Florida Senate - 2012               CS for CS for CS for SB 1568
       
       
       
       By the Committees on Budget Subcommittee on General Government
       Appropriations; Community Affairs; and Health Regulation; and
       Senators Gaetz and Garcia
       
       
       601-04256-12                                          20121568c3
    1                        A bill to be entitled                      
    2         An act relating to the sale or lease of a county,
    3         district, or municipal hospital; amending s. 155.40,
    4         F.S.; defining the terms; requiring that the governing
    5         board of a county, district, or municipal hospital
    6         evaluate the possible benefits to an affected
    7         community from the sale or lease of the hospital
    8         facility to a not-for-profit or for-profit entity
    9         within a specified time period; specifying the actions
   10         the board must take in evaluating whether to sell or
   11         lease the public hospital; requiring the board to
   12         determine whether qualified purchasers or lessees
   13         exist; specifying the factors that must be considered
   14         by the governing board before accepting a proposal to
   15         sell or lease the hospital; requiring the board to
   16         state in writing detailed findings related to its
   17         decision to accept or reject the proposal; requiring
   18         the governing board to make public the required
   19         findings and documents and to publish a notice of the
   20         proposed transaction in one or more newspapers of
   21         general circulation in the county in which the
   22         majority of the physical assets of the hospital are
   23         located; allowing persons to submit written comments
   24         regarding the proposed transaction; providing that the
   25         sale or lease is subject to the approval of the Chief
   26         Financial Officer; requiring the governing board to
   27         file a petition with the Chief Financial Officer
   28         seeking approval of the proposed transaction within a
   29         specified time period; requiring the Chief Financial
   30         Officer or his or her designee to issue a final order
   31         approving or denying the proposed transaction;
   32         specifying the criteria upon which the Chief Financial
   33         Officer must base his or her decision; authorizing an
   34         interested party to appeal the decision of the Chief
   35         Financial Officer; requiring that all costs be paid by
   36         the governing board unless an interested party
   37         contests the action, in which case the court may
   38         assign costs equitably to the parties; providing for
   39         the distribution of proceeds from the transaction;
   40         exempting the sale or lease of specified physical
   41         property of a county, district, or municipal hospital
   42         from processes required for the approval of a sale or
   43         lease of county, district, or municipal hospital
   44         property; providing an exemption from complying with
   45         the requirements of the act under certain
   46         circumstances; exempting application of the act to
   47         hospitals or health care systems for which a letter of
   48         intent to sell or lease is executed before a specified
   49         date; creating s. 155.401, F.S.; providing that the
   50         purposes for which a special taxing district may
   51         appropriate funds from the sale or lease of a hospital
   52         or health care system include the promotion and
   53         support of economic growth in the district and county
   54         in which the taxing district is located and the
   55         furthering of the purposes of the taxing district;
   56         providing that any general or special law that is
   57         inconsistent with or otherwise in conflict with the
   58         act is specifically superseded by the act; amending s.
   59         395.002, F.S.; revising the definition of the term
   60         “accrediting organizations”; reenacting s.
   61         395.003(2)(c), F.S., relating to licensure and
   62         regulation of hospitals, to incorporate the amendment
   63         made to s. 395.002, F.S., in a reference thereto;
   64         amending s. 395.3036, F.S.; conforming cross
   65         references; providing an effective date.
