County and City Hospitals

Several software vendors have been able to take advantage of the newer technologies while other vendors have been unable to replicate prescribed forms. Certainly the prescribed form replication is the preferred approach from our audit position. However, in an effort to accommodate, the State Board of Accounts offers the following alternative.

Decisions regarding the participation of hospitals with vendor software systems are the responsibility of the appropriate elected or appointed governing body of a hospital in accordance with statutory authority. Accordingly, a governing body, if desiring to use forms generated by a particular software program or package, may pass a resolution so stating their preference. The resolution and a letter (sample letter on Page 1-15) would be sent to the State Board of Accounts for compliance with applicable statutes and regulations and to provide assurance that the hospital does indeed desire to use the forms. The forms submitted should be a facsimile of the prescribed system (headings and titles, etc.). Otherwise, a cross-reference to the prescribed form intended to be replaced should be submitted. The State Board of Accounts' approval is based upon compliance with the conditions outlined on Page 1-16 and review during the audits of the hospital. Thereafter, other hospitals may use any forms previously approved for the original hospital using that particular software program (assuming compliance with the conditions outlined on Page 1-16 and subsequent audits).

Any forms not previously reviewed and approved by the State Board of Accounts would need to go through the traditional form approval process.

Summarization of the new form approval process:

1. Hospital "A" passes a resolution in a public meeting stating the desire to use forms generated by a specific software program.
2. A copy of the resolution along with information in the sample letter (Page 1-15) is sent to the State Board of Accounts by Hospital "A" along with a sample of all reports and forms of the system. The forms submitted should be similar to the prescribed system (headings and titles, etc.). Otherwise, a cross-reference to the prescribed form intended to be replaced must be submitted.
3. Hospital "A" receives an approval letter from the State Board of Accounts and begins using the forms without any further approvals in the future unless the forms change.
4. Hospital "B", "C", etc., sends to the State Board of Accounts the same type of resolution and sample letter (see below), (no forms are sent to the State Board of Accounts). Hospital "B", "C", etc., adheres to the conditions on Page 1-16 and recommendations made during audits and begin using the forms without further approvals in the future unless the forms change. Previously, approved forms for that system do not have to be sent in for approval. Hospital "B", "C", etc., will not receive approval letters as they have agreed to abide by these conditions.

We are hopeful the new process will provide an innovative procedure to save time and expense by a hospital while still complying with statutory and regulatory requirements.

LETTERHEAD OF GOVERNMENTAL UNIT

State Board of Accounts
302 West Washington Street, Room E418
Indianapolis, IN 46204-2765

Re: Form Approvals

The (NAME OF GOVERNING BODY) passed the attached resolution concerning usage of forms for the (NAME OF GOVERNMENTAL UNIT).

The (NAME OF GOVERNING BODY) is ultimately responsible for all forms and systems to be used. Accordingly, we are requesting to be authorized to use the forms and systems provided (1) and (NAME OF HOSPITAL WHICH FIRST RECEIVED AN APPROVAL) as these forms were approved by our office in writing as of (DATE OF ORIGINAL APPROVAL). We will abide by the form approval requirements during audits by the State Board of Accounts.

The (NAME OF GOVERNING BODY) will notify you in writing if desiring to discontinue use of the system approved. Any forms that are not in an all inclusive approved package would still need to be approved by your office. Furthermore, if we desire to use any forms which have changed since the date of original approval above, and those forms have not received a written approval from your office, we will immediately submit those forms for approval.

We also understand the process of a letter and resolution are not an attempt to provide preferential treatment to any vendor but instead are an effort to expedite the form approval process required by statute and regulation. Finally, we are aware that any system or hardware changes initiated by a vendor and the resultant costs, are vendor, market or consumer demand driven.

(1) The first Hospital approved would have a period after the word "provided" and the rest of the sentence would be deleted. All other Hospitals requesting use of that system should show the information stated after the word "provided."

