S.B. 176

             1     

LOCAL FUNDING FOR RURAL HEALTH CARE

             2     
AMENDMENTS

             3     
2014 GENERAL SESSION

             4     
STATE OF UTAH

             5     
Chief Sponsor: Ralph Okerlund

             6     
House Sponsor: John R. Westwood

             7     
             8      LONG TITLE
             9      General Description:
             10          This bill addresses local funding for rural health care.
             11      Highlighted Provisions:
             12          This bill:
             13          .    addresses General Fund distributions to fund rural health care;
             14          .    amends definitions;
             15          .    addresses the distribution and expenditure of revenue collected from local option
             16      sales and use taxes to fund rural health care; and
             17          .    makes technical and conforming changes.
             18      Money Appropriated in this Bill:
             19          None
             20      Other Special Clauses:
             21          None
             22      Utah Code Sections Affected:
             23      AMENDS:
             24           26-9-4 , as last amended by Laws of Utah 2010, Chapter 278
             25           59-12-801 , as last amended by Laws of Utah 2006, Chapter 302
             26           59-12-802 , as last amended by Laws of Utah 2011, Chapter 309
             27           59-12-804 , as last amended by Laws of Utah 2011, Chapter 309


             28           59-12-805 , as enacted by Laws of Utah 2000, Chapter 253
             29      REPEALS:
             30           59-12-803 , as last amended by Laws of Utah 2000, Chapter 253
             31     
             32      Be it enacted by the Legislature of the state of Utah:
             33          Section 1. Section 26-9-4 is amended to read:
             34           26-9-4. Rural Health Care Facilities Account -- Source of revenues -- Interest --
             35      Distribution of revenues -- Expenditure of revenues -- Unexpended revenues lapse into
             36      the General Fund.
             37          (1) As used in this section:
             38          (a) "Emergency medical services" is as defined in Section 26-8a-102 .
             39          (b) "Federally qualified health center" is as defined in 42 U.S.C. Sec. 1395x.
             40          (c) "Fiscal year" means a one-year period beginning on July 1 of each year.
             41          (d) "Freestanding urgent care center" is as defined in Section 59-12-801 .
             42          (e) "Nursing care facility" is as defined in Section 26-21-2 .
             43          (f) "Rural city hospital" is as defined in Section 59-12-801 .
             44          (g) "Rural county health care facility" is as defined in Section 59-12-801 .
             45          (h) "Rural county hospital" is as defined in Section 59-12-801 .
             46          (i) "Rural county nursing care facility" is as defined in Section 59-12-801 .
             47          (j) "Rural emergency medical services" is as defined in Section 59-12-801 .
             48          (k) "Rural health clinic" is as defined in 42 U.S.C. Sec. 1395x.
             49          (2) There is created a restricted account within the General Fund known as the "Rural
             50      Health Care Facilities Account."
             51          (3) (a) The restricted account shall be funded by amounts appropriated by the
             52      Legislature.
             53          (b) Any interest earned on the restricted account shall be deposited into the General
             54      Fund.
             55          (4) Subject to Subsections (5) and (6), the State Tax Commission shall for a fiscal year
             56      distribute money deposited into the restricted account to each:
             57          (a) county legislative body of a county that, on January 1, 2007, imposes a tax in
             58      accordance with Section 59-12-802 ; or


