HB 1101 - Georgia Health Care Authorities Law; enact

First Reader Summary

A BILL to amend Title 31 of the Official Code of Georgia Annotated, relating to health, so as to create health care authorities in every county and municipality in the state; and for other purposes.

Childers, E. (Buddy) M (13th) Martin, Jim (47th) Hudson, Sistie G (120th)
Culbreth, Ronnie (132nd) Shaw, Jay (176th) Orrock, Nan (56th)
Status Summary HC: H&E SC: H&HS LA: 03/05/98 S - Lost (CSFA )
Page Numbers - 1/ 2/ 3/ 4/ 5/ 6/ 7/ 8/ 9/ 10/ 11/ 12/ 13/ 14/ 15/ 16/ 17/ 18/ 19/ 20/ 21/ 22/ 23/ 24/ 25/ 26/ 27/ 28/ 29/ 30/ 31/ 32/ 33/ 34/ 35/ 36/ 37/ 38/ 39/ 40/ 41
Code Sections - 31-7-70/ 31-7-71/ 31-7-72/ 31-7-72.1/ 31-7-73/ 31-7-74/ 31-7-74.1/ 31-7-74.2/ 31-7-74.3/ 31-7-75/ 31-7-75.1/ 31-7-75.2/ 31-7-76/ 31-7-77/ 31-7-78/ 31-7-79/ 31-7-80/ 31-7-81/ 31-7-82/ 31-7-83/ 31-7-84/ 31-7-85/ 31-7-86/ 31-7-89.1/ 31-7-91/ 31-7-92/ 31-7-93/ 31-7-94/ 31-7-95/ 31-7-96
House Action Senate
3/28/97 Read 1st Time 2/19/98
1/12/98 Read 2nd Time 2/23/98
2/12/98 Favorably Reported 2/20/98
Sub Committee Amend/Sub
2/18/98 Read 3rd Time 3/5/98
2/18/98 Passed/Adopted
CSFA Comm/Floor Amend/Sub
Lost 3/5/98

HB 1101                                          HB 1101/CSFA 
 
      H. B. No. 1101 (COMMITTEE SUBSTITUTE)(AM) 
      By:  Representatives Childers of the 13th, Martin of the 
      47th, Hudson of the 120th, Culbreth of the 132nd, Shaw of 
      the 176th and others 
 
                        A BILL TO BE ENTITLED 
                               AN ACT 
 
 
  1- 1  To amend Chapter 7 of Title 31 of the Official Code of 
  1- 2  Georgia Annotated, relating to health care facilities, so as 
  1- 3  to substantially revise Article 4 thereof, the "Hospital 
  1- 4  Authorities Law"; to change the provisions regarding 
  1- 5  definitions; to change the composition and manner of 
  1- 6  appointment of such authorities and the provisions relating 
  1- 7  to vacancies and terms of office; to change certain 
  1- 8  limitations regarding the area of operation of such 
  1- 9  authorities; to change the provisions regarding hospital 
  1-10  authority mergers; to change the provisions regarding 
  1-11  additional hospital authorities in certain counties; to 
  1-12  change the provision regarding qualifications and 
  1-13  compensation of authority members; to provide for removal of 
  1-14  authority members; to change the provisions regarding powers 
  1-15  and duties of such authorities; to change the provisions 
  1-16  regarding required trust funds for proceeds from the sale or 
  1-17  lease of certain hospitals and the use of such funds; to 
  1-18  change the provisions regarding actions when it appears a 
  1-19  hospital authority has ceased to perform minimum functions; 
  1-20  to clarify the prohibition regarding operation or 
  1-21  construction of projects for a profit; to change the 
  1-22  provisions regarding issuance and sale of negotiable revenue 
  1-23  anticipation certificates; to exempt certain such 
  1-24  certificates from confirmation and validation; to provide 
  1-25  for moneys and contributions received by an authority and 
  1-26  provide for receipt of tax revenues and contracts relating 
  1-27  thereto; to change the provisions regarding hospital 
  1-28  authority budgets and procedures relating thereto; to change 
  1-29  certain provisions regarding local government property 
  1-30  acquired by such authorities; to change the provisions 
  1-31  regarding disposition of property upon dissolution of such 
  1-32  authorities; to change the provisions relating to grants to 
  1-33  hospital authorities and payments for residency programs at 
  1-34  teaching hospitals; to provide for immunity for certain 
  1-35  anticompetitive activities as governmental activities; to 
  1-36  provide for related matters; to provide an effective date; 
  1-37  to repeal conflicting laws; and for other purposes. 
 
 
 
                                 -1- 
 
 
 
  2- 1       BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA: 
 
  2- 2                           SECTION 1. 
 
  2- 3  Chapter 7 of Title 31 of the Official Code of Georgia 
  2- 4  Annotated, relating to health care facilities, is amended by 
  2- 5  striking Article 4, the "Hospital Authorities Law," in its 
  2- 6  entirety, and inserting in its place the following: 
 
 
 
  2- 7    31-7-70. 
 
  2- 8    This article shall be known and may be cited as the 
  2- 9    'Hospital Authorities Law.' 
 
  2-10    31-7-71. 
 
  2-11    As used in this article, the term: 
 
  2-12      (1) 'Area of operation' means the area within the city 
  2-13      or county activating an authority.  Such term shall also 
  2-14      mean any other city or county in which the authority 
  2-15      wishes to operate, provided the governing authorities 
  2-16      and the board of any hospital authorities of such city 
  2-17      and county request or approve such operation any city or 
  2-18      county, whether or not contiguous, in which an authority 
  2-19      owns or operates projects. 
 
  2-20      (2) 'Authority' or 'hospital authority' means any public 
  2-21      corporation created by this article. 
 
  2-22      (3) 'Authority board' means the duly appointed members 
  2-23      of any authority created under this article. 
 
  2-24      (4) 'Certificates,'  'revenue certificates,' or 'revenue 
  2-25      anticipation certificates' means the certificates, 
  2-26      bonds, notes, bond anticipation notes, interim 
  2-27      certificates, or other evidences of indebtedness issued 
  2-28      by an authority under Code Section 31-7-78. 
 
  2-29      (5) 'Cost' means, with respect to any project or 
  2-30      projects: 
 
  2-31        (A) All or any part of the costs of the acquisition, 
  2-32        construction, alteration, repair, improvement, 
  2-33        modernization, and other charges incident thereto in 
  2-34        connection with any project or projects; 
 
  2-35        (B) All costs of real or personal property required 
  2-36        for the purposes of such project and of all facilities 
  2-37        related thereto, including land and any rights or 
  2-38        undivided interest therein, easements, franchises, 
 
 
                                 -2- 
 
 
 
  3- 1        water rights, fees, permits, approvals, licenses, and 
  3- 2        certificates and the securing of such franchises, 
  3- 3        permits, approvals, licenses, and certificates and the 
  3- 4        preparation of applications therefor; 
 
  3- 5        (C) All machinery, equipment, furniture, fixtures, and 
  3- 6        other supplies to be installed in or located at any 
  3- 7        project or projects; 
 
  3- 8        (D) Financing charges and interest prior to and during 
  3- 9        construction and during such additional period as the 
  3-10        authority may reasonably determine to be necessary for 
  3-11        the placing of such project in operation; 
 
  3-12        (E) Costs of engineering, architectural, and legal 
  3-13        services related to any project; 
 
  3-14        (F) Fees paid to fiscal agents for financial and other 
  3-15        advice or supervision related to any project; 
 
  3-16        (G) Costs of plans and specifications and all expenses 
  3-17        necessary or incidental to determining the feasibility 
  3-18        or practicability of any project; and 
 
  3-19        (H) Administrative expenses and such other expenses as 
  3-20        may be necessary or incidental to the acquisition, 
  3-21        construction, alteration, repair, modernization, and 
  3-22        equipping of any project authorized in this article. 
 
  3-23      Any obligation or expense incurred for any of the 
  3-24      foregoing purposes shall be regarded as part of the 
  3-25      costs of a project and may be paid or reimbursed as such 
  3-26      out of the proceeds of revenue certificates issued under 
  3-27      this article. 
 
  3-28      (3)(6) 'Governing body' means the elected or duly 
  3-29      appointed officials constituting the governing body of a 
  3-30      city or county political subdivision. 
 
  3-31      (4)(7) 'Participating units' or 'participating 
  3-32      subdivisions' means any two or more counties, or any two 
  3-33      or more municipalities, or a combination of any county 
  3-34      and any municipality acting together for the creation of 
  3-35      an authority. 
 
  3-36      (8) 'Political subdivision' means each county and 
  3-37      municipal corporation for which a hospital authority was 
  3-38      created. 
 
  3-39      (5)(9) 'Project' includes the acquisition, construction, 
  3-40      and equipping of alteration, repair, improvement, or 
 
 
 
                                 -3- 
 
 
 
  4- 1      modernization of and the acquisition and installation of 
  4- 2      equipment, machinery, furniture, fixtures, and other 
  4- 3      items of personal property in hospitals, health care 
  4- 4      facilities, dormitories, office buildings, any inpatient 
  4- 5      or outpatient clinics, housing accommodations, 
  4- 6      ambulatory surgery centers, nursing homes, 
  4- 7      rehabilitation centers, extended care facilities, 
  4- 8      hospices, personal care homes, home health agencies, and 
  4- 9      other public health facilities for the use of patients 
  4-10      and officers and employees of any institution under the 
  4-11      supervision and control of any hospital authority or 
  4-12      leased by the hospital authority for operation by others 
  4-13      and services deemed necessary or desirable by the 
  4-14      authority in accordance with applicable rules and 
  4-15      statutes of State Health Planning and the office of 
  4-16      Regulatory Services to promote the public health needs 
  4-17      of the community, as well as and all utilities, 
  4-18      services, and facilities deemed by the authority 
  4-19      necessary or convenient for the efficient operation 
  4-20      thereof. Such term may also include any such 
  4-21      institutions, utilities, and facilities located outside 
  4-22      the city or county in which the authority is located, 
  4-23      provided that the acquisition, construction, equipping, 
  4-24      and operation thereof is requested or approved by the 
  4-25      governing bodies of such city and county in which the 
  4-26      project is located and by the board of any hospital 
  4-27      authorities located within such city and county or 
  4-28      provided that the acquisition, construction, equipping, 
  4-29      and operation is to be located in the area of operation 
  4-30      of the authority There may be included as part of any 
  4-31      such project all improvements necessary to the full 
  4-32      utilization thereof, including, without limitation, site 
  4-33      preparation, roads and streets, sidewalks, water supply, 
  4-34      outdoor lighting, bridges, causeways, or transportation 
  4-35      facilities incidental to the project. 
 
  4-36      (6)(10) 'Resolution' means the resolution or ordinance 
  4-37      to be adopted by governing bodies pursuant to which 
  4-38      authorities are established. 
 
  4-39    31-7-72. 
 
  4-40    (a) There is created in and for each county and municipal 
  4-41    corporation of the state a public body corporate and 
  4-42    politic to be known as the 'hospital authority' of such 
  4-43    county or city, which shall consist of a board of not less 
  4-44    than five nor more than nine 13 members to be appointed by 
 
 
 
                                 -4- 
 
 
 
  5- 1    the governing body of the such county or municipal 
  5- 2    corporation of the area of operation for staggered terms 
  5- 3    as specified by resolution of the governing body. The 
  5- 4    number of members of any hospital authority as of March 1, 
  5- 5    1984 the date this Code section becomes effective in 1998, 
  5- 6    may be increased by not more  than two additional members 
  5- 7    so that the total number of members does not exceed 13 by 
  5- 8    the adoption of a resolution of the members of the 
  5- 9    hospital authority before July 1, 1998 or by the adoption 
  5-10    of a resolution by the county or municipal corporation for 
  5-11    which the authority was created, and such additional 
  5-12    members shall be appointed through the same process used 
  5-13    for filling vacancies which was in effect for such 
  5-14    hospital authority on January 1, 1984. Whenever an 
  5-15    appointment to fill a vacancy on the board of any hospital 
  5-16    authority is made, either for an unexpired term or a full 
  5-17    term, consideration shall be given as to whether a 
  5-18    licensed doctor of medicine or registered nurse currently 
  5-19    serves on such authority.  If no licensed doctor of 
  5-20    medicine or registered nurse currently serves on such 
  5-21    authority, then consideration shall be given to the 
  5-22    nomination and choice of a licensed doctor of medicine or 
  5-23    a registered nurse to fill such vacancy at the time such 
  5-24    resolution was adopted.  No authority created under this 
  5-25    Code section shall transact any business or exercise any 
  5-26    powers under this Code section until the governing body of 
  5-27    the area of operation county or municipal corporation for 
  5-28    which the authority was created shall, by proper 
  5-29    resolution, declare that there is need for an authority to 
  5-30    function in such county or municipal corporation. Copies 
  5-31    of a resolution so adopted and any resolution adopted by 
  5-32    the governing body providing for filling vacancies in the 
  5-33    membership of the authority or making any changes in 
  5-34    membership shall be filed with the department. 
 
