1-1     By:  Swinford (Senate Sponsor - Bivins)               H.B. No. 3448
 1-2           (In the Senate - Received from the House April 26, 1999;
 1-3     April 27, 1999, read first time and referred to Committee on
 1-4     Intergovernmental Relations; May 13, 1999, reported favorably by
 1-5     the following vote:  Yeas 5, Nays 0; May 13, 1999, sent to
 1-6     printer.)
 1-7                            A BILL TO BE ENTITLED
 1-8                                   AN ACT
 1-9     relating to the Moore County Hospital District.
1-10           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-11           SECTION 1.  Section 4, Chapter 287, Acts of the 61st
1-12     Legislature, Regular Session, 1969, is amended to read as follows:
1-13           Sec. 4.  (a)  In this section, "medical staff" means
1-14     physicians licensed to practice medicine in this state and holding
1-15     medical staff privileges granted by the district.
1-16           (b)  The board of directors of the hospital district consists
1-17     of seven members, appointed as follows:
1-18                 (1)  six members appointed by the commissioners court
1-19     of the county to serve staggered three-year terms; and
1-20                 (2)  one member appointed by the medical staff of the
1-21     district's hospital under Subsection (d) of this section to serve a
1-22     two-year term.
1-23           (c)  The member of the board of directors appointed under
1-24     Subsection (b)(2) of this section must be a member of the medical
1-25     staff of the district's hospital.  If the member is no longer a
1-26     member of the medical staff, the person vacates the position.
1-27           (d)  The members of the board of directors appointed under
1-28     Subsection (b)(1) of this section shall prescribe the procedures by
1-29     which the medical staff of the district's hospital shall select a
1-30     board member under this section.
1-31           (e)  [Within 10 days after such election is held, or as soon
1-32     thereafter as possible, the commissioners court in such county
1-33     shall convene and canvass the returns of the election and, in the
1-34     event such election results favorably to the proposition specified
1-35     in Section 3, the commissioners court shall so find and declare the
1-36     hospital district established and created and appoint six persons
1-37     as directors of the hospital district to serve until the first
1-38     Saturday in April following the creation and establishment of the
1-39     district, at which time six directors shall be appointed by the
1-40     said commissioners court who shall also designate the length of
1-41     term for each appointee.  Three of the directors then appointed
1-42     shall serve for two years; the other three directors shall serve
1-43     for one year.  Thereafter, each director shall serve for a period
1-44     of two years and until his successor has been duly appointed and
1-45     has qualified.]  Vacancies in office shall be filled for the
1-46     unexpired term by the same appointing entity that appointed the
1-47     vacating member [commissioners court.  Each member of the board of
1-48     directors shall execute a good and sufficient bond for $5,000
1-49     payable to said district conditioned upon the faithful performance
1-50     of his duties, and each bond shall be purchased at the expense of
1-51     the district; nothing herein shall prohibit covering each of the
1-52     directors under a single blanket public officials' bond.  Each
1-53     member of the board of directors shall execute the constitutional
1-54     oath of office].
1-55           (f) [(b)]  No person shall be appointed as a member of the
1-56     board of directors unless the person [he] is a resident of the
1-57     district[, a freeholder,] and a qualified voter.  Except as
1-58     provided by Subsections (b)(2) and (c) of this section, a district
1-59     [Neither the] administrator, [an] employee, or [of the district,
1-60     nor] a member of the medical staff is not [of the hospital shall
1-61     be] eligible to serve as a director.
1-62           (g) [(c)]  The board of directors shall organize by electing
1-63     one of their number as president and one of their number as vice
1-64     president.  A secretary, who need not be a director, shall also be
 2-1     elected.  Officers shall be elected for a term of one year and
 2-2     vacancies shall be filled for the unexpired term by the board of
 2-3     directors.  Any four members of the board of directors shall
 2-4     constitute a quorum and a concurrence of four shall be sufficient
 2-5     in all matters pertaining to the business of the district.  All
 2-6     members of the board of directors and officers shall serve without
 2-7     compensation, but may be reimbursed for actual expenses incurred in
 2-8     the performance of their official duties upon the approval of such
 2-9     expenses by the board of directors and so reported in the minute
2-10     book of the district or other records of the district.
