Florida Senate - 2012                      CS for CS for SB 1568
       
       
       
       By the Committees on Community Affairs; and Health Regulation;
       and Senators Gaetz and Garcia
       
       
       
       578-02595-12                                          20121568c2
    1                        A bill to be entitled                      
    2         An act relating to the sale or lease of a county,
    3         district, or municipal hospital; amending s. 155.40,
    4         F.S.; defining the terms; requiring that the governing
    5         board of a county, district, or municipal hospital
    6         evaluate the possible benefits to an affected
    7         community from the sale or lease of the hospital
    8         facility to a not-for-profit or for-profit entity
    9         within a specified time period; specifying the actions
   10         the board must take in evaluating whether to sell or
   11         lease the public hospital; requiring the board to
   12         determine whether qualified purchasers or lessees
   13         exist; specifying the factors that must be considered
   14         by the governing board before accepting a proposal to
   15         sell or lease the hospital; requiring the board to
   16         state in writing detailed findings related to its
   17         decision to accept or reject the proposal; requiring
   18         the governing board to make public the required
   19         findings and documents and to publish a notice of the
   20         proposed transaction in one or more newspapers of
   21         general circulation in the county in which the
   22         majority of the physical assets of the hospital are
   23         located; allowing persons to submit written comments
   24         regarding the proposed transaction; providing that the
   25         sale or lease is subject to the approval of the Chief
   26         Financial Officer; requiring the governing board to
   27         file a petition with the Chief Financial Officer
   28         seeking approval of the proposed transaction within a
   29         specified time period; requiring the Chief Financial
   30         Officer or his or her designee to issue a final order
   31         approving or denying the proposed transaction;
   32         specifying the criteria upon which the Chief Financial
   33         Officer must base his or her decision; authorizing an
   34         interested party to appeal the decision of the Chief
   35         Financial Officer; requiring that all costs be paid by
   36         the governing board unless an interested party
   37         contests the action, in which case the court may
   38         assign costs equitably to the parties; providing for
   39         the distribution of proceeds from the transaction;
   40         exempting the sale or lease of specified physical
   41         property of a county, district, or municipal hospital
   42         from processes required for the approval of a sale or
   43         lease of county, district, or municipal hospital
   44         property; providing an exemption from complying with
   45         the requirements of the act under certain
   46         circumstances; exempting application of the act to
   47         hospitals or health care systems for which a letter of
   48         intent to sell or lease is executed before a specified
   49         date; creating s. 155.401, F.S.; providing that the
   50         purposes for which a special taxing district may
   51         appropriate funds from the sale or lease of a hospital
   52         include the promotion and support of economic growth
   53         in the district and county in which the taxing
   54         district is located and the furthering of the purposes
   55         of the taxing district; providing that any general or
   56         special law that is inconsistent with or otherwise in
   57         conflict with the act is specifically superseded by
   58         the act; amending s. 395.3036, F.S.; conforming cross
   59         references; providing an effective date.
   60  
   61  Be It Enacted by the Legislature of the State of Florida:
   62  
   63         Section 1. Section 155.40, Florida Statutes, is amended to
   64  read:
   65         155.40 Sale or lease of county, district, or municipal
   66  hospital; effect of sale.—
   67         (1) In the interest of providing quality health care
   68  services to the order that citizens and residents of this the
   69  state may receive quality health care, and notwithstanding any
   70  other provision of general or special law, a any county,
   71  district, or municipal hospital organized and existing under the
   72  laws of this state, acting by and through its governing board,
   73  may shall have the authority to sell or lease the such hospital
   74  to a for-profit or not-for-profit Florida entity corporation,
   75  and enter into leases or other contracts with a for-profit or
   76  not-for-profit Florida entity corporation for the purpose of
   77  operating the and managing such hospital and any or all of its
   78  facilities of whatsoever kind and nature. The term of any such
   79  lease, contract, or agreement and the conditions, covenants, and
   80  agreements to be contained therein shall be determined by the
   81  governing board of the such county, district, or municipal
   82  hospital. The governing board of the hospital must find that the
   83  sale, lease, or contract is in the best interests of the
   84  affected community public and must state the basis of that such
   85  finding. If the governing board of a county, district, or
   86  municipal hospital decides to lease the hospital, it must give
   87  notice in accordance with paragraph (4)(a) or paragraph (4)(b).
