79R9979 KEG-F


By:  Villarreal, Menendez, Flores, et al.                         H.B. No. 2463

Substitute the following for H.B. No. 2463:                                   

By:  Smith of Harris                                          C.S.H.B. No. 2463


A BILL TO BE ENTITLED
AN ACT
relating to the creation of health care funding districts in certain counties and authorizing the districts to impose taxes on certain institutional health care providers located in the districts. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Subtitle D, Title 4, Health and Safety Code, is amended by adding Chapters 288-291 to read as follows:
CHAPTER 288. HEALTH CARE FUNDING DISTRICTS IN CERTAIN COUNTIES LOCATED ON TEXAS-MEXICO BORDER THAT ARE ADJACENT TO COUNTIES WITH POPULATION OF 50,000 OR MORE
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 288.001. DEFINITIONS. In this chapter: (1) "Commission" means the commission of a district created under this chapter. (2) "District" means a county health care funding district created by this chapter. (3) "District taxpayer" means a person or entity subject to a tax imposed under this chapter. (4) "Institutional health care provider" means a nonpublic general hospital licensed under Chapter 241. Sec. 288.002. CREATION OF DISTRICT. A district is created in each county located on the Texas-Mexico border that has a population of 500,000 or more and is adjacent to two or more counties each of which has a population of 50,000 or more. Sec. 288.003. DURATION OF DISTRICT. (a) Unless continued in existence by the legislature, a district created by this chapter is abolished September 1, 2007. (b) Any money held by a district at the time the district is abolished shall be used to pay any outstanding administrative expenses of the district, and the commission shall direct the secretary of the commission to return the pro rata share of any remaining district money to each district taxpayer. Sec. 288.004. POLITICAL SUBDIVISION. A district created by this chapter is a political subdivision of this state. Sec. 288.005. DISTRICT TERRITORY. The boundaries of each district are coextensive with the boundaries of the county in which the district is created.
[Sections 288.006-288.050 reserved for expansion]
SUBCHAPTER B. DISTRICT ADMINISTRATION
Sec. 288.051. COMMISSION; APPOINTMENT. (a) Each district is governed by a commission of five members appointed as provided by this section. (b) Each county commissioner on the commissioners court of the county in which the district is located shall appoint one member who meets the qualifications prescribed by Section 288.052 to serve on the commission. The county judge of the county shall appoint one member who meets the qualifications prescribed by Section 288.052 to serve on the commission. Sec. 288.052. QUALIFICATION OF MEMBERS OF COMMISSION. To be eligible to serve as a member of the commission, a person must: (1) be a United States citizen; (2) be 18 years of age or older on the first day of the term that the person is appointed to fill; (3) have not been determined mentally incompetent by a final judgment of a court; (4) have not been finally convicted of a felony from which the person has not been pardoned or otherwise released from the resulting disabilities; (5) have resided continuously in this state for 12 months and in the county in which the district is located for six months immediately preceding the date of the appointment; and (6) be a person knowledgeable in the field of health care. Sec. 288.053. TERM OF MEMBERS OF COMMISSION. The members of the commission serve staggered two-year terms. Sec. 288.054. VACANCY. (a) If a vacancy occurs on the commission, the commissioners court of the county in which the district is located shall appoint a qualified person to fill the vacancy not later than the 30th day after the date the vacancy occurs. (b) If the commissioners court of the county in which the district is located does not appoint a member to the commission to fill a vacancy by the 30th day after the date the vacancy occurs, the remaining members of the commission may, by vote of the commission, appoint a replacement. Sec. 288.055. OFFICERS. (a) Each commission shall elect a chairperson and a secretary from among its members. (b) The chairperson and secretary shall each serve in that office until the expiration of their term as a member of the commission. Sec. 288.056. COMPENSATION; EXPENSES. A member of the commission serves without compensation but may, on the approval of the entire commission, be reimbursed for actual expenses incurred in the performance of the member's official duties. Sec. 288.057. EMPLOYEES AND INDEPENDENT CONTRACTORS. The commission may employ an attorney, financial advisor, and bookkeeper for the district or contract for those services. Sec. 288.058. MAINTENANCE OF RECORDS; PUBLIC INSPECTION. Except as otherwise provided by law, all district records, including books, accounts, notices, minutes, and all other matters of the district and the operation of its facilities, shall be: (1) maintained at the district office; and (2) open to public inspection at the district office during reasonable hours.
