1.
a.If a county hospital is established, the board of supervisors, at the time of levying
ordinary taxes, shall levy a tax at the rate voted not to exceed fifty-four cents per thousand
dollars of assessed value in any one year for the erection and equipment of the hospital, and
alsoataxnottoexceedtwenty-sevencentsperthousanddollarsofvaluefortheimprovement,
maintenance, and replacements of the hospital, as certified by the board of hospital trustees.
However, in counties having a population of two hundred twenty-five thousand or over, the
levy for taxes payable in the fiscal year beginning July 1, 2001, and for subsequent fiscal
years, for improvements and maintenance of the hospital shall not exceed two dollars and
five cents per thousand dollars of assessed value in any one year.
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1. a. If a county hospital is established, the board of supervisors, at the time of levying
ordinary taxes, shall levy a tax at the rate voted not to exceed fifty-four cents per thousand
dollars of assessed value in any one year for the erection and equipment of the hospital, and
alsoataxnottoexceedtwenty-sevencentsperthousanddollarsofvaluefortheimprovement,
maintenance, and replacements of the hospital, as certified by the board of hospital trustees.
However, in counties having a population of two hundred twenty-five thousand or over, the
levy for taxes payable in the fiscal year beginning July 1, 2001, and for subsequent fiscal
years, for improvements and maintenance of the hospital shall not exceed two dollars and
five cents per thousand dollars of assessed value in any one year.
b. The proceeds of the taxes constitute the county public hospital fund. The fund is
subject to review by the board of supervisors in counties having a population of two hundred
twenty-five thousand or over. However, the board of trustees of a county hospital, where
fundsareavailableinthecountypublichospitalfundofthecountywhichareunappropriated,
may use the unappropriated funds for erecting and equipping hospital buildings and
additions to the hospital buildings without authority from the voters of the county.
2. A levy shall not be made for the improvement, maintenance, or replacements of the
hospital until the hospital has been constructed, staffed, and receiving patients. If revenue
bonds are issued and outstanding under section 331.461, subsection 2, paragraph “d”, the
board may levy a tax to pay operating and maintenance expenses in lieu of the authority
otherwise contained in this section not to exceed twenty-seven cents per thousand dollars of
assessed value or not to exceed one dollar and twenty-one and one-half cents per thousand
dollars of assessed value for improvements and maintenance of the hospital in counties
having a population of two hundred twenty-five thousand or over.
3. In addition to levies otherwise authorized by this section, the board of hospital trustees
may certify for levy a tax at the rate, not to exceed twenty-seven cents per thousand dollars
of assessed value, necessary to raise the amount budgeted by the board of hospital trustees
for support of ambulance service as authorized in section 347.14, subsection 8.
4. a. Thetaxlevyauthorizedbythissectionforoperationandmaintenanceofthehospital
maybeavailableinwholeorinparttoanycountywithorwithoutacountyhospitalorganized
underthischapter, tobeusedtoenhanceruralhealthservicesinthecounty. However, thetax
levied may be expended for enhancement of rural health care services only following a local
planning process. The department of health and human services shall establish guidelines to
be followed by counties in implementing the local planning process which shall require legal
notice, public hearings, and a referendum in accordance with this subsection prior to the
authorization of any new levy or a change in the use of a levy. The notice shall describe the
new levy or the change in the use of the levy, indicate the date and location of the hearing,
and shall be published at least once each week for two consecutive weeks in a newspaper
having general circulation in the county. The hearing shall not take place prior to two weeks
after the second publication.
b. Enhancement of rural health services for which the tax levy may be used includes but is
not limited to emergency medical services, health care services shared with other hospitals,
rural health clinics, and support for rural health care practitioners and public health services.
c. When alternative use of funds from the tax levy is proposed in a county with a county
hospital organized under this chapter, use of the funds shall be agreed upon by the elected
board of trustees of the county hospital. When alternative use of funds from the tax levy is
proposed in a county without a county hospital organized under this chapter, use of the funds
shall be agreed upon by the board of supervisors and any publicly elected hospital board of
trustees within the county prior to submission of the question to the voters.
d. Moneys raised from a tax levied in accordance with this subsection for the purpose of
enhancing rural health services in a county without a county hospital shall be designated and
administeredbytheboardofsupervisorsinamannerconsistentwiththepurposesofthelevy.