Bill Text: TX SB2332 | 2023-2024 | 88th Legislature | Introduced
Bill Title: Relating to the operations of hospital districts in counties with a population of at least 190,000 persons.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2023-03-23 - Referred to Local Government [SB2332 Detail]
Download: Texas-2023-SB2332-Introduced.html
88R8186 SRA-F | ||
By: Kolkhorst | S.B. No. 2332 |
|
||
|
||
relating to the operations of hospital districts in counties with a | ||
population of at least 190,000 persons. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 281.021(d), Health and Safety Code, is | ||
amended to read as follows: | ||
(d) If a district is created under this chapter in a county | ||
with a population of more than 1.2 million [ |
||
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 by [ |
||
[ |
||
[ |
||
[ |
||
SECTION 2. Section 281.022(c), Health and Safety Code, is | ||
amended to read as follows: | ||
(c) A member [ |
||
appointed under Section 281.021(d) may not serve more than a total | ||
of eight years on the board [ |
||
[ |
||
[ |
||
[ |
||
SECTION 3. Subchapter B, Chapter 281, Health and Safety | ||
Code, is amended by adding Section 281.0221 to read as follows: | ||
Sec. 281.0221. QUALIFICATIONS FOR SERVICE ON BOARD. (a) A | ||
person may not serve on the board of hospital managers for a | ||
district if the person: | ||
(1) has not resided in the boundaries of the district | ||
for at least three years preceding the date of the person's | ||
appointment; | ||
(2) is an employee of the district, or is related to an | ||
employee of the district within two degrees of consanguinity or | ||
affinity as determined under Chapter 573, Government Code; | ||
(3) has served in a public elective office during any | ||
of the four years preceding the date of the person's appointment; or | ||
(4) is an employee or contractor of a vendor having a | ||
contract the price of which is more than $250,000 with: | ||
(A) the district; or | ||
(B) any entity created by or affiliated with the | ||
district. | ||
(b) At least half of the members of the board of hospital | ||
managers for a district serving at any one time must have at least | ||
four years of work experience: | ||
(1) in a hospital or other health care facility or as a | ||
licensed health professional; | ||
(2) in the financial services industry or accounting | ||
profession or as a licensed financial professional, including a | ||
certified public accountant or financial services advisor; or | ||
(3) as an attorney licensed to practice law in this | ||
state. | ||
(c) Not more than one third of the members of the board of | ||
hospital managers for a district serving at any one time may derive | ||
more than 10 percent of their annual income from the health care | ||
industry. | ||
(d) Except as otherwise provided by this subsection, at | ||
least one member of the board of hospital managers for a district | ||
must be an indigent patient that has been served by the district or | ||
a person who is related to an indigent patient that has been served | ||
by the district within two degrees of consanguinity, as determined | ||
under Chapter 573, Government Code. A board member described by | ||
this subsection must represent the demographic factors of indigent | ||
individuals generally served by the district, including geography, | ||
race, ethnicity, and gender. This subsection does not apply to the | ||
initial appointed board of hospital managers for a district. | ||
SECTION 4. The heading to Section 281.0222, Health and | ||
Safety Code, is amended to read as follows: | ||
Sec. 281.0222. QUALIFICATIONS FOR OFFICE IN CERTAIN | ||
DISTRICTS. | ||
SECTION 5. Section 281.0222, Health and Safety Code, is | ||
amended by adding Subsection (c) to read as follows: | ||
(c) In the event of a conflict between Section 281.0221 and | ||
this section, Section 281.0221 controls. | ||
SECTION 6. Subchapter B, Chapter 281, Health and Safety | ||
Code, is amended by adding Section 281.0223 to read as follows: | ||
Sec. 281.0223. STANDARDS OF CONDUCT; CONFLICTS OF INTEREST; | ||
RECUSAL. (a) A member of the board of hospital managers for a | ||
district is subject to the conflict of interest and other | ||
provisions applicable to the conduct of an appointed officer under | ||
Chapter 572, Government Code. | ||
(b) A member of the board of hospital managers for a | ||
district shall recuse himself or herself from participating in the | ||
deliberation regarding or voting on any district contract: | ||
(1) involving the board member's employer as a | ||
contractor or subcontractor; or | ||
(2) in which the board member or the board member's | ||
employer has a substantial interest as described by Section | ||
572.005, Government Code. | ||
SECTION 7. Section 281.031(a), Health and Safety Code, is | ||
amended to read as follows: | ||
(a) A member of the board of hospital managers of the El Paso | ||
