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Hospital districts provide health care to poor and low-income residents in various parts of Texas.
Hospital districts are a type of political subdivision falling partly under the control of the commissioners court in the county in which they are created.
Hospital districts may include one or more counties.
Most hospital districts in Texas directly provide medical services to residents. However, the Travis County Hospital District, known as Central Health, acts only as a funding mechanism and outsources medical care to various partners.
The state’s largest hospital districts by budget are Harris Health System (Harris County), Parkland Health & Hospital System (Dallas County), University Health System (Bexar County), JPS Health Network (Tarrant County), Central Health (Travis County), and El Paso County Hospital District.
Taxation
Hospital districts are authorized by the Texas Constitution to levy a tax not to exceed seventy-five ($ .75) cents on each $100 dollars valuation of all taxable property within the district.
Hospital districts in small counties (those with a population under 75,000) may also impose a sales tax.
A district’s annual budget and tax rate are subject to final approval by the county commissioners court.
In addition to local tax revenues, hospital districts may receive federal funding. However, the Texas Health and Safety Code prohibits the state legislature from making a direct appropriation for the construction, maintenance, or improvement of a facility of the hospital district.
Governance
Each hospital district is administered by an appointed board whose members serve a two-year term, except that some members may be appointed to only a one-year term in order to stagger terms.
In general, the members are appointed by the commissioners court of a county in which a district is created, and the each board is typically composed of five to seven members.
However, special statutory provisions govern the appointment of members in hospital districts in Travis County, Dallas County, and El Paso. For example, the nine-member board in Travis County includes some members appointed by the City of Austin.
Creation of New Hospital Districts
The constitution authorizes the legislature to create new hospital districts, provided that the voters of the counties therein approve the creation of the district.
An election may also be held to dissolve a hospital district. To initiate such an election, at least 15 percent of the registered voters in a district must sign a petition asking for the election.