1. Any items noted in red ink are a condition of approval.
2. The forms and system shall be subject to further review and/or recommendations during the audits of the hospital to allow for on-site review as well as to ensure compliance with current statutes.
3. Any other forms (checks, receipts, etc.) necessary to complete the system shall be submitted to the State Board of Accounts for approval. You shall continue to maintain all prescribed forms not otherwise covered by an approval.
4. All transactions that occur in the system must be recorded. Transactions can be maintained on-line, on backup tapes, microfilmed, or printed on hardcopy. These transactions include but are not limited to: all input transactions that generate checks, master file updates, and all transactions that affect the ledgers in any way. For all information maintained on the system, the system must be designed in such a manner that changes to a transaction file cannot occur without being processed through an application.
5. The ability must not exist to change data after being posted. If an error is discovered after the entry has been posted, then a separate correcting entry must be made. Both the correcting entry and the original entry must be maintained.
6. If the Hospital owns the source code, sufficient controls must exist to prevent unauthorized modification. If the Hospital does not own the source code, upon request or in the event the vendor no longer provides maintenance service for the system, the vendor shall provide representatives of the State Board of Accounts with access to all computer source code for the system. In addition, the vendor shall provide representatives of the State Board of Accounts with a document describing the operating system used, the language that the source code is written in, the name of the compiler used, and the structure of the data files including data file names and data file descriptions, field names and field descriptions for the system upon request.
7. Any checks, receipts, purchase orders, deposit advices or other prescribed forms that require numbering shall be serially prenumbered by the printing supplier prior to delivery to the Hospital. All receipts are to be printed at the time money is received. Furthermore, checks, receipts, purchase orders or deposit advices shall not be presigned and shall have duplicates. An approved check register may be used to meet the duplicate requirement for checks and deposit advices.
8. Recap sheets for each depository for deposit advices, if applicable, will be maintained indicating direct deposits. Individual wage assignment agreements will be kept on file to support direct deposit.
9. All printouts will be kept in post binders.
10. Checks drawn on multiple bank accounts should only occur as a result of compliance with the governing board's authorization in accordance with IC 16-22-3-16.
11. In the event a change is required due to the passage of a state or federal law, the vendor agrees to implement such change in a timely manner.

The following is a list of possible applications with generalized minimum requirements.

Basically, output requirements in an ITS environment are the same as the records of the manual accounting system prescribed by the State Board of Accounts.

Payroll

1. Properly authorized, edited and extended before input.
2. Record kept by individual.
3. Year to date totals available.
4. Generate monthly and quarterly reports.
5. Totals by department.
6. Overtime kept separately.
7. Hard copy of each payroll.
8. Generate annual reports - W-2's, WH-2's, 1099's, etc.

Purchase Orders

1. Properly authorized, edited and extended before input.
2. Reduce purchase order balance when claim paid.
3. Adjust for partial paid claim.
4. Adjust for change in purchase order.
5. Update appropriation ledger for encumbrances and payments.
6. Update vendor record if applicable.

Public Policy

Access to public records is governed by IC 5-14-3. The official policy of the State is: "all persons are entitled to full and complete information regarding the affairs of government and the official acts of those who represent them as public officials and employees. Providing persons with the information is an essential function of a representative government and an integral part of the routine duties of public officials and employees, whose duty it is to provide the information." [IC 5-14-3-1]

Definition of Public Record

A public record is defined as any writing, paper, report, study, map, photograph, book, card, tape recording, or other material that is created, received, retained, maintained, used, or filed by or with a public agency and which is generated on paper, paper substitutes, photographic media, chemically based media, magnetic or machine readable media, electronically stored data, or any other material regardless of form or characteristics. [IC 5-14-3-2]

Request for Access to Public Records

Any person may inspect and copy the public records of a public agency during regular business hours. A request for inspection or copying must identify with reasonable particularity the record being requested; and be, at the discretion of the public agency, in writing or on a form provided by the public agency. No request may be denied because the person making the request refuses to state the purpose of the request, unless such condition is required by other applicable statute. [IC 5-14-3-3(a)]