  5-35    (b) Appointments to fill vacancies on the board of any 
  5-36    hospital authority activated on or after March 15, 1964 
  5-37    July 1, 1998, for either an unexpired or full term as 
  5-38    fixed in the original resolution or ordinance creating the 
  5-39    authority, shall be made as follows: 
 
  5-40      (1) The governing body of the area of operation 
  5-41      authority board shall submit a list of three eligible 
  5-42      persons to the board of the hospital authority governing 
  5-43      body or bodies for such authority; 
 
 
 
 
                                 -5- 
 
 
 
  6- 1      (2) The board at its next regular meeting Within 45 days 
  6- 2      of its receipt of such list, such governing body shall 
  6- 3      either select one of the three persons named in such 
  6- 4      list or decline to select any of the persons named in 
  6- 5      the list. If the board such governing body declines to 
  6- 6      select any of the persons named on the list, it shall so 
  6- 7      notify the governing body authority board; and 
 
  6- 8      (3) Upon receipt of notification that the board 
  6- 9      governing body has declined to select any of the persons 
  6-10      named in the governing body's authority board's list, 
  6-11      the governing body authority board shall submit a second 
  6-12      list of three eligible persons, no one of whom was named 
  6-13      on the first list, to the board of the hospital 
  6-14      authority governing body or bodies for such authority. 
  6-15      The board at its next regular meeting after receipt of 
  6-16      such second list Within 45 days of its receipt of such 
  6-17      list, the governing body shall select one of the three 
  6-18      persons named in the second list. 
 
  6-19    (c) Appointments to fill vacancies for either an unexpired 
  6-20    or full term on the boards of all hospital authorities in 
  6-21    existence prior to March 15, 1964 July 1, 1998, shall be 
  6-22    governed by the terms of a resolution adopted prescribing 
  6-23    the manner by which vacancies are filled, unless changed 
  6-24    by local legislation or constitutional amendment. made as 
  6-25    follows: 
 
  6-26      (1) On or after July 1, 1998, and prior to September 1, 
  6-27      1998, the authority board shall adopt a resolution 
  6-28      electing to have the vacancies filled on such board 
  6-29      either pursuant to the provisions of subsection (b) of 
  6-30      this Code section or in the same manner as such 
  6-31      appointments were filled on June 30, 1998.  If the 
  6-32      authority board does not adopt such resolution by such 
  6-33      date or does not file such resolution as required by 
  6-34      paragraph (2) of this subsection within 30 days after 
  6-35      such adoption, vacancies on such board shall be filled 
  6-36      in the same manner as such vacancies were filled on June 
  6-37      30, 1998. 
 
  6-38      (2) After said resolution has been formally adopted by 
  6-39      the authority board, it shall be filed with the 
  6-40      governing body or bodies for such authority. Such 
  6-41      resolution which has been adopted and filed as provided 
  6-42      by this subsection shall become effective upon the 
  6-43      sixtieth day following such adoption unless any 
  6-44      governing body of such authority votes to veto such 
 
 
                                 -6- 
 
 
 
  7- 1      resolution.  Otherwise, all appointments to fill 
  7- 2      vacancies thereafter shall be governed by the terms of 
  7- 3      such resolution, when adopted and filed as provided in 
  7- 4      this subsection, unless changed by local legislation. 
  7- 5      No resolution may be adopted pursuant to this subsection 
  7- 6      if local legislation enacted in 1997 or 1998 established 
  7- 7      the method of filling vacancies. 
 
  7- 8      (3) Once the manner of filling vacancies upon a hospital 
  7- 9      authority has been established pursuant to paragraph (1) 
  7-10      or (2) of this subsection or pursuant to local 
  7-11      legislation, that manner of filling vacancies may 
  7-12      thereafter be changed only by local legislation. 
 
  7-13    (d) Any two or more counties or any two or more 
  7-14    municipalities or any county or municipality, or a 
  7-15    combination of any county and any municipality, by a like 
  7-16    resolution or ordinance of their respective governing 
  7-17    bodies, may authorize the exercise of the powers provided 
  7-18    for in this article by an authority. The membership of 
  7-19    such authority affected by like resolutions of the 
  7-20    respective governing bodies of any two or more of the 
  7-21    governing bodies of the participating units shall be not 
  7-22    less than five nor more than 15 members, the terms and 
  7-23    distribution of members between the participating units to 
  7-24    be provided for by the resolutions adopted by the 
  7-25    governing bodies of the participating units. The 
  7-26    resolutions of the governing bodies of participating units 
  7-27    acting together for the creation of an authority may be 
  7-28    amended by the governing bodies of the participating units 
  7-29    from time to time so as to change the number of members to 
  7-30    not less than five nor more than 15 members, to change the 
  7-31    terms and distribution of members between participating 
  7-32    units, and to change the method of filling vacancies upon 
  7-33    such authority, and such resolutions as so amended shall 
  7-34    control those matters until they are changed by local 
  7-35    legislation. 
 
  7-36      (e)(1) Nothing in this Code section is intended to 
  7-37      invalidate any of the acts of existing boards of 
  7-38      authorities. Hospital authorities shall be granted the 
  7-39      same exemptions and exclusions from taxes as are now 
  7-40      granted to cities and counties for the operation of 
  7-41      facilities similar to facilities to be operated by 
  7-42      hospital authorities as provided for under this title. 
 
  7-43      (2) Notwithstanding the provisions of paragraph (1) of 
  7-44      this subsection or any other law to the contrary, any 
 
 
                                 -7- 
 
 
 
  8- 1      real property in which 50 percent or more of the floor 
  8- 2      space thereof, excluding halls, corridors, and public 
  8- 3      spaces, is rented or leased by persons, firms, or 
  8- 4      corporations engaged in or conducting a private for 
  8- 5      profit business or profession owned by a hospital 
  8- 6      authority which is located in a county having a 
  8- 7      population of 50,000 or more according to the United 
  8- 8      States decennial census of 1990 or any future such 
  8- 9      census or owned by any subsidiary or affiliate thereof 
  8-10      and which hospital authority or subsidiary or affiliate 
  8-11      thereof operates a hospital containing more than 100 
  8-12      beds, shall be subject to all state, county, and 
  8-13      municipal ad valorem taxes in the same manner as other 
  8-14      private property.  
 
  8-15    (f) The project or projects of an authority created by two 
  8-16    or more counties, or two or more municipalities, or a 
  8-17    combination of any county and any municipality may be 
  8-18    located outside of the area of the sponsor's operation 
  8-19    when it is determined by the trustees that this will best 
  8-20    serve the purposes of the facility and provided it is 
  8-21    located within the area of service and within 12 miles of 
  8-22    the hospital location or within 12 miles of the sponsoring 
  8-23    county or municipality, whichever is farther. 
 
  8-24    (g)(f) Hospital authorities created pursuant to this Code 
  8-25    section shall have perpetual existence. 
 
  8-26    31-7-72.1. 
 
  8-27    (a) A hospital authority activated for a county pursuant 
  8-28    to Code Section 31-7-73 may be merged with a any other 
  8-29    hospital authority whether or not located in the same 
  8-30    county, activated for that county under Code Section 
  8-31    31-7-72 upon compliance with this Code section and 
  8-32    approval by resolution of the governing authority of the 
  8-33    county in which the authorities are located each governing 
  8-34    body for such authority. A majority of the board of each 
  8-35    such hospital authority must approve such merger by a 
  8-36    resolution which is adopted by each such board and is 
  8-37    filed with the department.  That resolution shall set 
  8-38    forth: 
 
  8-39      (1) The name of each hospital authority planning to 
  8-40      merge and the name of the surviving hospital authority 
  8-41      into which each plans to merge; and 
 
  8-42      (2) The terms and conditions of the planned merger. 
 
 
 
                                 -8- 
 
 
 
  9- 1    (b) The merger authorized by subsection (a) of this Code 
  9- 2    section shall not become effective until the governing 
  9- 3    authority of the county of operation bodies of the merging 
  9- 4    hospitals authorities appoint appoints the members of the 
  9- 5    board of the surviving hospital authority by proper 
  9- 6    resolution and files file copies of such resolution with 
  9- 7    the department.  The governing authority body is not 
  9- 8    required but is authorized to appoint as a member of the 
  9- 9    surviving hospital authority any member of a hospital 
  9-10    authority planning to merge.  The board of the surviving 
  9-11    hospital shall consist of not more than 15 members with 
  9-12    initial appointments for such staggered terms as provided 
  9-13    in the resolution of the county governing authority body. 
  9-14    Appointments to fill vacancies for either an unexpired or 
  9-15    full term shall thereafter be filled as authorized for an 
  9-16    authority under subsection (c) of Code Section 31-7-72. 
  9-17    The surviving hospital authority shall be in all other 
  9-18    respects a hospital authority created under Code Section 
  9-19    31-7-72. 
 
  9-20    (c) A county whose hospital authorities have merged under 
  9-21    the authority of this Code section shall not thereafter be 
  9-22    prohibited from activating a hospital authority under Code 
  9-23    Section 31-7-73. 
 
  9-24    (d) When a merger under this Code section takes effect: 
 
  9-25      (1) Each hospital authority party to participating in 
  9-26      the merger merges into the surviving hospital authority 
  9-27      and the separate existence of each such hospital 
  9-28      authority except the surviving hospital authority 
  9-29      ceases; 
 
  9-30      (2) The ownership of and authority to operate the 
  9-31      hospitals owned by each hospital authority and the title 
  9-32      to all real estate and other property owned by each 
  9-33      hospital authority party to participating in the merger 
  9-34      is vested in the surviving hospital authority without 
  9-35      reversion or impairment subject to any and all 
  9-36      conditions to which the property was subject prior to 
  9-37      the merger; 
 
  9-38      (3) The surviving hospital authority has all liabilities 
  9-39      and obligations of each hospital authority party to 
  9-40      participating in the merger; and 
 
  9-41      (4) A proceeding pending against any hospital authority 
  9-42      party to participating in the merger may be continued as 
  9-43      if the merger did not occur or the surviving hospital 
 
 
                                 -9- 
 
 
 
 10- 1      authority may be substituted in the proceeding for the 
 10- 2      hospital authority whose existence ceased. 
 
 10- 3    (e) It is declared by the General Assembly of Georgia that 
 10- 4    in the exercise of the power specifically granted to them 
 10- 5    by this Code section, hospital authorities are acting 
 10- 6    pursuant to state policy and shall be immune from 
 10- 7    antitrust liability to the same degree and extent as 
 10- 8    enjoyed by the State of Georgia. 
 
 10- 9    31-7-73. 
 
 10-10    (a) Any other provision of this article to the contrary 
 10-11    notwithstanding, there is created in and for each county 
 10-12    of this state having a population of 100,000 or more 
 10-13    according to the United States decennial census of 1970 
 10-14    1990 or any future such census a public body corporate and 
 10-15    politic to be known as the '______________ Hospital 
 10-16    Authority.' one or more additional authorities. Each such 
 10-17    hospital authority shall be created and initially 
 10-18    appointed in the same manner as provided in Code Section 
 10-19    31-7-72 but shall be a separate entity and in addition to 
 10-20    the hospital authority of each county of this state 
 10-21    created pursuant to Code Section 31-7-72. 
 
