Transcript No Slide Title

Introduction to Public
Hospital Districts
April 25, 2002
Association of
Washington Public
Hospital Districts
Goals of the Presentation
 Define hospital district
 Describe hospital districts and benefits of
being a hospital district
 Consider aspects of running a hospital
district--including tax revenue
 Provide an overview of hospital district
formation
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)
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
Other Persons
 District Treasurer
 District auditor
 Medical Staff
 Employees
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
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
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
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: 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
Hospital District Formation
 Governed by Chapter 70.44
RCW
 More complicated that
creating private entity
 Procedure for forming district
will depend on how
boundaries relate to county
boundaries
Sample Scenario: Hospital
District Within A County
 Precinct district boundaries must be
maintained
 May only be initiated through a public
petition process
 Hearing process required
 County commissioner resolution submits
proposal to electorate within the district
 Simple majority of those voting must vote
“Yes” to create the district
Commissioners
 Elected from the same
ballot that proposes
hospital district formation
 Terms of inaugural board
members are fixed by
statute ranging from one to
six years
 Greater number of votes
means longer term in office
Commissioner Districts
 Not a requirement
 Theoretically serve geographic
constituencies of the hospital district
 May be created at the same time as the
hospital district
 May be more trouble than they are worth
Actions Taken Upon District
Formation
 Adopt bylaws
 Elect president and secretary of
board
 Determine number of
commissioners
 Adopt seal
 Adopt resolution for
commissioner compensation
More Actions Taken Upon
District Formation
 Survey existing health
care facilities and services
 Adopt plan of
improvements
 Adopt budget
 Appoint superintendent
 Designate auditor
Resources
www.awphd.org
Thank you for
listening!
Taya Briley, Director, Legal Services
and Health Policy
(206) 216-2554
[email protected]