The Hays County Commissioners Court acknowledged the presentation of a voter petition that will allow residents to vote on the potential creation of a Chapter 281 hospital district during an Aug. 25 meeting.
The gist
The voter petition held 142 signatures verified by the county election office and tax assessor, passing the 100 signature threshold required to automatically call for an election, said Hays County Judge Ruben Becerra.
“Today’s action puts this decision exactly where it belongs, with the people of Hays County,” Becerra said in a statement. “This has always been about giving our residents the opportunity to decide what kind of healthcare system they want for their community.”
If approved by voters, the district would be responsible for providing medical aid and hospital care for all residents determined to be indigent or needy. The measure will not appear on the November 2026 general election ballot, but instead be present on the ballot of a future election.
“Hays County already spends millions of taxpayer dollars every year, meeting indigent healthcare obligations,” Becerra said. “The question before us is whether we can use those dollars more effectively, expand access to care, bring additional healthcare resources into our county and build something that works better for the people we serve.”
Commissioners pushed back on the proposition and the lack of discussion with industry professionals and residents prior to the presentation of the petition.
“I don't feel good about this thing at all,” said Precinct 2 Commissioner Michelle Cohen. “As a court, we had not been truly informed on what is the best option for us. With all this missing information, we have to vote for it. I feel that the petitioners that signed this were misinformed, and we did this backwards.”
During the meeting, Precinct 3 Commissioner Morgan Hammer talked about the potential liability the hospital district could expose the county to. She suggested the county was not currently equipped to take on the responsibility of furnishing medical and hospital care.
“I'm not saying a hospital district or some type of care is not needed and able to happen in Hays County,” Hammer said. “What I'm saying is, this is not for all. This is for indigent and needy, and it needs to be really understood that this presents and opens us up to a huge liability within the county.”
The acknowledgment of the petition was accepted in a 4-1 vote. Precinct 4 Commissioner Walt Smith voted against the motion.
“I have serious concerns over the validity of this, and I want the court to have an option to come back and look at this under statute,” Smith said. “I know that today it says that we have to pass it. It's going to pass. I'm not going to support this.”
Looking forward
The commissioners tabled two related agenda items during the meeting. The first would have ordered a special election on the first Saturday in May 2027 for residents to vote on the creation of the hospital district. Commissioners indicated that they would call the election in May, but tabled the motion to set the date.
Once the commissioners order the election, a board will be established to initiate the necessary steps for setting a proposed tax rate for the district and coordinate a feasibility study.
The second tabled item would have declared the court’s intent to establish a target operating tax rate of either $0.01 or $0.02 per $100 valuation for the district. A hospital district has a maximum possible tax rate of $0.75 per $100 valuation, according to agenda documents.
The background
The commissioners were scheduled to meet on Aug. 17, to discuss placing the creation of a hospital district on the November ballot. The meeting could not take place because three members of the court were not in attendance, according to previous Community Impact reporting.
To conduct county business, the court must have at least three commissioners in attendance to establish a quorum. Without a quorum, the court could not evaluate the topic, according to the Hays County Rules of Procedure, Conduct and Decorum.
