are sick or injured." Id. 263.028; see also UNITED STATES CENSUS BUREAU, 2000
CENSUS OF POPULATION: POPULATION FINDER, available at http://www.census.gov/ (population of
Seminole is 5,910; population of Seagraves is 2,334) (last visited June 4, 2007). In addition, section
263.080 requires a hospital superintendent to admit to the hospital "a person sent by the
commissioners court of an adjacent county if... [among other things] the adjacent county has
contracted with the board of managers for the care and treatment of persons who are sick or injured."
TEX. HEALTH & SAFETY CODE ANN. 263.080 (Vernon 2001). These sections do not forbid a
county to provide health services "on [its] own volition," in the absence of a contract. Request
Letter, supra note 1, at 4. Likewise, section 263.050, which permits a board of managers to
"establish and operate" a clinic "at the hospital or in the municipality located nearest the hospital"
or "in a municipality that is located in the county and that has 5,000 or more inhabitants," neither
requires that the nearest municipality be in the same county nor forbids a board of managers to
operate a clinic acquired by the county under section 263.022(c). TEX. HEALTH & SAFETY CODE
ANN. 263.050(a) (Vernon 2001).
We thus conclude that a county may purchase or lease a medical clinic in an adjacent county
without the adjacent county's consent under section 263.022(c) of the Health and Safety Code if the
county commissioners court determines that the acquisition is "necessary for hospital purposes" and
that any expenditure of county funds serves a county purpose. Id. 263.022(c); see Tex Att'y Gen.
Op. No. GA-0059 (2003) at 3. The hospital's board of managers may manage the facility, personnel,
and patients consistently with legal requirements. See TEX. HEALTH & SAFETY CODE ANN.
263.046(a) (Vernon 2001).
5Section 263.022(c)'s legislative history supports the conclusion that a commissioners court reasonably may
find that acquiring an out-of-county clinic serves hospital purposes. See TEX. HEALTH & SAFETY CODE ANN.
263.022(c) (Vernon 2001). The Legislature adopted the substance of subsection (c) in 1987. See Act of May 18, 1987,
70th Leg., R.S., ch. 737, 1, 1987 Tex. Gen. Laws 2645, 2645. In hearings on the bill before the House Committee on
County Affairs, Representative Criss, the bill's sponsor, testified that the bill would authorize the Mainland Center
Hospital in Galveston County to purchase a clinic in the City of Alvin in Brazoria County "and operate [the clinic] as
part of the county hospital." Hearings on Tex. H.B. 1002 Before the House Comm. on County Affairs, 70th Leg., R.S.
(Mar. 17, 1987) (testimony of Representative Criss) (transcript available from House Video/Audio Dep't). In
Representative Criss's words, "what this bill will allow, if a hospital..,. is servicing another county, this bill will allow
them to purchase land in that county, put up a clinic or whatever." Id.
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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/m1/3/: accessed June 24, 2021), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.