Transcript No Slide Title

Introduction to Public
Hospital District
Governance
February 14, 2002
Association of
Washington Public
Hospital Districts
Presenters
Brad Berg
Taya Briley, RN, JD
Partner, Foster Pepper and
Shefelman
Director, Legal Services and
Health Policy, Association of
Washington Public Hospital
Districts
Goals of the Web Cast
 Define hospital district
 Describe hospital districts and benefits of
being a hospital district
 Consider aspects of running a hospital
district
 Review pertinent areas of the law
Definition of a Hospital District
 Community supported governmental
entities that deliver health care to their
communities
 Creation is authorized by
Ch. 70.44 RCW
 Special purpose taxing
districts
 Purpose is defined by statute
 Different from other health care entities
Statutory “Purpose” of a
Public Hospital District
 “…operate hospital and other
health care facilities…and to
provide hospital… and other
health care services for the
residents of such districts and
other persons.” RCW 70.44.003
 Definition of “other health care
service” is broad RCW 70.44.007(2)
Nature and Limits of
Governmental Powers
 Broad powers—from a number of different
statutes—that are strictly construed
 Limited to express powers—
or those necessarily implied
 Engagement in prohibited
activities renders action void
Hospital District Powers and
Duties: Sources & Restrictions
 Revised Code of Washington (RCW)
 Enabling Statute Ch 70.44 RCW
 Other RCWs
 State Constitution
 Case Law
 Attorney General Opinions
 Other Statutes and
Regulations
Hospital District Benefits from
Local Government Status
 Immunity from taxation
(federal)
 Exemption from taxes (state)



Property taxes
Business and occupation taxes
Retail sales tax
 Power of condemnation and
eminent domain
 Ability to tax
Public Hospital District
Governance Structure
 Hospital Districts have a
3, 5 or 7 member board
 Elected commissioners
appoint an administrator
 Certain duties expressly
specified in hospital
district statute
Statutory Role of Commissioners
 The board is responsible for establishing
hospital district policy with respect to the
powers of a hospital district in RCW 70.44.060
 Board adopts
general policies necessary to
achieve these ends and
delegates day-to-day
operations to administrator
Statutory Role of Administrators
 Appointment, removal and compensation
of superintendents is governed by
RCW 70.44.070
 Superintendent powers and duties are set
forth in RCW 70.44.080 and 70.44.090
 Superintendent shall have control of
administrative functions of the district
Other Persons: Hospital District
Auditor and Treasurer
 Treasurer—default is county treasurer, but
commissioners may designate
an alternative
 District auditor—
appointed by resolution
of the board and serves
as auditor of the district
Medical Staff
 Relationship to district governed by
medical staff bylaws
 Because hospital district
is a local government,
due process
requirements apply to
denial of privileges
Hospital District Employees
 Working for a hospital district is much like
working for private hospitals
 National Labor Relations Act
does not apply but Public
Employee Relations
Commission rules do
 Hospital district
employees are not
allowed to strike
Conflicts of Interest:
Basic Rule
Municipal officers are prohibited from “...being
beneficially interested, directly or indirectly, in
any contract which may be made by, through, or
under the supervision of such officer in whole or
in part, or which may be made for the benefit of
his or her office, or
accept directly or indirectly
any compensation, gratuity
or reward in connection with
such contract from any other
person beneficially interested therein.”
RCW 42.23.030
Conflicts of Interest:
Municipal Officer
 Elected and appointed officers of a
municipality, and their deputies:





commissioners
administrators
treasurers
auditors
others, depending on the capacity in which
they are acting
Conflicts of Interest
 Exceptions