[Sections 288.059-288.100 reserved for expansion]
SUBCHAPTER C. POWERS AND DUTIES
Sec. 288.101. LIMITATION ON TAXING AUTHORITY. Each district may impose taxes only in the manner provided by this chapter. Sec. 288.102. MAJORITY VOTE REQUIRED. (a) A district may not impose any tax authorized by this chapter, spend any money, including for the administrative expenses of the district, or conduct any other business of the commission without an affirmative vote of a majority of the members of the commission. (b) Before imposing a tax under this chapter in any one year, the commission must obtain the affirmative vote required by Subsection (a). Sec. 288.103. ELECTION REQUIRED FOR CERTAIN EXPENDITURES. (a) In addition to the majority vote required under Section 288.102, a district may not spend any money of the district unless the district receives the approval of at least 95 percent of the district taxpayers. (b) This section does not apply to expenditures related to the administrative matters of the district. Sec. 288.104. RULES AND PROCEDURES. (a) The commission may adopt rules governing the operation of the district, including rules relating to the administration of a tax authorized by this chapter. (b) In order to implement the requirements of Sections 288.102 and 288.103, the commission shall adopt any necessary procedures. Sec. 288.105. PURCHASING AND ACCOUNTING PROCEDURES. (a) The commission may prescribe the method and manner for making purchases and expenditures by the district. (b) The commission shall prescribe: (1) all accounting and control procedures; and (2) the method of purchasing necessary supplies, materials, and equipment. Sec. 288.106. INSTITUTIONAL HEALTH CARE PROVIDER REPORTING; INSPECTION OF RECORDS. (a) A district shall require an institutional health care provider to submit to the district a copy of any financial and utilization data required by and reported to the Department of State Health Services under Sections 311.032 and 311.033 and any rules adopted by the department to implement those sections. (b) A district may inspect the records of an institutional health care provider to the extent necessary to ensure that the provider has submitted all required data under this section. Sec. 288.107. AUTHORITY TO SUE AND BE SUED. Each district may sue and be sued in its own name in any court of this state as a governmental agency.
[Sections 288.108-288.150 reserved for expansion]
SUBCHAPTER D. GENERAL FINANCIAL PROVISIONS
Sec. 288.151. BUDGET. (a) Each year, the commission shall prepare a budget for the following fiscal year that includes: (1) proposed expenditures and disbursements; (2) estimated receipts and collections; and (3) the rates and amounts of any taxes that the commission intends to impose during the year. (b) The commission shall hold a public hearing on the proposed budget. Not later than the 10th day before the date of the hearing, the commission shall publish at least once notice of the hearing in a newspaper of general circulation in the county in which the district is located. (c) Any district taxpayer is entitled to appear at the time and place designated in the public notice and to be heard regarding any item shown in the proposed budget. Sec. 288.152. FISCAL YEAR. Each district's fiscal year begins on September 1 and ends on August 31 of each year. Sec. 288.153. ANNUAL AUDIT. (a) For each fiscal year, each commission shall have an independent audit made of the district's books and records. (b) Not later than December 31 of each year, the audit made for a district shall be filed with the comptroller and at the office of the district. Sec. 288.154. DEPOSITORY. (a) Each commission by resolution shall designate one or more banks located in the district as the depository for the district. A bank designated as depository serves for two years or until a successor is designated. (b) All income received by a district, including tax revenue after deducting discounts and fees for assessing and collecting the taxes, shall be deposited with the district depository and may be withdrawn only as provided by this chapter. (c) All district funds shall be secured in the manner provided for securing county funds.
[Sections 288.155-288.200 reserved for expansion]
SUBCHAPTER E. TAXES
Sec. 288.201. TAX ON OUTPATIENT HOSPITAL SERVICES. (a) The commission of a district may impose an annual tax on all outpatient hospital visits to an institutional health care provider located in the district. In the first year in which the tax is imposed, the tax is assessed on the total number of outpatient hospital visits of an institutional health care provider reported to the Department of State Health Services under Sections 311.032 and 311.033 in the most recent fiscal year for which the information is available. The district shall update this tax basis with the number of outpatient hospital visits reported on a biennial basis. (b) A tax imposed under this section must be imposed uniformly on each institutional health care provider of outpatient hospital services located in the district. A tax imposed under this section also may not hold harmless any institutional health care provider of outpatient hospital services, as required under 42 U.S.C. Section 1396b(w). (c) The commission shall set the rate of the tax imposed under this section. The rate may not exceed $100 for each outpatient hospital visit. (d) Subject to the maximum tax rate prescribed by Subsection (c), the commission shall set the rate of the tax at a rate that will generate sufficient revenue to cover the administrative expenses of the district, to fund the nonfederal share of a Medicaid supplemental payment program, and to pay for indigent health care services, except that the amount of tax revenue used for administrative expenses of the district in a year may not exceed the lesser of four percent of the total revenue generated from the tax or $20,000. (e) An institutional health care provider may not add a tax imposed under this section as a surcharge to a patient. (f) An institutional health care provider that is a hospital that primarily treats patients with mental illness is exempt from a tax imposed by this section. Sec. 288.202. ASSESSMENT AND COLLECTION OF TAXES. (a) Except as provided by Subsection (b), the county tax assessor-collector shall collect a tax imposed under this subchapter unless the commission employs a tax assessor and collector for the district. The county tax assessor-collector shall charge and deduct from taxes collected for the district a fee for collecting the tax in an amount determined by the commission, not to exceed the county tax assessor-collector's usual and customary charges for the collection of similar taxes. (b) If determined by the commission to be appropriate, the commission may contract for the assessment and collection of taxes in the manner provided by Title 1, Tax Code, for the assessment and collection of ad valorem taxes. (c) Revenue from a fee charged by a county tax assessor-collector for collecting the tax shall be deposited in the county general fund and, if appropriate, shall be reported as fees of the county tax assessor-collector. Sec. 288.203. USE OF TAX REVENUE. Revenue generated by a district from a tax imposed under this subchapter may be used only to: (1) provide the nonfederal share of a Medicaid supplemental payment program; (2) subsidize indigent health care services; and (3) pay administrative expenses of the district. Sec. 288.204. INTEREST, PENALTIES, AND DISCOUNTS. Interest, penalties, and discounts on taxes imposed under this subchapter are governed by the law applicable to county ad valorem taxes.
