ENROLLED HB 0203, Engrossed 1 2003 Legislature
1	A bill to be entitled
2	An act relating to the Lower Florida Keys Hospital
3	District, Monroe County; providing legislative intent;
4	codifying, amending, repealing, and reenacting all special
5	acts relating to the district; repealing chapters 67-1724,
6	69-1322, 72-617, 73-555, 73-558, 75-450, 77-600, 77-601,
7	77-602, 77-603, 78-565, 79-511, 82-414, 87-459, 89-551,
8	and 94-415, Laws of Florida; providing an effective date.
9
10	WHEREAS, the transactions authorized by this act will
11	enhance the efficiency of the delivery of hospital services to
12	residents of the district and protect the availability of needed
13	hospital services to residents of the district, including
14	indigent residents, NOW, THEREFORE,
15
16	Be It Enacted by the Legislature of the State of Florida:
17
18	Section 1. Pursuant to section 189.429, Florida Statutes,
19	this act constitutes the codification of all special acts
20	relating to the Lower Florida Keys Hospital District. It is the
21	intent of the Legislature in enacting this law to provide a
22	single, comprehensive special act charter for the district
23	including all current legislative authority granted to the
24	district by its several legislative enactments and any
25	additional authority granted by this act. It is further the
26	intent of this act to preserve all District authority in
27	addition to any authority contained in the Florida Statutes, as
28	amended from time to time.
29	Section 2. Chapters 67-1724, 69-1322, 72-617, 73-555, 73-
30	558, 75-450, 77-600, 77-601, 77-602, 77-603, 78-565, 79-511, 82-
31	414, 87-459, 89-551, and 94-415, Laws of Florida, are amended,
32	codified, reenacted, and repealed as herein provided.
33	Section 3. The charter for the Lower Florida Keys Hospital
34	District is re-created and reenacted to read:
35	Section 1. A special tax district is created and
36	incorporated in Monroe County to be known as the "Lower Florida
37	Keys Hospital District,” hereafter referred to as the
38	"district." Said district shall include that portion of Monroe
39	County embracing Key West and the Florida Keys that is between
40	range 24 east and range 31 east.
41	Section 2. The governing body of the Lower Florida Keys
42	Hospital District, hereinafter referred to as the "board," shall
43	consist of nine commissioners, of whom no more than one
44	commissioner may be a member of the medical profession. On or
45	before September 12, 1977, the Governor shall appoint all nine
46	commissioners as follows: two for a term of four years each,
47	two for a term of three years each, two for a term of two years
48	each, and three for a term of one year each. Thereafter, all
49	commissioners shall be appointed by the Governor for terms of
50	four years each and vacancies shall be filled by appointment by
51	the Governor for the unexpired term. All commissioners shall
52	serve without compensation and shall be qualified electors
53	residing in the Lower Florida Keys Hospital District for more
54	than one year prior to the appointment; at least three
55	commissioners shall reside in said hospital district other than
56	at Key West, at least three commissioners shall reside in Key
57	West, and the remaining commissioners shall reside in any area
58	of the district. The commissioners shall be reimbursed for per
59	diem and traveling expenses in accordance with the provisions of
60	s. 112.061, Florida Statutes. Each commissioner shall give bond
61	to the Governor for the faithful performance of his or her
62	duties in the sum of $5,000 with a security company qualified to
63	do business in this state as surety, which bond shall be
64	approved and kept by the Clerk of the Circuit Court of Monroe
65	County. The board shall elect annually one of its members chair
66	and shall elect or appoint a vice chair, a secretary, a
67	treasurer, and such other officers and assistants as the board
68	may determine, who need not be members of the board. The office
69	of secretary and treasurer may be held by one person. Should the
70	treasurer be other than a member of the board, he or she shall
71	give a like bond of $5,000 for the faithful performance of his
72	or her duties. Premiums on all bonds required by this section
73	shall be paid as part of the expenses of the district. The
74	Governor of the State of Florida shall have the power to remove
75	any member of said board for cause.
76	Section 3.
77	(1) The board shall have all the powers of a body
78	corporate, including, but not limited to, the power to sue and
79	be sued under the name of the Lower Florida Keys Hospital
80	District; to enter into contracts; to adopt and use a common
81	seal and to alter same at pleasure; to create, establish, or
82	otherwise acquire corporations, under the control of the
83	district, which corporations shall have all the powers
84	enumerated in chapter 607, Florida Statutes, unless prohibited
85	by the Florida Constitution or this act; to enter into capital
86	or operating leases; to acquire, purchase, hold, lease,
87	mortgage, and convey such real and personal property as the
88	board may deem proper or expedient to carry out the purposes of
89	this act; to appoint and employ an administrator, and such other
90	agents and employees as the board may deem advisable to operate
91	and manage the district’s facilities; to fix the compensation of
92	all employees and to remove any appointees or employees; to
93	ensure the improvements, fixtures, and equipment against loss by
94	fire, windstorm, or other coverage in such amounts as may be
95	determined reasonable and proper; to borrow money and to issue
96	evidence of indebtedness of the district therefor to carry out
97	the provisions of this act in the manner as set forth in this
98	act.