             59          (b) city legislative body of a city that, on January 1, 2007, imposes a tax in accordance
             60      with Section 59-12-804 .
             61          (5) (a) Subject to Subsection (6), for purposes of the distribution required by Subsection
             62      (4), the State Tax Commission shall:
             63          (i) estimate for each county and city described in Subsection (4) the amount by which
             64      the revenues collected from the taxes imposed under Sections 59-12-802 and 59-12-804 for
             65      fiscal year 2005-06 would have been reduced had:
             66          (A) the amendments made by Laws of Utah 2007, Chapter 288, Sections 25 and 26, to
             67      Sections 59-12-802 and 59-12-804 been in effect for fiscal year 2005-06; and
             68          (B) each county and city described in Subsection (4) imposed the tax under Sections
             69      59-12-802 and 59-12-804 for the entire fiscal year 2005-06;
             70          (ii) calculate a percentage for each county and city described in Subsection (4) by
             71      dividing the amount estimated for each county and city in accordance with Subsection (5)(a)(i)
             72      by $555,000; and
             73          (iii) distribute to each county and city described in Subsection (4) an amount equal to
             74      the product of:
             75          (A) the percentage calculated in accordance with Subsection (5)(a)(ii); and
             76          (B) the amount appropriated by the Legislature to the restricted account for the fiscal
             77      year.
             78          (b) The State Tax Commission shall make the estimations, calculations, and
             79      distributions required by Subsection (5)(a) on the basis of data collected by the State Tax
             80      Commission.
             81          (6) If a county legislative body repeals a tax imposed under Section 59-12-802 or a city
             82      legislative body repeals a tax imposed under Section 59-12-804 :
             83          (a) the commission shall determine in accordance with Subsection (5) the distribution
             84      that, but for this Subsection (6), the county legislative body or city legislative body would
             85      receive; and
             86          (b) after making the determination required by Subsection (6)(a), the commission shall:
             87          (i) if the effective date of the repeal of a tax imposed under Section 59-12-802 or
             88      59-12-804 is October 1:
             89          (A) (I) distribute to the county legislative body or city legislative body 25% of the


             90      distribution determined in accordance with Subsection (6)(a); and
             91          (II) deposit 75% of the distribution determined in accordance with Subsection (6)(a)
             92      into the General Fund; and
             93          (B) beginning with the first fiscal year after the effective date of the repeal and for each
             94      subsequent fiscal year, deposit the entire amount of the distribution determined in accordance
             95      with Subsection (6)(a) into the General Fund;
             96          (ii) if the effective date of the repeal of a tax imposed under Section 59-12-802 or
             97      59-12-804 is January 1:
             98          (A) (I) distribute to the county legislative body or city legislative body 50% of the
             99      distribution determined in accordance with Subsection (6)(a); and
             100          (II) deposit 50% of the distribution determined in accordance with Subsection (6)(a)
             101      into the General Fund; and
             102          (B) beginning with the first fiscal year after the effective date of the repeal and for each
             103      subsequent fiscal year, deposit the entire amount of the distribution determined in accordance
             104      with Subsection (6)(a) into the General Fund;
             105          (iii) if the effective date of the repeal of a tax imposed under Section 59-12-802 or
             106      59-12-804 is April 1:
             107          (A) (I) distribute to the county legislative body or city legislative body 75% of the
             108      distribution determined in accordance with Subsection (6)(a); and
             109          (II) deposit 25% of the distribution determined in accordance with Subsection (6)(a)
             110      into the General Fund; and
             111          (B) beginning with the first fiscal year after the effective date of the repeal and for each
             112      subsequent fiscal year, deposit the entire amount of the distribution determined in accordance
             113      with Subsection (6)(a) into the General Fund; or
             114          (iv) if the effective date of the repeal of a tax imposed under Section 59-12-802 or
             115      59-12-804 is July 1, beginning on that effective date and for each subsequent fiscal year,
             116      deposit the entire amount of the distribution determined in accordance with Subsection (6)(a)
             117      into the General Fund.
             118          (7) (a) Subject to Subsection (7)(b) and Section 59-12-802 , a county legislative body
             119      shall distribute the money the county legislative body receives in accordance with Subsection
             120      (5) or (6):


