Florida Senate - 2017 SB 740 By Senator Steube 23-00540-17 2017740__ 1 A bill to be entitled 2 An act relating to hospital districts; defining the 3 term “hospital district”; prohibiting hospital 4 districts from levying property tax without the 5 consent of electors residing within the hospital 6 district; requiring decennial reauthorization of the 7 taxing authority of certain hospital districts; 8 requiring tax revenues generated to fund indigent care 9 for residents of the district to be distributed to 10 hospitals within the district based on a certain 11 funding formula adopted by the district; terminating 12 the taxing authority of a hospital district by a 13 specified date if a referendum is not approved by a 14 majority vote of the electors; authorizing a governing 15 board to maintain a hospital district without taxing 16 authority or dissolve the hospital district if a 17 referendum is not approved by a majority vote of the 18 electors; providing for allocation of hospital 19 district assets and liabilities if the hospital 20 district is dissolved; authorizing the termination of 21 the taxing authority of a hospital district to be 22 delayed for a specified period under certain 23 circumstances; providing requirements for the 24 creation, expansion, or combination of certain 25 hospital districts; requiring a county to obtain and 26 publish an independent appraisal of certain public 27 hospitals’ assets and a certain independent economic 28 analysis; providing requirements for such analysis; 29 providing a referendum requirement for a property tax 30 levy contingent upon government-subsidized health care 31 funding; providing applicability; requiring tax 32 revenues generated to fund indigent care for residents 33 of the district to be distributed to hospitals within 34 the district based on a certain funding formula 35 adopted by the district; specifying that taxes 36 generated in a hospital taxing district be paid to the 37 district rather than a community redevelopment area; 38 prohibiting a hospital district from establishing 39 certain health care facilities unless a majority of 40 voting electors residing within the hospital district 41 approve it by referendum, subject to certain 42 requirements; providing applicability; providing an 43 effective date. 44 45 Be It Enacted by the Legislature of the State of Florida: 46 47 Section 1. (1) As used in this act, the term “hospital 48 district” means a special district as defined in s. 189.012, 49 Florida Statutes, the governing body of which is the governing 50 body of a facility licensed under chapter 395, Florida Statutes. 51 (2) Notwithstanding any general law, special law, or local 52 ordinance, a hospital district may not levy a property tax 53 without the approval of a majority of electors residing within 54 the district voting in a referendum as provided in this act. 55 (3)(a) On or before July 1, 2017, and every 10th year 56 thereafter, each hospital district with taxing authority, 57 whether organized as an independent or dependent special 58 district or created by special act or local ordinance, shall 59 arrange to place on the next general election ballot of the 60 electors residing within the hospital district the following 61 question: “Shall the taxing authority of the ...(name of 62 hospital district)... be reauthorized, for a 10-year period, to 63 levy a tax of ...(amount of tax not to exceed 2 mills)..., the 64 proceeds of which shall fund indigent care for residents of the 65 hospital district?” and thereafter the words “Yes” and “No.” 66 (b) If a majority of the electors voting approve the ballot 67 question, all tax revenues generated to fund indigent care for 68 residents of the district shall be distributed to hospitals 69 within the district based on a funding formula adopted by the 70 district. The funding formula must ensure that tax dollars are 71 equitably distributed to all hospitals based solely on the 72 number of indigent patients treated at each hospital, without 73 regard to whether the hospital is owned or operated by the 74 health care district or by a private entity. 75 (c) If a majority of the electors in a hospital district do 76 not approve the reauthorization ballot question described in 77 paragraph (a), effective January 1 of the year following the 78 general election, the taxing authority of the hospital district 79 is terminated. The governing board may maintain the hospital 80 district without taxing authority or dissolve the hospital 81 district. If the hospital district is dissolved, the assets and 82 liabilities of the hospital district shall be allocated in the 83 manner authorized by s. 189.076(2), Florida Statutes. 84 (4)(a) Notwithstanding paragraph (3)(c), the termination of 85 the taxing authority of the hospital district may be delayed for 86 1 additional year if the county where the district is located 87 places the following question on the ballot of the electors in 88 the county before December 31 of the subsequent year, and a 89 majority of electors voting approve the ballot question: “Shall 90 the taxing authority of the ...(name of hospital district)... be 91 reauthorized and expanded to include all property in ...(name of 92 county)..., for a 10-year period, for the district to levy a tax 93 of ...(amount of tax not to exceed 2 mills)... on all taxable 94 property within the county in order to fund indigent care?” and 95 thereafter the words “Yes” and “No.” 96 (b) If a majority of the electors voting do not approve the 97 reauthorization ballot question described in this subsection, 98 effective January 1 of the year following the election, the 99 taxing authority of the hospital district is terminated. The 100 governing board may maintain the hospital district without 101 taxing authority or dissolve the hospital district. If the 102 hospital district is dissolved, the assets and liabilities of 103 the hospital district shall be allocated in the manner 104 authorized by s. 189.076(2), Florida Statutes. 