   88         (2) A Any such lease, contract, or agreement made pursuant
   89  hereto shall:
   90         (a) Provide that the articles of incorporation of the such
   91  for-profit or not-for-profit corporation be subject to the
   92  approval of the board of directors or board of trustees of the
   93  such hospital;
   94         (b) Require that any not-for-profit corporation become
   95  qualified under s. 501(c)(3) of the United States Internal
   96  Revenue Code;
   97         (c) Provide for the orderly transition of the operation and
   98  management of the such facilities;
   99         (d) Provide for the return of the such facility to the
  100  county, municipality, or district upon the termination of the
  101  such lease, contract, or agreement; and
  102         (e) Provide for the continued treatment of indigent
  103  patients pursuant to the Florida Health Care Responsibility Act
  104  and pursuant to chapter 87-92, Laws of Florida.
  105         (3) Any sale, lease, or contract entered into pursuant to
  106  this section before prior to the effective date of this act must
  107  have complied with the requirements of subsection (2) in effect
  108  at the time of the sale, lease, or contract. Any lease
  109  modification, renewal, or extension relating to a lease
  110  transaction that occurred before the effective date of this act
  111  is not subject to subsections (6)-(17). It is the intent of the
  112  Legislature that this section does not impose any further
  113  requirements with respect to the formation of any for-profit or
  114  not-for-profit Florida entity corporation, the composition of
  115  the board of directors of any Florida entity corporation, or the
  116  manner in which control of the hospital is transferred to the
  117  Florida entity corporation.
  118         (4) As used in this section, the term:
  119         (a) “Affected community” means those persons residing
  120  within the geographic boundaries defined by the charter of the
  121  county, district, or municipal hospital, or if the boundaries
  122  are not specifically defined by charter of the hospital, by the
  123  geographic area from which 75 percent of the county, district,
  124  or municipal hospital’s inpatient admissions are derived.
  125         (b)“Expression of interest” means a bona fide request from
  126  a for-profit or not-for-profit entity that is a qualified
  127  purchaser or lessee to the board of directors of a county,
  128  district, or municipal hospital to enter into negotiations to
  129  sell or lease the hospital or health care system on commercially
  130  reasonable terms.
  131         (c) “Fair market value” means the price that a seller or
  132  lessor is willing to accept and a buyer or lessee is willing to
  133  pay on the open market and in an arms-length transaction, or
  134  what an independent expert in hospital valuation determines the
  135  fair market value to be.
  136         (d)“Increase tax support” means a vote to increase ad
  137  valorem or other taxes that are used to support operations of
  138  the hospital or health care system or any vote to allow the ad
  139  valorem tax rate to remain the same in any year in which
  140  property values in the taxing district have increased on the
  141  average, resulting in an increase in ad valorem tax revenues to
  142  the hospital.
  143         (e) “Interested party” includes a person submitting a
  144  proposal for sale or lease of the county, district, or municipal
  145  hospital, as well as the governing board.
  146         (f) “Net operating expenses” means the total operating
  147  expenses of the hospital, excluding depreciation, interest,
  148  taxes, amortization, and nonoperating expenses.
  149         (g) “Net operating revenues” has the same meaning as
  150  provided in s. 395.701(1). The term does not include restricted
  151  donations and grants for indigent care or nonoperating revenues,
  152  including, but not limited to, local unrestricted tax revenues
  153  and appropriated funds from state and local governments or any
  154  other type of tax support, gain or loss from the sale of assets,
  155  or unrestricted contributions.
  156         (h)“Qualified purchaser or lessee” means an entity that
  157  demonstrates access to capital in an amount equal to or in
  158  excess of 25 percent of the net revenue generated in the
  159  immediately preceding fiscal year of the hospital or health care
  160  system that is the subject of the sale or lease. Such access to
  161  capital can be demonstrated by cash reserves, an existing line
  162  of credit, or a binding commitment to obtain a line of credit to
  163  finance the purchase in an amount that equals or exceeds 25
  164  percent of the net revenue generated by the hospital or health
  165  care system.