             121          (i) for a county of the third[,] or fourth[, or fifth] class, to fund rural county health care
             122      facilities in that county; and
             123          (ii) for a county of the fifth or sixth class, to fund:
             124          (A) rural emergency medical services in that county;
             125          (B) federally qualified health centers in that county;
             126          (C) freestanding urgent care centers in that county;
             127          (D) rural county health care facilities in that county;
             128          (E) rural health clinics in that county; or
             129          (F) a combination of Subsections (7)(a)(ii)(A) through (E).
             130          (b) A county legislative body shall distribute [a percentage of] the money the county
             131      legislative body receives in accordance with Subsection (5) or (6) to [each] a center, clinic,
             132      facility, or service described in Subsection (7)(a) [equal to the same percentage that the county
             133      legislative body distributes to that center, clinic, facility, or service in accordance with Section
             134      59-12-803 for the calendar year ending on the December 31 immediately preceding the first
             135      day of the fiscal year for which the county legislative body receives the distribution in
             136      accordance with Subsection (5) or (6)] as determined by the county legislative body.
             137          (c) A center, clinic, facility, or service that receives a distribution in accordance with
             138      this Subsection (7) shall expend that distribution for the same purposes for which money
             139      [generated by] collected from a tax under Section 59-12-802 may be expended.
             140          (8) (a) Subject to Subsection (8)(b), a city legislative body shall distribute the money
             141      the city legislative body receives in accordance with Subsection (5) or (6) to fund rural city
             142      hospitals in that city.
             143          (b) A city legislative body shall distribute a percentage of the money the city legislative
             144      body receives in accordance with Subsection (5) or (6) to each rural city hospital described in
             145      Subsection (8)(a) equal to the same percentage that the city legislative body distributes to that
             146      rural city hospital in accordance with Section 59-12-805 for the calendar year ending on the
             147      December 31 immediately preceding the first day of the fiscal year for which the city
             148      legislative body receives the distribution in accordance with Subsection (5) or (6).
             149          (c) A rural city hospital that receives a distribution in accordance with this Subsection
             150      (8) shall expend that distribution for the same purposes for which money [generated by]
             151      collected from a tax under Section 59-12-804 may be expended.


             152          (9) Any money remaining in the Rural Health Care Facilities Account at the end of a
             153      fiscal year after the State Tax Commission makes the distributions required by this section
             154      shall lapse into the General Fund.
             155          Section 2. Section 59-12-801 is amended to read:
             156           59-12-801. Definitions.
             157          As used in this part:
             158          (1) "Emergency medical services" is as defined in Section 26-8a-102 .
             159          (2) "Federally qualified health center" is as defined in 42 U.S.C. Sec. 1395x.
             160          (3) "Freestanding urgent care center" means a facility that provides outpatient health
             161      care service:
             162          (a) on an as-needed basis, without an appointment;
             163          (b) to the public;
             164          (c) for the diagnosis and treatment of a medical condition if that medical condition
             165      does not require hospitalization or emergency intervention for a life threatening or potentially
             166      permanently disabling condition; and
             167          (d) including one or more of the following services:
             168          (i) a medical history physical examination;
             169          (ii) an assessment of health status; or
             170          (iii) treatment:
             171          (A) for a variety of medical conditions; and
             172          (B) that is commonly offered in a physician's office.
             173          (4) "Nursing care facility" is as defined in Section 26-21-2 .
             174          (5) "Rural city hospital" means a hospital owned by a city that is located within a third,
             175      fourth, fifth, or sixth class county.
             176          (6) "Rural county health care facility" means a:
             177          (a) rural county hospital; or
             178          (b) rural county nursing care facility.
             179          (7) "Rural county hospital" means a hospital owned by a county that is:
             180          (a) a third, fourth, fifth, or sixth class county, as defined in Section 17-50-501 ; and
             181          (b) located outside of a standard metropolitan statistical area, as designated by the
             182      United States Bureau of the Census.


             183          (8) "Rural county nursing care facility" means a nursing care facility owned by:
             184          (a) a county that is:
             185          [(a)] (i) a third, fourth, fifth, or sixth class county, as defined in Section 17-50-501 ; and
             186          [(b)] (ii) located outside of a standard metropolitan statistical area, as designated by the
             187      United States Census Bureau[.]; or
             188          (b) a special service district if the special service district is:
             189          (i) created for the purpose of operating the nursing care facility; and
             190          (ii) within a county that is:
             191          (A) a third, fourth, fifth, or sixth class county, as defined in Section 17-50-501 ; and
             192          (B) located outside of a standard metropolitan statistical area, as designated by the
             193      United States Census Bureau.
             194          (9) "Rural emergency medical services" means emergency medical services that are
             195      provided by a county that is:
             196          (a) a [third, fourth,] fifth[,] or sixth class county, as defined in Section 17-50-501 ; and
             197          (b) located outside of a standard metropolitan statistical area, as designated by the
             198      United States Census Bureau.
             199          (10) "Rural health clinic" is as defined in 42 U.S.C. Sec. 1395x.
             200          Section 3. Section 59-12-802 is amended to read:
             201           59-12-802. Imposition of rural county health care facilities tax -- Expenditure of
             202      tax revenues -- Base -- Rate -- Administration, collection, and enforcement of tax --
             203      Administrative charge.
             204          (1) (a) A county legislative body of a county of the third, fourth, fifth, or sixth class
             205      may impose a sales and use tax of up to 1%[: (i)] on the transactions described in Subsection
             206      59-12-103 (1) located within the county[; and].
             207          [(ii) subject] (b) Subject to Subsection (3), the money collected from a tax under this
             208      section may be used to fund:
             209          [(A)] (i) for a county of the third[,] or fourth[, or fifth] class, rural county health care
             210      facilities in that county; or
             211          [(B)] (ii) for a county of the fifth or sixth class:
             212          [(I)] (A) rural emergency medical services in that county;
             213          [(II)] (B) federally qualified health centers in that county;