County Hospital District is considered to have resigned the | ||
member's position if the member: | ||
(1) is absent from all the regularly scheduled board | ||
and committee meetings that the member is eligible to attend during | ||
a 90-day period; | ||
(2) is absent from more than half of the regularly | ||
scheduled board and committee meetings that the member is eligible | ||
to attend during a 12-month period; | ||
(3) fails to pay a local tax, including an ad valorem | ||
tax, when due; or | ||
(4) would be ineligible to serve on the board as | ||
provided by Section 281.0221 or 281.0222. | ||
SECTION 8. Section 281.045(a), Health and Safety Code, is | ||
amended to read as follows: | ||
(a) On or after the creation of the district, the county or a | ||
municipality located in the district may not levy taxes for | ||
hospital purposes or to provide the services described by Section | ||
61.028 or 61.0285. This subsection may not be construed to restrict | ||
the ability of a county or municipality located in the district to | ||
levy taxes for essential public health services, as that term is | ||
defined by Section 121.002. | ||
SECTION 9. Section 281.046, Health and Safety Code, is | ||
amended to read as follows: | ||
Sec. 281.046. DISTRICT RESPONSIBILITY FOR MEDICAL AID AND | ||
HOSPITAL CARE. Beginning on the date on which taxes are collected | ||
for the district, the district assumes full responsibility for | ||
furnishing medical and hospital care, including the services | ||
described by Sections 61.028 and 61.0285, for indigent and needy | ||
persons residing in the district. | ||
SECTION 10. Section 281.048, Health and Safety Code, is | ||
amended to read as follows: | ||
Sec. 281.048. DISTRICT RULES. Subject to any applicable | ||
restriction provided by law, the [ |
||
governing the operation of the hospital or hospital system. | ||
SECTION 11. Section 281.049, Health and Safety Code, is | ||
amended by amending Subsections (a) and (c) and adding Subsection | ||
(e) to read as follows: | ||
(a) The commissioners court shall [ |
||
and procedures to ensure efficiency, fiscal accountability, | ||
financial controls, and transparency. The policies and procedures | ||
must include: | ||
(1) the method of making purchases and expenditures by | ||
and for the district; and | ||
(2) accounting and control procedures for the district | ||
that ensure that district revenue is spent: | ||
(A) in accordance with all applicable provisions | ||
of law; and | ||
(B) in a manner that is transparent to the | ||
residents of the district. | ||
(c) A county officer, employee, contractor, or agent shall | ||
perform any function or service ordered [ |
||
commissioners court under this section. | ||
(e) At least once every five years, the commissioners court | ||
shall contract with an independent auditor to have performed a | ||
comprehensive performance audit of the district's management, | ||
accounting, financial controls, recordkeeping, and compliance with | ||
applicable law. The audit must assess the performance of the | ||
district and the district's vendors and determine whether the | ||
district's management adheres to best practices and national | ||
standards applicable to the administration of hospitals and | ||
hospital systems. The auditor shall produce a written report | ||
identifying any identified issues and recommendations to the | ||
commissioners court and provide a copy of the report to the district | ||
and the commissioners court. The district shall post the report in | ||
a conspicuous location on the district's publicly accessible | ||
Internet website. The commissioners court shall hold a public | ||
hearing on the report. | ||
SECTION 12. Section 281.051, Health and Safety Code, is | ||
amended by adding Subsections (d) and (e) to read as follows: | ||
(d) A contract entered into under this section: | ||
(1) must be for fair and reasonable compensation; | ||
(2) is subject to all legal restrictions on the use of | ||
district money; and | ||
(3) must include provisions that require district | ||
money received by a party to the contract to be: | ||
(A) subject to appropriate recordkeeping, | ||
financial accounting, and financial control practices; and | ||
(B) held in a separate account from other money | ||
held by the party. | ||
(e) Records of expenditures of district money and the | ||
purposes of those expenditures are subject to Chapter 552, | ||
Government Code. | ||
SECTION 13. Section 281.053, Health and Safety Code, is | ||
amended to read as follows: | ||
Sec. 281.053. DISTRICT INSPECTIONS. (a) The district, or | ||
the district's contractors or subcontractors, may be inspected by | ||
an employee, agent, contractor, or [ |
||
commissioners court or the Department of State Health Services. | ||
(b) A person subject to inspection under Subsection (a) | ||
[ |
||
(1) admit an inspector into the person's [ |
||
facilities to the extent those facilities relate to the district or | ||