99	(2) Without limitation by any other provision of this act
100	and notwithstanding any other provision of this act, the
101	district is authorized and empowered to: form a Florida not-for-
102	profit corporation of which the district is the sole member but
103	which may include on its board a minority of the members thereof
104	designated by a private person; lease the district’s facilities
105	to such not-for-profit corporation; provide in such leases
106	options to sell and/or purchase such facilities for fair market
107	value as determined in a manner acceptable to the district;
108	transfer the operations of the district’s facilities to such
109	not-for-profit corporation; sell, assign, or transfer contracts
110	or leases of the district to such not-for-profit corporation;
111	and enter into and perform agreements for the provision of
112	hospital and other health care services to indigent and other
113	residents of the district, with all of the foregoing being on
114	such terms and conditions as the district in its sole discretion
115	may determine is in the public interest, but subject to
116	subsection (3). Nevertheless, the district shall supervise such
117	not-for-profit corporation by election of a majority of such
118	not-for-profit corporation’s board and by review and approval of
119	such not-for-profit corporation’s budgets, rates, and charges;
120	its policies regarding medical staff appointment, reappointment,
121	and adverse action; and its policies regarding admission and
122	discharge of patients and purchases of goods and services. Each
123	member of the not-for-profit corporation’s board must file full
124	and public disclosure of his or her financial interest in the
125	same manner and to the same extent as is required of
126	constitutional officers by Section 8 of Article II of the State
127	Constitution. For the purposes of the foregoing, the word
128	“person” has the meaning ascribed thereto in section 1.01,
129	Florida Statutes, 1989. This section does not abrogate or limit
130	the district’s responsibilities under this act relating to the
131	provision of indigent care to residents of the district.
132	(3) Any transaction entered into pursuant to subsection
133	(2) must:
134	(a) Provide that the articles of incorporation of each
135	such not-for-profit corporation be subject to the approval of
136	the board of commissioners of the district;
137	(b) Provide for the orderly transition of the district’s
138	hospital facilities to not-for-profit corporate status; and
139	(c) Provide for the return of the district’s facilities
140	upon termination of the lease thereof or dissolution of such
141	not-for-profit corporation except that the district may not be
142	prohibited from granting and performing options to purchase any
143	or all of the district’s facilities for fair market value
144	determined in a manner acceptable to the district.
145	(d) Any transfer, sale, or lease of a hospital facility by
146	the district shall be preconditioned upon the transferee, buyer,
147	or lessee providing, on an annual basis, an amount of indigent
148	care and Medicaid care to residents of the district which is not
149	less than the amount of such care previously provided by the
150	hospital as reported to the Health Care Cost Containment Board
151	in the last year prior to the transfer, sale, or lease of the
152	hospital facility, provided there is the demand for such level
153	of indigent care and Medicaid care in the district. Any
154	contract, agreement, or lease of a hospital entered into by the
155	district shall also comply with the provisions of section
156	155.40, Florida Statutes.
157	Section 4. Regular meetings shall be held not less than
158	quarterly, but may be held as frequently as deemed necessary,
159	which additional regular meetings shall be called in the same
160	manner as special meetings. A special meeting may be called by
161	the chair or at the request of three (3) members of the board of
162	commissioners, and said meeting shall be held no later than
163	three (3) days from the date called or requested. A quorum for
164	special and regular meetings shall consist of at least one half
165	(1/2) of the membership of said board then appointed, qualified,
166	and so serving. Death and accepted resignation of members shall
167	not be considered in ascertaining the number necessary for a
168	quorum. In the absence of the chair or his or her inability to
169	act at any regular or special meeting, warrants for payment of
170	money may be signed by the vice chair or by any other member of
171	the board selected by the members present as chair pro tem.
172	Section 5. The board through its secretary, or secretary-
173	treasurer as the case may be, shall keep true and accurate
174	minutes and records of all business transacted by it, and shall
175	keep full, true, and complete books of account and minutes,
176	which minutes, records, and books of account at all reasonable
177	times shall be open and subject to inspection and copying by any
178	inhabitant of the district. Failure to comply with this section
179	shall constitute a misdemeanor and be punishable as such as
180	provided by law.
181	Section 6. The board is authorized to establish,
182	construct, lease, operate, and maintain a hospital or hospitals,
183	medical facilities, and other health care related facilities and
184	services as in its opinion shall be necessary for the use of the
185	people of the district. Said hospital or hospitals, medical
186	facilities, and other health care related facilities and
187	services shall be established, constructed, leased, operated,
188	and maintained by the board for the preservation of the public
189	health, for the public good, and for the use of the public of
190	the district, and maintenance of such hospital or hospitals,
191	medical facilities, or other health care related facilities and
192	services within the district is hereby found and declared to be
193	a public purpose and necessary for the preservation of the
194	public health and welfare of the district and inhabitants
195	thereof. The board may enter into contractual relationships
196	with other health service organizations, either public or
197	private, for the provision of such administrative and medical
198	services as it does not on its own provide in connection with
199	said hospital or hospitals, medical facilities, or other health
200	care related facilities and services. The location of any
201	hospital, medical facility, or other health care related
202	facility established under this act shall be determined by the
203	board. The board is authorized to accept any and all gifts,
204	loans, or advancements for the purchase of property, real or
205	personal, for the construction, equipping, and maintenance of
206	any hospital, medical facility, or other health care related
207	facility established hereunder.