 10-22    (b) Each such additional hospital authority shall consist 
 10-23    of a board of not less than five nor more than nine 13 
 10-24    members to be appointed by the governing body of each such 
 10-25    county for staggered terms, as specified by resolution of 
 10-26    the governing body. No hospital authority created under 
 10-27    this Code section shall transact any business or exercise 
 10-28    any powers under this Code section until the governing 
 10-29    body of each such county declares by proper resolution 
 10-30    that there is a need for an additional hospital authority 
 10-31    to function within such county, which resolution shall 
 10-32    also determine and declare that such hospital authority is 
 10-33    being created pursuant to this Code section and shall 
 10-34    adopt a designation for the hospital authority so as to 
 10-35    reflect that it is a separate and distinct entity from the 
 10-36    hospital authority created pursuant to Code Section 
 10-37    31-7-72. A copy of such resolution shall be filed with the 
 10-38    department. Copies of any resolutions adopted by the 
 10-39    governing body of the county for the purpose of filling 
 10-40    vacancies in the membership of the hospital authority or 
 10-41    for making any changes in membership shall also be filed 
 10-42    with the department. 
 
 
 
 
                                 -10- 
 
 
 
 11- 1    (c) Appointments to fill vacancies on the board of any 
 11- 2    such hospital authority shall be made as provided in Code 
 11- 3    Section 31-7-72. 
 
 11- 4    (d) All provisions of this article, including, but not 
 11- 5    limited to, the rights, powers, duties, obligations, and 
 11- 6    exemptions from taxation provided thereby for hospital 
 11- 7    authorities shall apply to the additional hospital 
 11- 8    authorities created pursuant to this Code section and the 
 11- 9    hospital authorities so created shall, in all respects, to 
 11-10    the extent applicable for the purposes of this chapter 
 11-11    article, be treated as though they had been created 
 11-12    pursuant to Code Section 31-7-72. 
 
 11-13    (e) It is declared that this Code section shall be 
 11-14    cumulative of and supplemental to Code Section 31-7-72 and 
 11-15    not in lieu thereof. It is expressly provided that nothing 
 11-16    contained in this Code section shall invalidate or 
 11-17    abrogate any of the actions or obligations of existing 
 11-18    hospital authorities created pursuant to Code Section 
 11-19    31-7-72 and further that nothing contained in this Code 
 11-20    section shall be construed as adversely affecting the 
 11-21    rights and interests of the holders or owners of any 
 11-22    bonds, certificates, or obligations now or hereafter 
 11-23    issued by such existing hospital authorities. 
 
 11-24    31-7-74. 
 
 11-25    The members of a hospital authority shall be residents of 
 11-26    one of the participating units comprising political 
 11-27    subdivisions for the authority. Physicians and other 
 11-28    health care providers are not prohibited from serving as 
 11-29    members.  The requirement of residence shall not apply to 
 11-30    authorities activated under subsection (d) of Code Section 
 11-31    31-7-72, provided they are selected from within the area 
 11-32    of service and within 12 miles of the hospital location or 
 11-33    within 12 miles of the sponsoring county or municipality, 
 11-34    whichever is farther.  The members shall elect one of 
 11-35    their number as chair and another as vice chair and shall 
 11-36    also elect a secretary-treasurer, who need not be a 
 11-37    member.  The members shall receive no compensation for 
 11-38    their services, either as members or as employees of the 
 11-39    authority but may be reimbursed for their actual expenses 
 11-40    incurred in the performance of their duties or, in the 
 11-41    alternative, the members may elect to be reimbursed for 
 11-42    such expenses on a per diem basis in an amount not to 
 11-43    exceed $100.00 per meeting and the total amount not to 
 11-44    exceed $100.00 $300.00 per month.  The authority shall 
 
 
                                 -11- 
 
 
 
 12- 1    make rules and regulations for its governance and may 
 12- 2    delegate to one or more of its members, officers, agents, 
 12- 3    or employees such powers and duties as may be deemed 
 12- 4    necessary and proper. 
 
 12- 5    31-7-74.1. 
 
 12- 6    (a) As used in this Code section, the term: 
 
 12- 7      (1) 'Family' means spouse, child, or sibling. 
 
 12- 8      (2) 'Financial interest' means the direct or indirect 
 12- 9      ownership of any assets or stock of any business. 
 
 12-10      (3) 'Substantial interest' means the direct or indirect 
 12-11      ownership of more than 25 percent of the assets or stock 
 12-12      of any business. 
 
 12-13      (4) 'Transact business' or 'transact any business' or 
 12-14      'transaction' means any sale or lease of any personal 
 12-15      property, real property, or services on behalf of 
 12-16      oneself or on behalf of any third party as an agent, 
 12-17      broker, dealer, or representative. 
 
 12-18    (b) Each member of a hospital authority shall disclose 
 12-19    upon his or her selection as a member, and at least 
 12-20    annually thereafter, the following described interests and 
 12-21    relationships: 
 
 12-22      (1) Any financial interest held by the member or the 
 12-23      member's family, or held by an entity in which the 
 12-24      member or the member's family owns a financial interest, 
 12-25      in any health care provider, any managed care provider 
 12-26      or network, or any entity which sells products or 
 12-27      services to the authority; 
 
 12-28      (2) Any position held by the member or the member's 
 12-29      family as an officer, director, or employee of a 
 12-30      hospital, hospital holding company, other health care 
 12-31      provider, or managed care network; and 
 
 12-32      (3) Any contract which exists between the member or the 
 12-33      member's family, or any entity in which the member or 
 12-34      the member's family owns a financial interest, and the 
 12-35      authority, including, but not limited to, supply 
 12-36      contracts, service contracts, and leases. 
 
 12-37    (c) Except as otherwise provided in this Code section, no 
 12-38    authority member, no hospital chief executive, and no 
 12-39    hospital system chief executive officer shall, for such 
 12-40    person or for any entity in which such person or such 
 
 
 
                                 -12- 
 
 
 
 13- 1    person's family has a substantial interest, transact any 
 13- 2    business with such authority. 
 
 13- 3    (d) The prohibition of subsection (c) of this Code section 
 13- 4    shall not apply to: 
 
 13- 5      (1) Any relationship whereunder a person licensed under 
 13- 6      Title 43 provides to such authority or its medical 
 13- 7      facilities any services; 
 
 13- 8      (2) Any officer or employee of a trust company or bank 
 13- 9      which has been selected to be the depository of the 
 13-10      funds of such nonprofit corporation; or 
 
 13-11      (3) Any transaction by a board member or a board 
 13-12      member's family where the amount of all transactions 
 13-13      between the parties is $1,000.00 or less in any one 
 13-14      year. 
 
 13-15    (e) A transaction in which any member of an authority has 
 13-16    a financial interest or relationship described in 
 13-17    subsection (b) of this Code section which does not 
 13-18    constitute a substantial interest may be approved if, at 
 13-19    the time of such approval: 
 
 13-20      (1) The material facts of the transaction and the 
 13-21      member's financial interest are disclosed or known to 
 13-22      the authority's board; 
 
 13-23      (2) The interested member is absent from any portion of 
 13-24      a meeting which discusses or votes upon said 
 13-25      transaction; and 
 
 13-26      (3) The members approving the transaction in good faith 
 13-27      reasonably believe that the transaction is fair to the 
 13-28      authority. 
 
 13-29    (f) Notwithstanding the provisions of subsection (c) of 
 13-30    this Code section, a transaction in which any member of an 
 13-31    authority has a substantial interest may be approved if: 
 
 13-32      (1) The transaction was submitted to a competitive 
 13-33      process for requests for proposals, which includes but 
 13-34      is not limited to consideration of all submitted 
 13-35      proposals for price, quality, and appropriateness; and 
 
 13-36      (2) Notice of the transaction was published in the 
 13-37      official county organ not less than two weeks prior to 
 13-38      the approval of the board; 
 
 
 
 
 
                                 -13- 
 
 
 
 14- 1      (3) Opportunity for public comment concerning the 
 14- 2      proposed transaction was provided at a meeting of the 
 14- 3      board; 
 
 14- 4      (4) At the time of approval, the members approving the 
 14- 5      transaction in good faith reasonably believe that the 
 14- 6      transaction is fair and is in the best interests of the 
 14- 7      authority; and 
 
 14- 8      (5) The interested member is absent from any portion of 
 14- 9      a meeting which discusses or votes upon said 
 14-10      transaction. 
 
 14-11    (g) For purposes of this Code section, a transaction is 
 14-12    authorized, approved, or ratified if it receives the 
 14-13    affirmative vote of a majority of the members on the board 
 14-14    present and voting who have no financial interest in the 
 14-15    transaction. A majority, but not less than two, of all the 
 14-16    noninterested members on the board present and voting 
 14-17    constitutes a quorum for purposes of action that complies 
 14-18    with this Code section. 
 
 14-19    (h) Any action by an authority which is taken in 
 14-20    compliance with the applicable requirements of this Code 
 14-21    section may not be enjoined, set aside, or give rise to an 
 14-22    award of damages or other sanctions against the authority 
 14-23    or any member or officer on the ground of a member's or 
 14-24    officer's interest in such transaction.  For any action by 
 14-25    an authority not in compliance with such requirements, any 
 14-26    member knowingly violating such requirements shall be 
 14-27    immediately sanctioned, which may include, but not be 
 14-28    limited to, reprimand, temporary suspension, or permanent 
 14-29    removal from the authority after appropriate notice and 
 14-30    hearing.  The entity having appointed such member shall 
 14-31    have the authority to impose any sanction. 
 
 14-32    (i) Nothing in this Code section shall prevent an 
 14-33    authority from having stricter rules relating to interests 
 14-34    or relationships than what is provided in this Code 
 14-35    section. 
 
 14-36    (j) To the extent the provisions of this Code section 
 14-37    conflict with the provisions of any other law, the 
 14-38    provisions of this Code section shall govern. 
 
 14-39    (k) The provisions of this Code section shall apply to 
 14-40    those individuals serving as members of an authority who 
 14-41    are appointed or reappointed on or after July 1, 1997. 
 14-42    However, this Code section shall apply to all members of 
 
 
 
                                 -14- 
 
 
 
 15- 1    an authority, regardless of appointment date, serving on 
 15- 2    or after July 1, 1998. 
 
 15- 3    31-7-74.2. 
 
 15- 4    Each member of a hospital authority shall take in the 
 15- 5    presence of an officer authorized to administer same the 
 15- 6    following oath: 
 
 15- 7      I, _______________________, citizen of __________ 
 15- 8      County, Georgia, do solemnly swear that I will, to the 
 15- 9      best of my ability, without favor or affection to any 
 15-10      person and without any unauthorized financial gain or 
 15-11      compensation to myself, faithfully and fairly discharge 
 15-12      all of the duties and responsibilities that devolve upon 
 15-13      me as a member of ______________ Hospital Authority, 
 15-14      during the term of my service as such member. 
 
 15-15    31-7-74.3. 
 
 15-16    (a) No hospital which is owned by a hospital authority may 
 15-17    be sold or leased to a for profit entity, a not for profit 
 15-18    entity, or another hospital authority unless a public 
 15-19    hearing regarding such action is held in the county where 
 15-20    such hospital is located at least 60 days prior to such 
 15-21    sale or lease becoming effective.  In the event there is 
 15-22    more than one participating unit for an authority, a 
 15-23    hearing shall be held in each participating unit's county 
 15-24    at least 60 days prior to the sale or lease becoming 
 15-25    effective.  The hospital authority must publish notice of 
 15-26    the hearing at least three times, with the first such 
 15-27    notice appearing at least 60 days prior to the hearing in 
 15-28    the legal organ of each participating unit.  At each such 
 15-29    public hearing, the hospital authority shall describe, 
 15-30    discuss, or otherwise disclose: 
 
 15-31      (1) The reasonably foreseeable adverse and beneficial 
 15-32      effects of such lease or sale upon health care in the 
 15-33      service area of the hospitals to be leased or sold, and, 
 15-34      for purposes of this paragraph, the service area shall 
 15-35      include the county in which the hospital is located and 
 15-36      each adjoining county; 
 
 15-37      (2) A financial statement indicating the estimated value 
 15-38      of the total assets and liabilities to be transferred or 
 15-39      received in the transaction; however, if the value of 
 15-40      any individual asset exceeds $100,000.00, a description 
 15-41      and the value of such assets shall be indicated on the 
 15-42      financial statement; and 
 
 
 
                                 -15- 
 
 
 
 16- 1      (3) The resumes of the top five executive officers who 
 16- 2      will manage the facility after it is sold or leased. 
 
 16- 3    This subsection shall not apply to any transaction which 
 16- 4    is subject to the provisions of Code Section 31-7-89.1 as 
 16- 5    such Code section may be enacted by HB 600 during the 1997 
 16- 6    regular session of the General Assembly. 
 