   66  
   67  Be It Enacted by the Legislature of the State of Florida:
   68  
   69         Section 1. 155.40, Florida Statutes, is amended to read:
   70         155.40 Sale or lease of county, district, or municipal
   71  hospital; effect of sale.—
   72         (1) In the interest of providing quality health care
   73  services to the order that citizens and residents of this the
   74  state may receive quality health care, and notwithstanding any
   75  other provision of general or special law, a any county,
   76  district, or municipal hospital organized and existing under the
   77  laws of this state, acting by and through its governing board,
   78  may shall have the authority to sell or lease the such hospital
   79  to a for-profit or not-for-profit Florida entity corporation,
   80  and enter into leases or other contracts with a for-profit or
   81  not-for-profit Florida entity corporation for the purpose of
   82  operating the and managing such hospital and any or all of its
   83  facilities of whatsoever kind and nature. The term of any such
   84  lease, contract, or agreement and the conditions, covenants, and
   85  agreements to be contained therein shall be determined by the
   86  governing board of the such county, district, or municipal
   87  hospital. The governing board of the hospital must find that the
   88  sale, lease, or contract is in the best interests of the
   89  affected community public and must state the basis of that such
   90  finding. If the governing board of a county, district, or
   91  municipal hospital decides to lease the hospital, it must give
   92  notice in accordance with paragraph (4)(a) or paragraph (4)(b).
   93         (2) A Any such lease, contract, or agreement made pursuant
   94  hereto shall:
   95         (a) Provide that the articles of incorporation of the such
   96  for-profit or not-for-profit corporation be subject to the
   97  approval of the board of directors or board of trustees of the
   98  such hospital;
   99         (b) Require that any not-for-profit corporation become
  100  qualified under s. 501(c)(3) of the United States Internal
  101  Revenue Code;
  102         (c) Provide for the orderly transition of the operation and
  103  management of the such facilities;
  104         (d) Provide for the return of the such facility to the
  105  county, municipality, or district upon the termination of the
  106  such lease, contract, or agreement; and
  107         (e) Provide for the continued treatment of indigent
  108  patients pursuant to the Florida Health Care Responsibility Act
  109  and pursuant to chapter 87-92, Laws of Florida.
  110         (3) Any sale, lease, or contract entered into pursuant to
  111  this section before prior to the effective date of this act must
  112  have complied with the requirements of subsection (2) in effect
  113  at the time of the sale, lease, or contract. Any lease
  114  modification, renewal, or extension relating to a lease
  115  transaction that occurred before the effective date of this act
  116  is not subject to subsections (6)-(17). It is the intent of the
  117  Legislature that this section does not impose any further
  118  requirements with respect to the formation of any for-profit or
  119  not-for-profit Florida entity corporation, the composition of
  120  the board of directors of any Florida entity corporation, or the
  121  manner in which control of the hospital is transferred to the
  122  Florida entity corporation.
  123         (4) As used in this section, the term:
  124         (a) “Affected community” means those persons residing
  125  within the geographic boundaries defined by the charter of the
  126  county, district, or municipal hospital or health care system,
  127  or if the boundaries are not specifically defined by charter, by
  128  the geographic area from which 75 percent of the county,
  129  district, or municipal hospital’s or health care system’s
  130  inpatient admissions are derived.
  131         (b) “Fair market value” means the price that a seller or
  132  lessor is willing to accept and a buyer or lessee is willing to
  133  pay on the open market and in an arms-length transaction, or
  134  what an independent expert in hospital valuation determines the
  135  fair market value to be.
  136         (c) “Interested party” includes a person submitting a
  137  proposal for sale or lease of the county, district, or municipal
  138  hospital or health care system, as well as the governing board.
  139         (5)The governing board of a county, district, or municipal
  140  hospital or health care system shall commence an evaluation of
  141  the possible benefits to an affected community from the sale or
  142  lease of hospital facilities owned by the board to a not-for
  143  profit or for-profit entity no later than December 31, 2012. In
  144  the course of evaluating the benefits of the sale or lease, the
  145  board shall:
  146         (a) Conduct a public hearing to provide interested persons
  147  the opportunity to be heard on the matter.
  148         (b) Publish notice of the public hearing in one or more
  149  newspapers of general circulation in the county in which the
  150  majority of the physical assets of the hospital or health care
  151  system are located and in the Florida Administrative Weekly at
  152  least 15 days before the hearing is scheduled to occur.
  153         (c) Contract with a certified public accounting firm or
  154  other firm that has substantial expertise in the valuation of
  155  hospitals to render an independent valuation of the hospital’s
  156  fair market value.