208	Section 7. (1) Before any single purchase of merchandise,
209	supplies, materials, machinery, or equipment is made, the price
210	of which exceeds five thousand dollars ($5,000.00), or any
211	contracts for any construction work is let, the price of which
212	exceeds five thousand dollars ($5,000.00), there shall be an
213	advertisement by the board at least one (1) time in a newspaper
214	of general circulation published in Key West, inviting sealed
215	bids or proposals to furnish such merchandise, supplies,
216	materials, machinery, or equipment or to perform such
217	construction. Sealed bids or proposals received shall be
218	properly evaluated by the board and the lowest responsible bid
219	or proposal shall be accepted unless the board shall reject all
220	sealed bids or proposals. If all sealed bids be rejected, new
221	sealed bids or proposals shall be solicited by advertisement.
222	The board may, by resolution or motion, dispense with
223	advertising for sealed bids or proposals in the event of an
224	emergency requiring that merchandise, supplies, materials,
225	machinery, or equipment or construction work is necessary and
226	required. If after two (2) successive unsuccessful attempts to
227	obtain sealed bids or proposals, or in the event of an
228	emergency, the board may purchase merchandise, supplies, or
229	materials or contract for construction or repairs by negotiation
230	with suppliers or contractors. When an emergency is declared to
231	exist by action of the majority of the board members meeting in
232	a regular or special meeting, the basis of such determination
233	and the vote of each member of the board shall be set forth in
234	writing in the minutes of the meeting.
235	(2) The district’s board of commissioners is specifically
236	delegated the authority to grant, deny, revoke, or suspend staff
237	privileges at its hospitals, medical facilities, or other health
238	care related facilities according to the applicable Florida
239	Statutes and the applicable rules and regulations. A decision
240	of the board of commissioners of the Lower Florida Keys Hospital
241	District to refuse, revoke, or suspend membership on the staff,
242	or to refuse, revoke, or suspend any privileges attendant to
243	such membership, is hereby declared to be a quasi-judicial
244	function of the board and judicial review of such decision shall
245	be by petition for certiorari to the District Court of Appeal of
246	Florida prescribed by the Florida Appellate Rules having
247	jurisdiction of the appeals from Monroe County, in the time and
248	manner prescribed by the Florida Appellate Rules for such
249	petitions for writ of certiorari, unless the provisions of such
250	appellate rules shall confer exclusive jurisdiction of such
251	petition upon the Supreme Court of Florida.
252	Section 8. The board in its discretion is authorized to
253	establish and maintain in connection with any hospital, medical
254	facility, or other health care related facility established
255	under this act a training school for nurses and other health
256	care related professionals, which school must conform to all the
257	requirements of the general state law governing schools of
258	professional nursing and the practice of nursing and such other
259	professional sciences. The board is authorized to promulgate
260	and adopt all rules and regulations necessary or required by
261	general law for the operation of such training schools and to
262	make all necessary expenditures in connection therewith. The
263	board is also authorized in its discretion to establish,
264	operate, and maintain a nursing home, an ambulance service, and
265	such other services related to the operation and maintenance of
266	a hospital, medical facility, or other health care related
267	facility in a manner provided by general law.
268	Section 9. The board of commissioners is authorized and
269	empowered, at any time in its discretion, to establish,
270	maintain, or participate in such programs and projects of and
271	for medical research, education, and development affecting human
272	physical or mental health and well-being as it may deem
273	desirable; and in connection with such programs and projects the
274	board of commissioners is authorized and empowered to cooperate
275	with public and private educational or research institutions,
276	corporations, foundations, or organizations of any and all types
277	as well as agencies, departments, divisions, branches, or bodies
278	of government, or created by government, whether federal, state,
279	county, municipal, or otherwise. In furtherance of such
280	programs and projects, the board of commissioners is further
281	authorized and empowered to expend moneys and utilize assets and
282	property, real or personal, of the district and to receive
283	donations, grants, or gifts of money or property, real or
284	personal, from any person or persons, firm, organization,
285	corporation, society, institution, foundation, or legal entity
286	of whatever nature whether private, governmental, or public.
287	Section 10. To carry out the provisions of this act, the
288	board is authorized to borrow money from time to time for
289	periods of time not exceeding one (1) year at any one time and
290	to issue any note of the district therefor upon such terms and
291	upon such rates of interest not exceeding the current prime rate
292	as the board may deem advisable and to secure the payment of
293	same by note or mortgage and note upon any property, real or
294	personal, owned by the district. The board shall have the
295	additional right to pledge as security for money borrowed any
296	moneys accruing to it or to accrue to it from any source,
297	including revenues derived from the operation of any hospital
298	established under this act; provided, however, that the
299	aggregate amount of principal of moneys so borrowed upon the
300	note or notes of the district shall not at any one time exceed
301	the sum of $3 million or 20 percent of the appraised value of
302	the capital assets of the district, whichever sum is greater.
