Untitled Texas Attorney General Opinion ( 1972 )

Criminal District Attorney
Bexar County Courthouse Re: Authority of the Bexar County
San Antonio, Texas 78204 Hospital District, pursuant
to Section S(b) of Article
4494n, Vernon’s Civil Statutes,
to fund the operation of a
clinic for the poor and in-
digent without assuming re-
sponsibility for control and
Dear Mr. Butler: supervision of such clinic.
Your recent letter requesting the opinion of this office
concerning the referenced matter states, in part, as follows:
“This office requests your opinion con-
cerning the following question: May the Bexar
County Hospital District fund the operation of
a clinic for the poor and indigent at Villa
Coronado in south Bexar County without taking
over the operation and supervision of the clinic?
“The Villa Coronado Clinic was originally
set up and funded by a Government Grant (OEO)
during the past year with the understanding
that it (OEO) would only fund the clinic for
one year. The Clinic is now operated by a
non-profit organization, “Southside Neighbor-
hood Association Corporation”. The Clinic’s
first year funds were expended on February 1,
1972. At this time the Bexar County Hospital
District decided to fund the operation since
the persons attended by the Clinic would or-
dinarily be cared for by the Bexar County
Hospital District facilities except for a
transportation problem of about 25 miles. It
is the Bexar County Hospital District’s con-
tention since the transportation problem is
so acute for these residences, that by the
time the patients from Villa Coronado finally
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Hon. Ted Butler, page 2 (M-1154)
came to the Bexar County Hospital District
facilities they would be so advanced in their
illnesses that they would become in-patients
of the hospital instead of clinical out-patients.
The Bexar County Hospital District is funding
this clinic through the non-profit corporation
(SSNAC) on a month to month basis without
assuming any operation or supervision of the
clinic and without a contract with the South-
side Neighborhood Association Corporation.”
Pursuant to the authority of Section 4 of Article IX of
the Constitution of Texas, the Bexar County Hospital District was
established by Article 4494n, Vernon’s Civil Statutes. Section 1
of that Article provides, in part, that:
“Any county having a population of
190,000 or more . . . may be constituted
a Hospital District as hereinafter set out
and . . . may provide for the establishment
of a hospital or hospital system to furnish
medical aid and hospital care to the indigent
and needy persons residing in said Hospital
District. . . .I’
Subsection (b) of Section 5b of that Article provides,
in pertinent part, as follows:
,1. . .(T)he (hospital district) Board of
Managers, with the approval of the Commissioners
Court, may cooperate and contract with . . . any
privately owned or operated hospitilircz;E;;;;;
or otherwise, which privately owne
hos ital is situated in the hospital district;
p& in
. the opinion of the Board of Managers
and of tie Commissioners Court, such a contract
is deemed expedient and advantageous to the
hospital district under existing circumstances,
and be for such fair and reasonable compensation
and on such other terms and for such length of
time as may be deemed to further and assist the
hospital district in performing its duty to
provide medical and hospital care to needy in-
habitants of the county.” (Emphasis added).
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Hon. Ted Butler, page 3 ‘M-l 154)
Section 2 of Article 4437f. Vernon’s Civil Statutes,
(the Texas Hospital Licensing Law) 9 defines the term “hospital.”
That Act’s definition of the term “hospital” is expressly made
applicable to the Bexar County HosPltal District by virtue of
Subsection (b) (1) of Section 2 of Article 4437f, which provides,
in part, as follows :
II . The definition of ‘hospital’ does,
however ’include those facilities maintained
or operited by lgovernmental’ or ‘governmental
unit 1 as those terms are defined in Section 2,
Subsection (d) of this Act.”
Subsection (d) , referred to in the foregoing statutory
provision, provides, in part, that
“The term ‘governmental ’ Or 'governmental
unit ) means any hospital district . . .”
(Emphasis added).
your letter has also advised US that the Villa Coronado
Clinic, the funding of which is at issue in your request, does
not fall within the definition of “hospital” set forth in Article
4437f, and, therefore, applicable to Article 4494n. For purposes
of this opinion, we assume that your statement concerning the Clinic’s
falling without the purview of the definition of “hospital** is correct
we are aware that prior to the enactment of Article 4494n,
the board of managers of a hospital district, pursuant to Articles
4478 and 4481, Vernon’s Civil Statutes, had authority to establish
clinics similar to the nature of the Villa Coronado Clinic. If the
Villa Coronado Clinic had been extant at the time of the enactment
i of Article 4494n (1953), which it.was not, it would have become the
property of the Bexar County Hospital District, by virtue of the pro-
visions of Section 4 of Article 4494n.
