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LEGISLATURE
OF
THE
STATE
OF
IDAHO
Sixty-eighth
Legislature
Second
Regular
Session
-
2026
IN
THE
HOUSE
OF
REPRESENTATIVES
HOUSE
BILL
NO.
853
BY
WAYS
AND
MEANS
COMMITTEE
AN
ACT
1
RELATING
TO
HOSPITALS;
PROVIDING
LEGISLATIVE
FINDINGS
AND
INTENT;
AMENDING
2
SECTION
39
-
1359,
IDAHO
CODE,
TO
REVISE
PROVISIONS
REGARDING
CONVEYANCE
3
OF
HOSPITAL
DISTRICT
PROPERTY
TO
A
NONPROFIT
CORPORATION;
AMENDING
TI
-
4
TLE
48,
IDAHO
CODE,
BY
THE
ADDITION
OF
A
NEW
CHAPTER
21,
TITLE
48,
IDAHO
5
CODE,
TO
DEFINE
TERMS,
TO
ESTABLISH
PROVISIONS
REGARDING
NOTICE
AND
6
PUBLIC
PROCESS,
AND
TO
ESTABLISH
PROVISIONS
REGARDING
STATE
REVIEW;
AND
7
DECLARING
AN
EMERGENCY
AND
PROVIDING
AN
EFFECTIVE
DATE.
8
Be
It
Enacted
by
the
Legislature
of
the
State
of
Idaho:
9
SECTION
1.
LEGISLATIVE
FINDINGS
AND
INTENT.
(1)
The
Legislature
finds
10
that:
1
1
(a)
Public
hospital
districts
were
created
and
funded
by
local
taxpay
-
12
ers
to
ensure
access
to
essential
health
care
services
and
to
maintain
13
local
governance
authority;
14
(b)
When
hospital
district
assets
are
conveyed
to
nonprofit
corpora
-
15
tions
pursuant
to
section
39
-
1359,
Idaho
Code,
such
conveyances
are
16
conditioned
upon
continued
nonprofit
operation
for
the
benefit
of
the
17
community;
18
(c)
The
transfer
or
control
of
such
hospitals
to
multistate
or
distant
19
systems
without
public
notice
or
meaningful
review
may
materially
re
-
20
duce
local
governance
authority
and
undermine
community
accountabil
-
21
ity;
and
22
(d)
Transparency,
public
participation,
and
state
review
of
control
23
transfers
are
necessary
to
protect
public
assets,
preserve
access
to
24
essential
services,
and
maintain
public
trust.
25
(2)
It
is
the
intent
of
the
Legislature
to
operate
prospectively
and
to
26
clarify
conditions
attached
to
the
conveyance
of
public
hospital
assets.
27
SECTION
2.
That
Section
39
-
1359,
Idaho
Code,
be,
and
the
same
is
hereby
28
amended
to
read
as
follows:
29
39
-
1359.
CONVEYANCE
OF
HOSPITAL
DISTRICT
PROPERTY
TO
NONPROFIT
CORPO
-
30
RATION.
(1)
As
an
alternative
to
the
procedure
set
forth
in
section
39
-
1358,
31
Idaho
Code,
the
board
of
trustees
of
a
hospital
district
may
convey
or
lease
32
hospital
district
real
property,
facilities,
and
the
personal
property
and
33
equipment
therein
subject
to
the
following
conditions:
34
(a)
The
conveyance
or
lease
shall
be
to
a
nonprofit
corporation;
35
(b)
No
lease
term
shall
exceed
ninety
-
nine
(99)
years;
36
(c)
The
governing
body
of
the
nonprofit
corporation
must
be
composed
37
initially
of
the
incumbent
trustees
of
the
hospital
district
board
of
38
trustees
as
individuals;
39
(d)
The
articles
of
incorporation
must
provide
for
a
membership
of
the
40
corporation
that
is:
41
2
(i)
Broadly
representative
of
the
public
it
serves;
or
1
(ii)
A
single
nonprofit
corporate
member
having
articles
of
in
-
2
corporation
that
provide
for
a
membership
of
the
corporation
that
3
is
broadly
representative
of
the
public
it
serves.
The
articles
4
must
further
provide
for
the
selection
of
the
governing
body
by
the
5
membership
of
the
corporation
or
exclusively
by
a
parent
corpora
-
6
tion
that
is
a
corporate
member,
with
voting
power,
and
not
by
the
7
governing
body
itself,
except
to
fill
a
vacancy
for
an
unexpired
8
term.