  166         (5)(a)The governing board of a county, district, or
  167  municipal hospital shall commence an evaluation of the possible
  168  benefits to an affected community from the sale or lease of
  169  hospital facilities owned by the board to a not-for-profit or
  170  for-profit entity within 60 calendar days after:
  171         1.The county, district, or municipal hospital or health
  172  care system receives a bona fide expression of interest by a
  173  qualified purchaser or lessee to buy or lease the county,
  174  district, or municipal hospital or health care system;
  175         2. The governing board of a county, district, or municipal
  176  hospital votes to increase the amount of tax support for the
  177  hospital or health care system;
  178         3.The county, district, or municipal hospital or health
  179  care system experiences operating deficits that result in net
  180  operating expenses that exceed net operating revenues by 10
  181  percent or more for 3 consecutive years;
  182         4.The county, district, or municipal hospital or health
  183  care system has had administrative complaint proceedings
  184  initiated against it by the Agency for Health Care
  185  Administration for licensure violations under chapter 395 in 3
  186  consecutive years;
  187         5. The county, district, or municipal hospital or health
  188  care system has been declared ineligible to participate in the
  189  Medicare or Medicaid program; or
  190         6.The county, district, or municipal hospital or health
  191  care system fails to achieve or loses accreditation by the Joint
  192  Commission on Accreditation of Healthcare Organizations.
  193         (b) In the course of evaluating the benefits of the sale or
  194  lease, the board shall:
  195         1. Conduct a public hearing to provide interested persons
  196  the opportunity to be heard on the matter.
  197         2. Publish notice of the public hearing in one or more
  198  newspapers of general circulation in the county in which the
  199  majority of the physical assets of the hospital are located and
  200  in the Florida Administrative Weekly at least 15 days before the
  201  hearing is scheduled to occur.
  202         3. Contract with a certified public accounting firm or
  203  other firm that has substantial expertise in the valuation of
  204  hospitals to render an independent valuation of the hospital’s
  205  fair market value. The firm chosen by the board must be
  206  agreeable to the qualified purchaser or lessee and the hospital
  207  or health care system. The firm’s valuation report shall be made
  208  available to the public 7 working days before the scheduled
  209  public hearing.
  210         4. Consider an objective operating comparison between a
  211  hospital or health care system operated by the district, county,
  212  or municipality and other similarly situated hospitals, both
  213  not-for-profit and for-profit, which have a similar service mix,
  214  in order to determine whether there is a difference in the cost
  215  of operation using publicly available data provided by the
  216  Agency for Health Care Administration and the quality metrics
  217  identified by the Centers for Medicare and Medicaid Services
  218  Core Measures. The comparison must determine whether it is more
  219  beneficial to taxpayers and the affected community for the
  220  hospital to be operated by a governmental entity, or whether the
  221  hospital can be operated by a not-for-profit or for-profit
  222  entity with similar or better cost-efficiencies or measurable
  223  outcomes identified by the Centers for Medicare and Medicaid
  224  Services Core Measures. The comparison must also determine
  225  whether there is a net benefit to the community to operate the
  226  hospital as a not-for-profit or for-profit entity and use the
  227  proceeds of the sale or lease for the purposes described in this
  228  section.
  229         5. Make publicly available all documents considered by the
  230  board in the course of such evaluation.
  231         (c)1.Within 160 days after the initiation of the process
  232  established in paragraphs (a) and (b), the governing board shall
  233  publish notice of the board’s findings in one or more newspapers
  234  of general circulation in the county in which the majority of
  235  the physical assets of the hospital are located and in the
  236  Florida Administrative Weekly.
  237         2. This evaluation is not required if a district, county,
  238  or municipal hospital has issued a public request for proposals
  239  for the sale or lease of a hospital on or before February 1,
  240  2012, for the purpose of receiving proposals from qualified
  241  purchasers or lessees, either not-for-profit or for-profit.
