A. This section applies only to a special health care district in a county with a population of two million or more persons.

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B. Notwithstanding section 48-5502 and except as provided in Section 48-5501.01, subsection B, the board of directors of a special health care district shall be elected pursuant to title 16 and shall consist of five members, one from each supervisorial district of the county in which the district is located. A member of the board of directors shall comply with all of the following:

1. A member shall be a qualified elector of the supervisorial district from which the member is elected.

2. A member shall not be an elected or appointed state or county official or a person who serves on a hospital board established pursuant to Section 36-183.01 and who is not a member of the board of supervisors of the county in which the district is located.

3. A member shall not be an employee of the special health care district or a director, officer or employee of another health care institution.

C. For at least ten years after the date that the district first operates a general hospital and within three miles of the location of a general hospital operated by the county in which the district is located, the district shall provide the following services commensurate with good business practices:

1. Emergency and trauma services and shall operate a general hospital and a burn center, all at a level of service no lower than that which existed on January 1, 2003.

2. Maternity services at levels required of public hospitals pursuant to title XIX of the social security act.

D. Following the expiration of the ten year period prescribed by subsection C of this section, the district may provide any of the services or operate any of the facilities permitted under this chapter.

E. This chapter does not establish a legal entitlement to services or reimbursement for services for any person or third party or obligate the district to provide programs or services that it cannot provide as the result of actions of third parties. The provisions of this section shall be included in any lease or management agreement for the general hospital of the district, and any sale, lease or management agreement shall not affect the status of the hospital as a public hospital or its licensure under section 36-422, subsection G.

F. Until ten years after the date that the district first operates a general hospital, the following apply:

1. The district may not construct an additional general hospital outside the three mile radius of a general hospital operated by the county. After the expiration of the ten year period, the district may not construct a general hospital outside a three mile radius of the general hospital operated by the county without the approval of the qualified electors of the entire county pursuant to an election called by the board of directors of the district.

2. The district may not acquire or lease a general hospital that is situated beyond the three mile radius of the general hospital operated by the county without the approval of the qualified electors of the entire county pursuant to an election called by the board of directors of the district.

3. Except for a psychiatric hospital or a behavioral health facility, the district may not construct, acquire or lease a specialty hospital that is located outside the three mile radius of a general hospital operated by the county.

G. Notwithstanding section 48-5541, paragraph 5, for a period of ten years after the date that the district first operates a general hospital, a district may own, operate, lease, manage or maintain no more than three outpatient surgical centers if all of the following apply:

1. One of the outpatient surgical centers is located at the campus of a general hospital operated by the district.

2. Any other surgical centers are located at health care institutions as defined in section 36-401 that were operated by the county in which the district is located on January 1, 2003.

3. All surgical centers are operated in furtherance of the district’s mission as prescribed by subsection H of this section.

H. A district shall operate a general hospital for the term of any tax authorized pursuant to section 48-5565, and the district’s primary but not sole mission is as provided in this subsection and met by providing directly at its facilities or by contract medical education programs, emergency and other services as required by this chapter, services to the medically underserved and facilities and equipment necessary for these services. The district’s annual expenditures to satisfy the requirements of this subsection shall be to the extent of the amount of taxes approved by the qualified electors, authorized by the board of directors of the district and available pursuant to sections 48-5563 and 48-5565.

I. The district and the county may not simultaneously operate a general hospital, and a district may not operate an ambulance service pursuant to section 48-5564.

J. If a district chooses to acquire or lease from a county an asset of a health system as defined in section 11-1401, the board of supervisors of that county, by a majority vote, may convey, sell, lease or otherwise transfer title to any such asset of a health system to the district and transfer any health system liability as defined in section 11-1401 to the district.

K. A district may:

1. Raise capital, borrow and invest monies, create debt, assume debt and refinance debt to carry out the purposes of this chapter.

2. Issue tax anticipation notes pursuant to Title 35, Chapter 3, Article 3.1.

3. Issue revenue anticipation notes pursuant to Title 35, Chapter 3, Article 3.3.

4. Issue revenue bonds in a manner consistent with chapter 12, article 5 of this title.

L. Notwithstanding section 48-5542, a district shall not lease any general hospital that it operates to any entity other than a political subdivision of this state until two years after the receipt of any special payments.

M. Subject to the other provisions in this chapter, the district:

1. Shall adopt administrative rules, including an employee merit system for its employees, and shall adopt and administer competitive procurement rules necessary to administer and operate the district’s programs and any property.

2. May employ or contract with individuals or other entities, including the county attorney, to provide services in furtherance of the purposes of the district.

3. May establish or acquire foundations or charitable organizations to solicit donations, financial contributions, real or personal property or services for use solely to perform the duties and obligations in furtherance of the district.

4. Shall disclose and make available records and other matters in the same manner as is required of a public body pursuant to Title 39, Chapter 1, except that the district is not required to disclose or make available any records or other matters that:

(a) Identify the care or treatment of a patient who receives services, including billing information, unless the patient or the patient’s representative consents to the disclosure in writing or unless otherwise permitted pursuant to federal or state law.

(b) Reveal proprietary information provided to the district by a nongovernmental source. For the purposes of this subdivision, "nongovernmental" means an entity other than the United States government or a public body as defined in Section 39-121.01.

(c) Would cause demonstrable and material harm and would place the district at a competitive disadvantage in the marketplace.

(d) Would violate any exception, privilege or confidentiality granted or imposed by statute or common law.

N. A district is entitled to a lien for the charges for any services provided by a hospital operated by the district, for medical care and treatment of an injured person or for long-term care services, on any and all claims of liability or indemnity for damages accruing to the person to whom hospital or medical service is rendered, or to the legal representative of that person, on account of injuries giving rise to such claims and that necessitated the hospital or medical care and treatment. Recovery of charges pursuant to this subsection shall be in a manner as nearly as possible the same as the procedures prescribed in section 36-2915.