303	The board shall have the authority to receive and accept grants,
304	gifts, and donations from any person, firm, trust, foundation,
305	corporation (whether profit or nonprofit), partnership, estate,
306	or governmental agency. The board shall have exclusive control
307	of all expenditures of and from the moneys, loan proceeds,
308	contributions, and revenues of the district, except that persons
309	who desire to make contributions to the district shall have the
310	right to attach conditions to their gifts. The board, upon
311	accepting any such contribution, shall be controlled by the
312	terms of the gift, bequest, or devise, and may, in such cases,
313	establish funds therefor separate and apart from items of
314	general revenue. Any such contribution made to the district
315	without conditions attached thereto may be expended by the board
316	for such purposes as shall be deemed necessary and proper by the
317	board of commissioners.
318	Section 11. The board is authorized to issue bonds of the
319	district bearing interest for the purposes set forth in this
320	act, for the purpose of raising funds to establish, construct,
321	refinance, or pay off existing obligations previously incurred
322	on capital expenditures, and maintain any hospital as in the
323	board’s opinion is necessary in the district, and for the
324	acquisition and development of real property, including
325	appurtenances, fixtures, and equipment, and for major repairs or
326	renovations to real property which significantly extend its
327	useful life or change its function, and for any necessary
328	operating capital outlay to furnish and operate a new or
329	improved facility. The board shall have the power to refund any
330	and all previous issues of bonds for any and all lawful hospital
331	purposes. All the proceeds derived from the sale of bonds or
332	refunding bonds, exclusive of expenses, shall be deposited in a
333	depository selected by the board. Nothing herein shall limit
334	any rights the district has or may have under general law.
335	Section 12. Prior to the issuance of bonds, the board
336	shall, by resolution, determine the amount which in its opinion
337	will be necessary to be raised annually by taxation for an
338	interest and sinking fund with which to pay the interest and
339	principal of the bonds; and the board is authorized and required
340	to provide annually for the levy and collection of a sufficient
341	tax upon all the taxable property in the district, not exempt by
342	law, to pay such interest, and with which to provide and
343	maintain a sinking fund for the payment of the principal of
344	bonds.
345	Section 13. All bonds issued by the board, except
346	refunding bonds, revenue bonds, or certificates and anticipation
347	time warrants, shall be issued only after the same shall have
348	been approved by the majority vote of the electors voting in an
349	election called and held by the board subject to reasonable
350	rules and regulations prepared by the board. In the event it is
351	determined to hold an election to decide whether the electors
352	are in favor of the issuance of bonds, the board, by resolution,
353	shall order an election to be held in the district and shall
354	give 30 days' notice of election by publication in a newspaper
355	of general circulation within the district once a week for 4
356	consecutive weeks during such period.
357	Section 14. Only registered electors of the district shall
358	be permitted to vote at a bond election. For the purpose of
359	determining the total number of qualified electors residing in
360	the district, the Supervisor of Registration of Monroe County
361	shall prepare a list of the names of all qualified electors
362	appearing upon the registration books of Monroe County and
363	qualified to vote in the election. Such lists shall be
364	furnished to the inspectors or clerks of the election at each
365	voting place and such lists shall be prima facie evidence of the
366	total number of qualified electors eligible to participate in
367	the election. No person shall be permitted to vote in such
368	election whose name does not appear on such list.
369	Section 15. As far as practicable and where not
370	inconsistent with the provisions of this act, the procedure
371	outlined in chapter 100, Florida Statutes, providing the
372	procedure for bond elections, shall govern.
373	Section 16. All bonds issued under this act shall be in
374	the denomination of $500 or some multiple thereof, shall bear
375	interest payable annually or semiannually, and both principal
376	and interest shall be payable at such prices as the board may
377	determine. The form of such bond shall be fixed by resolution
378	of the board and said bonds shall be signed by the chair and
379	countersigned by the secretary under the seal of the district.
380	The coupons, if any, shall be executed by the facsimile
381	signatures of said officers. The delivery at any subsequent
382	date of any bond and coupons so executed shall be valid,
383	although before the date of delivery the persons signing bonds
384	or coupons shall cease to hold office.
385	Section 17. Bonds issued hereunder may be either
386	registered or coupon bonds. Coupon bonds may be registered as
387	to principal in the holder’s name on the books of the district,
388	the registration being noted upon the bonds, after which no
389	transfer shall be valid unless made on the district’s books by
390	the registered holder and similarly noted on the bonds. Bonds
391	registered as to principal may be discharged from registration
392	by being transferred to bearer, after which they shall be
393	transferable by delivery, but may be again registered as to
394	principal as before. The registration of the bonds as to
395	principal shall not restrain the negotiability of the coupons by
396	delivery merely.
397	Section 18. Before any bonds of the district are issued
398	hereunder, the board shall investigate and determine the
399	legality of the proceedings. The resolution authorizing the
400	bonds may direct that they shall contain the following recital:
401	"It is certified that this bond is authorized by and is issued
402	in conformity with the requirements of the constitution and
403	statutes of the State of Florida."
404	Such recital shall be an authorized declaration by the board and
405	shall import that there is constitutional and statutory
406	authority for incurring the debts and issuing the bonds; that
407	all the proceedings therefor are regular; that all acts,
408	conditions, and things required to exist, happen, and be
409	performed precedent to and in the issuance of the bond have
410	existed, happened, and been performed in due time, form, and
411	manner, as required by law; and that the amount of the bond,
412	together with all other indebtedness, does not exceed any limit
413	prescribed by the constitution and statutes of this state. If
414	any bond be issued containing the recital, it shall be
415	conclusively presumed that the recital, construed according to
416	the import hereby declared, is true, and the district shall not
417	be permitted to question the validity or legality of the
418	obligation in any court in any action or proceeding.
