11-309. Hospital enterprise; accounting; fund; administration; budget

A. A county with a population of more than five hundred thousand persons as shown by the most recent United States decennial census may establish a hospital enterprise that may include all hospital and ambulatory care facilities, property, both tangible and intangible, and services owned, performed or provided by the county. A hospital enterprise shall be a separate unit of the county, and all revenues and expenditures of the hospital enterprise shall be accounted for as a separate unit. Notwithstanding section 36-187, subsection B, all monies received from the operation of the hospital enterprise shall be deposited in a hospital enterprise fund. All expenses of the hospital enterprise shall be paid from the hospital enterprise fund.

B. The board of supervisors of the county shall govern the hospital enterprise but may name one or more persons to administer the hospital enterprise and to direct its operations. Notwithstanding section 11-251, paragraph 9, the board of supervisors may pledge or assign any hospital improvements, additions or equipment purchased with the proceeds of any lease-purchase agreements and may take all other action or order all acts by agents, attorneys or independent contractors necessary and appropriate for the operation of the hospital enterprise and for the payment of any lease-purchase agreements.

C. A county with a hospital enterprise may incur lease-purchase agreements payable solely from the hospital enterprise fund, as augmented by the special fund authorized under subsection D of this section.

D. For each fiscal year in its annual budget prepared pursuant to title 42, chapter 17, article 3, the county may budget an amount equal to any expected shortfall between the hospital enterprise fund's expected revenues, proceeds and receipts and the hospital enterprise's expected disbursements, including disbursements for operation and maintenance expenses and payments on lease-purchase agreements, and may establish a special fund into which the county treasurer shall pay only excise tax revenues collected by the state and remitted to the county or collected by the county, unless these taxes are otherwise restricted by law to specific nonhealth care uses. The special fund may be set aside solely for the payment of operation and maintenance of the hospital enterprise and lease-purchase agreements as provided in this section. The amount of excise tax proceeds deposited in the special fund shall be determined by the board of supervisors in the annual budget. The treasurer shall transfer monies out of the special fund into the hospital enterprise fund or shall pay warrants drawn on the hospital enterprise fund with monies in the special fund whenever a shortfall exists in the hospital enterprise fund. The establishment of the special fund for any fiscal year does not obligate the county to the continued maintenance of the fund in any later fiscal year. The county treasurer shall administer the special fund as directed by the board of supervisors.

E. Lease-purchase agreements under this section may be payable over a term of not more than twenty years.