The opinion
April:20, 1969
Honorable H. B. Virgil Crawford Opinion No. M-385
County Attorney
Terry County Re: Whether.the Terry
Brownfield,, Texas 79316 County Hospital Dis-
trict must furnish
ambulance ser\ii.ce and
whether TerryCounty
and the City of .Brown-
field can participate
in providing funds for
Dear Mr. Crawford: ambulance service.
you have requested the opinion of 'this office on
the following questions:
"1. Is.'ambulance"service a part of '.
medical care required of a hospital dis-
trict, such as ours, and under tha present
situation?
.“2
. Are Terry County and the City of
Brownfield barred from participation in pro- .'
viding funds for ambulance service in Terry
Counicy?
"'3
. Can city, county;' or hospital ex-
pend money to subsidize private ambulance
service?"
The Terry Memorial Hospital District was created
pursuant to the provis.ions of House Bill 1146, Acts 59th.
Leg. R.S.; 1965, Ch. 653, p. 1502, 'as authorized by Section
9 of Article IX.of the Texas Constitution. Under House
Bill 1146, the district is given full responsibility for
the medical and hospital care of th8 needy ,and indigent
persons within the district.
;/ "
The pertinent parts of House Bill 1146 are as
* follows: '.,
"Sec.. '2. The District herein authot-
ized to b8,~created shall take OV8r and there
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Honorable k.'B. Virgil Crewf&d, Page 2. (M-385)
shall be transferred to it title to all
lands, buildings, improvements and equip-
ment in anywise pertaining to the hospitals
or hospital systemSowned by Terry County
and any city or town within such County,
and thereafter the.District shall provide
for the establishment of a hospital system
by'the purchase, construction, acquisition,
repair' or renovation.of -buildings an'd::equip-
ment, and equipping the same and the admin-
istration thereof for hbsoital uurooses:
Such District shall assum; full-responsibil-
ity for providing medical and hospital care
for its needy inhabitants and shall assume
the outstanding indebtednesswhich shall..
have .@een inCtiS8d by eny city or town.or by
Terry County for hospital purposes prior
to the creation of said District. . . .
"Sec. 5. . .. . The Board of Directors
shall have the authority to employ such
nurses, technicians, and other lay personnel
as may be deemed necessary fOS the efficient
operation of the District. . . .,
"Sec. 17. After creation of Terry Memo-
ri'al Hospital District, neither Terry County,
Texas, nor any city or town therein shall
thereafter.issue bonds or other eVid8nC8S of
indebtedness or levy .taxes for hospital pur-
poses or for medical care, and the said Terry
kemoriai Hospital DistriUz shall assume full-
responsibility for the operation oft all hos-
pital.facilities for the furnishing of medical
and hospital care of indigent persons."
(Emphasis added.).
This office has previously expressed the view,
in Attorney General's Opinion C-759 (19661, that the
operation of .an ambulance service, while not exclusively
a hospital Service, is sufficiently related to the effec-
tive aud efficient operation of a hospital as to be with-
in the authority of the Board of Managers of a hospital
district to acquire and operate such an ambulance.service
in carrying out its duties within the district. c-759
expressly stated that,the authority of the.disttict with
regard to the operation of anambulance service was not
8xclusiVe and did not preclude the operation of such a
service within th8 distric.t'by others.. The essence Of th8
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Honorable H. D. Virgil Crawford, page 3 ‘(M-385)
'.
holding in C-759 was that ambulance service was an an-
cillary function which a hospital district could undertake
if it were deemed nec8ssary, but that such s&vice was not
a duty which fell exclusively upon the district. We adhere
to that holding.
W.ith regard to your second question, the pro-
tection and~preservation of the public.health is within
the scope of the police power. of. the State, and, in darryihg
out its responsibilities, the county, city or.hospital dis-
trict is exercisinr deleaated DOW8rS of the State within
the limits of the.county1 city-or hospital district..
of Dallas v. Smith, 130 Tex. 225, 107 S.W.2d 872 (1937
Under the provisions of AStiC 4418f, Vernon's Civil
statutas, a county has the authority to operate and main-
tain an ambulance service within the county if the Com-
missioners Court determines,'that such service is in further-
'ante of the public health and sanitation. Under the au-'
thority.of'Article 4434 a ,county may cooperate with incor-
porated cities within the countyin the operation of an
ambulance se,rvice, provided tbat the,extent of the county's.
con'tribution under the agreement.does not contravene the
limitations of Article III, Section 52,.Texas Constitution.
Attorney General's Opinion C-772 (1966).
:
With regard to cities and towns, Attorney.
General's Opinion M-231 (1968) expressed the view that'
Article XI, 'Sections 4 and 5, Texas Constitution, and
Articles 1011 and 1175, Vernon's Civil Statutes, con-
stituted authority for .the governing bodies of such
cities and towns to operate emergency ambulance serv-
ices within their cities in order to protect the .health,
safety and.general'welfare of the citizens. "
Taking into bonsideration all of the various
authorities and powers that.bave bean discussed above,
~together with the fadt that at no time has the Legis- ',
lature ma;ae an express statement regarding the authority
to perform ambulance services, it is the opinion. of
this office that towns, cities, counties and hospital
districts each have the authority to provide such tier?-
ices to the citizens of .this State within the limits of
their respective donstitut$onal and statutory'authoriza-
tion, and,may also join together. in a cooperative enter-
prise for such services.
With respect to your 'third question, in accordance
with.Attorney General's Opinions C-759 and C-772, you.are
advised th.at Terry County,, ,tha City of Brownfield'and the
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.
Honorable H. B. Virgil Crawford, page 4 (M-385)
'Terry Memorial Hospital District have the authority to ex-
pend money to provide ambulance service when~ there has been
a determination by the governing body of each governmental
agency that'such service will be in furtherance of the pub-
lic health and general welfare of their citizens. This au-
thority extends to entering into contracts with a private
agency to provide ambulance Service, subject to the pro-
visions of Article III, SectiOn'52, Texas Constitution.
SUMMARY
-------
The furnishing of ambulance service
is not an exclusive duty of a,hospital
district within the meaning of House Bill
1146, Acts 59th Leg., 1965, RegularSession,
Ch. 653, p. 1502, but the furnishing of such
service is within the authority, of the dis-
trict if the Board of Directors deem such
service necessary for the effective and
effi~cient operation of the district.
Cities and counties within a hospital
district have authority to furnish ambulance
se'rvice , cooperate with 8aCh other and the
hospital district for the furnishing of such
services, or may contract with a private
agency for
C. MARTIN
Attorney General of'Texas
Prepared by. Malcolm L. Quick
Assistant Attorney General
APPROVED:
OPINION COMMITTEE
Pat.-Bailey, Chairman
W. 0. Shultz
Roger Tyler
Fisher Tyler
Allo.Crow
W. V. GEPPERT
Staff Legal Assistant
HAWTHORNE PHILLIPS
Executive Assistant
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