 16- 7    (b) No hospital which is owned by a hospital authority may 
 16- 8    be leased to another person, corporation, or business 
 16- 9    entity, other than as provided in paragraphs paragraph 
 16-10    (23) and (24) of Code Section 31-7-75, unless such lease 
 16-11    requires that: 
 
 16-12      (1) At least one member of the hospital authority will 
 16-13      serve as a full voting member upon the governing body or 
 16-14      local board of the business entity exercising control 
 16-15      and management powers over the leased hospital; and 
 
 16-16      (2) The governing body or local board of the business 
 16-17      entity exercising control and management powers over the 
 16-18      leased hospital submits to the governing authority of 
 16-19      each county in which the hospital is located, within 90 
 16-20      days after the close of the calendar year or that 
 16-21      entity's fiscal year, a complete and detailed financial 
 16-22      statement for that entity. 
 
 16-23    (c) Provisions of a lease required by subsection (b) of 
 16-24    this Code section may not be renegotiated or otherwise 
 16-25    altered or amended for the duration of such lease. 
 
 16-26    31-7-74.4. 
 
 16-27    Each authority member shall serve for the term specified 
 16-28    at the time of such member's appointment and shall 
 16-29    continue in office thereafter until such member's 
 16-30    successor has been appointed and qualified or until such 
 16-31    member's earlier death, resignation, retirement, 
 16-32    disqualification, or removal.  Any member may be removed 
 16-33    for cause upon a vote of two-thirds of the remaining 
 16-34    authority board members then in office, with cause to 
 16-35    include such member's failure to regularly attend 
 16-36    authority meetings, failure to diligently attend to his or 
 16-37    her duties as an authority member, failure to meet the 
 16-38    qualifications for membership established in this article, 
 16-39    or failure to meet any other requirement in the 
 16-40    authority's bylaws.  Any member so removed shall be 
 16-41    entitled to notice and opportunity for a hearing, and the 
 16-42    authority's bylaws shall so provide. 
 
 
 
                                 -16- 
 
 
 
 17- 1    31-7-75. 
 
 17- 2    Every hospital authority shall be deemed to exercise 
 17- 3    public and essential governmental functions and shall have 
 17- 4    all the powers necessary or convenient to carry out and 
 17- 5    effectuate the purposes and provisions of this article, 
 17- 6    including, but without limiting the generality of the 
 17- 7    foregoing, the following powers: 
 
 17- 8      (1) To sue and be sued; 
 
 17- 9      (2) To have a seal and alter the same; 
 
 17-10      (3) To make and execute contracts and other instruments 
 17-11      necessary to exercise the powers of the authority; 
 
 17-12      (4) To acquire by purchase, lease, or otherwise and to 
 17-13      operate projects, facilities, and related services; 
 
 17-14      (5) To provide, through its projects and facilities or 
 17-15      otherwise, any services deemed necessary or desirable by 
 17-16      the authority to promote  the public health needs of the 
 17-17      community, including but not limited to hospice 
 17-18      services, assisted living, home health services, durable 
 17-19      medical equipment, emergency transportation services, 
 17-20      and any personnel, utilities, and equipment related 
 17-21      thereto, provided the authority complies with the 
 17-22      provisions of Chapter 11 of Title 31 in accordance with 
 17-23      applicable rules and statutes of State Health Planning 
 17-24      and the office of Regulatory Services; 
 
 17-25      (5)(6) To construct, reconstruct, improve, alter, and 
 17-26      repair projects; 
 
 17-27      (6)(7) To sell to others, or to lease to others for any 
 17-28      number of years up to a maximum of 40 years, any lands, 
 17-29      buildings, structures, or facilities constituting all or 
 17-30      any part of any existing or hereafter established 
 17-31      project. In the event a hospital authority undertakes to 
 17-32      sell a hospital facility, such authority shall, prior to 
 17-33      the execution of a contract of sale, provide reasonable 
 17-34      public notice of such sale and provide for a public 
 17-35      hearing to receive comments from the public concerning 
 17-36      such sale. This power shall be unaffected by the 
 17-37      language set forth in paragraph (13) of this Code 
 17-38      section or any implications arising therefrom unless 
 17-39      grants of assistance have been received by the authority 
 17-40      with respect to such lands, buildings, structures, or 
 17-41      facilities, in which case approval in writing as set 
 17-42      forth in paragraph (13) of this Code section shall be 
 
 
                                 -17- 
 
 
 
 18- 1      obtained prior to selling or leasing to others within 20 
 18- 2      years after completion of construction;  
 
 18- 3      (7) To lease for any number of years up to a maximum of 
 18- 4      40 years for operation by others any project, provided 
 18- 5      that the authority shall have first determined that such 
 18- 6      lease will promote the public health needs of the 
 18- 7      community by making additional facilities available in 
 18- 8      the community or by lowering the cost of health care in 
 18- 9      the community and that the authority shall have retained 
 18-10      sufficient control over any project so leased so as to 
 18-11      ensure that the lessee will not in any event obtain more 
 18-12      than a reasonable rate of return on its investment in 
 18-13      the project, which reasonable rate of return, if and 
 18-14      when realized by such lessee, shall not contravene in 
 18-15      any way the mandate set forth in Code Section 31-7-77 
 18-16      specifying that no authority shall operate or construct 
 18-17      any project for profit. Any lessee shall agree in the 
 18-18      lease to pay rent sufficient in each year to pay the 
 18-19      principal of and the interest on any revenue 
 18-20      anticipation certificates proposed to be issued to 
 18-21      finance the cost of the construction or acquisition of 
 18-22      any such project and to pay off or refinance, in whole 
 18-23      or in part, any outstanding debt or obligation of the 
 18-24      lessee (including any redemption or prepayment premium 
 18-25      due thereon) which was incurred in connection with the 
 18-26      acquisition and construction of facilities of such 
 18-27      lessee and the amount necessary in the opinion of the 
 18-28      authority to be paid each year into any reserve funds 
 18-29      which the authority may deem advisable to be established 
 18-30      in connection with the retirement of the proposed 
 18-31      revenue anticipation certificates and the maintenance of 
 18-32      the project. Any such lease shall further provide that 
 18-33      the cost of all insurance with respect to the project 
 18-34      and the cost of maintenance and repair thereof shall be 
 18-35      borne by the lessee. In carrying out a refinancing plan 
 18-36      with regard to any outstanding debt or obligation of the 
 18-37      lessee which was incurred in connection with the 
 18-38      acquisition and construction of facilities of such 
 18-39      lessee, the authority may use proceeds of any revenue 
 18-40      anticipation certificates issued for such purpose to 
 18-41      acquire such outstanding debt or obligation, in whole or 
 18-42      in part, and may itself or through a fiduciary or agent 
 18-43      hold and pledge such acquired debt or obligation as 
 18-44      security for the payment of such revenue anticipation 
 18-45      certificates. The powers granted in this paragraph shall 
 
 
 
                                 -18- 
 
 
 
 19- 1      be unaffected by the language set forth in paragraph 
 19- 2      (13) of this Code section or any implications arising 
 19- 3      therefrom unless grants of assistance have been received 
 19- 4      by the authority with respect to such project, in which 
 19- 5      case approval in writing as set forth in paragraph (13) 
 19- 6      of this Code section shall be obtained prior to leasing 
 19- 7      to others within 20 years after completion of 
 19- 8      construction. Any revenues derived by the authority from 
 19- 9      any such lease shall be applied by the authority to the 
 19-10      payment of any revenue anticipation certificates issued 
 19-11      in connection with the acquisition and construction of 
 19-12      the project and the payment, in whole or in part, of any 
 19-13      outstanding debt or obligation of the lessee which was 
 19-14      incurred in connection with the acquisition and 
 19-15      construction of facilities of such lessee (including any 
 19-16      redemption or prepayment premium due thereon) or to the 
 19-17      payment of any other expenses incurred in connection 
 19-18      with acquiring, financing, maintaining, expanding, 
 19-19      operating, or equipping the project; 
 
 19-20      (8) To extend credit or make loans to others for the 
 19-21      planning, design, construction, acquisition, or carrying 
 19-22      out of any project, which credit or loans may be secured 
 19-23      by such loan agreements, mortgages, security agreements, 
 19-24      contracts, or other instruments or fees or charges, for 
 19-25      a term not to exceed 40 years, and upon such terms and 
 19-26      conditions as the authority shall determine reasonable 
 19-27      in connection with such loans, including provisions for 
 19-28      the establishment and maintenance of reserves and 
 19-29      insurance funds, and in the exercise of powers granted 
 19-30      by this Code section in connection with a project, to 
 19-31      require the inclusion in any contract, loan agreement, 
 19-32      security agreement, or other instrument such provisions 
 19-33      for guaranty, insurance, construction, use, operation, 
 19-34      maintenance, and financing of a project as the authority 
 19-35      may deem necessary or desirable; 
 
 19-36      (9) To acquire, accept, or retain equitable interests, 
 19-37      security interests, or other interests in any property, 
 19-38      real or personal, by mortgage, assignment, security 
 19-39      agreement, pledge, conveyance, contract, lien, loan 
 19-40      agreement, or other consensual transfer in order to 
 19-41      secure the repayment of any moneys loaned or credit 
 19-42      extended by the authority; 
 
 19-43      (10) To establish rates and charges for the services and 
 19-44      use of the facilities and projects of the authority; 
 
 
 
                                 -19- 
 
 
 
 20- 1      (11) To accept gifts, grants, or devises of any 
 20- 2      property; 
 
 20- 3      (12) To acquire by the exercise of the right of eminent 
 20- 4      domain any property essential to the purposes of the 
 20- 5      authority; 
 
 20- 6      (13) To sell or lease within 20 years after the 
 20- 7      completion of construction of properties or facilities 
 20- 8      operated by the hospital authority where grants of 
 20- 9      financial assistance have been received from federal or 
 20-10      state governments, other such action has first been 
 20-11      approved by the department in writing extend credit or 
 20-12      make loans to others for purposes other than those 
 20-13      specified in paragraph (8) of this Code section, which 
 20-14      credit or loans may be secured by such loan agreements 
 20-15      or other contracts or instruments for a term not to 
 20-16      exceed 40 years and upon such terms and conditions as 
 20-17      the authority shall determine reasonable in connection 
 20-18      with such loans; 
 
 20-19      (14) To exchange, transfer, assign, pledge, mortgage, or 
 20-20      dispose of any real or personal property or interest 
 20-21      therein; 
 
 20-22      (15) To mortgage, pledge, or assign any revenue, income, 
 20-23      tolls, charges, or fees received by the authority; 
 
 20-24      (16) To issue revenue anticipation certificates or other 
 20-25      evidences of indebtedness which do not constitute 
 20-26      revenue anticipation certificates for the purpose of 
 20-27      providing funds to carry out the duties of the 
 20-28      authority; provided, however, that the maturity of any 
 20-29      such indebtedness shall not extend for more than 40 
 20-30      years; 
 
 20-31      (17) To borrow money and to execute notes or other 
 20-32      evidence of indebtedness for any corporate purpose; 
 
 20-33      (18) To appoint, engage, and terminate officers, agents, 
 20-34      and employees; 
 
 20-35      (19) To make use of any facilities afforded by the 
 20-36      federal, state, or local government or any agency or 
 20-37      instrumentality thereof; 
 
 20-38      (20) To receive, from the governing body of political 
 20-39      subdivisions issuing the same, proceeds from local 
 20-40      option sales tax revenues where otherwise authorized by 
 20-41      law, the sale of general obligation bonds, or other 
 
 
 
                                 -20- 
 
 
 
 21- 1      county governmental obligations issued for hospital 
 21- 2      authority purposes; 
 
 21- 3      (21) To exercise any or all powers now or hereafter 
 21- 4      possessed by private corporations performing similar 
 21- 5      functions unless such power is specifically prohibited 
 21- 6      by this article; 
 
 21- 7      (22) To make plans for unmet needs of their respective 
 21- 8      communities;  
 
 21- 9      (23) To contract for the management and operation of the 
 21-10      project by a professional hospital or medical facilities 
 21-11      consultant or management firm. Each such contract shall 
 21-12      require the consultant or firm contracted with to post a 
 21-13      suitable and sufficient bond; 
 
