In Texas, Just What *Is* a Hospital Purpose? (Spending Money in Pecan Plantation) Somervell County Salon-Glen Rose, Rainbow, Nemo, Glass....Texas


In Texas, Just What *Is* a Hospital Purpose? (Spending Money in Pecan Plantation)

14 August 2013 at 3:04:55 PM

Saw an interesting opinion Greg Abbott, Attorney General of Texas, in 2007 regarding whether a county may own or operate a medical clinic in an adjacent county without the adjacent county's consent. This was from Yoakum County in Plains, TX. From reading this, it seems that Yoakum County wanted to put a clinic in Gaines County, that even though Gaines County had a hospital district, apparently the area that Yoakum wanted to open one up was in an area that neither Gaines County hospital district nor any other governmental health care entity covered.

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. .... But in our opinion, section 263.022(c), together with a board of manager's general power to manage hospital facilities, personnel, and patients, implicitly provides the authority you seek. Under section 263.022(c) a commisioners 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".... 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 property's consent is required. .. 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. Because determining whehter 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... Similarly, before the commissioners court may order an expenditure of county funds to own or operate a medical clinic in an adjacent county, it must determine that the expenditure serves a legitimate county purpose. See Tex Const Art III 52(2) (Prohibiting the expenditure of public funds for private purposes).  Texas Atty Gen Op N GA-0059 (2003) stating that county funds may be used for county purposes only).... 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.

So, the question becomes, what exactly is a "hospital purpose"? Here is a Texas Attorney General opinion LO97-068. In this case, Val Verde hospital district wanted to open up a physicians clinic in the same county near the hospital.

This office has never considered a hospital district plan to construct and lease a physician's office building for the purpose of attracting and retaining physicians to practice at a hospital in a rural, underserved part of the state, where no alternative, private sites are available near the hospital. While we doubt that a hospital district plan to construct and lease a physician's office building under other circumstances would serve a hospital purpose, we believe that a hospital district plan with the purpose here, in these very limited circumstances involving a hospital in an underserved area of the state where no alternative private sites are available, would serve a hospital purpose within the meaning of article IX section 9. Again, we assume that the plan is intended to attract or retain physicians who will provide services necessary to the operation of the hospital district. We also stress that this conclusion is predicated on the statement that the hospital district will require physicians leasing the building to serve needy patients.

Finally, we consider whether the proposed lease would violate article III, sections 51 and 51 of the Texas Constitution, which prohibit a political subdivision from using public funds for private purposes. In order to avoid this prohibition, the proposed lease must serve a public purpose and the hospital district must receive adequate quid pro quo. .. The lease must also include sufficient controls to ensure that the public purpose is accomplished. ..

.. provided that the lease will procure for the district necessary services, including services for needy patients, that would not otherwise be available.

With Pecan Family Medical Center, we have been told by Dr Peters that the other doctor in that clinic ONLY sees Pecan Plantation (ie, Hood County residents) as patients. Further, needy patients from Somervell County who might want to utilitze the clinic where their tax money is going cannot simply walk up to use the clinic, as the clinic is in a private, gated community where access must be granted by being cleared to be on a list. (And even then, as we've said, one doctor apparently would not even then have needy patients.) Notice that the AG's opinion shows that simply wanting a clinic for physiicans is not in itself a *hospital purpose*. And, of course, Somervell County being the second smallest county in the state, it is also not a matter that Hood County is underserved (as we've noted before, Hood County residents pay NO hospital district taxes, while we pay taxes for their gated clinic in another district).

P.S. Have to add, although discussion of this will be in an upcoming post, one of the reasons given for wanting a Somervell County hospital district in the first place was to free up monies that the county had to set aside for indigents that would no longer be a consideration for the district because there are, apparently , very few actually indigent/needy people in this county. If Somervell County itself has few needy people, then what is there to say about a clinic in a rich, private gated community if a primary reason to allow a clinic is to make sure there is a public purpose, including serving the needy?

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