  242         3. The fair market valuation established in paragraph (b)
  243  shall be valid for a period of 12 months following the date of
  244  its issuance, unless there are material financial changes in the
  245  hospitals financial condition as determined by the outside
  246  independent certified public accounting firm for the hospital or
  247  health care system, the Agency for Health Care Administration,
  248  or the Auditor General.
  249         4. This subsection does not apply to any county, district
  250  or municipal hospital, or health care system that is under lease
  251  as of February 1, 2012, as long as that lease remains in effect
  252  in accordance with the terms of the lease or such lease is
  253  extended or renewed. Any such hospital or health care system,
  254  however, becomes subject to this subsection upon:
  255         a. Termination of the lease;
  256         b. Notification provided to the lessee of a planned
  257  termination of the lease in accordance with the lease terms;
  258         c. Notification to the lessee that the lessor plans to seek
  259  potential new lessees or buyers; or
  260         d. Notification to the lessee that the lessor plans to
  261  resume operation of the hospital or health care system at the
  262  termination of the lease.
  263  
  264  Any such hospital or health care system may not thereafter be
  265  sold, leased to another lessee, or operated by the owner without
  266  first complying with the provisions of subsections (5)-(16).
  267         (6)(4)If, upon completion of the evaluation of the
  268  benefits of the sale or lease, In the event the governing board
  269  of a county, district, or municipal hospital determines that it
  270  is no longer in the best interest of the affected community to
  271  own or operate a hospital or health care system and elects to
  272  consider a sale or lease of the hospital or health care system
  273  to a third party, the governing board must first determine
  274  whether there are any qualified purchasers or lessees. In the
  275  process of evaluating any qualified purchaser or lessee elects
  276  to sell or lease the hospital, the board shall:
  277         (a) Negotiate the terms of the sale or lease with a for
  278  profit or not-for-profit Florida corporation and Publicly
  279  advertise the meeting at which the proposed sale or lease will
  280  be considered by the governing board of the hospital in
  281  accordance with s. 286.0105; or
  282         (b) Publicly advertise the offer to accept proposals in
  283  accordance with s. 255.0525 and receive proposals from all
  284  interested and qualified purchasers and lessees.
  285  
  286  Any sale or lease must be for fair market value, or, if not for
  287  fair market value, the lease must be in the best interest of the
  288  affected community. A and any sale or lease must comply with all
  289  applicable state and federal antitrust laws.
  290         (7)If, upon completion of the evaluation of the benefits
  291  of the sale or lease, the governing board determines that it is
  292  in the best interest of the affected community to maintain
  293  ownership or operation of the hospital or health care system and
  294  elects not to consider a sale or lease of the hospital or health
  295  care system, the qualified purchaser or lessee shall pay the
  296  final cost of the evaluation. If, however, the governing board
  297  and the qualified purchaser do not agree upon the firm chosen to
  298  evaluate the hospital or health care system, the governing board
  299  is responsible for the full cost of the evaluation.
  300         (8)A determination by the governing board to accept a
  301  proposal for sale or lease shall be made after consideration of
  302  all proposals received and negotiations with a qualified
  303  purchaser or lessee. The governing board’s determination must
  304  include, in writing, detailed findings of all reasons for
  305  accepting the proposal.
  306         (a)The governing board’s acceptance of a proposal for sale
  307  or lease must include a description of how the sale or lease
  308  satisfies each of the following requirements:
  309         1.The sale or lease represents fair market value, as
  310  determined by a certified public accounting firm or other
  311  qualified firm pursuant to paragraph (5)(b). If leased at less
  312  than fair market value, the governing board shall provide a
  313  detailed explanation of how the best interests of the affected
  314  community are served by the acceptance of less than fair market
  315  value for the lease of the hospital.
  316         2.Acceptance of the proposal will result in a reduction or
  317  elimination of ad valorem or other taxes for taxpayers in the
  318  district, if applicable.