CHAPTER 289. COUNTY HEALTH CARE FUNDING DISTRICTS IN CERTAIN COUNTIES LOCATED ADJACENT TO COUNTY WITH POPULATION OF
3.3 MILLION OR MORE
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 289.001. DEFINITIONS. In this chapter: (1) "Commission" means the commission of a district created under this chapter. (2) "District" means a county health care funding district created by this chapter. (3) "District taxpayer" means a person or entity subject to a tax imposed under this chapter. (4) "Institutional health care provider" means a nonpublic general hospital licensed under Chapter 241. Sec. 289.002. CREATION OF DISTRICT. A district is created in each county: (1) that has a population of 275,000 or more and is located adjacent to a county with a population of 3.3 million or more; and (2) in which no municipality with a population of 60,000 or more is located. Sec. 289.003. DURATION OF DISTRICT. (a) Unless continued in existence by the legislature, a district created by this chapter is abolished September 1, 2007. (b) Any money held by a district at the time the district is abolished shall be used to pay any outstanding administrative expenses of the district, and the commission shall direct the secretary of the commission to return the pro rata share of any remaining district money to each district taxpayer. Sec. 289.004. POLITICAL SUBDIVISION. A district created by this chapter is a political subdivision of this state. Sec. 289.005. DISTRICT TERRITORY. The boundaries of each district are coextensive with the boundaries of the county in which the district is created.
[Sections 289.006-289.050 reserved for expansion]
SUBCHAPTER B. DISTRICT ADMINISTRATION
Sec. 289.051. COMMISSION; APPOINTMENT. (a) Each district is governed by a commission of five members appointed as provided by this section. (b) Each county commissioner on the commissioners court of the county in which the district is located shall appoint one member who meets the qualifications prescribed by Section 289.052 to serve on the commission. The county judge of the county shall appoint one member who meets the qualifications prescribed by Section 289.052 to serve on the commission. Sec. 289.052. QUALIFICATION OF MEMBERS OF COMMISSION. To be eligible to serve as a member of the commission, a person must: (1) be a United States citizen; (2) be 18 years of age or older on the first day of the term that the person is appointed to fill; (3) have not been determined mentally incompetent by a final judgment of a court; (4) have not been finally convicted of a felony from which the person has not been pardoned or otherwise released from the resulting disabilities; (5) have resided continuously in this state for 12 months and in the county in which the district is located for six months immediately preceding the date of the appointment; and (6) be a person knowledgeable in the field of health care. Sec. 289.053. TERM OF MEMBERS OF COMMISSION. The members of the commission serve staggered two-year terms. Sec. 289.054. VACANCY. (a) If a vacancy occurs on the commission, the commissioners court of the county in which the district is located shall appoint a qualified person to fill the vacancy not later than the 30th day after the date the vacancy occurs. (b) If the commissioners court of the county in which the district is located does not appoint a member to the commission to fill a vacancy by the 30th day after the date the vacancy occurs, the remaining members of the commission may, by vote of the commission, appoint a replacement. Sec. 289.055. OFFICERS. (a) Each commission shall elect a chairperson and a secretary from among its members. (b) The chairperson and secretary shall each serve in that office until the expiration of their term as a member of the commission. Sec. 289.056. COMPENSATION; EXPENSES. A member of the commission serves without compensation but may, on the approval of the entire commission, be reimbursed for actual expenses incurred in the performance of the member's official duties. Sec. 289.057. EMPLOYEES AND INDEPENDENT CONTRACTORS. The commission may employ an attorney, financial advisor, and bookkeeper for the district or contract for those services. Sec. 289.058. MAINTENANCE OF RECORDS; PUBLIC INSPECTION. Except as otherwise provided by law, all district records, including books, accounts, notices, minutes, and all other matters of the district and the operation of its facilities, shall be: (1) maintained at the district office; and (2) open to public inspection at the district office during reasonable hours.
[Sections 289.059-289.100 reserved for expansion]
SUBCHAPTER C. POWERS AND DUTIES
Sec. 289.101. LIMITATION ON TAXING AUTHORITY. Each district may impose taxes only in the manner provided by this chapter. Sec. 289.102. MAJORITY VOTE REQUIRED. (a) A district may not impose any tax authorized by this chapter, spend any money, including for the administrative expenses of the district, or conduct any other business of the commission without an affirmative vote of a majority of the members of the commission. (b) Before imposing a tax under this chapter in any one year, the commission must obtain the affirmative vote required by Subsection (a). Sec. 289.103. ELECTION REQUIRED FOR CERTAIN EXPENDITURES. (a) In addition to the majority vote required under Section 289.102, a district may not spend any money of the district unless the district receives the approval of at least 95 percent of the district taxpayers. (b) This section does not apply to expenditures related to the administrative matters of the district. Sec. 289.104. RULES AND PROCEDURES. (a) The commission may adopt rules governing the operation of the district, including rules relating to the administration of a tax authorized by this chapter. (b) In order to implement the requirements of Sections 289.102 and 289.103, the commission shall adopt any necessary procedures. Sec. 289.105. PURCHASING AND ACCOUNTING PROCEDURES. (a) The commission may prescribe the method and manner for making purchases and expenditures by the district. (b) The commission shall prescribe: (1) all accounting and control procedures; and (2) the method of purchasing necessary supplies, materials, and equipment. Sec. 289.106. INSTITUTIONAL HEALTH CARE PROVIDER REPORTING; INSPECTION OF RECORDS. (a) A district shall require an institutional health care provider to submit to the district a copy of any financial and utilization data required by and reported to the Department of State Health Services under Sections 311.032 and 311.033 and any rules adopted by the department to implement those sections. (b) A district may inspect the records of an institutional health care provider to the extent necessary to ensure that the provider has submitted all required data under this section. Sec. 289.107. AUTHORITY TO SUE AND BE SUED. Each district may sue and be sued in its own name in any court of this state as a governmental agency.