 21-14      (24)(23) To provide management, consulting, and 
 21-15      operating services including, but not limited to, 
 21-16      administrative, operational, personnel, clinical, and 
 21-17      maintenance services to another hospital authority, 
 21-18      hospital, health care facility, as said term is defined 
 21-19      in Chapter 6 of this title, county board of health, 
 21-20      regional planning board established pursuant to Code 
 21-21      Section 31-2-4.1, community service board established 
 21-22      pursuant to Code Section 37-2-6, person, firm, 
 21-23      corporation, or any other entity or any group or groups 
 21-24      of the foregoing; to enter into contracts alone or in 
 21-25      conjunction with others to provide such services without 
 21-26      regard to the location of the parties to such 
 21-27      transactions; to receive management, consulting, and 
 21-28      operating services including, but not limited to, 
 21-29      administrative, operational, personnel, clinical, and 
 21-30      maintenance services from another such hospital 
 21-31      authority, hospital, health care facility, county board 
 21-32      of health, regional planning board established pursuant 
 21-33      to Code Section 31-2-4.1, community service board 
 21-34      established pursuant to Code Section 37-2-6, person, 
 21-35      firm, corporation, or any other entity or any group or 
 21-36      groups of the foregoing; and to enter into contracts 
 21-37      alone or in conjunction with others to receive such 
 21-38      services without regard to the location of the parties 
 21-39      to such transactions; 
 
 21-40      (25)(24) To provide financial assistance to individuals 
 21-41      for the purpose of obtaining educational training in 
 21-42      medicine, nursing, or another health care field if such 
 21-43      individuals are employed by, or are on an authorized 
 
 
 
                                 -21- 
 
 
 
 22- 1      leave of absence from, such authority or have committed 
 22- 2      to be employed by such authority or to provide 
 22- 3      professional services at any project of such authority 
 22- 4      upon completion of such educational training; and to 
 
 22- 5      (25) To provide services and financial assistance to 
 22- 6      private not-for-profit organizations in the form of 
 22- 7      grants and loans, with or without interest and secured 
 22- 8      or unsecured at the discretion of such authority, for 
 22- 9      any purpose related to the provision of health or 
 22-10      medical services or related social services to citizens; 
 22-11      and 
 
 22-12      (26) To exercise the same powers granted to joint 
 22-13      authorities in subsection (f) of Code Section 31-7-72; 
 22-14      and  
 
 22-15      (27) To form, own, and operate, either directly or 
 22-16      indirectly, provider sponsored health care corporations 
 22-17      or one or more networks of hospitals, physicians, and 
 22-18      other health care providers and to arrange for the 
 22-19      provision of health care services through such 
 22-20      corporations or networks; to contract, either directly 
 22-21      or through such corporations or networks, with payors, 
 22-22      including, but not limited to, the Department of Medical 
 22-23      Assistance, to provide services to Medicaid 
 22-24      beneficiaries to provide health care services in an 
 22-25      efficient and cost-effective manner on a prepaid, 
 22-26      capitation, or other reimbursement basis; and to 
 22-27      undertake other managed health care activities deemed 
 22-28      necessary or convenient by the authority; provided, 
 22-29      however, that for purposes of this paragraph only and 
 22-30      notwithstanding the provisions of Code Section 33-3-3, 
 22-31      as now or hereafter amended, a hospital authority shall 
 22-32      be permitted to and shall comply with the requirements 
 22-33      of Chapter 21 of Title 33 to the extent that such 
 22-34      requirements apply to the activities undertaken by the 
 22-35      hospital authority pursuant to this paragraph. No 
 22-36      hospital authority, whether or not it exercises the 
 22-37      powers authorized by this paragraph, shall be relieved 
 22-38      of compliance with Article 4 of Chapter 18 of Title 50, 
 22-39      relating to inspection of public records unless 
 22-40      otherwise authorized by law.  Any health care provider 
 22-41      licensed under Chapter 30 of Title 43 shall be eligible 
 22-42      to apply to become a participating provider under such a 
 22-43      hospital plan or network which provides coverage for 
 22-44      health care services which are within the lawful scope 
 
 
 
                                 -22- 
 
 
 
 23- 1      of his or her practice, provided that nothing contained 
 23- 2      in this Code section shall be construed to require any 
 23- 3      such hospital plan or network to provide coverage for 
 23- 4      any specific health care service. 
 
 23- 5    31-7-75.1. 
 
 23- 6    (a) The proceeds from any sale or lease of a hospital 
 23- 7    owned by a hospital authority or political subdivision of 
 23- 8    this state, which proceeds shall not include funds 
 23- 9    required to pay off the bonded indebtedness of the sold 
 23-10    hospital or any expense of the authority or political 
 23-11    subdivision attributable to the sale or lease, shall be 
 23-12    held by the authority or political subdivision or by a 
 23-13    trustee or other designee of the authority or political 
 23-14    subdivision in an irrevocable trust fund, except that this 
 23-15    requirement shall not apply to lease proceeds for any year 
 23-16    when such proceeds total less than $100,000.00.  Such 
 23-17    proceeds in that fund may be invested in the same way that 
 23-18    public moneys may be invested generally pursuant to 
 23-19    general law, but money in that trust fund shall be used 
 23-20    exclusively for funding the provision of hospital 
 23-21    inpatient or outpatient health care for the indigent 
 23-22    residents of the political subdivision which owned the 
 23-23    hospital or by which the authority was activated or for 
 23-24    which the authority was created, which health care may be 
 23-25    provided by the hospital or other health care provider 
 23-26    authorized by the owner of the hospital.  If the funds 
 23-27    available for a political subdivision in that irrevocable 
 23-28    trust fund are less than $100,000.00 $500,000.00, the 
 23-29    principal amount may be used to fund the provision of such 
 23-30    indigent hospital care; otherwise, only the income from 
 23-31    that fund may be used for that care. Such funding or 
 23-32    reimbursement for indigent care shall not exceed the 
 23-33    diagnosis related group rate for that hospital in each 
 23-34    individual case. 
 
 23-35    (b) In the event a hospital authority which sold or leased 
 23-36    a hospital was activated by or created for more than one 
 23-37    political subdivision or in the event a hospital having as 
 23-38    owner more than one political subdivision is sold or 
 23-39    leased by those political subdivisions, each such 
 23-40    constituent political subdivision's portion of the 
 23-41    irrevocable trust fund for indigent hospital care shall be 
 23-42    determined by multiplying the amount of that fund by a 
 23-43    figure having a numerator which is the population of that 
 23-44    political subdivision and a denominator which is the 
 
 
 
                                 -23- 
 
 
 
 24- 1    combined population of all the political subdivisions 
 24- 2    which owned the hospital or by which or for which the 
 24- 3    authority was activated or created. 
 
 24- 4    (c) For purposes of hospital care for the indigent under 
 24- 5    this Code section, the standard of indigency shall be that 
 24- 6    determined under the manner described in Code Section 
 24- 7    31-8-43, relating to standards of indigency for emergency 
 24- 8    care of pregnant women, except that such standard shall be 
 24- 9    based upon 125 175 percent of the federal poverty level. 
 
 24-10    (d) This Code section shall not apply to the following 
 24-11    actions: 
 
 24-12      (1) A reorganization or restructuring; 
 
 24-13      (2) Any sale of a hospital, or the proceeds from that 
 24-14      sale, made prior to April 2, 1986; and 
 
 24-15      (3) Any sale or lease of a hospital when the purchaser 
 24-16      or lessee pledges, by written contract entered into 
 24-17      concurrently with such purchase or lease, to provide an 
 24-18      amount of hospital care equal to that which would have 
 24-19      otherwise been available pursuant to subsections (a), 
 24-20      (b), and (c) of this Code section for the indigent 
 24-21      residents of the political subdivisions which owned the 
 24-22      hospital, by which the hospital authority was activated, 
 24-23      or for which the authority was created.  However, the 
 24-24      exception to this Code section provided by this 
 24-25      paragraph shall only apply to: 
 
 24-26        (A) Hospital authorities that operate a licensed 
 24-27        hospital pursuant to a lease from the county which 
 24-28        created the appropriate authority; and 
 
 24-29        (B) Hospitals that have a bed capacity of more than 
 24-30        150 beds; and 
 
 24-31        (C) Hospitals located in a county in which no other 
 24-32        medical-surgical licensed hospital is located; and 
 
 24-33        (D) Hospitals located in a county having a population 
 24-34        of less than 45,000 according to the United States 
 24-35        decennial census of 1990; and 
 
 24-36        (E) Hospitals operated by a hospital authority that 
 24-37        entered into a lease-purchase agreement between such 
 24-38        hospital and a private corporation prior to July 1, 
 24-39        1997. 
 
 
 
 
                                 -24- 
 
 
 
 25- 1    31-7-75.2. 
 
 25- 2    Notwithstanding any other provision of law to the 
 25- 3    contrary, no hospital authority shall be required by 
 25- 4    Chapter 14 of Title 50 or Article 4 of Chapter 18 of Title 
 25- 5    50 to disclose or make public any potentially commercially 
 25- 6    valuable plan, proposal, or strategy that may be of 
 25- 7    competitive advantage in the operation of the authority or 
 25- 8    its medical facilities and which has not been made public. 
 25- 9    This exemption shall terminate at such time as such plan, 
 25-10    proposal, or strategy has either been approved or rejected 
 25-11    by the hospital authority governing board.  Except as 
 25-12    provided in this Code section or as otherwise provided by 
 25-13    law, hospital authorities shall comply with the provisions 
 25-14    of Chapter 14 of Title 50 and Article 4 of Chapter 18 of 
 25-15    Title 50. 
 
 25-16    31-7-76. 
 
 25-17    (a) The General Assembly declares that it is the intent of 
 25-18    this article to provide a mechanism for the operation and 
 25-19    maintenance of needed health care facilities in the 
 25-20    several counties and municipalities of this state. It is 
 25-21    the further intent of the General Assembly that, whenever 
 25-22    an authority ceases to perform the minimum functions 
 25-23    required for the continued operation and maintenance of 
 25-24    needed health care facilities in the county or 
 25-25    municipality, a procedure be made available to recognize 
 25-26    the failure of the authority to perform these minimum 
 25-27    functions and to provide for the orderly and responsible 
 25-28    reorganization of the authority. 
 
 25-29    (b) Whenever it appears that an authority has ceased to 
 25-30    perform the minimum functions required for the continued 
 25-31    operation and maintenance of needed health care facilities 
 25-32    in the county or municipality in which the authority is 
 25-33    authorized to function its area of operation, a petition 
 25-34    may be filed in the superior court in the county where the 
 25-35    authority's principal place of business is located 
 25-36    requesting that the one or more members of the authority 
 25-37    be removed from office and that any vacancy created by a 
 25-38    removal be filled as provided in Code Section 31-7-72 for 
 25-39    the initial appointment of members of an authority. Each 
 25-40    such petition shall be filed by one or more residents of 
 25-41    the county in which the authority is authorized to 
 25-42    function, or by the county governing authority, the 
 25-43    political subdivision of the authority and shall be 
 25-44    supported by petition of a number of residents of the 
 
 
                                 -25- 
 
 
 
 26- 1    county that political subdivision equal to 5 percent or 
 26- 2    more of the number of electors registered to vote in the 
 26- 3    general election last held in the county that political 
 26- 4    subdivision. In the case of an authority authorized to 
 26- 5    function solely within a municipality, the petition shall 
 26- 6    be filed by one or more residents of the municipality in 
 26- 7    which the authority is authorized to function, or by the 
 26- 8    municipal governing authority, and shall be supported by 
 26- 9    petition of a number of residents of the municipality 
 26-10    equal to 5 percent or more of the number of electors 
 26-11    registered to vote in the general election last held in 
 26-12    the municipality. 
 
 26-13    (c) Upon the filing of any petition as provided in 
 26-14    subsection (b) of this Code section, the judge of the 
 26-15    superior court shall set a hearing to inquire into the 
 26-16    merits of the petition not sooner than ten days nor later 
 26-17    than 30 days from the date of filing of the petition. The 
 26-18    hearing may be continued, in the discretion of the judge, 
 26-19    on motion of any party. 
 