  319         3.The proposal includes an enforceable commitment that
  320  programs and services and quality health care will continue to
  321  be provided to all residents of the affected community,
  322  particularly to the indigent, the uninsured, and the
  323  underinsured.
  324         4. Disclosure has been made of all conflicts of interest,
  325  including, but not limited to, whether the sale or lease of the
  326  hospital would result in a special private gain or loss to
  327  members of the governing board or key management employees or
  328  members of the medical staff of the county, district, or
  329  municipal hospital, or if governing board members will be
  330  serving on the board of any successor private corporation.
  331  Conflicts of interest, if any, with respect to experts retained
  332  by the governing board shall also be disclosed.
  333         5. Disclosure has been made by the seller or lessor of all
  334  contracts with physicians or other entities providing health
  335  care services through a contract with the seller or lessor,
  336  including all agreements or contracts that would be void or
  337  voidable upon the consummation of the sale or lease.
  338         6. The proposal is in compliance with subsections (9) and
  339  (10).
  340         (b)The findings must be accompanied by all information and
  341  documents relevant to the governing board’s determination,
  342  including, but not limited to:
  343         1.The names and addresses of all parties to the
  344  transaction.
  345         2.The location of the hospital and all related facilities.
  346         3.A description of the terms of all proposed agreements.
  347         4.A copy of the proposed sale or lease agreement and any
  348  related agreements, including, but not limited to, leases,
  349  management contracts, service contracts, and memoranda of
  350  understanding.
  351         5.The estimated total value associated with the proposed
  352  agreement and the proposed acquisition price.
  353         6.Any valuations of the hospital’s assets prepared during
  354  the 3 years immediately preceding the proposed transaction date.
  355         7.The fair market value analysis required by paragraph
  356  (5)(b), or any other valuation prepared at the request of the
  357  board, owner of the hospital or health care system, or managing
  358  entity of the hospital or health care system.
  359         8.Copies of all other proposals and bids that the
  360  governing board may have received or considered in compliance
  361  with subsection (6).
  362         (9)Within 120 days before the anticipated closing date of
  363  the proposed transaction, the governing board shall make
  364  publicly available all findings and documents required under
  365  subsection (8) and publish a notice of the proposed transaction
  366  in one or more newspapers of general circulation in the county
  367  in which the majority of the physical assets of the hospital are
  368  located. The notice must include the names of the parties
  369  involved and the means by which a person may submit written
  370  comments about the proposed transaction to the governing board
  371  and obtain copies of the findings and documents required under
  372  subsection (8).
  373         (10)Within 20 days after the date of publication of the
  374  public notice, any person may submit to the governing board
  375  written comments regarding the proposed transaction.
  376         (11)The sale or lease of the hospital is subject to
  377  approval by the Chief Financial Officer or his or her designee,
  378  except, if otherwise required by law, approval of the sale or
  379  lease shall exclusively be by majority vote of the registered
  380  voters in the county, district, or municipality in which the
  381  hospital is located.
  382         (a)The governing board shall file a petition with the
  383  state Chief Financial Officer seeking approval of the proposed
  384  transaction at least 30 days after publication of the notice of
  385  the proposed transaction.
  386         (b)The petition for approval filed by the governing board
  387  must include all findings and documents required under
  388  subsection (8) and certification by the governing board of
  389  compliance with all requirements of this section. The chair of
  390  the governing board must certify under oath and subject to the
  391  penalty of perjury on a form accompanying the petition that the
  392  contents of the petition and representations therein are true
  393  and correct.
  394         (12) Within 30 days of receiving the petition, the Chief
  395  Financial Officer or his or her designee shall issue a final
  396  order approving or denying the proposed transaction based solely
  397  upon consideration of whether the procedures contained within
  398  this section have been followed by the governing board of the
  399  county, district, or municipal hospital. The order shall require
  400  the governing board to accept or reject the proposal for the
  401  sale or lease of the county, district, or municipal hospital
  402  based upon a determination that:
  403         (a)The proposed transaction is permitted by law.
