Is a county hospital district's behavioral health unit a 'private facility' for mental health filing fees?

TX AG Opinion GA-0757: Is a hospital district's behavioral health unit a "private facility"?

Plain-English summary

The Titus County Attorney asked the Attorney General a narrow question about court filing fees. When the Titus Regional Medical Center (TRMC) files a court application on behalf of an indigent patient for mental health services at its Behavioral Health Unit (BHU), how the filing fee is handled depends on whether the unit is a "private facility" under section 118.055(c) of the Local Government Code. That statute says the fee for a mental health or chemical dependency application is due at the time the application is filed if the services relate to a private facility, but if the services relate to a state Department of Mental Health and Mental Retardation facility or a federal facility, the county clerk may collect the fee only under a different rule (section 571.018(h) of the Health and Safety Code).

The TRMC is operated by the Titus County Hospital District, which the opinion treated as a political subdivision of the state. The Health and Safety Code expressly includes a hospital district in its definition of "political subdivision." The district was created in 1963 by a special act of the Legislature under article IX, section 9 of the Texas Constitution, and its enabling law makes it responsible for medical and hospital care of the needy in the district.

The statute does not define "private facility," and the opinion found no Texas statute that does. So the Attorney General turned to the ordinary dictionary meaning: "private" means belonging to or derived from nongovernment sources, conducted outside the system of government. A "private facility" is therefore one operated by an agency or institution not affiliated with any governmental body. Because the BHU is part of the TRMC, which is operated by a government hospital district, the opinion concluded that a court would probably hold neither the BHU nor the TRMC is a "private facility."

Currency note

This opinion was issued in 2010. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here.

Section 118.055 of the Local Government Code and the Health and Safety Code provisions on mental health applications may have been amended since 2010. Confirm current law before relying on anything below.

Who this opinion affected (as of 2010)

County clerks and county attorneys: The opinion indicated that for an application tied to a government-run hospital district's behavioral health unit, the "private facility" trigger in section 118.055(c) (fee due at filing) would not apply, because the unit is not private.

Hospital districts and their behavioral health units: The opinion described such a unit, when operated by a hospital district, as a government facility rather than a private one for purposes of the filing-fee statute.

Indigent patients and those filing on their behalf: The opinion explained that the fee-timing rule turns on the public-versus-private character of the facility, and a hospital-district unit falls on the public side.

Common questions

Why does it matter whether the unit is a "private facility"?
Because section 118.055(c) makes the application fee due at filing when the services relate to a private facility, while a different collection rule applies to state or federal mental health facilities. The opinion addressed which category a hospital-district unit falls into.

How did the AG decide what "private facility" means?
The statute does not define the term, so the opinion used the ordinary dictionary meaning of "private": belonging to nongovernment sources and conducted outside the system of government. By that meaning, a facility run by a government hospital district is not private.

Is a hospital district a government body?
Yes. The opinion noted that the Health and Safety Code's definition of "political subdivision" expressly includes a hospital district, and the Titus County Hospital District was created by a special act of the Legislature under the Texas Constitution.

Background and statutory framework

Section 118.055(c) of the Local Government Code sets the fee for a court action involving mental health or chemical dependency services (the services listed in Health and Safety Code sections 571.016, 571.017, 571.018, and 574.008(c), or services under subchapter C or D of chapter 462), and provides that the fee is paid by the person executing the application and is due at filing if the services relate to a private facility; for a state Department of Mental Health and Mental Retardation or federal facility, the clerk may collect the fee only under section 571.018(h) (Tex. Loc. Gov't Code Ann. § 118.055(c) (Vernon 2008)). The Titus Regional Medical Center is operated by the Titus County Hospital District, which is a political subdivision of the state (Tex. Health & Safety Code Ann. § 571.003(19) (Vernon Supp. 2008)). The district was created in 1963 under article IX, section 9 of the Texas Constitution by special act, with responsibility for medical and hospital care of the needy in the district (Tex. Const. art. IX, § 9; Act of May 9, 1963, 58th Leg., R.S., ch. 298, §§ 1-20, 1963 Tex. Gen. Laws 771).

Section 118.055 does not define "private facility," and the opinion found no Texas statute that does, so it applied the ordinary dictionary meaning of "private" (belonging to nongovernment sources; conducted outside the system of government). On that reading, a "private facility" is one operated by an institution not affiliated with any governmental body. Because the behavioral health unit is part of a medical center operated by a government hospital district, the opinion concluded a court would probably hold it is not a "private facility."

Citations

Statutes:

• Tex. Loc. Gov't Code Ann. § 118.055(c) (Vernon 2008)
• Tex. Health & Safety Code Ann. § 571.003(19) (Vernon Supp. 2008); §§ 571.016, 571.017, 571.018, 571.018(h), 574.008(c); ch. 462, subch. C, D
• Tex. Const. art. IX, § 9
• Act of May 9, 1963, 58th Leg., R.S., ch. 298, §§ 1-20, 1963 Tex. Gen. Laws 771

Source

• Landing page: https://www.texasattorneygeneral.gov/opinions/greg-abbott/ga-0757
• Original PDF: https://www.texasattorneygeneral.gov/sites/default/files/opinion-files/opinion/2010/ga0757.pdf

Original opinion text

Best-effort transcription from a scanned PDF. Minor errors may remain — the linked PDF is authoritative.