 26-20    (d) At each hearing held as provided in subsection (c) of 
 26-21    this Code section, the judge, sitting without a jury, 
 26-22    shall inquire into and determine the question of whether 
 26-23    the authority has ceased to perform the minimum functions 
 26-24    required for the continued operation and maintenance of 
 26-25    needed health care facilities in the county or 
 26-26    municipality. In making his or her determination the judge 
 26-27    shall consider, but shall not be limited by, whether the 
 26-28    authority has: 
 
 26-29      (1) Failed to establish and enforce rates and charges as 
 26-30      provided in Code Section 31-7-77 this article; 
 
 26-31      (2) Failed to take any reasonable action when the 
 26-32      failure has the effect of jeopardizing repayment of 
 26-33      principal or interest, when due, on revenue anticipation 
 26-34      certificates issued by the authority; 
 
 26-35      (3) Failed to take any reasonable action when the 
 26-36      failure has the effect of breaching a contract providing 
 26-37      for continued maintenance and use of the authority's 
 26-38      facilities and entered into with a county or 
 26-39      municipality as provided in Code Section 31-7-85 this 
 26-40      article; 
 
 26-41      (4) Failed to make plans for unmet needs of the 
 26-42      community as authorized by paragraph (22) of Code 
 26-43      Section 31-7-75 this article; 
 
 
                                 -26- 
 
 
 
 27- 1      (5) Failed to make and file its annual report as 
 27- 2      provided in Code Section 31-7-90 this article; 
 
 27- 3      (6) Failed to adopt an annual budget as provided in Code 
 27- 4      Section 31-7-90 this article; 
 
 27- 5      (7) Failed to conduct the annual audit as provided in 
 27- 6      Code Section 31-7-91 this article; 
 
 27- 7      (8) Failed to report or publish the annual audit as 
 27- 8      provided in Code Section 31-7-92 this article; 
 
 27- 9      (9) Failed to hold at least one meeting in the preceding 
 27-10      calendar quarter; or 
 
 27-11      (10) Failed to take any other action required pursuant 
 27-12      to this article. 
 
 27-13    (e) After giving all parties an opportunity to be heard, 
 27-14    the judge shall determine, based on the evidence 
 27-15    presented, whether the clear and convincing weight of the 
 27-16    evidence is that the authority has ceased to perform the 
 27-17    minimum functions required for the continued operation and 
 27-18    maintenance of needed health care facilities in the county 
 27-19    or municipality area of operation. In the event the judge 
 27-20    so decides, he or she shall order the immediate removal 
 27-21    from office of the such member or members of the authority 
 27-22    as the judge  deems appropriate, except that no member 
 27-23    shall be removed who demonstrates to the satisfaction of 
 27-24    the judge his a good faith attempt to fulfill his the 
 27-25    duties as a member of the authority. In the event the 
 27-26    court denies the petition, the petition shall be 
 27-27    dismissed. 
 
 27-28    (f) Vacancies created pursuant to this Code section shall 
 27-29    be filled in the same manner as provided in Code Section 
 27-30    31-7-72 for the initial appointment of members of an 
 27-31    authority. Vacancies created by the expiration of the term 
 27-32    or the resignation or disability of a member appointed 
 27-33    pursuant to this Code section shall be filled as provided 
 27-34    in Code Section 31-7-72 for the filling of vacancies. 
 
 27-35    31-7-77. 
 
 27-36    No authority shall operate or construct any project for 
 27-37    profit, which shall mean that it . It shall fix rates and 
 27-38    charges consistent with this declaration of policy and 
 27-39    such as will produce revenues only in amounts sufficient, 
 27-40    together with all other funds of the authority, to pay 
 27-41    principal and interest on certificates and obligations of 
 
 
 
                                 -27- 
 
 
 
 28- 1    the authority, to provide for maintenance and operation of 
 28- 2    the any project, and to create and maintain a reserve 
 28- 3    sufficient to meet principal and interest payments due on 
 28- 4    any certificates in any one year after the issuance 
 28- 5    thereof. The authority may provide reasonable reserves for 
 28- 6    the improvement, replacement, or expansion of its 
 28- 7    facilities, projects, or services. 
 
 28- 8    31-7-78. 
 
 28- 9    (a) Every authority is authorized to provide by resolution 
 28-10    for the issuance and sale of negotiable revenue 
 28-11    anticipation certificates for the purpose of: 
 
 28-12      (1) Paying all or any part of the cost of the 
 28-13      acquisition, construction, alteration, repair, 
 28-14      modernization, and other charges incident thereto in 
 28-15      connection with any facilities or any project; 
 
 28-16      (2) Paying all or any part of the cost of paying off or 
 28-17      refinancing any outstanding debt or obligation of any 
 28-18      nature owed by such authority or by persons who in 
 28-19      furtherance of the authority's public purposes lease 
 28-20      facilities from such authority pursuant to this article, 
 28-21      provided that such outstanding debt or obligation was 
 28-22      incurred in connection with the acquisition or 
 28-23      construction of facilities of the authority or any such 
 28-24      lessee; and 
 
 28-25      (3) Refunding outstanding certificates. 
 
 28-26    (b) The In addition to paying from the proceeds of any 
 28-27    revenue anticipation certificate issue interest accrued 
 28-28    during the construction period of any project and other 
 28-29    incidental and customary expenses such as those for 
 28-30    engineering, inspections, and fiscal and legal services, 
 28-31    the authority may also fund as a part of such issue and 
 28-32    set aside from the proceeds thereof an amount of money not 
 28-33    exceeding 15 percent of the principal amount of such issue 
 28-34    funds for the purpose of establishing a debt service 
 28-35    reserve, with respect to the principal and interest 
 28-36    requirements of such issue a renewal and replacement 
 28-37    reserve, and such other reserves as may be reasonably 
 28-38    required by the authority with respect to the financing 
 28-39    and operation of any project or projects and as may be 
 28-40    authorized by any bond resolution or trust agreement or 
 28-41    indenture. The authority may issue such types of 
 28-42    certificates as it determines appropriate, including 
 28-43    certificates on which principal and interest are payable: 
 
 
                                 -28- 
 
 
 
 29- 1      (1) Exclusively from income or revenues of the operation 
 29- 2      of the authority financed with the proceeds of such 
 29- 3      certificates or together with such proceeds and grants 
 29- 4      from the federal government, or any instrumentality, or 
 29- 5      other person or corporation in aid of such projects; 
 
 29- 6      (2) Exclusively from income and revenues of certain 
 29- 7      designated projects; or 
 
 29- 8      (3) From revenues of the authority generally, including 
 29- 9      any debt service reserve or other reserves established 
 29-10      with a portion of the certificate proceeds. 
 
 29-11    Any such certificate may be additionally secured by the 
 29-12    hypothecation or pledging of any revenues received from 
 29-13    participating units or subdivisions and by mortgage of the 
 29-14    project or any part thereof constituting real or personal 
 29-15    property of the authority, except as prohibited by law. 
 
 29-16    31-7-79. 
 
 29-17    Neither the members of an authority nor any person 
 29-18    executing certificates on behalf of an authority shall be 
 29-19    personally liable thereon by reason of the issuance 
 29-20    thereof. The certificates and other obligations of an 
 29-21    authority shall not be, and shall so state on the face 
 29-22    thereof, a debt of the city, the county, the state or any 
 29-23    political subdivision thereof, or any combination of 
 29-24    subdivisions acting jointly as provided in this article. 
 29-25    Certificates of any authority are declared to be issued 
 29-26    for an essential public and governmental purpose and, 
 29-27    together with interest thereon and income therefrom, shall 
 29-28    be exempt from all taxes. 
 
 29-29    31-7-80. 
 
 29-30    Certificates of an authority shall be authorized by its 
 29-31    resolution and may be issued in one or more series and 
 29-32    shall bear such date or dates; mature at such time or 
 29-33    times; bear interest at such rate or rates not exceeding 9 
 29-34    percent per annum; be in such denomination or 
 29-35    denominations; be in such form, either coupon or 
 29-36    registered; carry such conversion or registration 
 29-37    privileges; have such rank or priority; be executed in 
 29-38    such manner; be payable in such medium of payment, at such 
 29-39    place or places; and be subject to such terms of 
 29-40    redemption, with or without premium, as such resolution, 
 29-41    its trust indenture, or mortgage may provide. In the event 
 29-42    that any of the members or officers of the authority whose 
 
 
 
                                 -29- 
 
 
 
 30- 1    signatures appear on any certificates or coupons shall 
 30- 2    cease to be such members or officers before the delivery 
 30- 3    of such certificates, such signatures shall nevertheless 
 30- 4    be valid and sufficient for all purposes. 
 
 30- 5    31-7-81. 
 
 30- 6    (a) Certificates of an authority shall be confirmed and 
 30- 7    validated in accordance with the procedure of Article 3 of 
 30- 8    Chapter 82 of Title 36; and, when validated, the judgment 
 30- 9    of validation shall be final and conclusive with respect 
 30-10    to such certificates and against the authority issuing the 
 30-11    same; provided, however, certificates of an authority 
 30-12    which mature  not later than five years after their date 
 30-13    of issuance  and in a principal amount less than $1 
 30-14    million may, but shall not be required to, be so confirmed 
 30-15    and validated, but certificates secured by payments to be 
 30-16    made by any city or county as provided  in subsection (b) 
 30-17    of this Code section shall be so confirmed and validated. 
 
 30-18    (b) In the event that the payments to be made by any city 
 30-19    or county, under contract entered into between the 
 30-20    authority and the subdivision, are pledged to the security 
 30-21    or payment of revenue certificates sought to be validated, 
 30-22    the hospital authority, as an integral part of the 
 30-23    validation proceedings, shall have a right of action 
 30-24    against the contracting subdivision or subdivisions for a 
 30-25    declaratory adjudication of the validity and binding 
 30-26    effect of the contract, the actual controversy therein 
 30-27    being whether or not the contract is in all respects valid 
 30-28    and binding upon the subdivision or subdivisions. The 
 30-29    subdivision or subdivisions shall be made a party or 
 30-30    parties to the action, and it shall be incumbent on the 
 30-31    subdivisions to defend against an adjudication of the 
 30-32    validity of such contract or be forever bound. Notice of 
 30-33    the proceedings shall be included in the notice of 
 30-34    validation hearing required to be issued and published by 
 30-35    the clerk of the superior court in which such validation 
 30-36    proceeding is pending. Any citizen resident in any 
 30-37    subdivision which is a party to the contract may intervene 
 30-38    in the validation proceedings at or before the time set 
 30-39    for the validation hearing by order of the superior court 
 30-40    and assert any ground or objection to the validity and 
 30-41    binding effect of the contract on his or her own behalf 
 30-42    and on behalf of the subdivision and all citizens, 
 30-43    residents, and property owners thereof. An adjudication as 
 30-44    to the validity of the contract, unexcepted to within the 
 
 
 
                                 -30- 
 
 
 
 31- 1    time provided for exceptions in Article 3 of Chapter 82 of 
 31- 2    Title 36, shall be conclusive and binding upon the 
 31- 3    subdivision or subdivisions and the resident citizens and 
 31- 4    property owners thereof. 
 
 31- 5    31-7-82. 
 
 31- 6    Obligations of an authority evidenced by certificates and 
 31- 7    trust indentures and mortgages executed in connection 
 31- 8    therewith may contain such provisions not inconsistent 
 31- 9    with law as shall be determined by the authority. The 
 31-10    authority may in such instruments provide for pledging of 
 31-11    all or any part of its gross or net fees, tolls, charges, 
 31-12    revenues, and incomes and for mortgaging of all or any 
 31-13    part of its real or personal property and may covenant 
 31-14    against pledging any or all of its income, revenues, 
 31-15    tolls, charges, or fees; and the authority may further 
 31-16    provide for the disposition of proceeds realized from the 
 31-17    sale of any mutilated certificates and necessary 
 31-18    provisions as to payment and redemption of such 
 31-19    certificates. Undertakings of an authority may likewise 
 31-20    prescribe the procedure by which certificate holders may 
 31-21    enforce rights against the authority and provide for such 
 31-22    rights upon breach of any covenant, condition, or 
 31-23    obligation of the authority. Trust indentures, mortgages, 
 31-24    or deeds to secure debt executed by an authority may 
 31-25    provide that, in the event of default by the authority in 
 31-26    the payment of principal and interest on certificates or 
 31-27    obligations or breach of any covenant, a trustee or 
 31-28    trustees appointed under the terms of the indenture, 
 31-29    mortgage, or deed to secure debt, which shall be a bank or 
 31-30    trust company authorized to exercise trust powers, may 
 31-31    take possession of and use, operate, and manage any 
 31-32    project mortgaged as security for the repayment of any 
 31-33    indebtedness of the authority and provide the terms and 
 31-34    conditions upon which the trustee or trustees or holders 
 31-35    of certificates may enforce any right relating to such 
 31-36    certificates. Such trust indentures, mortgages, and deeds 
 31-37    to secure debt may contain such provisions, not 
 31-38    inconsistent with law, as may be deemed necessary or 
 31-39    desirable by the authority. 
 