2-11           SECTION 2.  Section 5, Chapter 287, Acts of the 61st
2-12     Legislature, Regular Session, 1969, is amended to read as follows:
2-13           Sec. 5.  The board of directors shall manage, control, and
2-14     administer the hospital system and all funds and resources of the
2-15     district, but in no event shall any operating, depreciation, or
2-16     building fund reserves be invested in any funds or securities
2-17     authorized by law, including Chapter 2256, Government Code [other
2-18     than those specified in Articles 836 and 837, Revised Civil
2-19     Statutes of Texas, 1925, as amended].  The board is given full
2-20     authority to establish rules and regulations relating to seniority
2-21     of employees of the district, including a retirement plan based
2-22     thereon, and may give effect to previous years of service for those
2-23     employees who have been continuously employed in the operation or
2-24     management of the hospital facilities acquired, including those
2-25     acquired upon the creation thereof by reason of Section 2 of this
2-26     Act, or constructed by the district.  The district, through its
2-27     board of directors, shall have the power and authority to sue and
2-28     be sued, and shall be entitled to all causes of action and defenses
2-29     enjoyed by similar authorities, to promulgate rules and regulations
2-30     governing the operation of the hospital, hospital system, its
2-31     staff, and its employees.  The board of directors shall appoint a
2-32     qualified person to be known as the administrator or manager of the
2-33     hospital district and may in its discretion appoint an assistant to
2-34     the administrator or manager.  Such administrator or manager and
2-35     assistant administrator or manager, if any, shall serve at the will
2-36     of the board and shall receive such compensation as may be fixed by
2-37     the board.  The administrator or manager shall, upon assuming his
2-38     duties, execute a bond payable to the hospital district in an
2-39     amount to be set by the board of directors, in no event less than
2-40     $500,000 [$5,000] conditioned that he shall perform the duties
2-41     required of him, and containing such other conditions as the board
2-42     may require.  The administrator or manager shall supervise all the
2-43     work and activities of the district and shall have general
2-44     direction of the affairs of the district, subject to the
2-45     limitations as may be prescribed by the board.  The board of
2-46     directors shall have the authority to appoint to the staff such
2-47     doctors as it may be deemed necessary for the efficient operation
2-48     of the district, and may provide for temporary appointments to the
2-49     staff if warranted by circumstances.  The board may delegate to the
2-50     administrator or manager the authority to employ technicians,
2-51     nurses, and employees of the district.  Such board shall be
2-52     authorized to contract with any other public or private entity,
2-53     including a county, municipality, hospital district, or any other
2-54     political subdivision, or a charitable organization, to provide
2-55     health care or related services inside or outside of the district
2-56     [political subdivision or governmental agency whereby the district
2-57     will provide investigatory or other services as to the hospital, or
2-58     welfare needs of the inhabitants of the district and shall be
2-59     authorized to contract with any county or incorporated municipality
2-60     located outside its boundaries for the care and treatment of the
2-61     sick, diseased, or injured persons of any such county or
2-62     municipality, and shall have the authority to contract with the
2-63     State of Texas or agencies of the federal government for the
2-64     treatment of sick, diseased, or injured persons].
2-65           SECTION 3.  Chapter 287, Acts of the 61st Legislature,
2-66     Regular Session, 1969, is amended by adding Section 5A to read as
2-67     follows:
2-68           Sec. 5A.  (a)  The board shall require reimbursement from:
2-69                 (1)  a county, municipality, or public hospital located
 3-1     outside the district's boundaries, for the district's care and
 3-2     treatment of a sick, diseased, or injured person of that county,
 3-3     municipality, or public hospital as provided by Chapter 61, Health
 3-4     and Safety Code;
 3-5                 (2)  the office of the sheriff of Moore County for the
 3-6     district's care and treatment of a person confined in a Moore
 3-7     County jail facility who is not indigent and does not reside in the
 3-8     district; or
 3-9                 (3)  the police department of a municipality located in
3-10     Moore County for the district's care and treatment of a person
3-11     confined in a jail facility in that municipality who is not
3-12     indigent and does not reside in the district.
