Amend HB 2383 as follows:
Insert the following as Section 2, and renumber subsequent
sections accordingly:
SECTION 2. Sections 11.18(d) and (e), Tax Code, are amended
to read as follows:
(d) A charitable organization must be organized exclusively
to perform religious, charitable, scientific, literary, or
educational purposes and, except as permitted by Subsection (h) of
this section, engage exclusively in performing one or more of the
following charitable functions:
(1) providing medical care without regard to the
beneficiaries' ability to pay, which in the case of a nonprofit
hospital or hospital system means providing charity care and
community benefits as set forth in Paragraph (A), (B), (C), (D),
(E), (F), (G), or (H):
(A) charity care and government-sponsored
indigent health care are provided at a level which is reasonable in
relation to the community needs, as determined through the
community needs assessment, the available resources of the hospital
or hospital system, and the tax-exempt benefits received by the
hospital or hospital system;
(B) charity care and government-sponsored
indigent health care are provided in an amount equal to at least
four percent of the hospital's or hospital system's net patient
revenue;
(C) charity care and government-sponsored
indigent health care are provided in an amount equal to at least
100 percent of the hospital's or hospital system's tax-exempt
benefits, excluding federal income tax;
(D) a nonprofit hospital that has been
designated as a disproportionate share hospital under the state
Medicaid program in the current year or in either of the previous
two fiscal years shall be considered to have provided a reasonable
amount of charity care and government-sponsored indigent health
care and shall be deemed in compliance with the standards in this
subsection;
(E) for tax years before 1996, charity care and
community benefits are provided in a combined amount equal to at
least five percent of the hospital's or hospital system's net
patient revenue, provided that charity care and
government-sponsored indigent health care are provided in an amount
equal to at least three percent of net patient revenue;
(F) beginning with the hospital's or hospital
system's tax year starting after 1995, charity care and community
benefits are provided in a combined amount equal to at least five
percent of the hospital's or hospital system's net patient revenue,
provided that charity care and government-sponsored indigent health
care are provided in an amount equal to at least four percent of
net patient revenue;
(G) a hospital operated on a nonprofit basis
that is located in a county with a population of less than 50,000
and in which the entire county or the population of the entire
county has been designated as a health professionals shortage area
is considered to be in compliance with the standards provided by
this subsection; or
(H) a hospital providing health care services to
inpatients or outpatients without receiving any payment for
providing those services from any source, including the patient or
person legally obligated to support the patient, third-party
payors, Medicare, Medicaid, or any other state or local indigent
care program but excluding charitable donations, legacies,
bequests, or grants or payments for research, is considered to be
in compliance with the standards provided by this subsection;
(2) providing support or relief to orphans,
delinquent, dependent, or handicapped children in need of
residential care, abused or battered spouses or children in need of
temporary shelter, the impoverished, or victims of natural disaster
without regard to the beneficiaries' ability to pay;
(3) providing support to elderly persons or the
handicapped without regard to the beneficiaries' ability to pay;
(4) preserving a historical landmark or site;
(5) promoting or operating a museum, zoo, library,
theater of the dramatic or performing arts, or symphony orchestra
or choir;
(6) promoting or providing humane treatment of
animals;
(7) acquiring, storing, transporting, selling, or
distributing water for public use;
(8) answering fire alarms and extinguishing fires with
no compensation or only nominal compensation to the members of the
organization;
(9) promoting the athletic development of boys or
girls under the age of 18 years;
(10) preserving or conserving wildlife;
(11) promoting educational development through loans
or scholarships to students;
(12) providing halfway house services pursuant to a
certification as a halfway house by the board of Pardons and
Paroles;
(13) providing permanent housing and related social,
health care, and educational facilities for persons who are 62
years of age or older without regard to the residents' ability to
pay;
(14) promoting or operating an art gallery, museum, or
collection, in a permanent location or on tour, that is open to the
public;
(15) providing for the organized solicitation and
collection for distributions through gifts, grants, and agreements
to nonprofit charitable, education, religious, and youth
organizations that provide direct human, health, and welfare
services;
(16) performing biomedical or scientific research or
biomedical or scientific education for the benefit of the public;
<or>
(17) operating a television station that produces or
broadcasts educational, cultural, or other public interest
programming and that receives grants from the Corporation for
Public Boardcasting under 47 U.S.C. Section 396; or
(18) providing housing for low-income and
moderate-income families, for unmarried individuals 62 years of age
or older, for handicapped individuals, and for families displaced
by urban renewal, through the use of trust assets that are
irrevocably and, pursuant to a contract entered into before
December 31, 1972, contractually dedicated on the sale or
disposition of the housing to a charitable organization that
performs charitable functions described by Subdivision (9).