  157         (d) Consider an objective operating comparison between a
  158  hospital or health care system operated by the district, county,
  159  or municipality and other similarly situated hospitals, both
  160  not-for-profit and for-profit, which have a similar service mix,
  161  in order to determine whether there is a difference in the cost
  162  of operation using publicly available data provided by the
  163  Agency for Health Care Administration and the quality metrics
  164  identified by the Centers for Medicare and Medicaid Services
  165  Core Measures. The comparison must determine whether it is more
  166  beneficial to taxpayers and the affected community for the
  167  hospital to be operated by a governmental entity, or whether the
  168  hospital can be operated by a not-for-profit or for-profit
  169  entity with similar or better cost-efficiencies or measurable
  170  outcomes identified by the Centers for Medicare and Medicaid
  171  Services Core Measures. The comparison must also determine
  172  whether there is a net benefit to the community to operate the
  173  hospital as a not-for-profit or for-profit entity and use the
  174  proceeds of the sale or lease for the purposes described in this
  175  section.
  176         (e) Make publicly available all documents considered by the
  177  board in the course of such evaluation.
  178         1.Within 160 days after the initiation of the process
  179  established in subsection (5), the governing board shall publish
  180  notice of the board’s findings in one or more newspapers of
  181  general circulation in the county in which the majority of the
  182  physical assets of the hospital are located and in the Florida
  183  Administrative Weekly.
  184         2. This evaluation is not required if a district, county,
  185  or municipal hospital has issued a public request for proposals
  186  for the sale or lease of a hospital on or before February 1,
  187  2012, for the purpose of receiving proposals from qualified
  188  purchasers or lessees, either not-for-profit or for-profit.
  189         (6)(4)If, upon completion of the evaluation of the
  190  benefits of the sale or lease, In the event the governing board
  191  of a county, district, or municipal hospital determines that it
  192  is no longer in the best interest of the affected community to
  193  own or operate a hospital or health care system and elects to
  194  consider a sale or lease of the hospital or health care system
  195  to a third party, the governing board must first determine
  196  whether there are any qualified purchasers or lessees. In the
  197  process of evaluating any qualified purchaser or lessee elects
  198  to sell or lease the hospital, the board shall:
  199         (a) Negotiate the terms of the sale or lease with a for
  200  profit or not-for-profit Florida corporation and Publicly
  201  advertise the meeting at which the proposed sale or lease will
  202  be considered by the governing board of the hospital in
  203  accordance with s. 286.0105; or
  204         (b) Publicly advertise the offer to accept proposals in
  205  accordance with s. 255.0525 and receive proposals from all
  206  interested and qualified purchasers and lessees.
  207  
  208  Any sale or lease must be for fair market value, or, if not for
  209  fair market value, the lease must be in the best interest of the
  210  affected community. A and any sale or lease must comply with all
  211  applicable state and federal antitrust laws.
  212         (7)A determination by the governing board to accept a
  213  proposal for sale or lease shall be made after consideration of
  214  all proposals received and negotiations with a qualified
  215  purchaser or lessee. The governing board’s determination must
  216  include, in writing, detailed findings of all reasons for
  217  accepting the proposal.
  218         (a)The governing board’s acceptance of a proposal for sale
  219  or lease must include a description of how the sale or lease
  220  satisfies each of the following requirements:
  221         1.The sale or lease represents fair market value, as
  222  determined by a certified public accounting firm or other
  223  qualified firm pursuant to subsection(5). If leased at less than
  224  fair market value, the governing board shall provide a detailed
  225  explanation of how the best interests of the affected community
  226  are served by the acceptance of less than fair market value for
  227  the lease of the hospital.
  228         2.Acceptance of the proposal will result in a reduction or
  229  elimination of ad valorem or other taxes for taxpayers in the
  230  district, if applicable.
  231         3.The proposal includes an enforceable commitment that
  232  programs and services and quality health care will continue to
  233  be provided to all residents of the affected community,
  234  particularly to the indigent, the uninsured, and the
  235  underinsured.