3-13           (b)  The board may contract with this or any other state, the
3-14     United States, or an agency or political subdivision of those
3-15     entities, to reimburse the district for the care and treatment of a
3-16     sick, diseased, or injured person.
3-17           (c)  The board may contract with any municipality, county,
3-18     special district, state, the United States, or an agency or
3-19     political subdivision of those entities, or a charitable or other
3-20     private entity inside or outside the district for the district to
3-21     furnish a mobile emergency medical service or to provide for the
3-22     investigatory or welfare needs of inhabitants of the district or of
3-23     persons for whom the public or private entity has an obligation to
3-24     provide care.
3-25           SECTION 4.  Section 6, Chapter 287, Acts of the 61st
3-26     Legislature, Regular Session, 1969, is amended to read as follows:
3-27           Sec. 6.  The district shall be operated on the basis of a
3-28     fiscal year commencing on July 1 of each year and ending on June 30
3-29     of the following year, and it shall cause an independent audit to
3-30     be made of the financial condition of said district, which,
3-31     together with other records of the district, shall be open to
3-32     inspection at the principal office of the district, such audit to
3-33     be made covering such fiscal year, and the same shall be filed at
3-34     the office of the district as soon as it is completed.  The
3-35     administrator or manager shall prepare an annual budget for
3-36     approval by the board of directors.  The budget shall also contain
3-37     a complete financial statement of the district showing all
3-38     outstanding obligations of the district, the cash on hand to the
3-39     credit of each and every fund of the district, the funds received
3-40     from all sources during the previous year, the funds available from
3-41     all sources during the ensuing year, with balances expected at year
3-42     end of the year in which the budget is being prepared, and
3-43     estimated revenues and balances available to cover the proposed
3-44     budget and the estimated tax rate which will be required, and the
3-45     proposed expenditures and disbursements and the estimated receipts
3-46     and collections for the following fiscal year.  A public hearing on
3-47     the annual budget shall be held by the board of directors after
3-48     notice of such hearing has been published one time at least 10 days
3-49     before the date set therefor.  Notice of the budget hearing shall
3-50     be published in a newspaper or newspapers which individually or
3-51     collectively provide general circulation in the hospital district.
3-52     Any resident [property taxpayer] of the district shall have the
3-53     right to be present and participate in said hearing.  At the
3-54     conclusion of the hearing, the budget, as proposed by the
3-55     administrator, shall be acted upon by the board of directors.  The
3-56     board of directors shall have authority to make such changes in the
3-57     budget as in their sole judgment and discretion, applicable federal
3-58     and state [the] law warrants and allows, and the interest of the
3-59     residents of the district requires in furtherance of hospital
3-60     purposes [taxpayers demands].  No expenditure may be made for any
3-61     expense not included in the annual budget or an amendment thereto.
3-62     The annual budget may be amended from time to time as the
3-63     circumstances may require, but the annual budget, and all
3-64     amendments thereto, shall be approved by the board of directors.
3-65     As soon as practicable after the close of each fiscal year, the
3-66     administrator or manager shall prepare for the board a full sworn
3-67     statement of all moneys belonging to the district and a full
3-68     account of the disbursement of same.
3-69           SECTION 5.  Section 7(a), Chapter 287, Acts of the 61st
 4-1     Legislature, Regular Session, 1969, is amended to read as follows:
 4-2           (a)  The board of directors shall have the power and
 4-3     authority to issue and sell [its] bonds, certificates of
 4-4     obligation, or any other type of financing authorized by the laws
 4-5     of this state, including that type of financing authorized by
 4-6     Chapter 271, Local Government Code, in the name and upon the faith
 4-7     and credit of such hospital district for the purchase,
 4-8     construction, acquisition, repair, or renovation of buildings and
 4-9     improvements and equipping the same for hospital purposes, and for
4-10     any or all of such purposes.  At the time of the issuance of any
4-11     bonds by the district a tax shall be levied by the board sufficient
4-12     to create an interest and sinking fund to pay the interest on and
4-13     principal of said bonds as same mature, providing such tax together
4-14     with any other taxes levied for said district shall not exceed the
4-15     rate of tax voted under the provisions of Section 3 of this Act.