105 (5) A new, expanded, or combined hospital district may be 106 formed for the purpose of funding indigent care for residents 107 within the hospital district if the board of county 108 commissioners in the county in which the new, expanded, or 109 combined hospital district is located or will be located places 110 the following question on the general election ballot of the 111 electors in the new, expanded, or combined hospital district, 112 and a majority of electors voting approve the ballot question: 113 “Shall the ...(name of new, expanded, or combined hospital 114 district)... be authorized or reauthorized, for a 10-year 115 period, to levy a tax of ...(amount of tax not to exceed 2 116 mills)... on all taxable property within ...(name of new, 117 expanded, or combined hospital district)... in order to fund 118 indigent care?” and thereafter the words “Yes” and “No.” 119 Section 2. (1) For a public hospital described in 120 subsection (2), the county where the public hospital is located 121 shall obtain and publish an independent appraisal of the 122 hospital’s assets and an independent economic analysis of the 123 projected public benefit derived from maintaining the hospital 124 as a public hospital or leasing or selling the hospital to a 125 for-profit entity pursuant to s. 155.40, Florida Statutes. The 126 economic analysis must consider the property and sales tax 127 revenue available after the lease or sale and conversion of the 128 hospital and the projected earnings of a potential endowment 129 created from the proceeds of the lease or sale. The economic 130 analysis must provide that, notwithstanding s. 155.40(16)(b), 131 Florida Statutes, 100 percent of the net proceeds of the lease 132 or sale shall be used to fund indigent care and that, 133 notwithstanding s. 155.40(17), Florida Statutes, any ad valorem 134 revenues shall be annually added to the endowment fund and 100 135 percent of such revenues used for indigent care. 136 (2) This section applies to a public hospital that: 137 (a) Does not make an operating profit for 3 out of 5 138 consecutive years, that is not within a hospital district, and 139 that has not been subject to a hospital district referendum as 140 provided in this act. 141 (b) Does not make an operating profit for 3 out of 5 142 consecutive years, that is not within a hospital district, and 143 that has been subject to a hospital district referendum as 144 provided in this act but in which a majority of electors voting 145 did not approve the referendum. 146 (c) Does not make an operating profit for 3 out of 5 147 consecutive years, that is within a hospital district, and that 148 has been subject to a hospital district referendum as provided 149 in this act in which a majority of electors voting approved the 150 referendum. For purposes of this paragraph, the calculation of 151 the hospital’s operating profit shall include the property tax 152 authorized by the electors as revenue. 153 Section 3. (1)(a) An existing or planned hospital district 154 seeking authorization or reauthorization to levy a property tax 155 after health care coverage is provided by federal, state, or 156 local government via Medicaid or other government-subsidized 157 funding for residents who qualify for a subsidy on the health 158 insurance exchange shall arrange to place on the next general 159 election ballot of the electors residing within the hospital 160 district the following question: “Shall the taxing authority of 161 the ...(name of hospital district)... be authorized so the 162 district may levy a tax of ...(amount of tax not to exceed 2 163 mills)... in order to fund indigent care for residents of the 164 taxing district whose care is not otherwise funded by Medicaid 165 or other governmental programs?” and thereafter the words “Yes” 166 and “No.” 167 (b) If a majority of the electors voting approve the ballot 168 question, the provisions of this act regarding reauthorization 169 shall apply to the hospital district and its taxing authority. 170 (c) All tax revenues generated to fund indigent care for 171 residents of the district shall be distributed to all hospitals 172 within the district based on a funding formula adopted by the 173 district. The funding formula must ensure that tax dollars are 174 equitably distributed based on the number of indigent patients 175 treated at each hospital, without regard to whether the hospital 176 is owned or operated by the health care district or by a private 177 entity. 178 (2) Taxes generated by an independent special hospital 179 taxing district within a community redevelopment area shall be 180 paid to the hospital taxing district and not the community 181 redevelopment area. 182 Section 4. (1) A hospital district may not establish a 183 health care facility to be licensed under chapter 395 or chapter 184 400 which is located outside the geographic boundaries of the 185 district, unless the county where the district is located places 186 the following question on the ballot of the electors in the 187 county before December 31 of the year prior to commencing 188 construction, and a majority of electors residing within the 189 hospital district voting approve the ballot question: “Shall the 190 ...(name of hospital district)... be authorized to establish a 191 ...(identify type of facility to be licensed under chapter 395 192 or chapter 400)... outside of the geographic boundaries of the 193 hospital district in ...(identify county and municipality in 194 which facility is to be located)....?” and thereafter the words 195 “Yes” and “No.” 196 (2) This section does not apply to or affect any health 197 care facility licensed under chapter 395 or chapter 400 before 198 the effective date of this act. 199 Section 5. This act shall take effect upon becoming a law.