Title: Hospital Districts

Summary: Prohibiting hospital districts from levying property tax without the consent of electors residing within the hospital district; requiring a county to obtain and publish an independent appraisal of certain public hospitals' assets and a certain independent economic analysis; providing a referendum requirement for a property tax levy contingent upon government-subsidized health care funding; prohibiting a hospital district from establishing certain health care facilities unless a majority of voting electors residing within the hospital district approve it by referendum, subject to certain requirements, etc.

Full Text:
An act relating to hospital districts; defining the term  hospital district ; prohibiting hospital districts from levying property tax without the consent of electors residing within the hospital district; requiring decennial reauthorization of the taxing authority of certain hospital districts; requiring tax revenues generated to fund indigent care for residents of the district to be distributed to hospitals within the district based on a certain funding formula adopted by the district; terminating the taxing authority of a hospital district by a specified date if a referendum is not approved by a majority vote of the electors; authorizing a governing board to maintain a hospital district without taxing authority or dissolve the hospital district if a referendum is not approved by a majority vote of the electors; providing for allocation of hospital district assets and liabilities if the hospital district is dissolved; authorizing the termination of the taxing authority of a hospital district to be delayed for a specified period under certain circumstances; providing requirements for the creation, expansion, or combination of certain hospital districts; requiring a county to obtain and publish an independent appraisal of certain public hospitals  assets and a certain independent economic analysis; providing requirements for such analysis; providing a referendum requirement for a property tax levy contingent upon government-subsidized health care funding; providing applicability; requiring tax revenues generated to fund indigent care for residents of the district to be distributed to hospitals within the district based on a certain funding formula adopted by the district; specifying that taxes generated in a hospital taxing district be paid to the district rather than a community redevelopment area; prohibiting a hospital district from establishing certain health care facilities unless a majority of voting electors residing within the hospital district approve it by referendum, subject to certain requirements; providing applicability; providing an effective date. Be It Enacted by the Legislature of the State of Florida: Section 1.  (1)   As used in this act, the term  hospital district  means a special district as defined in s. 189.012, Florida Statutes, the governing body of which is the governing body of a facility licensed under chapter 395, Florida Statutes. (2)   Notwithstanding any general law, special law, or local ordinance, a hospital district may not levy a property tax without the approval of a majority of electors residing within the district voting in a referendum as provided in this act. (3)(a)   On or before July 1, 2017, and every 10th year thereafter, each hospital district with taxing authority, whether organized as an independent or dependent special district or created by special act or local ordinance, shall arrange to place on the next general election ballot of the electors residing within the hospital district the following question:  Shall the taxing authority of the...(name of hospital district)... be reauthorized, for a 10-year period, to levy a tax of...(amount of tax not to exceed mills)...,the proceeds of which shall fund indigent care for residents of the hospital district?  and thereafter the words  Yes  and  No.  (b) If a majority of the electors voting approve the ballot question, all tax revenues generated to fund indigent care for residents of the district shall be distributed to hospitals within the district based on a funding formula adopted by the district. The funding formula must ensure that tax dollars are equitably distributed to all hospitals based solely on the number of indigent patients treated at each hospital, without regard to whether the hospital is owned or operated by the health care district or by a private entity. (c)   If a majority of the electors in a hospital district do not approve the reauthorization ballot question described in paragraph (a), effective January of the year following the general election, the taxing authority of the hospital district is terminated. The governing board may maintain the hospital district without taxing authority or dissolve the hospital district. If the hospital district is dissolved, the assets and liabilities of the hospital district shall be allocated in the manner authorized by s. 189.076(2), Florida Statutes. (4)(a)   Notwithstanding paragraph (3)(c), the termination of the taxing authority of the hospital district may be delayed for additional year if the county where the district is located places the following question on the ballot of the electors in the county before December of the subsequent year, and a majority of electors voting approve the ballot question:  Shall the taxing authority of the...(name of hospital district)... be reauthorized and expanded to include all property in...(name of county)..., for a 10-year period, for the district to levy a tax of...(amount of tax not to exceed mills)... on all taxable property within the county in order to fund indigent care?  and thereafter the words  Yes  and  No.  (b)   If a majority of the electors voting do not approve the reauthorization ballot question described in this subsection, effective January of the year following the election, the taxing authority of the hospital district is terminated. The governing board may maintain the hospital district without taxing authority or dissolve the hospital district. If the hospital district is dissolved, the assets and liabilities of the hospital district shall be allocated in the manner authorized by s. 189.076(2), Florida Statutes. (5)   A new, expanded, or combined hospital district may be formed for the purpose of funding indigent care for residents within the hospital district if the board of county commissioners in the county in which the new, expanded, or combined hospital district is located or will be located places the following question on the general election ballot of the electors in the new, expanded, or combined hospital district, and a majority of electors voting approve the ballot question:  Shall the...(name of new, expanded, or combined hospital district)... be authorized or reauthorized, for a 10-year period, to levy a tax of...(amount of tax not to exceed mills)... on all taxable property within...(name of new, expanded, or combined hospital district)... in order to fund indigent care?  and thereafter the words  Yes  and  No.  Section 2.  (1)   For a public hospital described in subsection (2),the county where the public hospital is located shall obtain and publish an independent appraisal of the hospital s assets and an independent economic analysis of the projected public benefit derived from maintaining the hospital as a public hospital or leasing or selling the hospital to a for-profit entity pursuant to s. 155.40, Florida Statutes. The economic analysis must consider the property and sales tax revenue available after the lease or sale and conversion of the hospital and the projected earnings of a potential endowment created from the proceeds of the lease or sale. The economic analysis must provide that, notwithstanding s. 155.40(16)(b), Florida Statutes, percent of the net proceeds of the lease or sale shall be used to fund indigent care and that, notwithstanding s. 155.40(17), Florida Statutes, any ad valorem revenues shall be annually added to the endowment fund and percent of such revenues used for indigent care. (2) This section applies to a public hospital that: (a)   Does not make an operating profit for out of consecutive years, that is not within a hospital district, and that has not been subject to a hospital district referendum as provided in this act. (b)   Does not make an operating profit for out of consecutive years, that is not within a hospital district, and that has been subject to a hospital district referendum as provided in this act but in which a majority of electors voting did not approve the referendum. (c)   Does not make an operating profit for out of consecutive years, that is within a hospital district, and that has been subject to a hospital district referendum as provided in this act in which a majority of electors voting approved the referendum. For purposes of this paragraph, the calculation of the hospital s operating profit shall include the property tax authorized by the electors as revenue. Section 3.  (1)(a)   An existing or planned hospital district seeking authorization or reauthorization to levy a property tax after health care coverage is provided by federal, state, or local government via Medicaid or other government-subsidized funding for residents who qualify for a subsidy on the health insurance exchange shall arrange to place on the next general election ballot of the electors residing within the hospital district the following question:  Shall the taxing authority of the...(name of hospital district)... be authorized so the district may levy a tax of...(amount of tax not to exceed mills)... in order to fund indigent care for residents of the taxing district whose care is not otherwise funded by Medicaid or other governmental programs?  and thereafter the words  Yes  and  No.  (b)   If a majority of the electors voting approve the ballot question, the provisions of this act regarding reauthorization shall apply to the hospital district and its taxing authority. (c) All tax revenues generated to fund indigent care for residents of the district shall be distributed to all hospitals within the district based on a funding formula adopted by the district. The funding formula must ensure that tax dollars are equitably distributed based on the number of indigent patients treated at each hospital, without regard to whether the hospital is owned or operated by the health care district or by a private entity. (2)   Taxes generated by an independent special hospital taxing district within a community redevelopment area shall be paid to the hospital taxing district and not the community redevelopment area. Section 4.  (1) A hospital district may not establish a health care facility to be licensed under chapter or chapter which is located outside the geographic boundaries of the district, unless the county where the district is located places the following question on the ballot of the electors in the county before December of the year prior to commencing construction, and a majority of electors residing within the hospital district voting approve the ballot question:  Shall the...(name of hospital district)... be authorized to establish a...(identify type of facility to be licensed under chapter or chapter 400)... outside of the geographic boundaries of the hospital district in...(identify county and municipality in which facility is to be located)....?  and thereafter the words  Yes  and  No.  (2) This section does not apply to or affect any health care facility licensed under chapter or chapter before the effective date of this act. Section 5. This act shall take effect upon becoming a law.