services provided to the district; and | ||
(2) on demand give the inspector full access to | ||
records, reports, books, papers, and accounts related to the | ||
district, including, if applicable, records, reports, books, | ||
papers, and accounts related to expenditures made with district | ||
money received under a contract with the district. | ||
(c) The district or commissioners court may terminate the | ||
contract of a district vendor that fails to comply with this | ||
section. | ||
SECTION 14. Section 281.056, Health and Safety Code, is | ||
amended by amending Subsection (b-1) and adding Subsection (e) to | ||
read as follows: | ||
(b-1) The county attorney, district attorney, or criminal | ||
district attorney, as appropriate, with the duty to represent the | ||
county in civil matters shall, in all legal matters, represent a | ||
district located in: | ||
(1) a county with a population of 800,000 or more that | ||
borders the United Mexican States; or | ||
(2) a county with a population of 3.4 million or more[ |
||
[ |
||
(e) The county attorney, district attorney, or criminal | ||
district attorney, as appropriate, with the duty to represent a | ||
county in civil matters may not advise both the commissioners court | ||
of the county and a district located in the county if there is a | ||
potential conflict of interest between the county and the district. | ||
The limitation provided by this subsection applies to advice | ||
relating to the authority of the commissioners court to supervise | ||
and oversee the district. The commissioners court shall hire | ||
private legal counsel if there is a potential conflict of interest. | ||
The county is responsible for the fee charged by private legal | ||
counsel hired by the commissioners court under this subsection. | ||
SECTION 15. Section 281.0565, Health and Safety Code, is | ||
amended by amending Subsections (a), (b), (c), and (d) and adding | ||
Subsections (g) and (h) to read as follows: | ||
(a) In this section, "charitable organization" means an | ||
organization that is exempt from federal income tax under Section | ||
501(a) of the Internal Revenue Code of 1986 by being listed as an | ||
exempt organization in Section 501(c)(3) [ |
||
[ |
||
(b) For the purpose of providing medical and hospital care | ||
for the district's indigent residents, a [ |
||
charitable organization to facilitate the management of a district | ||
health care program by providing or arranging health care services, | ||
developing resources for health care services, or providing | ||
ancillary support services for the district. The district is | ||
responsible for the actions of a charitable organization created by | ||
the district. | ||
(c) A charitable organization created by a district under | ||
this section is a unit of local government only for purposes of | ||
Chapter 101, Civil Practice and Remedies Code. The charitable | ||
organization is subject to Chapters 551 and 552, Government Code. | ||
(d) For the purpose of providing medical and hospital care | ||
for the district's indigent residents, a [ |
||
reasonable and necessary capital or other financial contribution to | ||
a charitable organization created by the district to provide | ||
regional administration and delivery of health care services to or | ||
for the district. | ||
(g) A charitable organization contract: | ||
(1) is subject to all legal restrictions on the use of | ||
district money; and | ||
(2) must include standard requirements for | ||
recordkeeping, financial accounting, and financial control | ||
practices relating to district money. | ||
(h) A charitable organization shall hold district money in a | ||
separate account from other money held by the organization. | ||
SECTION 16. Section 281.073(a), Health and Safety Code, is | ||
amended to read as follows: | ||
(a) The recordkeeping, preservation, microfilming, | ||
destruction, or other disposition of the records of a district is | ||
subject to all requirements applicable to a local government under | ||
Subtitle C, Title 6, Local Government Code. | ||
SECTION 17. Section 281.091, Health and Safety Code, is | ||
amended to read as follows: | ||
Sec. 281.091. BUDGET. (a) The administrator shall prepare | ||
a comprehensive, detailed [ |
||
direction. | ||
(b) The budget and budget revisions must be approved by the | ||
board and then shall be presented to the commissioners court for | ||
final approval. The commissioners court may approve the budget in | ||
its entirety or may approve only a portion of the budget. | ||
SECTION 18. Section 281.092, Health and Safety Code, is | ||
amended by amending Subsection (b) and adding Subsections (c), (d), | ||
and (e) to read as follows: | ||
(b) The report must: | ||
(1) consist of a sworn statement of all assets, | ||
liabilities, obligations, money, and property rights [ |
||
applicable, a charitable organization created by the district or | ||