             214          [(III)] (C) freestanding urgent care centers in that county;
             215          [(IV)] (D) rural county health care facilities in that county;
             216          [(V)] (E) rural health clinics in that county; or
             217          [(VI)] (F) a combination of Subsections [(1)(a)(ii)(B)(I) through (V)] (1)(b)(ii)(A)
             218      through (E).
             219          [(b)] (c) Notwithstanding Subsection (1)(a)[(i)], a county legislative body may not
             220      impose a tax under this section on:
             221          (i) the sales and uses described in Section 59-12-104 to the extent the sales and uses
             222      are exempt from taxation under Section 59-12-104 ;
             223          (ii) a transaction to the extent a rural city hospital tax is imposed on that transaction in
             224      a city that imposes a tax under Section 59-12-804 ; and
             225          (iii) except as provided in Subsection (1)[ (d) ](e), amounts paid or charged for food and
             226      food ingredients.
             227          [(c)] (d) For purposes of this Subsection (1), the location of a transaction shall be
             228      determined in accordance with Sections 59-12-211 through 59-12-215 .
             229          [(d)] (e) A county legislative body imposing a tax under this section shall impose the
             230      tax on amounts paid or charged for food and food ingredients if the food and food ingredients
             231      are sold as part of a bundled transaction attributable to food and food ingredients and tangible
             232      personal property other than food and food ingredients.
             233          (2) (a) Before imposing a tax under Subsection (1)[(a)], a county legislative body shall
             234      obtain approval to impose the tax from a majority of the:
             235          (i) members of the county's legislative body; and
             236          (ii) county's registered voters voting on the imposition of the tax.
             237          (b) The county legislative body shall conduct the election according to the procedures
             238      and requirements of Title 11, Chapter 14, Local Government Bonding Act.
             239          (3) (a) The money [generated by] collected from a tax imposed under Subsection (1) by
             240      a county legislative body of a county of the third[,] or fourth[, or fifth] class may only be used
             241      for the financing of:
             242          (i) ongoing operating expenses of a rural county health care facility within that county;
             243          (ii) the acquisition of land for a rural county health care facility within that county; or
             244          (iii) the design, construction, equipping, or furnishing of a rural county health care


             245      facility within that county.
             246          (b) The money [generated by] collected from a tax imposed under Subsection (1) by a
             247      county of the fifth or sixth class may only be used [for the financing of] to fund:
             248          (i) ongoing operating expenses of a center, clinic, or facility described in Subsection
             249      (1)[(a)(ii)(B)](b)(ii) within that county;
             250          (ii) the acquisition of land for a center, clinic, or facility described in Subsection
             251      (1)[(a)(ii)(B)](b)(ii) within that county;
             252          (iii) the design, construction, equipping, or furnishing of a center, clinic, or facility
             253      described in Subsection (1)[(a)(ii)(B)](b)(ii) within that county; or
             254          (iv) [the provision of] rural emergency medical services within that county.
             255          (4) (a) A tax under this section shall be:
             256          (i) except as provided in Subsection (4)(b), administered, collected, and enforced in
             257      accordance with:
             258          (A) the same procedures used to administer, collect, and enforce the tax under:
             259          (I) Part 1, Tax Collection; or
             260          (II) Part 2, Local Sales and Use Tax Act; and
             261          (B) Chapter 1, General Taxation Policies; and
             262          (ii) levied for a period of 10 years and may be reauthorized at the end of the ten-year
             263      period by the county legislative body as provided in Subsection (1).
             264          (b) Notwithstanding Subsection (4)(a)(i), a tax under this section is not subject to
             265      Subsections 59-12-205 (2) through (6).
             266          (c) A county legislative body shall distribute money collected from a tax under this
             267      section quarterly.
             268          (5) The commission shall retain and deposit an administrative charge in accordance
             269      with Section 59-1-306 from the revenues the commission collects from a tax under this section.
             270          Section 4. Section 59-12-804 is amended to read:
             271           59-12-804. Imposition of rural city hospital tax -- Base -- Rate -- Administration,
             272      collection, and enforcement of tax -- Administrative charge.
             273          (1) (a) A city legislative body may impose a sales and use tax of up to 1%:
             274          (i) on the transactions described in Subsection 59-12-103 (1) located within the city;
             275      and


