Opinion
November 9, 1951.
Appeal from the Circuit Court for Dade County, George E. Holt, J.
Robert L. Achor, Miami, for appellant.
Hudson Cason, Miami, for Dade County.
Glenn C. Mincer, State Atty., Miami, for appellee-intervenors.
Pursuant to an approving vote of the freeholders, Dade County issued $6,000,000 in bonds for the purpose of extending and improving Jackson Memorial Hospital. Appellant, a citizen taxpayer brought this as a class suit to enjoin the County from using the proceeds of said bonds for erecting and equipping a unit of Jackson Memorial Hospital to be used in part for a medical school offering instruction to students leading to a degree in medicine. The County answered the bill of complaint, admitting the material allegations thereof but countered with the defense that provision for medical instruction together with research facilities and a qualified staff would modernize and extend the capacity of Jackson Memorial Hospital to serve its clientele in a way that would otherwise be unattainable.
When the bill of complaint and answer were filed defendant moved for summary judgment. The cause was set for final hearing and the State Attorney was directed to intervene and answer on behalf of all property owners and taxpayers. Due notice of the intervention was given but no one appeared or offered any aid to the injunction. Evidence was taken on the issues made, the prayer for injunction was denied and the bill of complaint was dismissed. The plaintiff appealed.
The point for determination is whether or not Dade County is authorized to use any portion of the proceeds of said bond issue to construct and equip a medical science building as an integral part of Jackson Memorial Hospital when said building is to be used in part as a medical college but with the view of improving and extending the hospital facilities.
The proposal before the freeholders when they voted on the bond issue was as follows: "Shall Dade County, Florida, issue bonds of the County in the amount of $6,000,000, bearing interest at 4% per annum, for the purpose of extending and improving the `Jackson Memorial Hospital', including the construction of additional buildings and the enlargement of existing buildings and the acquisition of any land and equipment necessary therefor?"
A fair interpretation of this proposal shows that those who voted in the bond election knew that they were voting for funds to extend and improve Jackson Memorial Hospital, to enlarge existing buildings, to construct and equip additional buildings and to acquire land for that purpose. It is true that the bond proposal does not in terms specify what the buildings enlarged or constructed shall be used for except "extending and improving" Jackson Memorial Hospital. "Extending and improving" are terms of broad import and the range given them will conclude the question raised.
It is shown that the County Commissioners and the people of Dade County had long cherished the hope of establishing a medical school and ultimately a medical center around Jackson Memorial Hospital. The thing that had much to do with precipitating the matter to a focus at this time was the passage of Chapter 26763, Acts of 1951, F.S.A. §§ 242.62, 242.63, making a liberal appropriation for and authorizing the Board of Control to extend aid to the first approved and accredited medical school established in Florida. The authority of the County to establish a medical school is not questioned so we are in no way concerned with that. The sole contention is that no part of the $6,000,000 bond issue may be used for constructing any building for Jackson Memorial Hospital in aid of a medical school.
What is contemplated by the phrase "enlarging and expanding" Jackson Memorial Hospital? Thinking in terms of the small town where the hospital is limited primarily to an emergency center to give first aid and minister to the sick who apply for treatment, one could not think of a bond issue with the limitation placed on the one in question, as contemplating an expenditure for a medical school. Miami is in a very different category and commands a different pattern of thinking. It is a rapidly growing metropolitan community of more than a half million people, it is progressive and reaching out for those things which improve its hospitals, schools and other public institutions. In many communities the proportion of Miami, the Hospital is tied in with a Medical School. In fact, the hospital is an integral part of the Medical School and the latter can hardly exist without the former.
The Mayo Clinic, the Ochsner Clinic, the Johns Hopkins Hospital and other outstanding Medical Centers of the country started from scratch and matured under just such circumstances as are proposed for improving Jackson Memorial Hospital. Even the best County and City Hospitals now have their blood banks, X-ray equipment, staffs of doctors and technicians with facilities for microscopic examination of the blood and urine including other fluids and organs of the body. A large part of their energy is given to research and training doctors and nurses to make them more efficient. Since the County Commissioners were voted $6,000,000 for "extending and improving" the County Hospital, no other limitations on the expenditure, can it in reason be said that a portion of this money may not be used for the construction of a medical science building as the nucleus for a medical school in aid of the hospital? One's imagination that cannot affirmatively answer such logic must be atrophying. The people of Dade County were evidently content to give the County Commissioners free rein since no one entered a protest when given a chance to do so.
The evidence shows, and the chancellor found, that the operation of a medical college in conjunction with the hospital is beneficial to the hospital and the community. The research facilities and technical staff of the medical school lend aid to and enable the hospital to perform a more efficient service. It is shown that the Medical Science Building is to be constructed on the Hospital site, that it is to be physically connected with the hospital and that if used in part as a medical college it will immeasurably enlarge the facilities of the hospital. The medical testimony shows without qualification that the operation of Jackson Memorial Hospital in connection with the medical school would greatly extend and improve its services.
Appellant contends that money voted for a hospital cannot be used for a medical college, since both are separate and distinct institutions and those who approved the bonds did not contemplate a medical school. The answer to this contention is, as heretofore pointed out, that the hospital and the medical school when both exist, each supplement the work of the other and both become a much greater asset to the community. They are reciprocally complimentary and interdependent and when viewed in the larger aspect each is essential to the other if performing at maximum efficiency. When the freeholders of Dade County voted the bond issue they gave the County Commissioners carte blanche to extend and improve Jackson Memorial Hospital, including the construction of additional buildings. The County Commissioners have a liberal discretion in defining the pattern for these improvements. Their proposal is in line with the best approved methods in the country for doing so. We think the words "extending and improving" should be construed in the light of Dade County potential and not in the light of the small town or country potential whose hospital program is not near so ambitious.
From what has been said we think it necessarily follows that "extending and improving" a hospital in a place like Miami contemplates any approved program that contributes to the health of the community. We have enumerated some but have not attempted to catalog all of the agencies that do this. The hospital and the medical school are at the top of the list and both are indispensable for a health, sanitary and research program, the proportions of that contemplated in this case. Miami is unusually well located for research and exploration in communicable infections and other diseases peculiar to the tropics. The program that it has in view as revealed by the record points to this and much more. The hospital and the medical school are both essential to the accomplishment of such a program.
The judgment appealed from is therefore affirmed.
Affirmed.
CHAPMAN, HOBSON and ROBERTS, JJ., concur.
SEBRING and THOMAS, JJ., dissent.
MATHEWS, J., not participating.