The public agency shall either: (a) provide the requested copies to the person making the request; or (b) allow the person to make copies on the political subdivision's equipment or on his own equipment. [IC 5-14-3-3(b)]

The denial of access to a public record is covered in IC 5-14-3-9. 3-3

Access to Electronic Data Storage Systems

A public agency that maintains or contracts for the maintenance of public records in an electronic data storage system shall make reasonable efforts to provide to a person making a request a copy of all disclosable data contained in the records on paper, disk, tape, drum, or any other method of electronic retrieval if the medium requested is compatible with the agency's data storage system. [IC 5-14-3-3(d)]

The public agency may adopt an ordinance or resolution prescribing the conditions under which a person who receives information on disk or tape may or may not use the information for commercial purposes, including to sell, advertise, or solicit the purchase of merchandise, goods, or services, or sell, loan, give away, or otherwise deliver the information obtained by the request to any other person for these purposes. Use of this information in connection with the preparation or publication of news, for nonprofit activities, or for academic research is not prohibited. A person who uses information in a manner contrary to the ordinance or resolution may be prohibited by the public agency from obtaining a copy or any further data. [IC 5-14-3-3(e)]

A public agency may not enter into or renew a contract or an obligation (a) for the storage or copying of public records or (b) that requires the public to obtain a license or pay copyright royalties for obtaining the right to inspect and copy the records unless otherwise provided by applicable statute; if the contract, obligation, license, or copyright unreasonably impairs the right of the public to inspect and copy the agency's public records. [IC 5-14-3-3(f)]

Enhanced Access

As an additional means of inspecting and copying public records, a public agency may provide enhanced access to public records maintained by the public agency. A public agency may provide a person with enhanced access to public records if any of the following apply:

1. The public agency provides enhanced access to the person through its own computer gateway and provides for the protection of public records.
2. The public agency has entered into a contract with a third party under which the public agency provides enhanced access to the person through the third party's computer gateway or otherwise, and the contract between the public agency and the third party provides for the protection of public records.

A contract entered into under this section and any other provision of enhanced access must provide that the third party and the person will not engage in the following:

1. Unauthorized enhanced access to public records.
2. Unauthorized alteration of public records.
3. Disclosure of confidential public records.

A contract entered into under this section or any provision of enhanced access may require the payment of a reasonable fee to either the third party to a contract or to the public agency, or both, from the person.

A public agency may provide enhanced access to public records through the computer gateway administered by the Intelenet Commission established under IC 5-21-2. [IC 5-14-3-3.6]

Records Which May Be Excepted From Disclosure

Pursuant to IC 5-14-3-4(b), the following public records may be excepted from the disclosure requirements if the governing board approves a policy to that effect:

1. Personnel files of employees and files of applicants for employment, except for:
   1. The name, compensation, job title, business address, business telephone number, job descriptions, education and training background, previous work experience, or dates of first and last employment of present or former officers or employees of the public agency;
   2. Information relating to the status of any formal charges against the employee; and
   3. Information concerning disciplinary actions in which final action has been taken and that resulted in the employee being disciplined or discharged.
      
      However, all personnel file information shall be made available to the affected employee or his representative. General personnel information on all employees or for groups of employees, without individual names, may not be excepted from disclosure.
2. Administrative or technical information that would jeopardize a record keeping or security system.
3. Computer programs, computer codes, computer filing systems, and other software that are owned by the public agency or entrusted to it and portions of electronic maps entrusted to a public agency by a utility.
4. Records specifically prepared for discussion or developed during discussion in an executive session under IC 5-14-1.5-6.1.
5. The identity of a donor of a gift made to a public agency if the donor requires nondisclosure of his identity as a condition of making the gift; or after the gift is made, the donor, or the donor's family, requests nondisclosure.

Names and addresses of employees may not be disclosed by the political subdivision to commercial entities for commercial purposes and may not be used by commercial entities for commercial purposes. [IC 5-14-3-4(c)]

The hospital should also give consideration to applicable requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPPA).