  236         4. Disclosure has been made of all conflicts of interest,
  237  including, but not limited to, whether the sale or lease of the
  238  hospital or health care system would result in a special private
  239  gain or loss to members of the governing board or key management
  240  employees or members of the medical staff of the county,
  241  district, or municipal hospital, or if governing board members
  242  will be serving on the board of any successor private
  243  corporation. Conflicts of interest, if any, with respect to
  244  experts retained by the governing board shall also be disclosed.
  245         5. Disclosure has been made by the seller or lessor of all
  246  contracts with physicians or other entities providing health
  247  care services through a contract with the seller or lessor,
  248  including all agreements or contracts that would be void or
  249  voidable upon the consummation of the sale or lease.
  250         6. The proposal is in compliance with subsections (8) and
  251  (9).
  252         (b)The findings must be accompanied by all information and
  253  documents relevant to the governing board’s determination,
  254  including, but not limited to:
  255         1.The names and addresses of all parties to the
  256  transaction.
  257         2.The location of the hospital or health care system and
  258  all related facilities.
  259         3.A description of the terms of all proposed agreements.
  260         4.A copy of the proposed sale or lease agreement and any
  261  related agreements, including, but not limited to, leases,
  262  management contracts, service contracts, and memoranda of
  263  understanding.
  264         5.The estimated total value associated with the proposed
  265  agreement and the proposed acquisition price.
  266         6.Any valuations of the hospital’s or health care system’s
  267  assets prepared during the 3 years immediately preceding the
  268  proposed transaction date.
  269         7.The fair market value analysis required by paragraph
  270  (5)(c), or any other valuation prepared at the request of the
  271  board, owner of the hospital or health care system, or managing
  272  entity of the hospital or health care system.
  273         8.Copies of all other proposals and bids that the
  274  governing board may have received or considered in compliance
  275  with subsection (6).
  276         (8)Within 120 days before the anticipated closing date of
  277  the proposed transaction, the governing board shall make
  278  publicly available all findings and documents required under
  279  subsection (7) and publish a notice of the proposed transaction
  280  in one or more newspapers of general circulation in the county
  281  in which the majority of the physical assets of the hospital or
  282  health care system are located. The notice must include the
  283  names of the parties involved and the means by which a person
  284  may submit written comments about the proposed transaction to
  285  the governing board and obtain copies of the findings and
  286  documents required under subsection (7).
  287         (9)Within 20 days after the date of publication of the
  288  public notice, any person may submit to the governing board
  289  written comments regarding the proposed transaction.
  290         (10)The sale or lease of the hospital or health care
  291  system is subject to approval by the Chief Financial Officer or
  292  his or her designee, except, if otherwise required by law,
  293  approval of the sale or lease shall exclusively be by majority
  294  vote of the registered voters in the county, district, or
  295  municipality in which the hospital or health care system is
  296  located.
  297         (a)The governing board shall file a petition with the
  298  state Chief Financial Officer seeking approval of the proposed
  299  transaction at least 30 days after publication of the notice of
  300  the proposed transaction.
  301         (b)The petition for approval filed by the governing board
  302  must include all findings and documents required under
  303  subsection (7) and certification by the governing board of
  304  compliance with all requirements of this section. The chair of
  305  the governing board must certify under oath and subject to the
  306  penalty of perjury on a form accompanying the petition that the
  307  contents of the petition and representations therein are true
  308  and correct.
  309         (11) Within 30 days of receiving the petition, the Chief
  310  Financial Officer or his or her designee shall issue a final
  311  order approving or denying the proposed transaction based solely
  312  upon consideration of whether the procedures contained within
  313  this section have been followed by the governing board of the
  314  county, district, or municipal hospital or health care system.
  315  The order shall require the governing board to accept or reject
  316  the proposal for the sale or lease of the county, district, or
  317  municipal hospital or health care system based upon a
  318  determination that:
  319         (a)The proposed transaction is permitted by law.
