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Amend CSHB 2292 (Senate committee printing) by adding the
following appropriately numbered SECTIONS to Article 2 of the bill
and renumbering subsequent SECTIONS accordingly:
SECTION ____. Section 281.002, Health and Safety Code, is
amended by adding Subsection (c) to read as follows:
(c) A county with at least 190,000 inhabitants that has
within its boundaries a municipality that owns a hospital or
hospital system for indigent or needy persons that is operated by or
on behalf of the municipality may create a countywide hospital
district to assume ownership of the hospital or hospital system and
to furnish medical aid and hospital care to indigent and needy
persons residing in the district.
SECTION ____. Section 281.004, Health and Safety Code, is
amended to read as follows:
Sec. 281.004. BALLOT PROPOSITIONS. (a) Except as provided
by Subsection (a-1) or (b), the ballot for an election under this
chapter shall be printed to provide for voting for or against the
proposition: "The creation of a hospital district and the levy of a
tax not to exceed 75 cents on each $100 of the taxable value of
property taxable by the district."
(a-1) The ballot for an election under this chapter held in
a county with a population of more than 800,000 that is not
included in the boundaries of a hospital district before September
1, 2003, shall be printed to provide for voting for or against the
proposition: "The creation of a hospital district and the levy of a
tax not to exceed 25 cents on each $100 of the taxable value of
property taxable by the district."
(b) If the county or a municipality in the county has any
outstanding bonds issued for hospital purposes, the ballot for an
election under this chapter shall contain the proposition
prescribed by Subsection (a) or (a-1), as appropriate, followed by
" [be printed to provide for voting for or against the proposition:
"The creation of a hospital district, the levy of a tax not to
exceed 75 cents on each $100 of the taxable value of property
taxable by the district], and the assumption by the district of all
outstanding bonds previously issued for hospital purposes by
__________ County and by any municipality in the county."
SECTION ____. Section 281.021, Health and Safety Code, is
amended by adding Subsection (d) to read as follows:
(d) If a district is created under this chapter in a county
with a population of more than 800,000 that was not included in the
boundaries of a hospital district before September 1, 2003, the
district shall be governed by a nine-member board of hospital
managers, appointed as follows:
(1) the commissioners court of the county shall
appoint four members;
(2) the governing body of the municipality with the
largest population in the county shall appoint four members; and
(3) the commissioners court and the governing body of
the municipality described by Subdivision (2) shall jointly appoint
one member.
SECTION ____. Section 281.022, Health and Safety Code, is
amended by adding Subsection (c) to read as follows:
(c) The members of a board of hospital managers appointed
under Section 281.021(d) serve staggered four-year terms, with as
near as possible to one-fourth of the members' terms expiring each
year. The terms of the members appointed under that section are as
follows:
(1) the members appointed solely by the governing body
of the municipality with the largest population in the county shall
draw lots to determine which member serves a one-year term, which
member serves a two-year term, which member serves a three-year
term, and which member serves a four-year term;
(2) the members appointed solely by the commissioners
court of the county shall draw lots to determine which member serves
a one-year term, which member serves a two-year term, which member
serves a three-year term, and which member serves a four-year term;
and
(3) the member appointed jointly by the governing body
of the municipality described by Subdivision (1) and the
commissioners court serves a four-year term.
SECTION ____. Section 281.041, Health and Safety Code, is
amended by amending Subsections (a) and (b) and adding Subsections
(e) and (f) to read as follows:
(a) Except as provided by Subsection (e), on [On] the
creation of a district under this chapter and the appointment and
qualification of the district board, the county owning the hospital
or hospital system, [or] the county and municipality jointly
operating a hospital or hospital system, or the municipality owning
a hospital or hospital system shall execute and deliver to the
district board a written instrument conveying to the district the
title to land, buildings, and equipment jointly or separately owned
by the county and municipality and used to provide medical services
or hospital care, including geriatric care, to indigent or needy
persons of the county or municipality.
(b) On the creation of a district under this chapter and the
appointment and qualification of the district board, the county
owning the hospital or hospital system, [or] the county and
municipality jointly operating a hospital or hospital system, or
the municipality owning a hospital or hospital system shall, on the
receipt of a certificate executed by the board's chairman stating
that a depository for the district has been chosen and qualified,
transfer to the district:
(1) all joint or separate county and municipal funds
that are the proceeds of any bonds assumed by the district under
Section 281.044; and
(2) all unexpended joint or separate county and
municipal funds that have been established or appropriated by the
county or municipality to support and maintain the hospital
facilities for the year in which the district is created, to be used
by the district to operate and maintain those facilities for the
remainder of the year.