Fees

The governing board shall establish a fee schedule for the certification, copying, or facsimile machine transmission of documents. The fee may not exceed the actual cost of certifying, copying, or facsimile transmission of the document by the agency and the fee must be uniform throughout the public agency and uniform to all purchasers. "Actual Cost" means the cost of paper and the per-page cost for use of copying or facsimile equipment, and does not include labor costs or overhead costs. [IC 5-14-3-8(d)]

Suggested Procedures

We suggest that the hospital board adopt a formal records retention and destruction policy. The policy should adequately describe the records to be retained, the length of time to be retained, and the method of disposition. The policy should be designed to comply with the records retention requirements of the various federal, state, and local agencies. The hospital attorney should be consulted to ensure that all legal requirements are met.

A pamphlet entitled "Guide for Preservation and Destruction of Local Public Records" published by the State Commission on Public Records may be used for reference in establishing a records retention policy. This information may be obtained at http://www.in.gov/icpr/records_management.

Public Records Retention - Audit

No financial records or records relating thereto are to be destroyed until the audit of the records by the State Board of Accounts has been completed, report filed, and any exceptions set out in the report satisfied.

Supporting documentation such as receipts, cancelled checks, invoices, bills, contracts, etc., must be available for audit to provide supporting information for the validity and accountability of monies disbursed.

Conflict of Interest

A public servant who knowingly or intentionally has a pecuniary interest in or derives a profit from a contract or purchase connected with an action by the government entity served by the public servant, commits a conflict of interest, a Class D felony. [IC 35-44-1-3(a)]

Exception for Compensation and Expenses

A public servant is not prohibited from receiving compensation for services provided as a public servant or for expenses incurred by the public servant as provided by law. [IC 35-44-1-3(b)]

Other Exceptions

IC 35-44-1-3 does not prohibit a public servant from having a pecuniary interest in or deriving a profit from a contract or purchase connected with the governmental entity served under any of the following conditions:

1. If the public servant is not a member or on the staff of the governing body empowered to contract or purchase on behalf of the governmental entity; the functions and duties the public servant performs for the governmental entity are unrelated to the contract or purchase; and the public servant makes a disclosure as provided in IC 35-44-1-3(d). [IC 35-44-1-3(c)(1)]
2. If the contract or purchase involves utility services from a utility whose rate structure is regulated by the state or federal government. [IC 35-44-1-3(c)(2)]
3. If the public servant was appointed by an elected public servant and makes a disclosure under the procedures in IC 35-44-1-3(d). [IC 35-44-1-3(c)(4)]

Definition of Pecuniary Interest

A public servant has a pecuniary interest in a contract or purchase if the contract or purchase will result or is intended to result in an ascertainable increase in the income or net worth of:

1. The public servant; or
2. A dependent of the public servant who:
   1. Is under the direct or indirect administrative control of the public servant; or
   2. Receives a contract or purchase order that is reviewed, approved, or directly or indirectly administered by the public servant. [IC 35-44-1-3(g)]

Definition of Dependent

A dependent may be any of the following:

1. The spouse of a public servant.
2. A child, stepchild, or adoptee of a public servant who is:
   1. Unemancipated.
   2. Less than 18 years of age.
3. Any individual more than one-half of whose support is provided during a year by the public servant. [IC 35-44-1-3(k)]

Disclosure Requirements

A disclosure as required above must:

1. Be in writing;
2. Describe the contract or purchase to be made by the governmental entity;
3. Describe the pecuniary interest that the public servant has in the contract or purchase;
4. Be affirmed under penalty of perjury;
5. Be submitted to the governmental entity and be accepted by the governmental entity in a public meeting of the governmental entity prior to final action on the contract or purchase;
6. Be filed within fifteen days after final action on the contract or purchase with: (a) the state board of accounts; and (b) with the clerk of the circuit court in the county where the governmental entity takes final action on the contract or purchase; and
7. Contain, if the public servant is appointed, the written approval of the elected public servant (if any) that appointed the public servant.