For purposes of satisfying Paragraph (F) of Subdivision (1),
a hospital or hospital system may not change its existing fiscal
year unless the hospital or hospital system changes its ownership
or corporate structure as a result of a sale or merger.
For purposes of this subsection, a hospital that satisfies
Paragraph (A), (D), (G), or (H) of Subdivision (1) shall be
excluded in determining a hospital system's compliance with the
standards provided by Paragraph (B), (C), (E), or (F) of
Subdivision (1).
For purposes of this subsection, the terms "charity care,"
"government-sponsored indigent health care," "health care
organization," "hospital system," "net patient revenue," "nonprofit
hospital," and "tax-exempt benefits" have the meaning set forth in
Sections 311.031 and 311.042, Health and Safety Code. A
determination of the amount of community benefits and charity care
and government-sponsored indigent health care provided by a
hospital or hospital system and the hospital's or hospital system's
compliance with the requirements of Section 311.045, Health and
Safety Code, shall be based on the most recently completed and
audited prior fiscal year of the hospital or hospital system.
The providing of charity care and government-sponsored
indigent health care in accordance with Paragraph (a) of
Subdivision (1) shall be guided by the prudent business judgment of
the hospital which will ultimately determine the appropriate level
of charity care and government-sponsored indigent health care based
on the community needs, the available resources of the hospital,
the tax-exempt benefits received by the hospital, and other factors
that may be unique to the hospital, such as the hospital's volume
of Medicare and Medicaid patients. These criteria shall not be
determinative factors, but shall be guidelines contributing to the
hospital's decision along with other factors which may be unique to
the hospital. The formulas contained in Paragraphs (B), (C), (E),
and (F) of Subdivision (1) shall also not be considered
determinative of a reasonable amount of charity care and
government-sponsored indigent health care.
The requirements of this subsection shall not apply to the
extent a hospital or hospital system demonstrates that reductions
in the amount of community benefits, charity care, and
government-sponsored indigent health care are necessary to maintain
financial reserves at a level required by a bond covenant, are
necessary to prevent the hospital or hospital system from
endangering its ability to continue operations, or if the hospital
or hospital system, as a result of a natural or other disaster, is
required substantially to curtail its operations.
In any fiscal year that a hospital or hospital system,
through unintended miscalculation, fails to meet any of the
standards in Subdivision (1), the hospital or hospital system shall
not lose its tax-exempt status without the opportunity to cure the
miscalculation in the fiscal year following the fiscal year the
failure is discovered by both meeting one of the standards and
providing an additional amount of charity care and
government-sponsored indigent health care that is equal to the
shortfall from the previous fiscal year. A hospital or hospital
system may apply this provision only once every five years.
(e) A charitable organization must be operated in a way that
does not result in accrual of distributable profits, realization of
private gain resulting from payment of compensation in excess of a
reasonable allowance for salary or other compensation for services
rendered, or realization of any other form of private gain and, if
the organization performs one or more of the charitable functions
specified by Subsection (d) of this section other than a function
specified in Subdivision (1), (2), (8), (9), (12), <or> (16), or
(18), be organized as a nonprofit corporation as defined by the
Texas Non-Profit Corporation Act.