any another organization affiliated with the district, and their | ||
disposition; and | ||
(2) show in detail the operations of the district for | ||
the fiscal year, including the revenue received and expenditures | ||
made by the district in that fiscal year, in a manner that is clear | ||
and concise and posted on the district's publicly accessible | ||
Internet website or in an annual report posted on the district's | ||
publicly accessible Internet website. | ||
(c) In a manner consistent with federal and state privacy | ||
laws, the administrator in the report required by Subsection (a) | ||
shall list the medical services provided to individuals who qualify | ||
as indigent, the actual cost of those services, and the provider of | ||
the services, if the cost of the services was paid under a contract | ||
with the district. | ||
(d) The commissioners court shall review in a public hearing | ||
the information reported under Subsection (c) and evaluate the | ||
district's performance in providing medical and hospital care to | ||
indigent residents of the district. | ||
(e) The commissioners court may request at any time more | ||
detailed information on an issue contained in or related to the | ||
report and the district shall promptly provide the requested | ||
information. | ||
SECTION 19. Section 281.093(d), Health and Safety Code, is | ||
amended to read as follows: | ||
(d) All income of the district shall be deposited in the | ||
district depository. Income attributable to taxes imposed by the | ||
district must be kept in a separate account. | ||
SECTION 20. Section 281.095(a), Health and Safety Code, is | ||
amended to read as follows: | ||
(a) In this section, "district" means the Bexar County | ||
Hospital District, Nueces County Hospital District, El Paso County | ||
Hospital District, or Harris County Hospital District. The term | ||
includes a district to which Section 281.0475 applies. | ||
SECTION 21. Subchapter E, Chapter 281, Health and Safety | ||
Code, is amended by adding Sections 281.097 and 281.098 to read as | ||
follows: | ||
Sec. 281.097. USE OF DISTRICT TAX REVENUE. (a) Taxes | ||
levied by a district and any money derived from those taxes, | ||
including interest or other earnings, may be used only to provide | ||
medical and hospital care for indigent and needy persons residing | ||
in the district and to pay the costs described by Subsection (b). | ||
(b) A district may use its tax levy to pay the reasonable and | ||
necessary costs of: | ||
(1) providing health care and health care support | ||
services at teaching hospitals by physicians and resident | ||
physicians if teaching physicians are physically present to provide | ||
the service to the patient; | ||
(2) administering and providing health services, | ||
whether through the direct provision of services or as a payor; and | ||
(3) providing necessary clinical patient education, | ||
mental health services, and social work services, including primary | ||
and preventative care. | ||
(c) The district administrator, board of hospital managers | ||
for the district, and commissioners court shall ensure compliance | ||
with this section. | ||
Sec. 281.098. MATCHING FEDERAL FUNDS FOR MENTAL HEALTH | ||
CARE. This chapter may not be construed to prevent a district from | ||
using district revenue to provide for the nonfederal share of | ||
Medicaid payments for any reimbursement to a hospital for which | ||
federal matching funds are available for mental health services | ||
provided to the residents of the district. | ||
SECTION 22. The following provisions of the Health and | ||
Safety Code are repealed: | ||
(1) Section 281.049(b); | ||
(2) Section 281.0511; and | ||
(3) Section 281.0565(e). | ||
SECTION 23. Sections 281.022 and 281.0222, Health and | ||
Safety Code, as amended by this Act, and Section 281.0221, Health | ||
and Safety Code, as added by this Act, do not affect the entitlement | ||
of a member serving on the board of managers of a hospital district | ||
subject to those sections immediately before the effective date of | ||
this Act to continue to serve for the remainder of the member's | ||
term. As the terms of members expire, the appropriate | ||
commissioners court shall appoint or reappoint members who have the | ||
terms and qualifications required by Sections 281.022, 281.0221, | ||
and 281.0222, Health and Safety Code, as applicable. | ||
SECTION 24. The changes in law made by this Act with respect | ||
to a contract or agreement, including an agreement under Chapter | ||
311, Tax Code, apply only to a contract or agreement entered into on | ||
or after the effective date of this Act. A contract or agreement | ||
entered into before the effective date of this Act is governed by | ||
the law in effect immediately before the effective date of this Act, | ||
and the former law is continued in effect for that purpose. | ||
SECTION 25. This Act takes effect September 1, 2023. |