419	Section 19. In issuing bonds under the provision of this
420	act, it shall be lawful for the board to include more than one
421	(1) improvement or hospital purpose in any bond issue.
422	Section 20. All bonds issued hereunder shall be advertised
423	for sale on sealed bids, which advertisement shall be published
424	once a week for three (3) weeks, the first publication to be
425	made at least twenty-one (21) days preceding the date fixed for
426	the reception of bids, in a newspaper published in the hospital
427	district. Notice of sale shall also be published once a week
428	for three (3) weeks preceding the date fixed for the reception
429	of bids, either in a financial paper published in the city of
430	New York, the city of Chicago, or the city of Baltimore, or in a
431	newspaper of general circulation published in a city in Florida
432	having a population of not less than twenty thousand (20,000)
433	inhabitants according to the latest official decennial census.
434	The board may reject any and all bids. If the bonds are not
435	sold pursuant to such advertisements, they may be sold by the
436	board at private sale within sixty (60) days after the date
437	advertised for the reception of sealed bids, but no private sale
438	shall be made at a price less than the highest bid which shall
439	have been received. If not sold, bonds shall be readvertised in
440	the manner herein prescribed. No bonds issued hereunder shall
441	be sold for less than ninety-five percent (95%) of the par value
442	and accrued interest.
443	Section 21. No resolution or proceeding in respect to the
444	issuance of bonds shall be necessary except as required by this
445	act. Any publication prescribed hereby may be made in any
446	newspaper conforming to the terms of this act, without regard to
447	the designation thereof as the official organ of the district.
448	Bonds issued hereunder shall have all the qualities of
449	negotiable paper under the law merchant, shall not be invalid
450	for any irregularity or defect in the proceedings for the issue
451	and sale thereof, and shall be incontestable in the hands of a
452	bona fide purchaser or holder for value.
453	Section 22. The board shall have the power to provide by
454	resolution for the issuance of refunding bonds to refund
455	principal and interest of an existing bond indebtedness, for the
456	payment of which the tax moneys derived from the district is
457	pledged, and such bonds may be issued at or prior to maturity of
458	the bonds to be refunded. Such resolution may be adopted at a
459	regular or special meeting, and at the same meeting at which it
460	is introduced, by a majority of the members of the board then in
461	office. It is determined and declared as a matter of
462	legislative intent that no election to authorize the issuance of
463	refunding bonds shall be necessary except in cases where an
464	election may be required by the state constitution. In all
465	cases where it is not necessary under the constitution to hold
466	an election on the issuance of such refunding bonds, such
467	resolution shall take effect immediately upon the adoption
468	thereof. No other proceedings shall be required for the
469	issuance of bonds by the district other than the provisions of
470	section 20 of this act which shall be applicable to this
471	section.
472	Section 23. The resolution of the board authorizing the
473	issuance of the refunding bonds may provide that the refunding
474	bonds may be issued in one (1) or more series, bear the date,
475	mature at the time not exceeding thirty (30) years from their
476	respective dates, bear interest at the rate not exceeding the
477	maximum rate of interest borne by the notes, bonds, or other
478	obligations refinanced thereby, be in the denomination, be in
479	the form either coupon or registered, carry the registration and
480	conversion privileges, be executed in the manner, be payable in
481	the medium of payment at the place, be subject to the terms of
482	redemption with or without a premium, be declared or become due
483	before the maturity date thereof, provide for the replacement of
484	mutilated, destroyed, stolen, or lost bonds, be authenticated in
485	the manner and upon compliance with the conditions, and contain
486	such other terms and covenants as may be desired.
487	Notwithstanding the form or tenor of a bond and in the absence
488	of an express recital on the face that the bond is
489	nonnegotiable, all refunding bonds shall be considered
490	negotiable instruments for all purposes.
491	Section 24. Refunding bonds bearing the signature of board
492	officers of the district in office on the date of the signing
493	thereof shall be valid and binding obligations of the district
494	for all purposes, notwithstanding that before the delivery
495	thereof any or all of the persons whose signatures appear
496	thereon shall have ceased to be officers of the district. Any
497	resolution authorizing refunding bonds may provide that any
498	refunding bonds issued pursuant to this act may contain such a
499	recital, and any refunding bond issued under authority of any
500	resolution shall be conclusively deemed to be valid and to have
501	been issued in conformity with the provisions of this act. The
502	authority of a district to issue obligations under this act may
503	be determined and obligations to be issued under this act may be
504	validated as provided by law.
505	Section 25. Refunding bonds may be sold or exchanged as
506	follows:
507	(1) In installments at different times, or an entire issue
508	or series may be sold or exchanged at one (1) time. Any issue
509	or series of refunding bonds may be exchanged in part or sold in
510	parts in installments at different times or at one (1) time.
511	The refunding bonds may be sold or exchanged at any time on,
512	before, or after the maturity of any of the outstanding notes,
513	bonds, certificates, or other obligations to be refinanced
514	thereby.