  320         (b)The proposed transaction does not unreasonably exclude
  321  a potential purchaser or lessee on the basis of being a for
  322  profit or a not-for-profit Florida corporation or other form of
  323  business organization, such as a partnership or limited
  324  liability company.
  325         (c)The governing board of the hospital or health care
  326  system publicly advertised the meeting at which the proposed
  327  transaction was considered by the board in compliance with s.
  328  286.0105.
  329         (d)The governing board of the hospital or health care
  330  system publicly advertised the offer to accept proposals in
  331  compliance with s. 255.0525.
  332         (e)Any conflict of interest was disclosed, including, but
  333  not limited to, how the proposed transaction could result in a
  334  special private gain or loss to members of the governing board
  335  or key management employees of the county, district, or
  336  municipal hospital, or if governing board members will be
  337  serving on the board of any successor private corporation.
  338  Conflicts of interest, if any, with respect to experts retained
  339  by the governing board shall also be disclosed.
  340         (f)The seller or lessor documented that it will receive
  341  fair market value for the sale or lease of the assets as
  342  indicated in paragraph (5)(c) or, if leased at less than fair
  343  market value, the governing board provided a detailed
  344  explanation of how the best interests of the affected community
  345  are served by the acceptance of less than fair market value for
  346  the lease of the hospital or health care system.
  347         (g)The acquiring entity has made an enforceable commitment
  348  that programs and services and quality health care will continue
  349  to be provided to all residents of the affected community,
  350  particularly to the indigent, the uninsured, and the
  351  underinsured.
  352         (h)The governing board disclosed whether the sale or lease
  353  will result in a reduction or elimination of ad valorem or other
  354  taxes used to support the hospital.
  355         (12)Any interested party to the action has the right to
  356  seek judicial review of the decision in the appellate district
  357  where the hospital is located or in the First District Court of
  358  Appeal pursuant to s. 120.68.
  359         (a)All proceedings shall be instituted by filing a notice
  360  of appeal in accordance with the Florida Rules of Appellate
  361  Procedure within 30 days after the date of the final order.
  362         (b)In such judicial review, the appellate court shall
  363  affirm the decision of the Chief Financial Officer, unless the
  364  decision by the Chief Financial Officer is shown to be clearly
  365  erroneous.
  366         (13)All costs shall be paid by the governing board, unless
  367  an interested party contests the action, in which case the court
  368  may assign costs equitably to the parties.
  369         (14) If any provision of subsection (5), subsection (6), or
  370  subsection (7) is not followed, the contract for sale or lease
  371  is voidable by any party to the contract. If any member of the
  372  governing board negligently or willfully violates subsection
  373  (5), subsection (6), or subsection (7), as determined by the
  374  Commission on Ethics after receipt of a sworn complaint pursuant
  375  to s. 112.322, the member is subject to a penalty, as determined
  376  by the Commission on Ethics pursuant to s. 112.317.
  377         (15)If a county, district, or municipal hospital is sold,
  378  any and all special district tax authority associated with the
  379  hospital subject to the sale shall cease on the effective date
  380  of the closing date of the sale. Any special law inconsistent
  381  with this subsection is superseded by this act.