[Sections 289.108-289.150 reserved for expansion]
SUBCHAPTER D. GENERAL FINANCIAL PROVISIONS
Sec. 289.151. BUDGET. (a) Each year, the commission shall prepare a budget for the following fiscal year that includes: (1) proposed expenditures and disbursements; (2) estimated receipts and collections; and (3) the rates and amounts of any taxes that the commission intends to impose during the year. (b) The commission shall hold a public hearing on the proposed budget. Not later than the 10th day before the date of the hearing, the commission shall publish at least once notice of the hearing in a newspaper of general circulation in the county in which the district is located. (c) Any district taxpayer is entitled to appear at the time and place designated in the public notice and to be heard regarding any item shown in the proposed budget. Sec. 289.152. FISCAL YEAR. Each district's fiscal year begins on September 1 and ends on August 31 of each year. Sec. 289.153. ANNUAL AUDIT. (a) For each fiscal year, each commission shall have an independent audit made of the district's books and records. (b) Not later than December 31 of each year, the audit made for a district shall be filed with the comptroller and at the office of the district. Sec. 289.154. DEPOSITORY. (a) Each commission by resolution shall designate one or more banks located in the district as the depository for the district. A bank designated as depository serves for two years or until a successor is designated. (b) All income received by a district, including tax revenue after deducting discounts and fees for assessing and collecting the taxes, shall be deposited with the district depository and may be withdrawn only as provided by this chapter. (c) All district funds shall be secured in the manner provided for securing county funds.
[Sections 289.155-289.200 reserved for expansion]
SUBCHAPTER E. TAXES
Sec. 289.201. TAX ON EMERGENCY ROOM SERVICES. (a) The commission of a district may impose an annual tax on all emergency room visits to an institutional health care provider located in the district. In the first year in which the tax is imposed, the tax is assessed on the total number of emergency room visits of an institutional health care provider reported to the Department of State Health Services under Sections 311.032 and 311.033 in the most recent fiscal year for which information is available. The district shall update this tax basis with the number of emergency room visits reported on a biennial basis. (b) A tax imposed under this section must be imposed uniformly on each institutional health care provider of emergency room services located in the district. A tax imposed under this section also may not hold harmless any institutional health care provider of emergency room services, as required under 42 U.S.C. Section 1396b(w). (c) The commission shall set the rate of the tax imposed under this section. The rate may not exceed $150 for each emergency room visit. (d) Subject to the maximum tax rate prescribed by Subsection (c), the commission shall set the rate of the tax at a rate that will generate sufficient revenue to cover the administrative expenses of the district, to fund the nonfederal share of a Medicaid supplemental payment program, and to pay for indigent health care services, except that the amount of tax revenue used for administrative expenses of the district in a year may not exceed the lesser of four percent of the total revenue generated from the tax or $20,000. (e) An institutional health care provider may not add a tax imposed under this section as a surcharge to a patient. (f) An institutional health care provider that is a hospital that primarily treats patients with mental illness is exempt from a tax imposed by this section. Sec. 289.202. ASSESSMENT AND COLLECTION OF TAXES. (a) Except as provided by Subsection (b), the county tax assessor-collector shall collect a tax imposed under this subchapter unless the commission employs a tax assessor and collector for the district. The county tax assessor-collector shall charge and deduct from taxes collected for the district a fee for collecting the tax in an amount determined by the commission, not to exceed the county tax assessor-collector's usual and customary charges for the collection of similar taxes. (b) If determined by the commission to be appropriate, the commission may contract for the assessment and collection of taxes in the manner provided by Title 1, Tax Code, for the assessment and collection of ad valorem taxes. (c) Revenue from a fee charged by a county tax assessor-collector for collecting the tax shall be deposited in the county general fund and, if appropriate, shall be reported as fees of the county tax assessor-collector. Sec. 289.203. USE OF TAX REVENUE. Revenue generated by a district from a tax imposed under this subchapter may be used only to: (1) provide the nonfederal share of a Medicaid supplemental payment program; (2) subsidize indigent health care services; and (3) pay administrative expenses of the district. Sec. 289.204. INTEREST, PENALTIES, AND DISCOUNTS. Interest, penalties, and discounts on taxes imposed under this subchapter are governed by the law applicable to county ad valorem taxes.