4-16     No bonds shall be issued by such hospital district except refunding
4-17     bonds until authorized by a majority of the qualified electors of
4-18     the district who own taxable property therein and who have duly
4-19     rendered the same for taxation voting at an election called for
4-20     such purpose.  The order for bond election shall specify the date
4-21     of the election, the amount of bonds to be authorized, the maximum
4-22     maturity thereof, the maximum rate of interest they are to bear,
4-23     the place or places where the election shall be held, the presiding
4-24     judge and alternate judge for each voting place and provide for
4-25     clerks as in county elections.  Notice of any bond election shall
4-26     be given as provided in Article 704, Revised Civil Statutes of
4-27     Texas, 1925, as amended, and shall be conducted in accordance with
4-28     the general laws of Texas pertaining to general elections, except
4-29     as modified by the provisions of this Act.
4-30           SECTION 6.  Section 10, Chapter 287, Acts of the 61st
4-31     Legislature, Regular Session, 1969, is amended to read as follows:
4-32           Sec. 10.  The board of directors of such district shall have
4-33     the power to prescribe the method and manner of making purchases
4-34     and expenditures by and for such hospital district, and shall also
4-35     be authorized to prescribe all accounting and control procedures.
4-36     All contracts for construction or purchases involving the
4-37     expenditure of more than $15,000 [$2,000] may be made only after
4-38     advertising in the manner provided by Subchapter B, Chapter 271,
4-39     Local Government Code [Chapter 163, Acts of the 42nd Legislature,
4-40     Regular Session, 1931, as amended  (Article 2368a, Vernon's Texas
4-41     Civil Statutes)].  Section 271.059, Local Government Code [The
4-42     provisions of Article 5160, Revised Civil Statutes of Texas, 1925,
4-43     as amended], relating to performance and payment bonds, applies
4-44     [shall apply] to construction contracts let by the district.  The
4-45     district may acquire equipment for use in its hospital system and
4-46     mortgage or pledge the property so acquired as security for the
4-47     payment of the purchase price[, but any such contract shall provide
4-48     for the entire obligation of the district to be retired within five
4-49     years from the date of the contract].  Except as permitted in the
4-50     preceding sentence and as permitted by Sections 7 and 8 of this
4-51     Act, the district may incur no obligation payable from any revenues
4-52     of the district, taxes or otherwise, except those on hand or to be
4-53     on hand within the then current and following fiscal year of the
4-54     district.
4-55           SECTION 7.  Section 11, Chapter 287, Acts of the 61st
4-56     Legislature, Regular Session, 1969, is amended to read as follows:
4-57           Sec. 11.  The board of directors of the district shall name
4-58     one or more depositories [banks within its boundaries to serve as
4-59     depository] for the funds of the district.  All funds of the
4-60     district, except those invested as provided in Section 5 of this
4-61     Act, and those transmitted to a bank or banks of payment for bonds
4-62     or obligations issued or assumed by the district, shall be
4-63     deposited as received with the depository [bank] and shall remain
4-64     on deposit, provided that nothing herein shall limit the power of
4-65     the board to place a portion of such funds on time deposit or other
4-66     forms of deposit or purchase certificates of deposit.
4-67           SECTION 8.  Section 15, Chapter 287, Acts of the 61st
4-68     Legislature, Regular Session, 1969, is amended to read as follows:
4-69           Sec. 15.  The directors shall have the authority to levy
 5-1     taxes for the entire year in which the district is established as
 5-2     the result of the election herein provided.  All taxes of the
 5-3     district shall be assessed and collected on appraisal district
 5-4     [county] tax values as provided in Subsection (a) of this section
 5-5     hereof unless the directors, by majority vote, elect to have taxes
 5-6     assessed and collected by its own tax assessor-collector under
 5-7     Subsection (b) of this section hereof.  Any such election may be
 5-8     made prior to December 1 annually and shall govern the manner in
 5-9     which taxes are thereafter assessed and collected, until changed by
5-10     a similar resolution.  Hospital tax shall be levied upon all
5-11     taxable property within said district subject to hospital district
5-12     taxation.