  404         (b)The proposed transaction does not unreasonably exclude
  405  a potential purchaser or lessee on the basis of being a for
  406  profit or a not-for-profit Florida corporation or other form of
  407  business organization, such as a partnership or limited
  408  liability company.
  409         (c)The governing board of the hospital publicly advertised
  410  the meeting at which the proposed transaction was considered by
  411  the board in compliance with s. 286.0105.
  412         (d)The governing board of the hospital publicly advertised
  413  the offer to accept proposals in compliance with s. 255.0525.
  414         (e)Any conflict of interest was disclosed, including, but
  415  not limited to, how the proposed transaction could result in a
  416  special private gain or loss to members of the governing board
  417  or key management employees of the county, district, or
  418  municipal hospital, or if governing board members will be
  419  serving on the board of any successor private corporation.
  420  Conflicts of interest, if any, with respect to experts retained
  421  by the governing board shall also be disclosed.
  422         (f)The seller or lessor documented that it will receive
  423  fair market value for the sale or lease of the assets as
  424  indicated in paragraph (5)(b) or, if leased at less than fair
  425  market value, the governing board provided a detailed
  426  explanation of how the best interests of the affected community
  427  are served by the acceptance of less than fair market value for
  428  the lease of the hospital.
  429         (g)The acquiring entity has made an enforceable commitment
  430  that programs and services and quality health care will continue
  431  to be provided to all residents of the affected community,
  432  particularly to the indigent, the uninsured, and the
  433  underinsured.
  434         (h)The governing board disclosed whether the sale or lease
  435  will result in a reduction or elimination of ad valorem or other
  436  taxes used to support the hospital.
  437         (13)Any interested party to the action has the right to
  438  seek judicial review of the decision in the appellate district
  439  where the hospital is located or in the First District Court of
  440  Appeal pursuant to s. 120.68.
  441         (a)All proceedings shall be instituted by filing a notice
  442  of appeal in accordance with the Florida Rules of Appellate
  443  Procedure within 30 days after the date of the final order.
  444         (b)In such judicial review, the appellate court shall
  445  affirm the decision of the Chief Financial Officer, unless the
  446  decision by the Chief Financial Officer is shown to be clearly
  447  erroneous.
  448         (14)All costs shall be paid by the governing board, unless
  449  an interested party contests the action, in which case the court
  450  may assign costs equitably to the parties.
  451         (15) If any provision of subsection (5), subsection (6), or
  452  subsection (8) is not followed, the contract for sale or lease
  453  is voidable by any party to the contract. If any member of the
  454  governing board negligently or willfully violates subsection
  455  (5), subsection (6), or subsection (7), as determined by the
  456  Commission on Ethics after receipt of a sworn complaint pursuant
  457  to s. 112.322, the member is subject to a penalty, as determined
  458  by the Commission on Ethics pursuant to s. 112.317.
  459         (16) If a county, district, or municipal hospital is sold
  460  or leased, the governing board shall:
  461         (a) Deposit 50 percent of the net proceeds of the sale or
  462  lease into a health care economic development trust fund, which
  463  shall be under the control of the county commission of the
  464  county in which the property is located. The use and
  465  distribution of the funds shall be at the discretion of a
  466  majority of the county commission, the members of which shall
  467  serve as trustees of the trust fund. The net proceeds in the
  468  health care economic development trust fund shall be
  469  distributed, in consultation with the Department of Economic
  470  Opportunity, to promote job creation in the health care sector
  471  of the economy through new or expanded health care business
  472  development, new or expanded health care services, or new or
  473  expanded health care education programs or commercialization of
  474  health care research within the affected community; and
  475         (b) Appropriate 50 percent of the net proceeds of the sale
  476  or lease for funding the delivery of indigent and uncompensated
  477  care on an equitable basis, based on the amount of indigent and
  478  uncompensated care provided, to all hospitals within the
  479  boundaries of the district.
  480  
  481  For the purposes of this subsection, the term “net proceeds”
  482  means the sale price after payment of all district debts and
  483  obligations.