515	(2) If the board determines to exchange any refunding
516	bonds, the refunding bonds may be exchanged privately for and in
517	payment and discharge of any of the outstanding notes, bonds, or
518	other obligations of the district. The refunding bonds may be
519	exchanged for a like or greater principal amount of notes,
520	bonds, or other obligations of the district, except the
521	principal amount of the outstanding notes, bonds, or other
522	obligations to the extent necessary or advisable, in the
523	discretion of the board, to fund interest in arrears or about to
524	become due. The holder of outstanding notes, bonds, or other
525	obligations need not pay accrued interest on the refunding bonds
526	to be delivered in exchange therefor if and to the extent that
527	interest is due or accrued and unpaid on the outstanding notes,
528	bonds, or other obligations to be surrendered.
529	(3) If the board determines to sell any refunding bonds,
530	the refunding bonds shall be sold at not less than ninety-five
531	percent (95%) of par at public or private sale, in such manner
532	and upon the terms the board shall deem best for the interest of
533	the district.
534	Section 26. All bonds or refunding bonds issued pursuant
535	to this act shall be legal investments for state, county,
536	municipal, and all other public funds and for banks, savings
537	banks, insurance companies, executors, administrators, trustees,
538	and all other fiduciaries, and shall also be and constitute
539	securities eligible as collateral security for all state,
540	county, municipal, or other public funds.
541	Section 27. The funds of the district shall be paid out
542	only upon warrants signed by the chair or vice chair or such
543	other member of the board designated by the board. Warrants
544	shall have affixed thereto the corporate seal of the district
545	which may be an impression thereon or facsimile thereof. No
546	warrant shall be drawn or issued against funds of the district
547	except for a purpose authorized by this act after the account or
548	expenditure for which the same is to be given in payment has
549	been ordered and approved by the board at a meeting in which a
550	quorum is present.
551	Section 28. A special account shall be set up which shall
552	require only the signature of the administrator of the hospital
553	or hospitals or such other employees as the board shall
554	determine for such purposes. The administrator’s account shall
555	be such sum or sums as the board deems necessary from time to
556	time and shall be used only as a payroll account or for such
557	other purposes as the board shall determine.
558	Section 29. The board is authorized and directed annually
559	to levy upon taxable real property only within the district, not
560	exempt by law, a sufficient tax necessary for the purposes and
561	needs of the district incurred in the exercise of the powers and
562	purposes herein granted. The rate of taxation per annum shall
563	not exceed two (2) mills on the dollar of the county assessed
564	valuation of the property within the district for tax purposes.
565	The term “mill” as used in this section shall be deemed to mean
566	one-tenth (1/10) part of one cent (1c) or one thousandth
567	(1/1000) of a dollar ($1).
568	Section 30. The levy by the board of the taxes authorized
569	by any provision of this act shall be by resolution of the board
570	duly entered upon the minutes of the board. Certified copies of
571	such resolution executed in the name of the board by its chair,
572	under its corporate seal, shall be made and delivered to the
573	board of county commissioners of Monroe County and to the
574	comptroller of the state no later than July 1 of each year. It
575	shall be the mandatory duty of the county commissioners of
576	Monroe County to order and require the county tax assessor of
577	the county to assess, and the county tax collector of the county
578	to collect the amount of taxes so assessed or levied by the
579	board of the district upon the taxable property in the district,
580	not exempt by law, at the rate of taxation adopted by the board
581	of the district for the year and included in the warrant of the
582	tax assessor and attached to the assessment roll of taxes for
583	said county of each year. The tax collector shall collect such
584	tax so levied by the board in the same manner as other taxes are
585	collected and shall pay the same over to the board within the
586	time and in the manner prescribed by law for the payment by the
587	tax collector of county taxes to the county depository. All
588	such taxes shall be held by the board and paid out by them as
589	provided in this act. The board is authorized to pay necessary
590	expenses to the forenamed officers for the assessment and
591	collection of taxes on a reasonable fee basis. If any surplus
592	shall occur in the operation and maintenance fund, the board is
593	authorized to use the surplus or any portion thereof to retire
594	bonded indebtedness, but not to the extent that the financial
595	security of the operation and maintenance fund shall be
596	impaired.
597	Section 31. The board is authorized to pay from the funds
598	of the district all expenses of the organization of the board
599	and all expenses necessarily incurred with the formation of the
600	district and all other reasonable and necessary expenses
601	approved and certified by the board, including the fees and
602	expenses of an attorney in the transaction of the business of
603	the district, and in carrying out and accomplishing the purposes
604	of this act. This section, however, shall not be construed to
605	limit or destroy any of the powers vested in the board by any
606	other section or provision of this act.
607	Section 32. (1) Subject to such provisions and
608	restrictions as may be set forth in the resolution authorizing
609	or securing any bonds issued under the provisions of this act,
610	the board shall have the power to enter into contracts with the
611	government of the United States or any agency or instrumentality
612	thereof, or with the state or any county, municipality,
613	district, authority, or political subdivision, private
614	corporation, partnership, association, or individual providing
615	for or relating to the construction or acquisition of additions,
616	extensions, and improvements to the hospital or hospitals,
617	medical facilities, or other health care related facilities, and
618	any other matters relevant thereto or otherwise necessary to
619	effect the purpose of this act, and to receive and accept from
620	any federal agency, state agency, or other public body grants or
621	loans for or in aid of said purposes and to receive and accept
622	aid or contributions or loans from any other source of either
623	money, property, labor, or other things of value, to be held,
624	used, and applied only for the purpose for which such grants,
625	contributions, or loans may be made.