5-13           (a)  Under this subsection, district taxes shall be assessed
5-14     and collected on appraisal district [county] tax values in the same
5-15     manner as provided by law with relation to county taxes.  The tax
5-16     assessor-collector [of the county in which said district is
5-17     situated] shall be charged and required to accomplish the
5-18     assessment and collection of all taxes levied by and on behalf of
5-19     the district.  The assessor-collector of taxes shall charge and
5-20     deduct from payments to the hospital district an amount as fees for
5-21     assessing and collecting the taxes at a rate [of not exceeding two
5-22     percent of the amounts collected] as may be determined by the board
5-23     of directors [, but in no event shall the amount paid exceed $5,000
5-24     in any one calendar year].  [Such fees shall be deposited in the
5-25     officers' salary fund of the county and reported as fees of office
5-26     of the county tax assessor-collector.]  Interest and penalties on
5-27     taxes paid to the hospital district shall be the same as in the
5-28     case of county taxes.  Discounts shall be the same as allowed by
5-29     the county.  The residue of tax collections [after deductions of
5-30     discounts and fees for assessing and collecting] shall be deposited
5-31     in the district's depository.  The bond of the [county] tax
5-32     assessor-collector shall stand as security for the proper
5-33     performance of the assessor-collector's [his] duties as
5-34     assessor-collector of the district; or, if in the judgment of the
5-35     district board of directors it is necessary, additional bond
5-36     payable to the district may be required.  In all matters pertaining
5-37     to the assessment, collection, and enforcement of taxes for the
5-38     district, the [county] tax assessor-collector shall be authorized
5-39     to act in all respects according to the laws of the State of Texas
5-40     relating to state and county taxes.
5-41           (b)  Under this subsection, taxes shall be assessed and
5-42     collected by a tax assessor-collector appointed by the directors,
5-43     who shall also fix the terms of the assessor-collector's [his]
5-44     employment, compensation and requirement for bond to assure the
5-45     faithful performance of the assessor-collector's [his] duties, but
5-46     in no event shall such bond be for less than $100,000 [$5,000.  The
5-47     directors shall also annually appoint five persons to serve as a
5-48     board of equalization and shall fix their compensation.  Each
5-49     member of the board and the tax assessor shall be residents of the
5-50     district and own real property subject to hospital district
5-51     taxation, and each shall have the same duties, including the
5-52     obligation to execute the oath of office, as required by county
5-53     officials exercising such powers and duties.  Except as in this Act
5-54     provided to the contrary, all the provisions of Title 122, Revised
5-55     Civil Statutes of Texas, 1925, as amended, shall apply to the
5-56     district].
5-57           SECTION 9.  Section 17, Chapter 287, Acts of the 61st
5-58     Legislature, Regular Session, 1969, is amended to read as follows:
5-59           Sec. 17.  (a)  Whenever a patient residing within the
5-60     district has been admitted to the facilities thereof, the
5-61     administrator or manager may cause inquiry to be made as to the
5-62     patient's [his] circumstances and those of the relatives of such
5-63     patient legally liable for the patient's [his] support.  If the
5-64     administrator [he] finds that such patient or the patient's [said]
5-65     relatives are able to pay for the patient's [his] care and
5-66     treatment in whole or in part, an order shall be made directing
5-67     such patient or said relatives to pay to the hospital district for
5-68     the care and support of such patient a specified sum per week in
5-69     proportion to their financial ability.  The administrator or
 6-1     manager shall have power and authority to collect such sums from
 6-2     the estate of the patient or the patient's [his] relatives legally
 6-3     liable for the patient's [his] support in the manner provided by
 6-4     law for collection of expenses in the last illness of a deceased
 6-5     person.  If the administrator or manager finds that such patient or
 6-6     the patient's [said] relatives are not able to pay either in whole
 6-7     or in part for the patient's [his] care and treatment in such
 6-8     hospital, same shall become a charge upon the hospital district as
 6-9     to the amount of the inability to pay.  Should there be any dispute
6-10     as to the ability to pay or doubt in the mind of the administrator
6-11     or manager, the board of directors shall hear and determine same
6-12     after calling witnesses, and shall make such order or orders as may
6-13     be proper.  Appeals from the final order of the board shall lie to
6-14     the district court.  The substantial evidence rule shall apply.