(e) A county or municipality transferring property or funds
under this section is not required to transfer to the district:
(1) a medical facility used primarily for the
treatment of inmates of a jail or any other correctional
facilities, including juvenile justice facilities;
(2) property owned by the municipality that is used in
connection with the provision of utility services, including
electricity, water, wastewater, and sewer services;
(3) any real property or other assets related to a
medical clinic facility on which construction has begun, but has
not been completed, by the date on which the board members have been
appointed and qualified to serve;
(4) a building and related land owned by the county or
municipality that are used for purposes related or unrelated to the
hospital or hospital system, except that:
(A) if the county or municipality retains
ownership of the building and related land, the county or
municipality shall lease the space used for hospital or hospital
system purposes to the district for an initial term of three years
unless a shorter term is otherwise agreed to by the district and the
transferring entity; or
(B) if the county or municipality transfers the
building and related land to the district, the district shall lease
to the transferring entity the space not used for hospital or
hospital system purposes for an initial term of three years unless a
shorter term is otherwise agreed to by the district and the
transferring entity;
(5) any or all of the public health services and
related facilities of the county or municipality, other than a
hospital or hospital district, unless the transfer of the public
health services or a related facility to the district is mutually
agreed to by the district and the transferring entity; or
(6) an ambulance service, emergency medical service,
search and rescue service, or medical transport service that is
owned or operated by the county or municipality, unless the
transfer of all or part of the service and related buildings and
equipment to the district is mutually agreed to by the district and
the transferring entity.
(f) A transfer of an asset under this section, including a
federally qualified health center, that would violate federal or
state law unless a waiver or other authorization or approval is
granted by a federal or state agency may not occur until the
required waiver, authorization, or approval is obtained. A
facility designated as a federally qualified health center under 42
U.S.C. Section 1396d(l)(2)(B), as amended, may not be transferred
to the district until the district board has confirmed that the
transfer will not jeopardize the federal designation of that
facility.
SECTION ____. Section 281.043, Health and Safety Code, is
amended to read as follows:
Sec. 281.043. ASSUMPTION OF CONTRACT OBLIGATIONS. On the
creation of the district, the district assumes, without prejudice
to the rights of third parties, any outstanding contract
obligations legally incurred by the county or municipality, or
both, for the construction, support, [or] maintenance, or operation
of hospital facilities and the provision of health care services or
hospital care, including mental health care, to indigent residents
of the county or municipality before the creation of the district.
SECTION ____. Subchapter C, Chapter 281, Health and Safety
Code, is amended by adding Section 281.0461 to read as follows:
Sec. 281.0461. STUDY. (a) This section applies only to a
district created in a county with a population of more than 800,000
that was not included in the boundaries of a hospital district
before September 1, 2003.
(b) The board shall contract with an independent and
disinterested person or entity to conduct a study to:
(1) examine the necessity of increased indigent,
pediatric, trauma, and mental health care in the geographical area
served by the district over the 5-year, 15-year, and 30-year
periods following the date of the district's creation;
(2) examine the necessity of an increased number of
health care specialists and nurses to adequately serve the district
over the 5-year, 15-year, and 30-year periods following the date of
the district's creation; and
(3) determine whether additional education and
training programs will be required to address the issues studied
under this section.
SECTION ____. The heading to Subchapter G, Chapter 281,
Health and Safety Code, is amended to read as follows:
SUBCHAPTER G. TAXES [TO PAY BONDS]
SECTION ____. Section 281.121(b), Health and Safety Code,
is amended to read as follows:
(b) The tax amount:
(1) must be sufficient to create an interest and
sinking fund to pay the principal of and interest on the bonds as
they mature; and
(2) may not exceed 75 cents on each $100 of the taxable
value of property taxable by the district, or the rate authorized in
the election to create the district.
SECTION ____. Subchapter G, Chapter 281, Health and Safety
Code, is amended by adding Sections 281.122 and 281.123 to read as
follows:
Sec. 281.122. REDUCTION IN AD VALOREM TAX RATE BY
GOVERNMENTAL ENTITY. (a) This section applies only to a district
created in a county with a population of more than 800,000 that was
not included in the boundaries of a hospital district before
September 1, 2003.
(b) The commissioners court of the county and the governing
body of the municipality with the largest population in the county,
in determining the ad valorem tax rate of the county or
municipality, as appropriate, for the first year in which the
district imposes ad valorem taxes on property in the district,
shall:
(1) take into account the decrease in the amount the
county or municipality will spend for health care purposes in that
year because the district is providing health care services
previously provided or paid for by the county or municipality; and
(2) reduce the ad valorem tax rate adopted for the
county or municipality, as appropriate, in accordance with the
amount of the decrease.
(c) The commissioners court of the county and the governing
body of the municipality with the largest population in the county
shall retain an independent auditor to verify that the ad valorem
tax rate of the county or municipality, as appropriate, has been
reduced as required by Subsection (b).
Sec. 281.123. SALES AND USE TAX PROHIBITED FOR CERTAIN
DISTRICTS. (a) This section applies only to a district created in
a county with a population of more than 800,000 that was not
included in the boundaries of a hospital district before September
1, 2003.
(b) The board may not impose a sales and use tax under
Subchapter E, Chapter 285, or any other law.