  484         (17) If a county, district, or municipal hospital is sold
  485  or leased to a for-profit corporation or other business entity
  486  subject to local taxation, in addition to the distribution of
  487  funds as directed in subsection (16):
  488         (a) Fifty percent of the resulting county and municipal ad
  489  valorem tax revenue from the formerly tax-exempt property shall
  490  be distributed by the county commission of the county in which
  491  the property is located, in consultation with the Department of
  492  Economic Opportunity, for purposes set forth in subsection (16);
  493  and
  494         (b) Fifty percent of the resulting county and municipal ad
  495  valorem tax revenue from the formerly tax-exempt property shall
  496  be appropriated by the county commission for the sole purpose of
  497  enhancing education and law enforcement programs within the
  498  county.
  499         (18)(5)If In the event a hospital operated by a for-profit
  500  or not-for-profit Florida entity corporation receives annually
  501  more than $100,000 in revenues from the county, district, or
  502  municipality that owns the hospital, the Florida entity
  503  corporation must be accountable to the county, district, or
  504  municipality with respect to the manner in which the funds are
  505  expended by either:
  506         (a) Having the revenues subject to annual appropriations by
  507  the county, district, or municipality; or
  508         (b) Where there is a contract to provide revenues to the
  509  hospital, the term of which is longer than 12 months, the
  510  governing board of the county, district, or municipality must be
  511  able to modify the contract upon 12 months notice to the
  512  hospital.
  513  
  514  A not-for-profit entity corporation that is subject to this
  515  subsection and that does not currently comply with the
  516  accountability requirements in this subsection shall have 12
  517  months after the effective date of this act to modify any
  518  contracts with the county, district, or municipality in a manner
  519  that is consistent with this subsection.
  520         (19)(6) Unless otherwise expressly stated in the lease
  521  documents, the transaction involving the sale or lease of a
  522  hospital may shall not be construed as:
  523         (a) A transfer of a governmental function from the county,
  524  district, or municipality to the private purchaser or lessee;
  525         (b) Constituting a financial interest of the public lessor
  526  in the private lessee; or
  527         (c) Making a private lessee an integral part of the public
  528  lessor’s decisionmaking process.
  529         (20)(7) The lessee of a hospital, under this section or any
  530  special act of the Legislature, operating under a lease may
  531  shall not be construed to be “acting on behalf of” the lessor as
  532  that term is used in statute, unless the lease document
  533  expressly provides to the contrary.
  534         (21)(8)(a) If, whenever the sale of a public hospital by a
  535  public agency to a private corporation or other private entity
  536  pursuant to this section or pursuant to a special act of the
  537  Legislature reflects that:
  538         1. The private corporation or other private entity
  539  purchaser acquires 100 percent ownership in the hospital
  540  enterprise;
  541         2. The private corporation or other private entity
  542  purchases the physical plant of the hospital facility and has
  543  complete responsibility for the operation and maintenance of the
  544  facility, regardless of ownership of the underlying real
  545  property;
  546         3. The public agency seller retains no control over
  547  decisionmaking or policymaking for the hospital;
  548         4. The private corporation or other private entity
  549  purchaser receives no funding from the public agency seller
  550  other than by contract for services rendered to patients for
  551  whom the public agency seller has the responsibility to pay for
  552  hospital or medical care;
  553         5. The public agency seller makes no substantial investment
  554  in or loans to the private entity;
  555         6. The private corporation or other private entity
  556  purchaser was not created by the public entity seller; and
  557         7. The private corporation or other private entity
  558  purchaser operates primarily for its own financial interests and
  559  not primarily for the interests of the public agency,
  560  
  561  such a sale shall be considered a complete sale of the public
  562  agency’s interest in the hospital or health care system.
  563         (b) A complete sale of a hospital or health care system as
  564  described in this subsection may shall not be construed as:
  565         1. A transfer of a governmental function from the county,
  566  district, or municipality to the private corporation or other
  567  private entity purchaser;
  568         2. Constituting a financial interest of the public agency
  569  in the private corporation or other private entity purchaser;
  570         3. Making the private corporation or other private entity
  571  purchaser an “agency” as that term is used in statutes;
  572         4. Making the private corporation or other private entity
  573  purchaser an integral part of the public agency’s decisionmaking
  574  process; or
  575         5. Indicating that the private corporation or other private
  576  entity purchaser is “acting on behalf of a public agency” as
  577  that term is used in statute.
