Sec. 286.101.  EXPANSION OF DISTRICT TERRITORY.  (a)  Registered voters of a defined territory that is not included in a district may file a petition with the secretary of the board requesting the inclusion of the territory in the district.  The petition must be signed by at least 50 registered voters of the territory or a majority of those voters, whichever is less.
(b)  The board by order shall set a time and place to hold a hearing on the petition to include the territory in the district.  The board shall set a date for the hearing that is after the 30th day after the date the board issues the order.
(c)  If after the hearing the board finds that annexation of the territory into the district would be feasible and would benefit the district, the board may approve the annexation by a resolution entered in its minutes.  The board is not required to include all of the territory described in the petition if the board finds that a modification or change is necessary or desirable.
(d)  Annexation of territory is final when approved by a majority of the voters at an election held in the district and by a majority of the voters at a separate election held in the territory to be annexed.  If the district has outstanding debts or taxes, the voters in the election to approve the annexation must also determine if the annexed territory will assume its proportion of the debts or taxes if added to the district.
(e)  The election ballots shall be printed to provide for voting for or against the following, as applicable:
(1)  "Adding (description of territory to be added) to the __________ Hospital District."
(2)  "(Description of territory to be added) assuming its proportionate share of the outstanding debts and taxes of the __________ Hospital District, if it is added to the district."
(f)  The election shall be ordered and notice of the election shall be given in the same manner as provided by Sections 286.024 and 286.025 for ordering and giving notice of an election authorizing creation of the district.  Section 41.001(a), Election Code, does not apply to an election held under this section.
(g)  If a district imposes a sales and use tax under Subchapter I, the territory added to the district must be located in a county or counties each with a population of 75,000 or less, and the addition of the territory may not result in a combined tax rate by the hospital district and other political subdivisions of this state of more than two percent at any location in the district.
Added by Acts 1991, 72nd Leg., ch. 14, Sec. 121, eff. Sept. 1, 1991.  Amended by Acts 2001, 77th Leg., ch. 1290, Sec. 8, eff. Sept. 1, 2001.
Amended by: 
Acts 2023, 88th Leg., R.S., Ch. 848 (H.B. 3191), Sec. 12, eff. September 1, 2023.