CHAPTER 290. COUNTY HEALTH CARE FUNDING DISTRICTS IN CERTAIN COUNTIES LOCATED ON TEXAS-MEXICO BORDER THAT HAVE POPULATION OF LESS THAN 200,000
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 290.001. DEFINITIONS. In this chapter: (1) "Commission" means the commission of a district created under this chapter. (2) "District" means a county health care funding district created by this chapter. (3) "District taxpayer" means a person or entity subject to a tax imposed under this chapter. (4) "Institutional health care provider" means a nonpublic general hospital licensed under Chapter 241. Sec. 290.002. CREATION OF DISTRICT. A district is created in each county located on the Texas-Mexico border that has a population of less than 200,000 and contains one or more municipalities with a population of 100,000 or more. Sec. 290.003. DURATION OF DISTRICT. (a) Unless continued in existence by the legislature, a district created by this chapter is abolished September 1, 2007. (b) Any money held by a district at the time the district is abolished shall be used to pay any outstanding administrative expenses of the district, and the commission shall direct the secretary of the commission to return the pro rata share of any remaining district money to each district taxpayer. Sec. 290.004. POLITICAL SUBDIVISION. A district created by this chapter is a political subdivision of this state. Sec. 290.005. DISTRICT TERRITORY. The boundaries of each district are coextensive with the boundaries of the county in which the district is created.
[Sections 290.006-290.050 reserved for expansion]
SUBCHAPTER B. DISTRICT ADMINISTRATION
Sec. 290.051. COMMISSION; APPOINTMENT. (a) Each district is governed by a commission of five members appointed as provided by this section. (b) Each county commissioner on the commissioners court of the county in which the district is located shall appoint one member who meets the qualifications prescribed by Section 290.052 to serve on the commission. The county judge of the county shall appoint one member who meets the qualifications prescribed by Section 290.052 to serve on the commission. Sec. 290.052. QUALIFICATION OF MEMBERS OF COMMISSION. To be eligible to serve as a member of the commission, a person must: (1) be a United States citizen; (2) be 18 years of age or older on the first day of the term that the person is appointed to fill; (3) have not been determined mentally incompetent by a final judgment of a court; (4) have not been finally convicted of a felony from which the person has not been pardoned or otherwise released from the resulting disabilities; (5) have resided continuously in this state for 12 months and in the county in which the district is located for six months immediately preceding the date of the appointment; and (6) be a person knowledgeable in the field of health care. Sec. 290.053. TERM OF MEMBERS OF COMMISSION. The members of the commission serve staggered two-year terms. Sec. 290.054. VACANCY. (a) If a vacancy occurs on the commission, the commissioners court of the county in which the district is located shall appoint a qualified person to fill the vacancy not later than the 30th day after the date the vacancy occurs. (b) If the commissioners court of the county in which the district is located does not appoint a member to the commission to fill a vacancy by the 30th day after the date the vacancy occurs, the remaining members of the commission may, by vote of the commission, appoint a replacement. Sec. 290.055. OFFICERS. (a) Each commission shall elect a chairperson and a secretary from among its members. (b) The chairperson and secretary shall each serve in that office until the expiration of their term as a member of the commission. Sec. 290.056. COMPENSATION; EXPENSES. A member of the commission serves without compensation but may, on the approval of the entire commission, be reimbursed for actual expenses incurred in the performance of the member's official duties. Sec. 290.057. EMPLOYEES AND INDEPENDENT CONTRACTORS. The commission may employ an attorney, financial advisor, and bookkeeper for the district or contract for those services. Sec. 290.058. MAINTENANCE OF RECORDS; PUBLIC INSPECTION. Except as otherwise provided by law, all district records, including books, accounts, notices, minutes, and all other matters of the district and the operation of its facilities, shall be: (1) maintained at the district office; and (2) open to public inspection at the district office during reasonable hours.
[Sections 290.059-290.100 reserved for expansion]
SUBCHAPTER C. POWERS AND DUTIES
Sec. 290.101. LIMITATION ON TAXING AUTHORITY. Each district may impose taxes only in the manner provided by this chapter. Sec. 290.102. MAJORITY VOTE REQUIRED. (a) A district may not impose any tax authorized by this chapter, spend any money, including for the administrative expenses of the district, or conduct any other business of the commission without an affirmative vote of a majority of the members of the commission. (b) Before imposing a tax under this chapter in any one year, the commission must obtain the affirmative vote required by Subsection (a). Sec. 290.103. ELECTION REQUIRED FOR CERTAIN EXPENDITURES. (a) In addition to the majority vote required under Section 290.102, a district may not spend any money of the district unless the district receives the approval of at least 95 percent of the district taxpayers. (b) This section does not apply to expenditures related to the administrative matters of the district. Sec. 290.104. RULES AND PROCEDURES. (a) The commission may adopt rules governing the operation of the district, including rules relating to the administration of a tax authorized by this chapter. (b) In order to implement the requirements of Sections 290.102 and 290.103, the commission shall adopt any necessary procedures. Sec. 290.105. PURCHASING AND ACCOUNTING PROCEDURES. (a) The commission may prescribe the method and manner for making purchases and expenditures by the district. (b) The commission shall prescribe: (1) all accounting and control procedures; and (2) the method of purchasing necessary supplies, materials, and equipment. Sec. 290.106. INSTITUTIONAL HEALTH CARE PROVIDER REPORTING; INSPECTION OF RECORDS. (a) A district shall require an institutional health care provider to submit to the district a copy of any financial and utilization data required by and reported to the Department of State Health Services under Sections 311.032 and 311.033 and any rules adopted by the department to implement those sections. (b) A district may inspect the records of an institutional health care provider to the extent necessary to ensure that the provider has submitted all required data under this section. Sec. 290.107. AUTHORITY TO SUE AND BE SUED. Each district may sue and be sued in its own name in any court of this state as a governmental agency.