  382         (16) If a county, district, or municipal hospital is sold
  383  or leased, the governing board shall:
  384         (a) Deposit 50 percent of the net proceeds of the sale or
  385  lease into a health care economic development trust fund, which
  386  shall be under the control of the county commission of the
  387  county in which the property is located, if the hospital is a
  388  county hospital or district hospital whose geographic boundaries
  389  extend beyond a single municipality, or, if the hospital is a
  390  municipal hospital or district hospital whose geographic
  391  boundaries lie entirely within a single municipality, under the
  392  control of the city or municipal government in which the
  393  hospital is located. The use and distribution of the funds shall
  394  be at the discretion of a majority of the county commission if
  395  the hospital is a county hospital or district hospital whose
  396  geographic boundaries extend beyond a single municipality, or,
  397  if the hospital is a municipal hospital or district hospital
  398  whose geographic boundaries lie entirely within a single
  399  municipality, at the discretion of a majority of the members of
  400  the municipal government. The members of the county commission
  401  or the municipal government, depending on the type of hospital
  402  being sold, shall serve as trustees of the trust fund. The net
  403  proceeds in the health care economic development trust fund
  404  shall be distributed, in consultation with the Department of
  405  Economic Opportunity, to promote job creation in the health care
  406  sector of the economy through new or expanded health care
  407  business development, new or expanded health care services, or
  408  new or expanded health care education programs or
  409  commercialization of health care research within the affected
  410  community; and
  411         (b) Appropriate 50 percent of the net proceeds of the sale
  412  or lease for funding the delivery of indigent care, including
  413  but not limited to primary care, physician specialty care, out
  414  patient care, in-patient care and behavioral health, to
  415  hospitals within the boundaries of the district with
  416  consideration given to the levels of indigent care provided.
  417  
  418  For the purposes of this subsection, the term “net proceeds”
  419  means the sale price after payment of all district debts and
  420  obligations.
  421         (17) If a county, district, or municipal hospital or health
  422  care system is sold or leased to a for-profit corporation or
  423  other business entity subject to local taxation, the resulting
  424  county and municipal ad valorem tax revenue from the formerly
  425  tax-exempt property shall be distributed by the county
  426  commission of the county in which the property is located, if
  427  the hospital is a county hospital or district hospital whose
  428  geographic boundaries extend beyond a single municipality, or,
  429  if the hospital is a municipal hospital or district hospital
  430  whose geographic boundaries lie entirely within a single
  431  municipality, such ad valorem tax revenues shall be distributed
  432  by the municipal government. The distribution of such ad valorem
  433  tax revenues shall be made in consultation with the Department
  434  of Economic Opportunity, for purposes set forth in subsection
  435  (16).
  436         (18)(5)If In the event a hospital operated by a for-profit
  437  or not-for-profit Florida entity corporation receives annually
  438  more than $100,000 in revenues from the county, district, or
  439  municipality that owns the hospital, the Florida entity
  440  corporation must be accountable to the county, district, or
  441  municipality with respect to the manner in which the funds are
  442  expended by either:
  443         (a) Having the revenues subject to annual appropriations by
  444  the county, district, or municipality; or
  445         (b) Where there is a contract to provide revenues to the
  446  hospital, the term of which is longer than 12 months, the
  447  governing board of the county, district, or municipality must be
  448  able to modify the contract upon 12 months notice to the
  449  hospital.
  450  
  451  A not-for-profit entity corporation that is subject to this
  452  subsection and that does not currently comply with the
  453  accountability requirements in this subsection shall have 12
  454  months after the effective date of this act to modify any
  455  contracts with the county, district, or municipality in a manner
  456  that is consistent with this subsection.
  457         (19)(6) Unless otherwise expressly stated in the lease
  458  documents, the transaction involving the sale or lease of a
  459  hospital may shall not be construed as:
  460         (a) A transfer of a governmental function from the county,
  461  district, or municipality to the private purchaser or lessee;
  462         (b) Constituting a financial interest of the public lessor
  463  in the private lessee; or
  464         (c) Making a private lessee an integral part of the public
  465  lessor’s decisionmaking process.
  466         (20)(7) The lessee of a hospital, under this section or any
  467  special act of the Legislature, operating under a lease may
  468  shall not be construed to be “acting on behalf of” the lessor as
  469  that term is used in statute, unless the lease document
  470  expressly provides to the contrary.