The
articles
must
further
provide
that
no
member
of
the
gov
-
9
erning
body
shall
serve
more
than
two
(2)
consecutive
three
(3)
10
year
terms;
1
1
(e)
The
nonprofit
corporation
must
provide
care
for
indigent
patients
12
and
receive
any
person
falling
sick
or
maimed
within
the
hospital
dis
-
13
trict;
14
(f)
The
conveyance
or
lease
agreement
must
provide
for
the
transfer
of
15
patients,
staff,
and
employees
and
for
the
continuing
administration
of
16
any
trusts
or
bequests
or
maintenance
of
records
pertaining
to
the
ex
-
17
isting
hospital
district;
and
18
(g)
The
conveyance
or
lease
agreement
shall
provide
for
a
price
that
is
19
either
of
the
following:
20
(i)
The
acceptance
of
all
assets
and
assumption
of
all
liabili
-
21
ties;
or
22
(ii)
Such
other
price
to
which
the
hospital
district
board
of
23
trustees
and
the
nonprofit
corporation
agree.
24
(2)
If
any
hospital
that
has
been
conveyed
pursuant
to
this
section
25
ceases
to
be
used
as
a
nonprofit
hospital,
then
the
hospital
so
conveyed
26
shall
revert
to
the
ownership
of
the
hospital
district,
unless
the
premises
27
so
conveyed
are
sold
and
the
proceeds
used
to
erect
or
enlarge
another
non
-
28
profit
hospital.
If
any
hospital
that
has
been
leased
pursuant
to
this
29
section
ceases
to
be
used
as
a
nonprofit
hospital,
then
the
lease
shall
ter
-
30
minate.
31
(3)
A
hospital
shall
be
deemed
to
have
ceased
to
be
used
as
a
nonprofit
32
hospital
if:
33
(a)
Control
of
the
hospital
is
transferred
to
another
entity
without
34
approval
pursuant
to
chapter
21,
title
48,
Idaho
Code;
or
35
(b)
The
hospital
enters
into
a
transaction
that
materially
eliminates
36
local
governance
authority.
37
(4)
As
used
in
this
section,
"materially
eliminates
local
governance
38
authority"
means
the
transfer
of
decision
-
making
authority
over
hospital
39
budgets,
service
lines,
facility
closures,
executive
leadership
selection,
40
or
strategic
planning
to
an
entity
that
is
not
locally
governed
within
the
41
county
or
counties
primarily
served
by
the
hospital.
42
SECTION
3.
That
Title
48,
Idaho
Code,
be,
and
the
same
is
hereby
amended
43
by
the
addition
thereto
of
a
NEW
CHAPTER
,
to
be
known
and
designated
as
Chap
-
44
ter
21,
Title
48,
Idaho
Code,
and
to
read
as
follows:
45
CHAPTER
21
46
HEALTH
CARE
CONTROL
TRANSFER
TRANSPARENCY
47
48
-
2101.
DEFINITIONS.
As
used
in
this
chapter:
48
3
(1)
"Control
transfer"
means
any
transaction
or
arrangement
that
re
-
1
sults
in:
2
(a)
A
change
in
majority
voting
power
of
the
governing
board;
3
(b)
Substitution
of
a
parent
or
controlling
entity;
or
4
(c)
Delegation
of
material
governance
authority
through
management,
5
affiliation,
or
similar
agreement.
6
(2)
"Covered
hospital"
means
any
hospital
located
in
Idaho
that:
7
(a)
Is
organized
as
a
nonprofit
corporation;
and
8
(b)
Has
received
public
hospital
district
assets
pursuant
to
section
9
39
-
1359,
Idaho
Code.
10
48
-
2102.
NOTICE
AND
PUBLIC
PROCESS
REQUIRED.
(1)
A
covered
hospital
1
1
shall
provide
written
notice
to
the
attorney
general
and
the
department
of
12
health
and
welfare
at
least
ninety
(90)
days
prior
to
entering
into
any
con
-
13
trol
transfer.
14
(2)
A
covered
hospital
shall
conduct,
with
no
less
than
thirty
(30)
15
days'
public
notice,
at
least
one
(1)
public
hearing
within
the
county
it
16
primarily
serves
prior
to
entering
into
any
control
transfer.
17
(3)
The
notice
required
pursuant
to
subsection
(2)
of
this
section
18
shall
include
a
summary
of
the
proposed
transaction
and
its
anticipated
im
-
19
pact
on
governance,
services,
and
community
benefit
obligations.
20
48
-
2103.
STATE
REVIEW.
(1)
The
attorney
general
shall
review
any
21
proposed
control
transfer
of
a
covered
hospital
to
determine
whether
such
22
transfer
is
consistent
with
the
public
interest,
including
effects
on:
23
(a)
Local
governance
and
accountability;
24
(b)
Access
to
essential
services;
and
25
(c)
Community
benefit
obligations.
26
(2)
The
attorney
general
may
approve,
condition,
or
disapprove
a
con
-
27
trol
transfer
pursuant
to
subsection
(1)
of
this
section.
28
(3)
No
control
transfer
shall
take
effect
without
written
approval
of
29
the
attorney
general.
30
SECTION
4.
An
emergency
existing
therefor,
which
emergency
is
hereby
31
declared
to
exist,
this
act
shall
be
in
full
force
and
effect
on
and
after
32
July
1,
2026.
33