[Sections 290.108-290.150 reserved for expansion]
SUBCHAPTER D. GENERAL FINANCIAL PROVISIONS
Sec. 290.151. BUDGET. (a) Each year, the commission shall prepare a budget for the following fiscal year that includes: (1) proposed expenditures and disbursements; (2) estimated receipts and collections; and (3) the rates and amounts of any taxes that the commission intends to impose during the year. (b) The commission shall hold a public hearing on the proposed budget. Not later than the 10th day before the date of the hearing, the commission shall publish at least once notice of the hearing in a newspaper of general circulation in the county in which the district is located. (c) Any district taxpayer is entitled to appear at the time and place designated in the public notice and to be heard regarding any item shown in the proposed budget. Sec. 290.152. FISCAL YEAR. Each district's fiscal year begins on September 1 and ends on August 31 of each year. Sec. 290.153. ANNUAL AUDIT. (a) For each fiscal year, each commission shall have an independent audit made of the district's books and records. (b) Not later than December 31 of each year, the audit made for a district shall be filed with the comptroller and at the office of the district. Sec. 290.154. DEPOSITORY. (a) Each commission by resolution shall designate one or more banks located in the district as the depository for the district. A bank designated as depository serves for two years or until a successor is designated. (b) All income received by a district, including tax revenue after deducting discounts and fees for assessing and collecting the taxes, shall be deposited with the district depository and may be withdrawn only as provided by this chapter. (c) All district funds shall be secured in the manner provided for securing county funds.
[Sections 290.155-290.200 reserved for expansion]
SUBCHAPTER E. TAXES
Sec. 290.201. TAX ON OUTPATIENT SERVICES. (a) The commission of a district may impose an annual tax on all outpatient hospital visits to an institutional health care provider located in the district. In the first year in which the tax is imposed, the tax is assessed on the total number of outpatient hospital visits of an institutional health care provider reported to the Department of State Health Services under Sections 311.032 and 311.033 in the most recent fiscal year for which information is available. The district shall update this tax basis with the number of outpatient hospital visits reported on a biennial basis. (b) A tax imposed under this section must be imposed uniformly on each institutional health care provider of outpatient hospital services located in the district. A tax imposed under this section also may not hold harmless any institutional health care provider of outpatient hospital services, as required under 42 U.S.C. Section 1396b(w). (c) The commission shall set the rate of the tax imposed under this section. The rate may not exceed $100 for each outpatient hospital visit. (d) Subject to the maximum tax rate prescribed by Subsection (c), the commission shall set the rate of the tax at a rate that will generate sufficient revenue to cover the administrative expenses of the district, to fund the nonfederal share of a Medicaid supplemental payment program, and to pay for indigent health care services, except that the amount of tax revenue used for administrative expenses of the district in a year may not exceed the lesser of four percent of the total revenue generated from the tax or $20,000. (e) An institutional health care provider may not add a tax imposed under this section as a surcharge to a patient. (f) An institutional health care provider that is a hospital that primarily treats patients with mental illness is exempt from a tax imposed by this section. Sec. 290.202. ASSESSMENT AND COLLECTION OF TAXES. (a) Except as provided by Subsection (b), the county tax assessor-collector shall collect a tax imposed under this subchapter unless the commission employs a tax assessor and collector for the district. The county tax assessor-collector shall charge and deduct from taxes collected for the district a fee for collecting the tax in an amount determined by the commission, not to exceed the county tax assessor-collector's usual and customary charges for the collection of similar taxes. (b) If determined by the commission to be appropriate, the commission may contract for the assessment and collection of taxes in the manner provided by Title 1, Tax Code, for the assessment and collection of ad valorem taxes. (c) Revenue from a fee charged by a county tax assessor-collector for collecting the tax shall be deposited in the county general fund and, if appropriate, shall be reported as fees of the county tax assessor-collector. Sec. 290.203. USE OF TAX REVENUE. Revenue generated by a district from a tax imposed under this subchapter may be used only to: (1) provide the nonfederal share of a Medicaid supplemental payment program; (2) subsidize indigent health care services; and (3) pay administrative expenses of the district. Sec. 290.204. INTEREST, PENALTIES, AND DISCOUNTS. Interest, penalties, and discounts on taxes imposed under this subchapter are governed by the law applicable to county ad valorem taxes.
CHAPTER 291. COUNTY HEALTH CARE FUNDING DISTRICTS IN CERTAIN COUNTIES WITH POPULATION OF 1.4 MILLION OR LESS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 291.001. DEFINITIONS. In this chapter: (1) "Commission" means the commission of a district created under this chapter. (2) "District" means a county health care funding district created by this chapter. (3) "District taxpayer" means a person or entity subject to a tax imposed under this chapter. (4) "Institutional health care provider" means a nonpublic general hospital licensed under Chapter 241. Sec. 291.002. CREATION OF DISTRICT. A district is created in each county that has a population of 1.4 million or less and in which a municipality with a population of 1.1 million or more is predominantly located. Sec. 291.003. DURATION OF DISTRICT. (a) Unless continued in existence by the legislature, a district created by this chapter is abolished September 1, 2007. (b) Any money held by a district at the time the district is abolished shall be used to pay any outstanding administrative expenses of the district, and the commission shall direct the secretary of the commission to return the pro rata share of any remaining district money to each district taxpayer. Sec. 291.004. POLITICAL SUBDIVISION. A district created by this chapter is a political subdivision of this state. Sec. 291.005. DISTRICT TERRITORY. The boundaries of each district are coextensive with the boundaries of the county in which the district is created.