             276          (ii) to fund rural city hospitals in that city.
             277          (b) Notwithstanding Subsection (1)(a)(i), a city legislative body may not impose a tax
             278      under this section on:
             279          (i) the sales and uses described in Section 59-12-104 to the extent the sales and uses
             280      are exempt from taxation under Section 59-12-104 ; and
             281          (ii) except as provided in Subsection (1)(d), amounts paid or charged for food and food
             282      ingredients.
             283          (c) For purposes of this Subsection (1), the location of a transaction shall be
             284      determined in accordance with Sections 59-12-211 through 59-12-215 .
             285          (d) A city legislative body imposing a tax under this section shall impose the tax on
             286      amounts paid or charged for food and food ingredients if the food and food ingredients are sold
             287      as part of a bundled transaction attributable to food and food ingredients and tangible personal
             288      property other than food and food ingredients.
             289          (2) (a) Before imposing a tax under Subsection (1)(a), a city legislative body shall
             290      obtain approval to impose the tax from a majority of the:
             291          (i) members of the city legislative body; and
             292          (ii) city's registered voters voting on the imposition of the tax.
             293          (b) The city legislative body shall conduct the election according to the procedures and
             294      requirements of Title 11, Chapter 14, Local Government Bonding Act.
             295          (3) The money [generated by] collected from a tax imposed under Subsection (1) may
             296      only be used [for the financing of] to fund:
             297          (a) ongoing operating expenses of a rural city hospital;
             298          (b) the acquisition of land for a rural city hospital; or
             299          (c) the design, construction, equipping, or furnishing of a rural city hospital.
             300          (4) (a) A tax under this section shall be:
             301          (i) except as provided in Subsection (4)(b), administered, collected, and enforced in
             302      accordance with:
             303          (A) the same procedures used to administer, collect, and enforce the tax under:
             304          (I) Part 1, Tax Collection; or
             305          (II) Part 2, Local Sales and Use Tax Act; and
             306          (B) Chapter 1, General Taxation Policies; and


             307          (ii) levied for a period of 10 years and may be reauthorized at the end of the ten-year
             308      period by the city legislative body as provided in Subsection (1).
             309          (b) Notwithstanding Subsection (4)(a)(i), a tax under this section is not subject to
             310      Subsections 59-12-205 (2) through (6).
             311          (5) The commission shall retain and deposit an administrative charge in accordance
             312      with Section 59-1-306 from the revenues the commission collects from a tax under this section.
             313          Section 5. Section 59-12-805 is amended to read:
             314           59-12-805. Distribution of money collected from rural city hospital tax.
             315          (1) Except as provided in Subsection 59-12-804 (5) and Subsection (2), all [revenues]
             316      money collected [by a city] from a tax under Section 59-12-804 shall be distributed quarterly
             317      by the city legislative body to rural city hospitals.
             318          (2) [Notwithstanding Subsection (1), if] If there is more than one rural city hospital in a
             319      city, the [revenues] money collected [by the city] from a tax under Section 59-12-804 shall be
             320      distributed as determined by the city legislative body.
             321          Section 6. Repealer.
             322          This bill repeals:
             323          Section 59-12-803 , Distribution of revenues generated by rural county health care
             324      facilities tax.




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    as of 1-30-14 11:19 AM


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