certain contracts are
exceptions to the rule
 Remote Interests

some interests are so
remote they are not
beneficial interests
 Penalties

void contract, $500 penalty,
civil/criminal liability
Meetings:
The Open Public Meetings Act
“All meetings of the governing body of a
public agency shall be open and public and
all persons shall be permitted to attend any
meeting of the governing body of a public
agency, except as otherwise provided in this
chapter.” RCW 42.30.030
Open Public Meetings Act:
Exemptions
 Commissioners may convene in “executive
session” for certain reasons set out
in RCW 42.17.310 and
RCW 70.44.062
 Executive session must
be announced at a regular
or special meeting
Regular, Special and
Emergency Meetings
 Regular Meeting
 time established by hospital
district bylaws or by resolution
 no agenda required
 Special Meeting
 notify proper parties
 24 hour notice
 agenda required
 Emergency Meeting
 true emergencies only
Open Public Meetings Act:
Penalties for Violation
 Action taken in violation of the act is void
 $100 penalty for KNOWING
violations of the act
 District may have to pay
attorney fees
Questions?
Press 1 on
Your Phone
Property Issues
 Hospital District Bid Law

bidding on construction projects required
 Eminent Domain

condemnation and
purchase of private
land authorized
 Surplus Property

procedures for sale
or lease of surplus
property must be followed
Sources of Funds
 Tax Levies
 Borrowed Funds
 Patient Revenue
Taxing Power:Regular/Maintenance
and Operation (M&O) Levies
 Authority to levy property taxes:





Maximum levy rate limitation is $0.75 per
$1000 assessed value
“Competition” with other local governments
Levy lid is established by limit factors
Impact
of I-747
Future initiatives
may also change
law
Taxing Power:
Raising the Levy Lid
Levy lid may be raised
if a simple majority of
voters approves
an increase
Taxing Power:
One Year Special Levy
 One year levy, in excess of regular levy
 Revenue may be used for any purpose
 May be for any amount
the voters approve
 Supermajority and
validation requirements
must be met
 General or special election
Taxing Power:
Supermajority & Validation Example
 In last general election
10,000 votes were cast
 Scenario A — 3,000 VOTES CAST:
To validate 60% of 40%
of 10,000 needed
2,400 yes votes required
 Scenario B — 5,000 VOTES CAST:
To validate 60% of 5,000 needed
3,000 yes votes required
Taxing Power: Special Levy for
Unlimited Tax General Obligation
(UTGO) Bonds
 Needed if levy to pay debt service on
bonds exceeds the district’s regular levy
 Supermajority and validation requirement
 Amount levied is whatever is necessary to
pay debt service on bonds
 Bonds issued only for capital purposes
Taxing Power:
Emergency Medical Services Levy
 District authorized to run Emergency Medical
Services (EMS) levy if no other EMS levies
cover all or part of the district (Exception for
county-wide EMS levy)
 May impose a regular levy
of up to $0.50 per $1000
assessed value for 6 years,
10 years or permanently,
based on voter approval
EMERGENCY
 Supermajority and validation requirement
Borrowed Funds:
Bonds
 Limited Tax General Obligation (LTGO)
Bond

payable solely from district’s
regular property tax levy
 Unlimited Tax General
Obligation (UTGO) Bond

payable from special levy in
excess of district’s regular levy
 Revenue Bonds

payable from special fund
Borrowed Funds:
Conditional Sales Contracts
 Permits purchase of real or
personal property on an
installment basis
 Property being purchased
serves as security for
financing
Borrowed Funds:
Warrants
 Revenue Warrants

paid out of special fund
 Tax Anticipation Warrants

payable from first tax monies
available from levy of taxes on
property in district
 General Warrants

treasurer disburses funds on
warrants issued by hospital district
auditor and approved by commissioners
Patient Revenue
 Receipt of patient revenue is much like
other hospitals
 Charity Care and Article VIII, Section 7 of
the Washington Constitution
Public Records
 Hospital districts must make all public
records available for public inspection and
copying
 Some hospital district
records are not public
records
 District should establish
policies for accessing
records
Responding to Records
Requests
 Hospital districts must respond to a
request within 5 business days:



provide the record, OR
give estimation on
amount of time
needed to provide
the record, OR
deny the request
 Penalties
Resources
www.awphd.org
Questions?
Press 1 on
Your Phone
Thank you for
participating!
Please fill
out the
evaluation.