6-15           (b)  Not later than the beginning of each operating year, the
6-16     district shall adopt an application procedure to determine
6-17     eligibility for assistance, as provided by Section 61.053, Health
6-18     and Safety Code.
6-19           SECTION 10.  Chapter 287, Acts of the 61st Legislature,
6-20     Regular Session, 1969, is amended by adding Section 25 to read as
6-21     follows:
6-22           Sec. 25.  (a)  In this section, "long-term lease" means a
6-23     lease for a term that exceeds 10 years.
6-24           (b)  The board of directors may not sell a hospital owned and
6-25     operated by the hospital district, including real property, or
6-26     lease the hospital under a long-term lease that relinquishes
6-27     control of the hospital to the lessee unless:
6-28                 (1)  the agreement for the sale or lease of the
6-29     hospital provides for indigent care in the district;
6-30                 (2)  in the event of a sale of the hospital, the board
6-31     has published notice of the proposed sale twice in a newspaper with
6-32     general circulation in Moore County, with the first publication
6-33     occurring not later than the 61st day before the date of the
6-34     proposed sale, and the second publication occurring not earlier
6-35     than the 30th day or later than the eighth day before the date of
6-36     the proposed sale; and
6-37                 (3)  the majority of the votes cast by qualified voters
6-38     of the district at an election called and held for that purpose
6-39     under the Election Code approve the sale or lease, as appropriate.
6-40           (c)  Notice required by Subsection (b)(2) of this section
6-41     must include the:
6-42                 (1)  date of the proposed sale;
6-43                 (2)  name and address of the proposed buyer; and
6-44                 (3)  proposed purchase price.
6-45           SECTION 11.  (a)  To succeed the directors of the Moore
6-46     County Hospital District who were appointed by the commissioners
6-47     court and whose terms expire in 2000, the Moore County
6-48     Commissioners Court shall appoint two directors to serve terms
6-49     expiring April 1, 2002, and one director to serve a term expiring
6-50     April 1, 2003.
6-51           (b)  To succeed the directors of the Moore County Hospital
6-52     District who were appointed by the commissioners court and whose
6-53     terms expire in 2001, the Moore County Commissioners Court shall
6-54     appoint one director to serve a term expiring April 1, 2003, and
6-55     two directors to serve terms expiring April 1, 2004.
6-56           (c)  Subsequent appointees of the Moore County Commissioners
6-57     Court serve three-year terms.
6-58           SECTION 12.  As soon as possible after the effective date of
6-59     this Act, the medical staff of the Moore County Hospital District's
6-60     hospital shall appoint one director of the district in the manner
6-61     provided by Section 4, Chapter 287, Acts of the 61st Legislature,
6-62     Regular Session, 1969, as amended by this Act.
6-63           SECTION 13.  The changes in law made by this Act to Section
6-64     10, Chapter 287, Acts of the 61st Legislature, Regular Session,
6-65     1969, apply only to a request for competitive bids made by the
6-66     board of directors of the Moore County Hospital District on or
6-67     after the effective date of this Act.  A request for competitive
6-68     bids by a board made before the effective date of this Act is
6-69     covered by the law in effect when the board submitted the request
 7-1     for competitive bids, and the former law is continued in effect for
 7-2     that purpose.
 7-3           SECTION 14.  This Act takes effect September 1, 1999.
 7-4           SECTION 15.  The importance of this legislation and the
 7-5     crowded condition of the calendars in both houses create an
 7-6     emergency and an imperative public necessity that the
 7-7     constitutional rule requiring bills to be read on three several
 7-8     days in each house be suspended, and this rule is hereby suspended.
 7-9                                  * * * * *