Defense

It is a defense in a prosecution under this section that the public servant's interest in the contract or purchase and all other contracts and purchases made by the governmental entity during the twelve (12) months before the date of the contract or purchase was two hundred fifty dollars ($250) or less. [IC 35-44-1-3 (h)]

Form

A suggested format for the disclosure of conflict of interest for employees and officers other than board members is located at the end of this section. The attorney for the governmental entity or a private attorney should be consulted in regard to whether a conflict of interest statement should be filed and whether the format of the disclosure is sufficient.

Conflict of Interest

Pursuant to IC 5-16-11-5.5, a consultant has a conflict of interest if any of the following apply:

1. The entity has given a gift or gifts:
   1. To the consultant, the consultant's spouse, or the consultant's unemancipated children;
   2. That have a total fair market value of more than one hundred dollars ($100); and
   3. Within the preceding year.
2. The consultant, the consultant's spouse, or the consultant's unemancipated children have an equitable or a legal interest in real property the value of which:
   1. Either is at least $5,000 or comprises at least ten percent (10%) of the net worth of the consultant, the consultant's spouse, or the consultant's unemancipated children; and
   2. Has been or would be increased or decreased if a contract were awarded to the entity.
3. The consultant or the consultant's spouse is employed by the entity.
4. The entity is the sole proprietorship or professional practice of the consultant or the consultant's spouse.
5. The consultant or the consultant's spouse is a partner in the entity.
6. The consultant or the consultant's spouse is an officer or a director of the entity.
7. The consultant, the consultant's spouse, or the consultant's unemancipated children own stock or options to purchase stock in the entity and the stock or the options to purchase stock have a fair market value of more than ten thousand dollars ($10,000). This subdivision does not apply to the following:
   1. Time deposits or demand deposits in a financial institution.
   2. An insurance policy.

Definition of Consultant

"Consultant" means an individual who, under a contract with the state or a political subdivision, does either of the following for the state or the political subdivision:

1. Evaluates bids for contracts.
2. Awards contracts.

The term does not include a public employee (as defined in IC 34-6-2-38).

An individual is not required to be a party to the contract with the state or the political subdivision to be a consultant under this section. [IC 5-16-11-2]

Definition of Entity

As used in this section, "entity" refers to a person that:

1. Has submitted a bid to be evaluated by a consultant; or
2. Was awarded a contract by a consultant. (IC 5-16-11-3.5)

Disclosure Requirements

A conflict of interest must be disclosed as follows:

1. A consultant shall file a conflict of interest disclosure if the consultant has a conflict of interest under IC 5-16-11-5.5.
2. The disclosure must describe the conflict of interest.
3. The consultant shall file the disclosure within ten (10) days of the earlier of the following events:
   1. The closing day for receipt of bids.
   2. The award of the contract.
4. The consultant shall file the disclosure required by IC 5-16-11-6 with the governing board, if the consultant contracts with the political subdivision. [IC 5-16-11-7]
5. The consultant shall make the disclosure required by IC 5-16-11-6 under affirmation. [IC 5-16-11-6,7,8]

Penalties

A consultant who fails to file a disclosure required by this chapter commits a Class A infraction. [IC 5-15-11-11]

A consultant who files a false disclosure under this chapter is subject to the penalties for perjury under IC 35-44-2-1. [IC 5-16-11-12]

Article 2, Section 9 of the Constitution of Indiana, states in part: ". . . no person may hold more than one lucrative office at the same time, except as expressly permitted in this Constitution." Any person holding two offices which have been or may be deemed lucrative should obtain the written opinion of the attorney for the unit or units served to determine compliance with Article 2, Section 9 of the Constitution of Indiana.

IC 5-11-9-4 requires that records be maintained showing which hours are worked each day for employees employed by more than one political subdivision or in more than one position by the same public agency. This requirement can be met by indicating the number of hours worked on each Employee's Service Record, General Form No. 99A and/or General Form No. 99B.