 31-40    31-7-83. 
 
 31-41    Pending use for the purpose for which received, each 
 31-42    hospital authority created by and under this article is 
 31-43    authorized and empowered to invest all moneys or any part 
 31-44    thereof received through the issuance and sale of revenue 
 
 
                                 -31- 
 
 
 
 32- 1    certificates of the authority in any securities which are 
 32- 2    legal investments or which are provided for in the trust 
 32- 3    indenture securing such certificates or other legal 
 32- 4    investments; provided, however, that such investments will 
 32- 5    be used at all times while held, or upon sale, for the 
 32- 6    purposes for which the money was originally received and 
 32- 7    no other. Contributions All other moneys, contributions, 
 32- 8    or gifts received by any authority shall be invested as 
 32- 9    provided by the terms of the contribution or gift or, in 
 32-10    the absence thereof, as determined by the authority. 
 
 32-11    31-7-84. 
 
 32-12    (a) An authority shall have no power to tax, but upon the 
 32-13    adoption of the resolution by the governing body or bodies 
 32-14    of participating units or subdivisions as provided in this 
 32-15    article and the execution of a contract for the use of 
 32-16    facilities and services of the authority by political 
 32-17    subdivisions or participating units as authorized in Code 
 32-18    Section 31-7-85, provision shall be made annually by such 
 32-19    participating units or political subdivisions contracting 
 32-20    with an authority for the payment for the services and 
 32-21    facilities of the authority used by the participating 
 32-22    units or subdivisions or the residents thereof out of 
 32-23    general funds of the participating units or subdivisions, 
 32-24    or out of tax revenues realized for the purpose of 
 32-25    providing medical care or hospitalization for the indigent 
 32-26    sick and others entitled to the use of the services and 
 32-27    facilities of the authority, or out of both general funds 
 32-28    and such tax revenues. 
 
 32-29    (b) For the purpose of providing such tax revenues as 
 32-30    specified above, there is authorized to be levied an ad 
 32-31    valorem tax not exceeding seven mills, exclusive of all 
 32-32    other taxes which may be levied by counties or by cities 
 32-33    or by towns, from which revenues when realized there shall 
 32-34    be appropriated annually sums sufficient to pay for the 
 32-35    cost of the use of the services and facilities of 
 32-36    authorities by participating subdivisions or the residents 
 32-37    thereof pursuant to the provisions and covenants of the 
 32-38    contract between such participating units and subdivisions 
 32-39    and authorities. In determining the cost of such services 
 32-40    and facilities furnished pursuant to such contract, there 
 32-41    may be included, but without limiting same, the following: 
 
 32-42      (1) The cost of acquiring, constructing, altering, 
 32-43      repairing, renovating, improving, operating, 
 32-44      maintaining, and equipping projects; and 
 
 
                                 -32- 
 
 
 
 33- 1      (2) Principal, interest, and sinking fund and other 
 33- 2      reserve requirements in connection with the issuance of 
 33- 3      revenue certificates, bonds, or obligations by 
 33- 4      authorities to finance, in whole or in part, the cost of 
 33- 5      projects and the payment of expenses incident thereto; 
 33- 6      the cost of operating, maintaining, and repairing such 
 33- 7      projects; and the cost of retiring, refinancing, or 
 33- 8      refunding any outstanding debt or other obligation of 
 33- 9      any nature incurred by such authorities. 
 
 33-10    (c) Whenever the fiscal operations of any county falling 
 33-11    within the classification of this chapter providing tax 
 33-12    revenues to an authority under this Code section are 
 33-13    governed by any state statutory budget law applicable to 
 33-14    the fiscal affairs and budget of such county, the 
 33-15    governing authorities bodies of such county shall have 
 33-16    full power and authority hereunder to require the hospital 
 33-17    authority to conform, in whole or in part, to the same 
 33-18    budgetary procedures as are made binding by statute upon 
 33-19    the county government itself. 
 
 33-20    31-7-85. 
 
 33-21    (a) For the purpose of using such facilities, any city or 
 33-22    county is authorized by action of its governing body to 
 33-23    enter into contracts with an authority for such periods of 
 33-24    time not exceeding 40 years as shall be necessary to 
 33-25    provide for the continued operation, maintenance, and use 
 33-26    of the facilities of an authority. Sums due and payable 
 33-27    under such contract shall be determined from year to year 
 33-28    during the period of such contract and no sums shall be 
 33-29    paid for the services in excess of the amounts necessary 
 33-30    to provide for the maintenance and operation of projects 
 33-31    of authorities and such sums as shall be necessary to 
 33-32    provide adequate and necessary facilities for medical care 
 33-33    and hospitalization of the indigent sick, including 
 33-34    reasonable reserves necessary for expansion and necessary 
 33-35    for the payment of the cost of facilities of the projects, 
 33-36    provided that any such contract may obligate a city or 
 33-37    county or any combination thereof to pay for such services 
 33-38    a fixed and definite minimum sum each year based or 
 33-39    calculated upon the anticipated cost of such services 
 33-40    including the cost and expense of making the facilities of 
 33-41    the authority available for the furnishing and performance 
 33-42    of such services. The contracts authorized under this Code 
 33-43    section to be entered into between cities or counties or 
 33-44    any combination thereof and an authority may provide for 
 
 
 
                                 -33- 
 
 
 
 34- 1    the conveyance or lease of any existing hospital 
 34- 2    facilities or projects to an authority created by any such 
 34- 3    cities or counties for a nominal consideration only, 
 34- 4    provided that such conveyance shall contain a clause 
 34- 5    providing that, upon dissolution of the authority, such 
 34- 6    hospital facilities or projects shall revert to the city 
 34- 7    or county conveying the same to the authority and 
 34- 8    provided, further, that no property so conveyed may be 
 34- 9    mortgaged or in any way given as security for an 
 34-10    indebtedness of the authority; this limitation is not to 
 34-11    be construed as limiting the right of the authority to 
 34-12    pledge or hypothecate revenues which may be realized by 
 34-13    the authority from the operation of any property so 
 34-14    conveyed to the authority. 
 
 34-15    (b) When, in accordance with this article, any county 
 34-16    shall activate a hospital authority for such county and 
 34-17    such authority shall acquire or construct or shall make 
 34-18    preparations to acquire or construct a hospital in the 
 34-19    county, any municipality in the county shall be authorized 
 34-20    to contract with the hospital authority for the care in 
 34-21    such hospital of indigent sick or injured persons who are 
 34-22    residents of the municipality either on a 
 34-23    per-patient-per-day basis or for a fixed amount of money 
 34-24    payable at such time as the contracting parties may agree 
 34-25    upon; and any such contract may, at the election of such 
 34-26    municipality, be binding upon it for a period of not 
 34-27    exceeding 40 years. Such contract and the amount to be 
 34-28    received by the hospital authority thereunder may be 
 34-29    pledged by the hospital authority as security for the 
 34-30    payment of the principal and interest of any bonds or 
 34-31    revenue anticipation certificates which it may issue in 
 34-32    order to acquire or construct the hospital. 
 
 34-33    31-7-86. 
 
 34-34    Any property conveyed or leased to an authority by cities 
 34-35    or counties shall be operated by the authority to which 
 34-36    the same is conveyed, together with other facilities of 
 34-37    the authority, in accordance with this article and the 
 34-38    resolution of the governing body or bodies or 
 34-39    participating units.  
 
 34-40    31-7-87. 
 
 34-41    Should an authority acquire by purchase existing hospital 
 34-42    facilities of political subdivisions and pay the 
 34-43    reasonable value therefor, nothing in this article shall 
 
 
 
                                 -34- 
 
 
 
 35- 1    be construed to prevent the hypothecation or mortgaging of 
 35- 2    such facilities as security for the repayment of any 
 35- 3    indebtedness which may be legally incurred by such 
 35- 4    authority. 
 
 35- 5    31-7-88 31-7-87. 
 
 35- 6    Obligations of an authority other than certificates shall 
 35- 7    be payable from general funds of an authority and shall at 
 35- 8    no time be a charge against any special fund allocated to 
 35- 9    the payment of certificates except upon payment of current 
 35-10    annual maturities and reserves required to be created 
 35-11    under Code Section 31-7-77. The maturity of any such 
 35-12    obligations shall not extend for more than 40 years. 
 
 35-13    31-7-89 31-7-88. 
 
 35-14    By joint action of the board of trustees of an authority 
 35-15    and the governing bodies of participating units, 
 35-16    authorities created under and pursuant to the terms of 
 35-17    this article may be dissolved, provided that no such 
 35-18    dissolution shall in any way impair the rights of third 
 35-19    persons or the contracts of the authority with such third 
 35-20    persons. Disposition to be made of the property of the 
 35-21    authority upon dissolution shall be covered in any 
 35-22    resolution adopted by the participating units and the 
 35-23    board of trustees of the authority. At no time, however, 
 35-24    shall any authority upon dissolution convey any of its 
 35-25    property, except as may be otherwise authorized by law, to 
 35-26    any private person, or to any for-profit association, or 
 35-27    corporation. 
 
 35-28    31-7-90 31-7-89. 
 
 35-29    The board of trustees of each Each authority created by 
 35-30    and under this article shall file with the governing body 
 35-31    or bodies of political subdivisions or participating 
 35-32    units, on forms prescribed by the department, an annual 
 35-33    report of the activities of the authority and shall 
 35-34    annually consider and adopt as a part of such report a 
 35-35    budget, which budget shall be filed with the annual 
 35-36    report. The board of trustees may hold a public hearing on 
 35-37    the budget, and representatives of any governing body 
 35-38    within the area of operation of the authority or any other 
 35-39    person having an interest in such budget shall have the 
 35-40    right to be heard with respect to any matter covered by 
 35-41    the report of the board of trustees or by the budget. 
 
 
 
 
                                 -35- 
 
 
 
 36- 1    31-7-89.1. 
 
 36- 2    (a) As used in this Code section, the term 'control' means 
 36- 3    ownership of 50 percent or more of the assets of the 
 36- 4    entity in question or the ability to influence 
 36- 5    significantly the operations or decisions of the entity in 
 36- 6    question. 
 
 36- 7    (b) The sale or lease of assets of a hospital owned or 
 36- 8    operated by a hospital authority to an individual, 
 36- 9    business corporation, general partnership, limited 
 36-10    partnership, limited liability company, limited liability 
 36-11    partnership, joint venture, nonprofit corporation, 
 36-12    hospital authority, or any other for profit or not for 
 36-13    profit entity shall be subject to the notice, hearing, 
 36-14    certification, enforcement, and other requirements of 
 36-15    Article 15 of this chapter which are applicable to 
 36-16    dispositions of nonprofit hospitals to acquiring entities 
 36-17    if the disposition of assets constitutes a sale or lease 
 36-18    of 50 percent or more of the assets of a hospital having a 
 36-19    permit under this chapter or constitutes a sale or lease 
 36-20    which, when combined with one or more transfers between 
 36-21    the same or related parties occurring within a period of 
 36-22    five years, constitutes a sale or lease of 50 percent or 
 36-23    more of the assets of a hospital having a permit under 
 36-24    this chapter; provided, however, that the provisions of 
 36-25    this Code section shall not apply to the restructuring of 
 36-26    a hospital owned by a hospital authority involving a lease 
 36-27    of assets to any not for profit or for profit entity which 
 36-28    has a principal place of business located in the same 
 36-29    county where the main campus of the hospital in question 
 36-30    is located and which is not owned, in whole or in part, or 
 36-31    controlled by any other for profit or not for profit 
 36-32    entity whose principal place of business is located 
 36-33    outside such county. 
 
 36-34    31-7-90.1 31-7-90. 
 
