EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

1-1 Section 1. Chapter 450 of NRS is hereby amended by adding thereto

1-15 district pursuant to this section unless it determines that:

2-1 (a) The proposed hospital district constitutes a geographic area of the

2-2 county that is not served by adequate medical services;

2-3 (b) There is no county hospital or the county hospital is not capable of

2-4 providing the necessary services; and

2-5 (c) The proposal is approved by a majority of the votes cast on the

2-6 issue by persons in the proposed hospital district.

2-7 3. If a hospital district is created pursuant to this section, the board

2-8 of county commissioners may be designated by ordinance as, ex officio,

2-9 the board of trustees of the hospital district, notwithstanding the

2-10 provisions of subsection 3 of NRS 450.620.

2-11 Sec. 3. The board of trustees may contract with a public agency or a

2-12 privately owned hospital to provide the services of a hospital to the

2-13 residents of the hospital district if it determines that:

2-14 1. There is a need to provide medical services to the residents of the

2-15 district which are not being provided by the district; or

2-16 2. It is less costly or more efficient to provide the services of a

2-17 hospital to the residents of the district by contracting with a public

2-18 agency or a privately owned hospital.

2-19 Sec. 4. 1. The board of trustees may contract with a company

2-20 which manages hospitals for the rendering of management services in a

2-21 district hospital.

2-22 2. The agreement may provide:

2-23 (a) That the chief executive officer of the hospital must be an

2-24 employee of the company which manages the hospital; and

2-25 (b) That the hospital may, in accordance with the requirements of

2-26 section 6 of this act, purchase supplies, materials and equipment through

2-27 the purchasing contracts of the company which manages the hospital, or

2-28 through a purchasing group, without complying with the requirements

2-29 for competitive bidding set forth in chapter 332 of NRS.

2-30 Sec. 5. 1. A district hospital may, with the approval of the board of

2-31 trustees, become a member of a purchasing group for the purpose of

2-32 purchasing supplies, materials and equipment used by the district

2-33 hospital.

2-34 2. A district hospital that becomes a member of a purchasing group

2-35 may, in accordance with the requirements of section 6 of this act,

2-36 purchase supplies, materials and equipment through the purchasing

2-37 group without complying with the requirements for competitive bidding

2-38 set forth in chapter 332 of NRS.

2-39 Sec. 6. A district hospital that is authorized pursuant to section 4 or

2-40 5 of this act to purchase supplies, materials and equipment in accordance

2-41 with this section through the purchasing contracts of the company that

2-42 manages the hospital or through a purchasing group may purchase the

3-1 supplies, materials and equipment without complying with the

3-2 requirements for competitive bidding set forth in chapter 332 of NRS if:

3-3 1. The documents pertaining to the proposed purchase, including,

3-4 without limitation, the prices available to the company or purchasing

3-5 group, are summarized in writing and, together with a sworn statement

3-6 by an officer or agent of the company or purchasing group that the

3-7 prices were obtained by the company or purchasing group through a

3-8 process of competitive bidding, are presented to the board of trustees at

3-9 its next regularly scheduled meeting; and

3-10 2. The board of trustees, after reviewing the summary and statement,

3-11 finds that the proposed purchase will be made at a lower price than the

3-12 lowest price reasonably obtainable by the hospital through competitive

3-13 bidding pursuant to chapter 332 of NRS or available to the hospital

3-14 pursuant to NRS 333.470 and approves the proposed purchase.

3-15 Sec. 7. NRS 450.550 is hereby amended to read as follows:

3-16 450.550 As used in NRS 450.550 to 450.750, inclusive, and section 2

3-28 450.620 1. Except as otherwise provided in subsection 2 and NRS

3-43 district hospital during their terms of office as county commissioners; and

4-1 (b) If hospital trustees have been elected pursuant to subsection 1, the

4-2 term of office of each hospital trustee of the district hospital who is serving

4-3 in that capacity on the effective date of the ordinance is terminated as of the

4-4 effective date of the ordinance.

4-5 3. [A] Except as otherwise provided in section 2 of this act, a board of

4-6 county commissioners shall not enact an ordinance pursuant to subsection 2

4-7 unless it determines that:

4-8 (a) The county has fully funded its indigent care account created

4-9 pursuant to NRS 428.010;

4-10 (b) The county has fulfilled its duty to reimburse the hospital for

4-11 indigent care provided to qualified indigent patients; and

4-12 (c) During the previous calendar year:

4-13 (1) At least one of the hospital’s accounts payable was more than 90

4-14 days in arrears;

4-15 (2) The hospital failed to fulfill its statutory financial obligations,

4-16 including the payment of taxes, premiums for industrial insurance or

4-17 contributions to the public employees’ retirement system;

4-18 (3) One or more of the conditions relating to financial emergencies

4-19 set forth in subsection 1 of NRS 354.685 existed at the hospital; or

4-20 (4) The hospital received notice from the Federal Government or the

4-21 State of Nevada that the certification or license of the hospital was in

4-22 imminent jeopardy of being revoked because the hospital had not carried

4-23 out a previously established plan of action to correct previously noted

4-24 deficiencies found by the regulatory body.