The federal Fair Labor Standards Act (FLSA) requires that records of wages paid, daily and weekly hours of work, and the time of day and day of week on which the employee's work week begins be kept for all employees. These requirements can be met by use of the following prescribed general forms:

• General Form 99A, Employees' Service Record
• General Form 99B, Employee's Earnings Record
• General Form 99C, Employee's Weekly Earnings Record

General Form 99C is required only for employees who are not exempt from FLSA, are not on a fixed work schedule, and are not paid weekly.

Additional information regarding FLSA rules and regulations may be obtained from the Department of Labor.

Legislation was passed in 1977 amending the Indiana Employment Security Act, IC 22-4, to include the State and all its political subdivisions as employers under the act, effective January 1, 1978.

Employers may elect payment of a percentage rate on a quarterly basis or to make "payments in lieu of contributions" on a monthly basis for benefits paid out during the month. If the employer chooses the first option they pay an unemployment insurance tax on a fixed sum of wages paid to each employee during a calendar year. The political subdivision's rate will be determined by the size of their credit reserve in relation to past claims. Employers wishing to change their elected option of payment may do so upon giving proper notification to the Department of Workforce Development. Employers under each option are required to file quarterly reports on their payroll and contributions. Each employer must display posters (available from the Department of Workforce Development) where all employees can see them.

The governing body may contract for and purchase adequate pension and retirement plans for hospital personnel from the Public Employees Retirement Fund of Indiana or from any company authorized to do such business in Indiana. [IC 16-22-3-11(5)]

The governing body may enter into deferred compensation agreements with employees and other contractual personnel and fund deferred obligations by contracting with insurance companies licensed to transact business in Indiana. [IC 16-22-3-11(6)]

Each governmental unit should adopt a written travel policy in conformity with applicable statutes.

Reimbursement for lodging and meals, should be based upon actual receipts for amounts paid unless otherwise authorized by statute.

Reimbursed mileage shall not include travel to and from the officer's or employee's home and the governmental office in which he works, unless otherwise authorized by statute.

Generally, public funds may not be used to make improvements to property not owned by the governmental unit, unless permitted by statute, federal requirements, state requirements, or safety concerns.

Assets of the governmental unit may not be used in a manner unrelated to the functions and purposes of the governmental unit.

Whenever an item or other asset owned by the political subdivision is entrusted to an officer or employee, to be used at times outside the normal work time for business purposes, such as a cellular phone, or vehicle, a log should be maintained which clearly shows the business use.

Public funds may not be used to pay for personal items or for expenses which do not relate to the functions and purposes of the governmental unit. Any personal expenses paid by the governmental unit may be the personal obligation of the responsible official or employee.

Any compensation, premium, bonus, or product earned as a result of the purchase of goods or services by the governmental unit becomes the property of the governmental unit.

Unless specifically authorized by statute, severance pay, or other payments to employees upon separation from employment, must be supported by the written opinion of the attorney for the governmental unit stating that the payments are in accordance with all federal laws and regulations and state laws, including IC 35-44-2-4, and a properly enacted Home Rule ordinance or resolution, as applicable.

Whenever the cost of a public work project will be at least $25,000 in a political subdivision or an agency not described in IC 36-1-12-4(1 or 2) the board must comply with the following procedures:

Plans and Specifications

The board shall prepare general plans and specifications describing the kind of public work required, but shall avoid specifications which might unduly limit competition. [IC 36-1-12-4(b)(1)]

The board shall file the plans and specifications in a place reasonably accessible to the public, which shall be specified in the notice required. [IC 36-1-12-4(b)(2)]

All plans and specifications for public buildings must be approved by the State Board of Health, State Fire Marshal, State Building Commissioner, and other state agencies designated by statute. [IC 36-1-12-10]

Notice

Upon filing of the plans and specifications, the board shall publish a notice two times, at least one week apart, with the second publication made at least ten days before the date the bids will be received, calling for sealed proposals for the public work. [IC 36-1-12-4(b)(3)]

The notice must specify the place where the plans and specifications are on file, the date fixed for receiving bids, and the amount of the bond or certified check to be filed with each bid. [IC 36-1-12-4(b)(4); IC 36-1-12-4.5]

The period of time between the date of the first publication and the date of receiving bids may not be more than six weeks. [IC 36-1-12-4(b)(5)]

Evidence of Financial Responsibility

A bond or certified check shall be filed with each bid by a bidder in the amount specified by the board. The amount may not be more than 10% of the contract price. The bond or certified check shall be made payable to the political subdivision.