626	(2) The board is hereby authorized and empowered to lease
627	or sell any real or personal property owned by the district, or
628	to otherwise relinquish and dispose of the district’s title or
629	right to immediate possession of such property, according to the
630	following terms and conditions:
631	(a) Any real or personal property of a fair value of less
632	than $2,500 may be leased or sold, or the title or right to
633	immediate possession otherwise relinquished or disposed of
634	according to the manner and procedure and according to the terms
635	and conditions the board at the time might determine.
636	(b) Any real or personal property of a fair market value
637	of more than $2,500 may be leased, or the right to immediate
638	possession otherwise relinquished, according to the procedures,
639	terms, and conditions that the board approves, to a public or
640	private health service organization for the provision of medical
641	services that the board cannot on its own provide, as authorized
642	by section 6.
643	(c) Any real or personal property of a fair value of more
644	than $2,500 may be sold, or leased for a term of more than 1
645	year and 1 day, or the title or right to immediate possession
646	otherwise relinquished or disposed of for a term of more than 1
647	year and 1 day, after the board has determined by appropriate
648	resolution that such property is surplus to the needs and
649	requirements of the district, and after the board has submitted
650	the property to the general public for offers by publishing a
651	Notice of Intent to Dispose of Property in a newspaper of
652	general circulation published in Key West at least 30 days in
653	advance of such lease, sale, or other disposition. Any person
654	desiring such property shall submit his or her offer to lease or
655	buy to the board during such 30-day period, or during such
656	longer period as the board might establish, along with the terms
657	and conditions of such offer. The published notice shall be
658	sufficient if it shall reasonably identify the property in
659	question and inform any persons interested in such property that
660	the board desires to dispose of said property and seeks offers
661	to lease or buy thereon. It is not required that such notice
662	specify the terms and conditions desired by the district, and if
663	such terms and conditions are included in such notice, or
664	otherwise provided, they are to be for general information only
665	and shall not prevent the board from accepting different terms
666	and conditions which the board might determine to be more
667	beneficial to the district. Offers submitted by the bidders are
668	not required to be sealed or to be kept confidential to the
669	district, unless otherwise specified in the published notice,
670	and any bidder may submit any number of alternate offers at any
671	time during the bidding period.
672	(d) The board is hereby authorized and empowered to accept
673	any bid upon surplus property, and to lease, sell, or otherwise
674	convey said property, in accordance with the provisions of this
675	section, or to reject all the bids, as the board might determine
676	to be in the best interests of the district.
677	(e) The board is authorized and empowered to convey to
678	Monroe County, or to any municipality or to any other
679	governmental body or agency of the State of Florida or of the
680	United States located partially or entirely within the
681	boundaries of the district, any surplus property for a nominal
682	consideration and according to those terms and conditions as the
683	board may at that time determine, regardless of the value of
684	such property, whenever it shall appear to the board that such
685	conveyance would be in the best interests of the district and
686	the residents thereof; provided, however, that such conveyance
687	for nominal consideration shall not be made until at least 30
688	days after the terms and conditions thereof shall have been
689	published in a newspaper of general circulation published in Key
690	West, or until residents and taxpayers of the district shall
691	have been afforded an opportunity to be heard upon such
692	conveyance at a regular meeting of the board.
693	(f) Except as authorized in this section, any real or
694	personal property of a fair market value of more than $2,500 may
695	not be leased, nor may right to immediate possession be
696	otherwise relinquished, for a term exceeding 1 year and 1 day.
697	Section 33. At least once each year the board shall
698	publish once in some newspaper published in the district, a
699	complete detailed annual statement of all moneys received and
700	disbursed by them since the creation of the district as to the
701	first published statement and since the last published statement
702	as to any other year. The statements shall also show the
703	several sources from which the funds were received and shall
704	show the balance on hand at the time of the published statement.
705	It shall show a complete statement of the financial condition of
706	the district.
707	Section 34. Each hospital, medical facility, or other
708	health care related facility established under this act shall be
709	for the use and benefit of the residents of the district.
710	Residents shall be admitted to the hospital or hospitals or any
711	of the related facilities and shall be entitled to
712	hospitalization and treatment, subject, however, to the rules
713	and regulations prescribed by the board effective as of the date
714	of admission of such resident. The board shall be authorized to
715	accept money from any welfare funds provided for Monroe County
716	or moneys available to the indigent patients from a federal,
717	state, or county agency or municipality or moneys available to
718	Monroe County from said governmental agencies for welfare and
719	hospital purposes, for the payment of costs of treatment and
720	care of indigent residents of the district; the board may
721	collect from patients financially able such charges as the board
722	may from time to time establish. The board may exclude from
723	treatment and care any person having a communicable or
724	contagious disease where such disease may be a detriment to the
725	best interests of the hospital or hospitals or related
726	facilities or which may constitute a source of contagion or
727	infection to the patients in its care, unless the institution
728	involved has a separate building or ward for the special
729	treatment of such persons and can properly and with safety to
730	the other patients retain the communicable or contagious case in
731	such separate ward or building. The board may extend the
732	privileges and use of a hospital or related facilities to
733	nonresidents of the district but who pay the rates established
734	by the board and upon such terms and conditions as the board may
735	from time to time by its rules and regulations provide.