[Sections 291.006-291.050 reserved for expansion]
SUBCHAPTER B. DISTRICT ADMINISTRATION
Sec. 291.051. COMMISSION; APPOINTMENT. (a) Each district is governed by a commission of five members appointed as provided by this section. (b) Each county commissioner on the commissioners court of the county in which the district is located shall appoint one member who meets the qualifications prescribed by Section 291.052 to serve on the commission. The county judge of the county shall appoint one member who meets the qualifications prescribed by Section 291.052 to serve on the commission. Sec. 291.052. QUALIFICATION OF MEMBERS OF COMMISSION. To be eligible to serve as a member of the commission, a person must: (1) be a United States citizen; (2) be 18 years of age or older on the first day of the term that the person is appointed to fill; (3) have not been determined mentally incompetent by a final judgment of a court; (4) have not been finally convicted of a felony from which the person has not been pardoned or otherwise released from the resulting disabilities; (5) have resided continuously in this state for 12 months and in the county in which the district is located for six months immediately preceding the date of the appointment; and (6) be a person knowledgeable in the field of health care. Sec. 291.053. TERM OF MEMBERS OF COMMISSION. The members of the commission serve staggered two-year terms. Sec. 291.054. VACANCY. (a) If a vacancy occurs on the commission, the commissioners court of the county in which the district is located shall appoint a qualified person to fill the vacancy not later than the 30th day after the date the vacancy occurs. (b) If the commissioners court of the county in which the district is located does not appoint a member to the commission to fill a vacancy by the 30th day after the date the vacancy occurs, the remaining members of the commission may, by vote of the commission, appoint a replacement. Sec. 291.055. OFFICERS. (a) Each commission shall elect a chairperson and a secretary from among its members. (b) The chairperson and secretary shall each serve in that office until the expiration of their term as a member of the commission. Sec. 291.056. COMPENSATION; EXPENSES. A member of the commission serves without compensation but may, on the approval of the entire commission, be reimbursed for actual expenses incurred in the performance of the member's official duties. Sec. 291.057. EMPLOYEES AND INDEPENDENT CONTRACTORS. The commission may employ an attorney, financial advisor, and bookkeeper for the district or contract for those services. Sec. 291.058. MAINTENANCE OF RECORDS; PUBLIC INSPECTION. Except as otherwise provided by law, all district records, including books, accounts, notices, minutes, and all other matters of the district and the operation of its facilities, shall be: (1) maintained at the district office; and (2) open to public inspection at the district office during reasonable hours.
[Sections 291.059-291.100 reserved for expansion]
SUBCHAPTER C. POWERS AND DUTIES
Sec. 291.101. LIMITATION ON TAXING AUTHORITY. Each district may impose taxes only in the manner provided by this chapter. Sec. 291.102. MAJORITY VOTE REQUIRED. (a) A district may not impose any tax authorized by this chapter, spend any money, including for the administrative expenses of the district, or conduct any other business of the commission without an affirmative vote of a majority of the members of the commission. (b) Before imposing a tax under this chapter in any one year, the commission must obtain the affirmative vote required by Subsection (a). Sec. 291.103. ELECTION REQUIRED FOR CERTAIN EXPENDITURES. (a) In addition to the majority vote required under Section 291.102, a district may not spend any money of the district unless the district receives the approval of at least 95 percent of the district taxpayers. (b) This section does not apply to expenditures related to the administrative matters of the district. Sec. 291.104. RULES AND PROCEDURES. (a) The commission may adopt rules governing the operation of the district, including rules relating to the administration of a tax authorized by this chapter. (b) In order to implement the requirements of Sections 291.102 and 291.103, the commission shall adopt any necessary procedures. Sec. 291.105. PURCHASING AND ACCOUNTING PROCEDURES. (a) The commission may prescribe the method and manner for making purchases and expenditures by the district. (b) The commission shall prescribe: (1) all accounting and control procedures; and (2) the method of purchasing necessary supplies, materials, and equipment. Sec. 291.106. INSTITUTIONAL HEALTH CARE PROVIDER REPORTING; INSPECTION OF RECORDS. (a) A district shall require an institutional health care provider to submit to the district a copy of any financial and utilization data required by and reported to the Department of State Health Services under Sections 311.032 and 311.033 and any rules adopted by the department to implement those sections. (b) A district may inspect the records of an institutional health care provider to the extent necessary to ensure that the provider has submitted all required data under this section. Sec. 291.107. AUTHORITY TO SUE AND BE SUED. Each district may sue and be sued in its own name in any court of this state as a governmental agency.