Inasmuch as the Villa Coronado Clinic is not the property
of the Hospital District? the only way whereby the Hospital District
may have a legal connection with such Clinic is through rhe provisions
of Section 5b of Article 4494n, quoted supra.
pursuant to Subsection (a) of Section Sb, the “ospital
District could elect to purchase the Clinic to effectuat? its duty
of providing for “the establishment of a hospital or hosFita1 system
to furnish medical aid and hospital care to the indigent and need?
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Hon. Ted Butler, page 4 (M-1154)
persons” residing in the District.
However, the District cannot , pursuant to Subsection
(b) of Section Sb, contract with the Clinic, inasmuch as it is
not a “hospital” as that term is used in Subsection (b), by virtue
of the provisions of Subsection (b)(l) of Section 2 of Article
443?f, quoted supra. Furthermore? no authority is found in Section
5b of Article 4494n whereby the District could contract with any
clinic, as opposed to a hospital, in the District. Cf. Attorney
-1’s Opinion No. M-85 (1967), and authorities cxed therein,
whereby the right of a hospital district to pay private hos itals
for medical care rendered to needy and indigent persons o
-7T-hixty
was upheld, where it was not practical to treat such persons in the
hospital district’s own facilities.
Even if, arguendo , clinics fell within the purview of
Subsection (b) of Section Sb of Article 4494n, it is manifest from
the import, and specific terms,of that Subsection that the only
way the District could have a relationship with the Clinic would
be by contract.
Your letter clearly states that the Hospital District
is presently funding the Clinic, on a month-to-month basis, through
a non-profit corporation, and that the District neither assumes any
operation or supervision of the Clinic, nor does it have any con-
tract with the parent non-profit corporation.
We are unable to find any legal authority sanctioning the
fact situation at issue in your request. You are advised that the
Bexar County Hospital District may contract only with those entities
set forth in Subsection (b) of Section 5b of Article 4494n. If the
Villa Coronado Clinic meets the definition of “hospital” (as that
term is used in Article 4437f, quoted supra), you are further ad-
vised that the Hospital District may contract with the Clinic to
render such medical services to the needy and indigent of the
District as the Board of Managers deems necessary.
No funding of the operations of the Clinic, or of its
parent non-profit corporation, may be granted from funds of the
Hospital District until a contract is executed between the Dis-
trict and the parent corporation, whereby the District will assume
appropriate responsibility for the operation and control of the
Clinic.
We are mindful of the fact that the Bexar County Hospital
District has the constitutional and statutory duty to furnish medical
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Hon. Ted Butler, page 5 (M-1154)
aid and hospital care to the indigent and needy persons residing
in said District. Accordingly, you are further advised that the
Hospital District may acquire the facilities of the Villa Coronado
Clinic if it deems such acquisition necessary to the proper perfor-
mance of its constitutional and statutory duties in this regard.
In view of the foregoing, your question is answered in the
negative.
SUMMARY
(1) Pursuant to Subsection (b) of Section
5b of Article 4494n, Vernon’s Civil Statutes,
the Bexar County Hospital District has no au-
thority to fund the operations of a clinic, or
its parent non-profit corporation, unless: (a)
the clinic meets the definition of “hospital”
and (b) a contract is executed between the
Hospital District and the parent corporation
whereby the District will have an appropriate
degree of supervision and control over the
operations of the funded facility.
(2) The Hospital District has the consti-
tutional and statutory duty to furnish medical
and hospital care to the indigent and needy
persons residing in its District.
(3) Pursuant to Subsection (a) of Section
5b of Article 4494n, Vernon’s Civil Statutes,
the Hospital District may acquire the Villa
Coronado Clinic, and operate the Clinic as a
part of the Hospital District, if the Board of
Managers of the District deems such acquisition
necessary and proper to the effectuation of its
duties.
truly yours,
ey General of Texas
Prepared by Austin C. Bray, Jr.
Assistant Attorney General
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Hon. Ted Butler, page i (M-1154)
APPROVED:
OPINION COMMITTEE
Kerns Taylor, Chairmaz
W. E. Allen, Co-Chaizz
John Banks
Charles Lind
John Reeves
Scott Garrison
SAMUELD. MCDANIEL
Staff Legal Assistant
ALFRED WALKER
Executive Assistant
NOLA WHITE
First Assistant
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