736	However, the residents of the district wherein a hospital or
737	related facility is located shall have first claim to admission.
738	The board further shall have the power to furnish and extend the
739	benefits of a hospital or related facility and treatment to the
740	homes of indigent residents of the district. Each municipal
741	corporation situated within the district and the law enforcing
742	agencies of Monroe County shall be liable to the board for the
743	occupancy, care, medicine, and treatment of prisoners in the
744	custody of the municipal corporation or county officers who are
745	admitted to the hospital or other facility operated by the
746	board.
747	Section 35. Realizing that factors other than professional
748	must enter into qualification of those who practice medicine and
749	surgery, the board is authorized to promulgate and adopt rules,
750	regulations, and bylaws for the governing of the operation of
751	any hospital, nursing home, ambulance service, or such other
752	services as may be established under this act and the hospital
753	staff, nursing home, nursing home staff, ambulance service, and
754	medical staff; and the board is authorized to give, refuse,
755	grant, revoke, suspend, and otherwise curtail licenses and/or
756	privileges of staff members so that the welfare and health of
757	patients and the interests of any such hospital, nursing home,
758	and ambulance service may be best served at all times. The
759	board further is authorized to set up rules and regulations for
760	the hospital, nursing home, and an ambulance service, which
761	terms shall include nurses on general duty or on private duty
762	attending patients, and all other personnel in the hospital,
763	nursing home, and ambulance service who are in any capacity in
764	attendance upon patients. There shall be no liability on the
765	part of, and no cause of action of any nature shall arise
766	against any hospital, nursing home, hospital medical staff,
767	ambulance service, district board of commissioners, individually
768	or collectively, or hospital disciplinary body or its agents or
769	employees for any action taken in good faith and without malice
770	in carrying out the provisions of this section. However,
771	nothing in this section shall be construed to relieve any person
772	of liability in the case of medical malpractice or negligence.
773	Section 36. The board on behalf of the district shall
774	secure and keep in force in amounts it may determine reasonable,
775	in companies duly authorized to do business in Florida,
776	liability insurance covering vehicles and premises. The board
777	on behalf of the district shall attempt to secure and keep in
778	force in amounts it may determine reasonable, in companies duly
779	authorized to do business in Florida, liability insurance
780	covering professional malpractice. In the event such
781	professional malpractice insurance is not available or is
782	otherwise available at costs the board deems unreasonable, the
783	board on behalf of the district may elect to self-insure for
784	such risk. In consideration of the premium at which each policy
785	of insurance, if any, shall be written, it shall be part of the
786	insurance contract that the insurance company shall not be
787	entitled to the benefit of the defense of governmental immunity
788	for the insured by reason of exercising a governmental function
789	on any suit brought against the insured. Immunity of the
790	hospital district against liability damages is waived to the
791	extent of liability insurance carried. However, no attempt
792	shall be made at the trial of any action against the district to
793	suggest the existence of any insurance which covers in whole or
794	in part any judgment which may be rendered in favor of a
795	plaintiff. The board, on its behalf individually and on behalf
796	of the district, shall be indemnified by the district for any
797	and all acts taken by it, both collectively and individually, in
798	good faith and without malice in carrying out their duties under
799	this act.
800	Section 37. The board is empowered to destroy any of its
801	records together with any of the records of the hospital or
802	hospitals or related facilities established under this act
803	provided that the records are photographed or microfilmed prior
804	to their destruction.
805	Section 38. It is declared to be the legislative intent
806	that if any section, subsection, paragraph, sentence, clause, or
807	provision of this act is held invalid, the remainder of the act
808	shall not be affected.
809	Section 39. This act shall become effective only upon
810	approval by a majority vote of the qualified freeholder electors
811	voting in a referendum election in which a majority of the
812	freeholders who are qualified registered electors in the
813	district shall participate, to be held in Monroe County at a
814	special election to be called by the county commission within
815	forty-five (45) days from the date this act is filed with the
816	Secretary of State. If the election so held is favorable to the
817	establishment of a hospital district, then the cost of said
818	election shall be borne by the hospital commission created
819	thereby. If such measure fails, then the cost of the special
820	election shall be borne by the county commission of Monroe
821	County.
822	Section 4. If any provision of this act or the application
823	thereof to any person or circumstance is held invalid, the
824	invalidity shall not affect other provisions or applications of
825	the act which can be given effect without the invalid provision
826	or application, and to this end the provisions of this act are
827	declared severable.
828	Section 5. This act shall be construed as a remedial act
829	and shall be liberally construed to promote the purpose for
830	which it is intended.
831	Section 6. Chapters 67-1724, 69-1322, 72-617, 73-555, 73-
832	558, 75-450, 77-600, 77-601, 77-602, 77-603, 78-565, 79-511, 82-
833	414, 87-459, 89-551, and 94-415, Laws of Florida, are repealed.
834	Section 7. This act shall take effect upon becoming a law.
835