All checks of unsuccessful bidders shall be returned to them by the board upon selection of successful bidders. Checks of successful bidders shall be held until delivery of the performance bond. [IC 36-1-12-4.5]

Bidder's Affidavit

The board shall require the bidder to submit an affidavit that the bidder has not entered into a combination or agreement:

1. Relative to the price to be bid by a person;
2. To prevent a person from bidding; or,
3. To induce a person to refrain from bidding and that his bid is made without reference to any other bid. [IC 36-1-12-4(b)(12)]

Public Meeting

The board may not require a bidder to submit a bid before the meeting at which bids are to be received. The meeting for receiving bids must be open to the public. All bids received shall be opened publicly and read aloud at the time and place designated. Bids shall be submitted on prescribed General Form 96 (Bid for Construction). [IC 36-1-12-4(b)(7)]

Responsive Bidder

In determining whether a bidder is responsive, the board may consider the following factors:

1. Whether the bidder has submitted a bid or quote that conforms in all material respects to the specifications.
2. Whether the bidder has submitted a bid that complies specifically with the invitation to bid and the instructions to bidders.
3. Whether the bidder has complied with all applicable statutes, ordinances, resolutions, or rules pertaining to the award of a public contract. [IC 36-1-12-4(b)(10)]

Responsible Bidder

In determining whether a bidder is a responsible bidder, the board may consider the following factors:

1. The ability and capacity of the bidder to perform the work.
2. The integrity, character, and reputation of the bidder.
3. The competence and experience of the bidder. [IC 36-1-12-4(b)(11)]

Award of Contract

The board shall award the contract for public work or improvements to the lowest responsible and responsive bidder or the board may reject all bids submitted. [IC 36-1-12-4(b)(8)]

If the board awards the contract to a bidder other than the lowest bidder, the board must state in the minutes or memoranda, at the time the award is made, the factors used to justify the award. The board shall keep a copy of the minutes or memoranda available for public inspection. [IC 36-1-12-4(b)(6)]

Except as provided below, the board shall award the contract and shall provide the successful bidder with written notice to proceed within sixty (60) days after the date on which bids are opened.

1. If general obligation bonds are to be sold to finance the construction that is the subject of the bid, the board shall allow the bidder ninety (90) days.
2. If revenue bonds are to be issued and sold to finance the construction, the board shall allow the bidder one hundred fifty (150) days.

A failure to award and execute the contract and to issue notice within the time required entitles the successful bidder to reject the contract and withdraw his bid without prejudice, or extend the time to award the contract and provide notice to proceed at an agreed later date. If the successful bidder elects to reject the contract and withdraw his bid, notice of that election must be given to the board in writing within fifteen (15) days of the sixty (60) day expiration date or any other extension date. [IC 36-1-12-6]

Contract Provision - Payment of Subcontractors

A contract for public work must contain a provision for the payment of subcontractors, laborers, material supplies, and those performing services. The board shall withhold money from the contract price in a sufficient amount to pay the subcontractors, laborers, material suppliers, and those furnishing services. [IC 36-1-12-13]

Change Orders

If, in the course of construction, reconstruction or repair of a public work project, it becomes necessary to change or alter the original specifications, a change order may be issued to add, delete, or change an item or items in the original contract. All change orders must be directly related to the original public work project.