ATTORNEY GENERAL OF TEXAS

GREG ABBOTT

February 3, 2010

The Honorable John Mark Cobern
Titus County Attorney
Titus County Courthouse
100 West First Street
Mount Pleasant, Texas 75455

Opinion No. GA-0757

Re: Whether the Behavioral Health Unit of the Titus Regional Medical Center is a "private facility" for purposes of section 118.055, Local Government Code (RQ-0795-GA)

Dear Mr. Cobern:

You ask whether the Behavioral Health Unit (the "BHU") of the Titus Regional Medical Center (the "TRMC") is a "private facility" for purposes of section 118.055, Local Government Code.[1] See TEX. LOC. GOV'T CODE ANN. § 118.055(c) (Vernon 2008).

You indicate that the TRMC is a general medical facility operated by the Titus County Hospital District (the "District").[2] We presume for purposes of this opinion that the TRMC is owned and operated by the District. A hospital district is a political subdivision of the State of Texas. See TEX. HEALTH & SAFETY CODE ANN. § 571.003(19) (Vernon Supp. 2008) (the term "political subdivision" includes a hospital district). The District was created in 1963, pursuant to article IX, section 9 of the Texas Constitution, by a special act of the Legislature. See Act of May 9, 1963, 58th Leg., R.S., ch. 298, §§ 1-20, 1963 Tex. Gen. Laws 771, 771-77; TEX. CONST. art. IX, § 9. Its enabling statute requires the District to "assume full responsibility for providing medical and hospital care for the needy residing within the District." Act of May 9, 1963, 58th Leg., R.S., ch. 298, § 2, 1963 Tex. Gen. Laws 771, 771. You state that the TRMC operates the BHU as part of its medical center and that periodically the TRMC "must make application on behalf of an indigent patient for mental health services to be provided to the patient at its behavioral health unit." Titus County Brief at 1.

You further state that when the TRMC files an action in county court on behalf of an indigent, payment of the application fee is determined by section 118.055(c) of the Local Government Code,[3] which provides:

(c) The fee for an action involving mental health or chemical dependency services is for the services listed in Sections 571.016, 571.017, 571.018, and 574.008(c), Health and Safety Code, or services under Subchapter C or D, Chapter 462, Health and Safety Code. The fees shall be paid by the person executing the application for mental health or chemical dependency services and are due at the time the application is filed if the services requested relate to services provided or to be provided in a private facility. If the services requested relate to services provided or to be provided in a mental health facility of the Texas Department of Mental Health and Mental Retardation or the federal government, the county clerk may collect the fees only in accordance with Section 571.018(h), Health and Safety Code.

TEX. LOC. GOV'T CODE ANN. § 118.055(c) (Vernon 2008) (footnote omitted and emphasis added). You tell us the TRMC, which is operated by the District, is not a mental health facility of the Department of Mental Health and Mental Retardation or the federal government. See generally Titus County Brief. The question before us is thus whether the BHU, as part of the TRMC, is a "private facility."

The term "private facility" is not defined in section 118.055 of the Local Government Code, nor in any other Texas statute of which we are aware. However, the common meaning of the word "private" is well understood. One dictionary defines the term "private" in the context of section 118.055 as "[b]elonging to a particular person or persons, as opposed to the public or the government[;] ... [o]f, relating to, or derived from nongovernment sources[; and] ... [c]onducted and supported primarily by individuals or groups not affiliated with governmental agencies or corporations: a private college [or] a private sanatorium." AMERICAN HERITAGE DICTIONARY 1396 (4th ed. 2000). Another dictionary defines the word "private" to mean "of or relating to a system of education or medical treatment conducted outside the system of government." OXFORD AMERICAN DICTIONARY 1356 (1st ed. 2001). These common definitions indicate then that a "private facility" is one that is operated by an agency or institution that is not affiliated with any governmental body.

As we have indicated, the BHU is a part of the TRMC, which is operated by the Titus County Hospital District, a political subdivision of the state. As such, a court would probably conclude that neither the BHU nor the TRMC may properly be denominated a "private facility."

SUMMARY

A court would likely conclude that the Behavioral Health Unit of the Titus Regional Medical Center, as part of the Titus County Hospital District, is not a "private facility" for purposes of section 118.055, Local Government Code.

Very truly yours,

GREG ABBOTT
Attorney General of Texas

ANDREW WEBER
First Assistant Attorney General

JONATHAN K. FRELS
Deputy Attorney General for Legal Counsel

NANCY S. FULLER
Chair, Opinion Committee

Rick Gilpin
Assistant Attorney General, Opinion Committee

[Footnote 1: See Titus County Brief at 1 (attached to Request Letter) (available at http://www.texasattorneygeneral.gov).]

[Footnote 2: See id.]