 36-35    (a) Each hospital authority created by and under this 
 36-36    article shall annually prepare a community benefit report 
 36-37    disclosing the cost of indigent and charity care provided 
 36-38    by such authority for the preceding year not later than 90 
 36-39    days after the close of the fiscal or calendar year.  Such 
 36-40    report provided for in this Code section shall include a 
 36-41    statement of the cost and type of indigent and charity 
 36-42    care provided by the authority, including the number of 
 36-43    indigent persons served, categorization of those persons 
 36-44    by county of residence, as well as the cost of indigent 
 
 
                                 -36- 
 
 
 
 37- 1    and charity care provided in dollars.  Such community 
 37- 2    benefit report shall be filed with the clerk of superior 
 37- 3    court of the county in which the authority's hospital is 
 37- 4    located, as well as with the governing body or bodies of 
 37- 5    such authority's participating units. 
 
 37- 6    (b) Each hospital authority created by and under this 
 37- 7    article shall also annually prepare a report indicating 
 37- 8    any entity in which a member or member's family has a 
 37- 9    direct or indirect ownership of assets or stock 
 37-10    constituting between 10 percent and 25 percent which 
 37-11    transacted business with the authority during the previous 
 37-12    year. Such report shall be filed with the clerk of 
 37-13    superior court of the county in which the authority's 
 37-14    hospital is located, as well as with the governing body or 
 37-15    bodies of such authority's participating units. 
 
 37-16    31-7-91. 
 
 37-17    Each hospital authority created by and under this article 
 37-18    shall ensure that an annual audit of the financial 
 37-19    affairs, books, and records of such authority is conducted 
 37-20    at the end of each fiscal year for the preceding year. 
 37-21    Each hospital authority shall obtain either a certified 
 37-22    public accountant or a firm of certified public 
 37-23    accountants to conduct such audit. The auditor so 
 37-24    appointed shall perform the audit in accordance with 
 37-25    generally accepted accounting principles and shall submit 
 37-26    a complete and final report and audit to the authority not 
 37-27    later than 90 120 days after the close of the fiscal year. 
 37-28    All audits provided for in this Code section shall be 
 37-29    certified to and shall include, but in no way be limited 
 37-30    to, a full and complete audit containing a balance sheet, 
 37-31    profit and loss statement, and statement of receipts and 
 37-32    disbursements. 
 
 37-33    31-7-92. 
 
 37-34    All final audits provided for in Code Section 31-7-91 
 37-35    shall be reproduced in sufficient number and copies of the 
 37-36    audit shall be filed with the clerk of the superior court 
 37-37    in the county where any hospital is operated by a hospital 
 37-38    authority and in the office of the clerk of the superior 
 37-39    court of any county that is a participating unit of the 
 37-40    authority. In the event any hospital is operated by a 
 37-41    municipal hospital authority, the audit required by this 
 37-42    Code section to be filed with the office of the clerk of 
 37-43    the superior court shall be filed in the office of city 
 
 
 
                                 -37- 
 
 
 
 38- 1    clerk, clerk of council, clerk of the board of aldermen, 
 38- 2    or clerk of the governing body of the municipality, in 
 38- 3    lieu of being filed with the clerk of the superior court. 
 
 38- 4    31-7-93. 
 
 38- 5    In the event any hospital authority shall fail or refuse 
 38- 6    to provide for an annual audit and have such audit 
 38- 7    prepared and filed as set forth in Code Sections 31-7-91 
 38- 8    and 31-7-92, any taxpayer of any participating unit of 
 38- 9    such authority or the governing authority of such unit may 
 38-10    petition the superior court of the county wherein the 
 38-11    authority operates a hospital to require the authority to 
 38-12    have such audit prepared and filed as provided by the 
 38-13    above Code sections. The judge of such court shall set a 
 38-14    time for the hearing on such petition and after notice to 
 38-15    the authority shall hear and determine the petition. If it 
 38-16    is determined that the authority has failed to comply with 
 38-17    the requirements for the preparation and filing of the 
 38-18    audit, the judge shall pass such orders as are necessary 
 38-19    to effectuate compliance with such requirements. In the 
 38-20    event the authority fails to have an audit prepared and 
 38-21    filed as required by court order, the members of the 
 38-22    authority shall be subject to contempt proceedings by the 
 38-23    court as provided by law. 
 
 38-24    31-7-94. 
 
 38-25    The state is authorized to make grants, as funds are 
 38-26    available, to hospital authorities for public health 
 38-27    purposes, provided that any funds so granted shall be 
 38-28    distributed to and among the various public hospital 
 38-29    authorities in the state in proportion to the number of 
 38-30    hospital beds operated by each such hospital authority at 
 38-31    the end of the calendar year preceding the grant. Funds 
 38-32    shall be distributed to public hospitals operated by 
 38-33    consolidated governments in the same manner as to 
 38-34    authority hospitals prescribed in this Code section. 
 38-35    Grants made by the state pursuant to this Code section 
 38-36    shall be administered by the Department of Human Resources 
 38-37    in accordance with such rules, regulations, and procedures 
 38-38    as it shall deem necessary for effective administration of 
 38-39    such grants. 
 
 38-40    31-7-95. 
 
 38-41    (a) As used in this Code section, the term: 
 
 
 
 
                                 -38- 
 
 
 
 39- 1      (1) 'Designated teaching hospital' means a teaching 
 39- 2      hospital operated by other than a hospital authority, 
 39- 3      which hospital agrees to contract with the state to 
 39- 4      offer or continue to offer a residency program approved 
 39- 5      by the American Medical Association, which program has 
 39- 6      at least 50 residents and which hospital operates a 24 
 39- 7      hour, seven-day-per-week emergency room open to the 
 39- 8      public and which hospital files a semiannual statistical 
 39- 9      report consistent with those filed by other state funded 
 39-10      tertiary, neonatal, obstetrical centers with the Family 
 39-11      Health Section of the Department of Human Resources. 
 
 39-12      (2) 'Hospital authority' means a hospital authority 
 39-13      operating a teaching hospital which offers a residency 
 39-14      program approved by the American Medical Association. 
 
 39-15      (3) 'Resident' means a physician receiving medical 
 39-16      education and training through a teaching hospital 
 39-17      operated by a hospital authority or designated teaching 
 39-18      hospital. 
 
 39-19    (b) The General Assembly finds that the major hospital 
 39-20    authorities and designated teaching hospitals in this 
 39-21    state provide a valuable service benefiting the entire 
 39-22    state by operating teaching hospitals which provide 
 39-23    necessary medical education and training for physicians; 
 39-24    this service is provided through residency programs 
 39-25    offered by these teaching hospitals. By the provision of 
 39-26    residency programs operated by state teaching hospitals, 
 39-27    the state has recognized its responsibility to fund the 
 39-28    cost of training physicians; and it is the purpose of this 
 39-29    Code section to recognize that the state has a similar 
 39-30    responsibility when the medical education and training are 
 39-31    provided by teaching hospitals operated by hospital 
 39-32    authorities or by designated teaching hospitals. 
 
 39-33    (c) For each resident receiving medical education and 
 39-34    training through a teaching hospital operated by a 
 39-35    hospital authority or designated teaching hospital, the 
 39-36    Board of Regents of the University System of Georgia shall 
 39-37    pay $10,000.00 per annum to the hospital authority or 
 39-38    designated teaching hospital. Such payments shall be made 
 39-39    based upon certifications by the hospital authorities or 
 39-40    designated teaching hospitals to the board of regents. The 
 39-41    board of regents is authorized to designate the Joint 
 39-42    Advisory Board of Family Practice to promulgate rules and 
 39-43    regulations specifying procedures for making the 
 39-44    certifications provided for in this Code section and to 
 
 
                                 -39- 
 
 
 
 40- 1    establish a procedure for making payments to hospital 
 40- 2    authorities and designated teaching hospitals as provided 
 40- 3    in this Code section. 
 
 40- 4    (d) The funds necessary to carry out this Code section 
 40- 5    shall derive from funds appropriated for such purpose to 
 40- 6    the board of regents. In the event the funds appropriated 
 40- 7    by the General Assembly are insufficient to fund the full 
 40- 8    amount payable to hospital authorities or designated 
 40- 9    teaching hospitals under subsection (c) of this Code 
 40-10    section, the amount otherwise payable thereunder shall be 
 40-11    reduced pro rata in accordance with the funds actually 
 40-12    appropriated for such purpose. The local government or 
 40-13    governments responsible for the governance or the 
 40-14    financial support of the hospital authority or authorities 
 40-15    shall provide a certified audit to the board of regents by 
 40-16    September 29, 1980, and on the same date yearly 
 40-17    thereafter, which shows clearly the exact amount of local 
 40-18    funds contributed to the authority during the most recent 
 40-19    full fiscal year of operation of the authority or 
 40-20    authorities. No funds provided for in this Code section 
 40-21    shall be distributed to any hospital or hospital authority 
 40-22    if the local government's contribution in any year after 
 40-23    1980 falls below the previous year's contribution as shown 
 40-24    in the certified audit. The board of regents shall have 
 40-25    the authority to promulgate rules and regulations to carry 
 40-26    out the provisions of this Code section. As used in this 
 40-27    subsection, the term 'local funds' means in kind or cash 
 40-28    contributions. The provisions of this subsection requiring 
 40-29    certified audits of local fund contributions and 
 40-30    prohibiting reduction in such contributions shall not 
 40-31    apply to any designated teaching hospital. No additional 
 40-32    teaching hospitals will be added until such funds have 
 40-33    been made available for any additional teaching hospitals. 
 
 40-34    (e) Nothing in this Code section shall be construed to 
 40-35    amend, modify, supersede, or repeal Chapter 10 of Title 
 40-36    49. 
 
 40-37    31-7-96. 
 
 40-38    As a basis for the powers granted to authorities in this 
 40-39    article, the General Assembly: 
 
 40-40      (1) Recognizes and contemplates that the nature and 
 40-41      scope of the powers conferred on authorities under this 
 40-42      article are such as may compel each authority, in the 
 40-43      course of exercising its other powers or by virtue of 
 
 
 
                                 -40- 
 
 
 
 41- 1      such exercise of such powers, to engage in activities 
 41- 2      that may be characterized as anticompetitive within the 
 41- 3      contemplation of the antitrust laws of the State of 
 41- 4      Georgia or of the United States; and 
 
 41- 5      (2) Determines, as an expression of the public policy of 
 41- 6      the State of Georgia with respect to the displacement of 
 41- 7      competition in the field of health care, that each 
 41- 8      authority, when exercising its powers under this chapter 
 41- 9      with respect to the operation and management of health 
 41-10      care facilities, projects, and services, acts as an 
 41-11      agency or instrumentality of its authorizing 
 41-12      subdivisions and as a political subdivision of this 
 41-13      state. 
 
 41-14    31-7-97. 
 
 41-15    This article, being necessary for the welfare of the 
 41-16    citizens of the state, shall be liberally construed to 
 41-17    effect the purposes hereof; and insofar as this article 
 41-18    may be inconsistent with any other law, whether by charter 
 41-19    of any political subdivision of the state or otherwise, 
 41-20    this article shall be controlling." 
 
 41-21                          SECTION 1A. 
 
 41-22  Neither the State of Georgia nor any political subdivision 
 41-23  located therein, including agencies and authorities, shall 
 41-24  discriminate on the basis of, and shall provide equal 
 41-25  opportunity without regard to, race, gender, age, religion 
 41-26  or national origin.  Courts of competent jurisdiction shall 
 41-27  be authorized to fashion appropriate remedies for violations 
 41-28  of these provisions.  Neither shall any of the foregoing 
 41-29  named political subdivisions use quotas or grant 
 41-30  preferential treatment based on race, gender, age, religion 
 41-31  or national origin except as permitted or authorized by 
 41-32  federal law.  Nothing herein shall be construed to deny the 
 41-33  ability of the State of Georgia to take action to further a 
 41-34  compelling or substantial state interest or prevent the 
 41-35  forfeiture or receipt of federal funds. 
 
 41-36                           SECTION 2. 
 
 41-37  This Act shall become effective upon its approval by the 
 41-38  Governor or upon its becoming law without such approval. 
 
 41-39                           SECTION 3. 
 
 41-40  All laws and parts of laws in conflict with this Act are 
 41-41  repealed. 
 
 
 
                                 -41- 

Clerk of the House
Robert E. Rivers, Jr., Clerk
Last Updated on 04/28/98

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