[Sections 291.108-291.150 reserved for expansion]
SUBCHAPTER D. GENERAL FINANCIAL PROVISIONS
Sec. 291.151. BUDGET. (a) Each year, the commission shall prepare a budget for the following fiscal year that includes: (1) proposed expenditures and disbursements; (2) estimated receipts and collections; and (3) the rates and amounts of any taxes that the commission intends to impose during the year. (b) The commission shall hold a public hearing on the proposed budget. Not later than the 10th day before the date of the hearing, the commission shall publish at least once notice of the hearing in a newspaper of general circulation in the county in which the district is located. (c) Any district taxpayer is entitled to appear at the time and place designated in the public notice and to be heard regarding any item shown in the proposed budget. Sec. 291.152. FISCAL YEAR. Each district's fiscal year begins on September 1 and ends on August 31 of each year. Sec. 291.153. ANNUAL AUDIT. (a) For each fiscal year, each commission shall have an independent audit made of the district's books and records. (b) Not later than December 31 of each year, the audit made for a district shall be filed with the comptroller and at the office of the district. Sec. 291.154. DEPOSITORY. (a) Each commission by resolution shall designate one or more banks located in the district as the depository for the district. A bank designated as depository serves for two years or until a successor is designated. (b) All income received by a district, including tax revenue after deducting discounts and fees for assessing and collecting the taxes, shall be deposited with the district depository and may be withdrawn only as provided by this chapter. (c) All district funds shall be secured in the manner provided for securing county funds.
[Sections 291.155-291.200 reserved for expansion]
SUBCHAPTER E. TAXES
Sec. 291.201. TAX ON EMERGENCY ROOM SERVICES. (a) The commission of a district may impose an annual tax on all emergency room visits to an institutional health care provider located in the district. In the first year in which the tax is imposed, the tax is assessed on the total number of emergency room visits of an institutional health care provider reported to the Department of State Health Services under Sections 311.032 and 311.033 in the most recent fiscal year for which information is available. The district shall update this tax basis with the number of emergency room visits reported on a biennial basis. (b) A tax imposed under this section must be imposed uniformly on each institutional health care provider of emergency room services located in the district. A tax imposed under this section also may not hold harmless any institutional health care provider of emergency room services, as required under 42 U.S.C. Section 1396b(w). (c) The commission shall set the rate of the tax imposed under this section. The rate may not exceed $100 for each emergency room visit. (d) Subject to the maximum tax rate prescribed by Subsection (c), the commission shall set the rate of the tax at a rate that will generate sufficient revenue to cover the administrative expenses of the district, to fund the nonfederal share of a Medicaid supplemental payment program, and to pay for indigent health care services, except that the amount of tax revenue used for administrative expenses of the district in a year may not exceed the lesser of four percent of the total revenue generated from the tax or $20,000. (e) An institutional health care provider may not add a tax imposed under this section as a surcharge to a patient. (f) An institutional health care provider that is a hospital that primarily treats patients with mental illness is exempted from a tax imposed by this section. Sec. 291.202. ASSESSMENT AND COLLECTION OF TAXES. (a) Except as provided by Subsection (b), the county tax assessor-collector shall collect any tax imposed under this subchapter unless the commission employs a tax assessor and collector for the district. The county tax assessor-collector shall charge and deduct from taxes collected for the district a fee for collecting the tax in an amount determined by the commission, not to exceed the county tax assessor-collector's usual and customary charges for the collection of similar taxes. (b) If determined by the commission to be appropriate, the commission may contract for the assessment and collection of taxes in the manner provided by Title 1, Tax Code, for the assessment and collection of ad valorem taxes. (c) Revenue from a fee charged by a county tax assessor-collector for collecting the tax shall be deposited in the county general fund and, if appropriate, shall be reported as fees of the county tax assessor-collector. Sec. 291.203. USE OF TAX REVENUE. Revenue generated by a district from a tax imposed under this subchapter may be used only to: (1) provide the nonfederal share of a Medicaid supplemental payment program; (2) subsidize indigent health care services; and (3) pay administrative expenses of the district. Sec. 291.204. INTEREST, PENALTIES, AND DISCOUNTS. Interest, penalties, and discounts on taxes imposed under this subchapter are governed by the law applicable to county ad valorem taxes. SECTION 2. (a) Not later than October 1, 2005: (1) the commissioners court of each county to which Chapter 288, Health and Safety Code, as added by this Act, applies shall each appoint the initial members of a commission in accordance with Section 288.051, Health and Safety Code, as added by this Act, for a county health care funding district created by Chapter 288, Health and Safety Code, as added by this Act, in that county; (2) the commissioners court of each county to which Chapter 289, Health and Safety Code, as added by this Act, applies shall each appoint the initial members of a commission in accordance with Section 289.051, Health and Safety Code, as added by this Act, for a county health care funding district created by Chapter 289, Health and Safety Code, as added by this Act, in that county; (3) the commissioners court of each county to which Chapter 290, Health and Safety Code, as added by this Act, applies shall each appoint the initial members of a commission in accordance with Section 290.051, Health and Safety Code, as added by this Act, for a county health care funding district created by Chapter 290, Health and Safety Code, as added by this Act, in that county; and (4) the commissioners court of each county to which Chapter 291, Health and Safety Code, as added by this Act, applies shall each appoint the initial members of a commission in accordance with Section 291.051, Health and Safety Code, as added by this Act, for a county health care funding district created by Chapter 291, Health and Safety Code, as added by this Act, in that county. (b) For each county health care funding district created by Chapters 288-291, Health and Safety Code, as added by this Act, the initial commission members appointed under Subsection (a) of this section shall draw lots to determine which two commission members shall serve one-year terms and which three commission members shall serve two-year terms. SECTION 3. This Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect September 1, 2005.