  471         (21)(8)(a) If, whenever the sale of a public hospital by a
  472  public agency to a private corporation or other private entity
  473  pursuant to this section or pursuant to a special act of the
  474  Legislature reflects that:
  475         1. The private corporation or other private entity
  476  purchaser acquires 100 percent ownership in the hospital
  477  enterprise;
  478         2. The private corporation or other private entity
  479  purchases the physical plant of the hospital facility and has
  480  complete responsibility for the operation and maintenance of the
  481  facility, regardless of ownership of the underlying real
  482  property;
  483         3. The public agency seller retains no control over
  484  decisionmaking or policymaking for the hospital;
  485         4. The private corporation or other private entity
  486  purchaser receives no funding from the public agency seller
  487  other than by contract for services rendered to patients for
  488  whom the public agency seller has the responsibility to pay for
  489  hospital or medical care;
  490         5. The public agency seller makes no substantial investment
  491  in or loans to the private entity;
  492         6. The private corporation or other private entity
  493  purchaser was not created by the public entity seller; and
  494         7. The private corporation or other private entity
  495  purchaser operates primarily for its own financial interests and
  496  not primarily for the interests of the public agency,
  497  
  498  such a sale shall be considered a complete sale of the public
  499  agency’s interest in the hospital or health care system.
  500         (b) A complete sale of a hospital or health care system as
  501  described in this subsection may shall not be construed as:
  502         1. A transfer of a governmental function from the county,
  503  district, or municipality to the private corporation or other
  504  private entity purchaser;
  505         2. Constituting a financial interest of the public agency
  506  in the private corporation or other private entity purchaser;
  507         3. Making the private corporation or other private entity
  508  purchaser an “agency” as that term is used in statutes;
  509         4. Making the private corporation or other private entity
  510  purchaser an integral part of the public agency’s decisionmaking
  511  process; or
  512         5. Indicating that the private corporation or other private
  513  entity purchaser is “acting on behalf of a public agency” as
  514  that term is used in statute.
  515         (22)If the governing board elects to sell or lease any
  516  physical property of a county, district, or municipal hospital
  517  or health care system and such property generated less than 20
  518  percent of the hospital’s net revenue within the hospital’s or
  519  health care system’s most recent fiscal year, the sale or lease
  520  of such property is exempt from the requirements under
  521  subsections (6)-(15). However, the governing board shall
  522  publicly advertise the meeting at which the proposed sale or
  523  lease of such property will be considered by the governing board
  524  of the hospital in accordance with s. 286.0105 or publicly
  525  advertise the offer to accept proposals in accordance with s.
  526  255.0525 and receive proposals from all qualified purchasers and
  527  lessees. The sale or lease of the property must be for fair
  528  market value or, if a lease is for less than fair market value,
  529  the lease must be in the best interest of the affected
  530  community.
  531         (23)A county, district or municipal hospital or health
  532  care system that is under lease as of the effective date of this
  533  act is not subject to subsections (5)-(16) as long as that lease
  534  remains in effect in accordance with the terms of the lease or
  535  such lease is modified, extended or renewed. Any such hospital
  536  or health care system, however, becomes subject to the
  537  provisions of this act upon:
  538         (a) Termination of the lease, unless the lease termination
  539  is the direct result of a new lease involving a partnership,
  540  transaction or contract in which both the existing lessor and
  541  lessee agree to the new lease between the lessor and another
  542  mutually agreed upon entity;
  543         (b) Notification provided to the lessee of a planned
  544  termination of the lease in accordance with the lease terms,
  545  unless the notification of lease termination is the direct
  546  result of a new lease involving a partnership, transaction or
  547  contract in which both the existing lessor and lessee agree to
  548  the new lease between the lessor and another mutually agreed
  549  upon entity;
  550         (c) Notification to the lessee that upon termination of the
  551  lease the lessor plans to seek potential new lessees or buyers;
  552  or
  553         (d) Notification to the lessee that the lessor plans to
  554  resume operation of the hospital or health care system at the
  555  termination of the lease.
  556  
  557  Any such hospital or health care system may not thereafter be
  558  sold, leased to another lessee, or operated by the owner without
  559  first complying with this act.
  560         (24)A county, district, or municipal hospital or health
  561  care system that has executed a letter of intent to sell or
  562  lease the hospital or health care system accepted at a properly
  563  noticed public meeting, and whose governing board has voted to
  564  approve the letter of intent before December 31, 2011, is not
  565  subject to subsections (6)-(17) as long as the final closing of
  566  the sale or lease transaction pursuant to the letter of intent
  567  occurs before December 31, 2012.