  578         (22)If the governing board elects to sell or lease any
  579  physical property of a county, district, or municipal hospital
  580  or health care system and such property generated less than 20
  581  percent of the hospital’s net revenue within the hospital’s or
  582  health care system’s most recent fiscal year, the sale or lease
  583  of such property is exempt from the requirements under
  584  subsections (6)-(17). However, the governing board shall
  585  publicly advertise the meeting at which the proposed sale or
  586  lease of such property will be considered by the governing board
  587  of the hospital in accordance with s. 286.0105 or publicly
  588  advertise the offer to accept proposals in accordance with s.
  589  255.0525 and receive proposals from all qualified purchasers and
  590  lessees. The sale or lease of the property must be for fair
  591  market value or, if a lease is for less than fair market value,
  592  the lease must be in the best interest of the affected
  593  community.
  594         (23)A county, district, or municipal hospital that has
  595  executed a letter of intent to sell or lease the hospital or
  596  health care system accepted at a properly noticed public
  597  meeting, and whose governing board has voted to approve the
  598  letter of intent before December 31, 2011, is not subject to
  599  subsections (6)-(17) as long as the final closing of the sale or
  600  lease transaction pursuant to the letter of intent occurs before
  601  December 31, 2012.
  602         Section 2. Section 155.401, Florida Statutes, is created to
  603  read:
  604         155.401Power of special taxing district to appropriate
  605  proceeds from sale or lease of hospital to economic development
  606  trust fund.—Notwithstanding any other general or special law,
  607  the purposes for which a special taxing district may appropriate
  608  funds from the sale or lease of a hospital to an economic
  609  development fund include the promotion and support of economic
  610  growth in such district and in the county in which such district
  611  is located and the furthering of the purposes of such district,
  612  as provided by law.
  613         Section 3. To the extent that any general or special law is
  614  inconsistent with or otherwise in conflict with this act, such
  615  conflicting provisions are specifically superseded by this act.
  616  A special tax district, public hospital, or municipal hospital
  617  is not exempt from this act.
  618         Section 4. Section 395.3036, Florida Statutes, is amended
  619  to read:
  620         395.3036 Confidentiality of records and meetings of
  621  entities corporations that lease public hospitals or other
  622  public health care facilities.—The records of a private entity
  623  corporation that leases a public hospital or other public health
  624  care facility are confidential and exempt from the provisions of
  625  s. 119.07(1) and s. 24(a), Art. I of the State Constitution, and
  626  the meetings of the governing board of a private entity
  627  corporation are exempt from s. 286.011 and s. 24(b), Art. I of
  628  the State Constitution if when the public lessor complies with
  629  the public finance accountability provisions of s. 155.40(18)
  630  155.40(5) with respect to the transfer of any public funds to
  631  the private lessee and if when the private lessee meets at least
  632  three of the five following criteria:
  633         (1) The public lessor that owns the public hospital or
  634  other public health care facility was not the incorporator or
  635  initial member of the private entity corporation that leases the
  636  public hospital or other health care facility.
  637         (2) The public lessor and the private lessee do not
  638  commingle any of their funds in any account maintained by either
  639  of them, other than the payment of the rent and administrative
  640  fees or the transfer of funds pursuant to subsection (5) (2).
  641         (3) Except as otherwise provided by law, the private lessee
  642  is not allowed to participate, except as a member of the public,
  643  in the decisionmaking process of the public lessor.
  644         (4) The lease agreement does not expressly require the
  645  lessee to comply with the requirements of ss. 119.07(1) and
  646  286.011.
  647         (5) The public lessor is not entitled to receive any
  648  revenues from the lessee, except for rental or administrative
  649  fees due under the lease, and the lessor is not responsible for
  650  the debts or other obligations of the lessee.
  651         Section 5. This act shall take effect upon becoming a law.