  568         Section 2. Section 155.401, Florida Statutes, is created to
  569  read:
  570         155.401Power of special taxing district to appropriate
  571  proceeds from sale or lease of hospital or health care system to
  572  economic development trust fund.—Notwithstanding any other
  573  general or special law, the purposes for which a special taxing
  574  district may appropriate funds from the sale or lease of a
  575  hospital or health care system to an economic development fund
  576  include the promotion and support of economic growth in such
  577  district and in the county in which such district is located and
  578  the furthering of the purposes of such district, as provided by
  579  law.
  580         Section 3. To the extent that any general or special law is
  581  inconsistent with or otherwise in conflict with this act, such
  582  conflicting provisions are specifically superseded by this act.
  583  A special tax district, public hospital, or municipal hospital
  584  is not exempt from this act.
  585         Section 4. Subsection (1) of section 395.002, Florida
  586  Statutes, is amended to read:
  587         395.002 Definitions.—As used in this chapter:
  588         (1) “Accrediting organizations” means national
  589  accreditation organizations that are approved by the Centers for
  590  Medicare and Medicaid Services and whose standards incorporate
  591  comparable licensure regulations required by the state the Joint
  592  Commission on Accreditation of Healthcare Organizations, the
  593  American Osteopathic Association, the Commission on
  594  Accreditation of Rehabilitation Facilities, and the
  595  Accreditation Association for Ambulatory Health Care, Inc.
  596         Section 5. For the purpose of incorporating the amendment
  597  made by this act to section 395.002, Florida Statutes, in a
  598  reference thereto, paragraph (c) of subsection (2) of section
  599  395.003, Florida Statutes, is reenacted to read:
  600         395.003 Licensure; denial, suspension, and revocation.—
  601         (2)
  602         (c) Intensive residential treatment programs for children
  603  and adolescents which have received accreditation from an
  604  accrediting organization as defined in s. 395.002(1) and which
  605  meet the minimum standards developed by rule of the agency for
  606  such programs shall be licensed by the agency under this part.
  607         Section 6. Section 395.3036, Florida Statutes, is amended
  608  to read:
  609         395.3036 Confidentiality of records and meetings of
  610  entities corporations that lease public hospitals or other
  611  public health care facilities.—The records of a private entity
  612  corporation that leases a public hospital or other public health
  613  care facility are confidential and exempt from the provisions of
  614  s. 119.07(1) and s. 24(a), Art. I of the State Constitution, and
  615  the meetings of the governing board of a private entity
  616  corporation are exempt from s. 286.011 and s. 24(b), Art. I of
  617  the State Constitution if when the public lessor complies with
  618  the public finance accountability provisions of s. 155.40(18)
  619  155.40(5) with respect to the transfer of any public funds to
  620  the private lessee and if when the private lessee meets at least
  621  three of the five following criteria:
  622         (1) The public lessor that owns the public hospital or
  623  other public health care facility was not the incorporator or
  624  initial member of the private entity corporation that leases the
  625  public hospital or other health care facility.
  626         (2) The public lessor and the private lessee do not
  627  commingle any of their funds in any account maintained by either
  628  of them, other than the payment of the rent and administrative
  629  fees or the transfer of funds pursuant to subsection (5) (2).
  630         (3) Except as otherwise provided by law, the private lessee
  631  is not allowed to participate, except as a member of the public,
  632  in the decisionmaking process of the public lessor.
  633         (4) The lease agreement does not expressly require the
  634  lessee to comply with the requirements of ss. 119.07(1) and
  635  286.011.
  636         (5) The public lessor is not entitled to receive any
  637  revenues from the lessee, except for rental or administrative
  638  fees due under the lease, and the lessor is not responsible for
  639  the debts or other obligations of the lessee.
  640         Section 7. This act shall take effect upon becoming a law.