• Addendum. The change order becomes an addendum to the contract and must be approved and signed by the board and the contractor.
• Architect or Engineer. If a licensed architect or engineer is assigned to the public work project the change order must be prepared by that person.
• Increase in Scope of Project. The total of all change orders issued that increase the scope of the project may not exceed twenty percent (20%) of the amount of the original contract. A change order issued as a result of circumstances that could not have been reasonably foreseen does not increase the scope of the project.
• Cost of Materials. If additional units of materials included in the original contract are needed, the cost of these units in the change order must be the same as those shown in the original contract.

A change order may not be issued before commencement of the actual construction, reconstruction, or repairs except in the case of an emergency. In that case, the board must make a declaration, and the board's minutes must show the nature of the emergency. [IC 36-1-12-18]

Installation of Plumbing

A person who submits a bid for a public works contract that involves the installation of plumbing must submit evidence that the person is a licensed plumbing contractor under Indiana Code 25-28.5-1. [IC 36-1-12-12]

Final Payment

The board shall withhold final payment to the contractor until the contractor has paid the subcontractors, material suppliers, laborers, or those furnishing services. However, if there is not a sufficient sum owed to the contractor to pay those bills, the sum owed to the contractor shall be prorated in payment of the bills among the parties entitled. To receive payment the subcontractor or subcontractors, material suppliers, laborers, or those furnishing services shall file their claims with the board within sixty days after the last labor performed, last material furnished, or last service rendered by them. [IC 36-1-12-12]

In addition to the foregoing items applying to major public work projects, the following items apply to public work projects costing more than $100,000.

Approval of Plans and Specifications

If the cost of the project is more than $100,000, the plans and specifications must be approved by an architect or engineer licensed under IC 25-34. [IC 36-1-12-7]

Bidder Information

If the cost of a project is $100,000 or more, the board shall require the bidder to submit a financial statement, a statement of experience, his proposed plan or plans for performing the public work, and the equipment that he has available for the performance of the public work. [IC 36-1-12-4(b)(6)]

Payment Bond

IC 36-1-12-13.1 requires a payment bond to be filed with a contract for public work only if the cost exceeds $100,000. The contractor shall execute a payment bond to the appropriate political subdivision or agency, approved by and for the benefit of the political subdivision or agency, in an amount equal to the contract price. The payment bond is binding on the contractor, the subcontractor, and their successors and assigns for the payment of all indebtedness to a person for labor and service performed, material furnished, or services rendered. The payment bond must state that it is for the benefit of the subcontractors, material suppliers, laborers, and those performing services. The payment bond shall be deposited with the board. [IC 36-1-12-13.1]

Performance Bonds

For public works contracts of less than two hundred fifty thousand dollars ($250,000), the board may waive the performance bond requirement and accept from a contractor an irrevocable letter of credit for an equivalent amount from an Indiana financial institution instead of a performance bond. [IC 36-1-12-14(h)]

Actions against a surety on a performance bond must be brought within one year after the date of the board's final settlement with the contractor. [IC 36-1-12-14(g)]

Filing of Final Record Drawings

The board must, within sixty (60) days after the completion of the public work project, file in the office of the State Building Commissioner a complete set of final record drawings for the public work project. [IC 36-1-12-11]

Retainage and Escrow Agreement

A board that enters into a contract for public work, and a contractor who subcontracts parts of that contract, shall include in their respective contracts provisions for the retainage of portions of payments by the board to contractors, by contractors to subcontractors, and for the payment of subcontractors. Either the board or contractor, or both, shall place the retainage in an escrow account, with a bank, savings and loan institution, or the state as the escrow agent. The escrow agent shall be selected by mutual agreement between board and contractor or subcontractor under a written agreement among the bank or savings and loan institution and: (1) the board and the contractor; or (2) the subcontractor and the contractor. [IC 36-1-12-14(b)]

IC 36-1-12-14(f) provides the board or escrow agent shall pay the contractor within sixty-one (61) days after the date of substantial completion subject to IC 36-1-12-11 and IC 36-1-12-12. Payment by the escrow agent shall include all escrowed principal and escrowed income.

To determine the amount of retainage to be withheld, the board shall:

1. Withhold no more than 10% of the dollar value of all work satisfactorily completed until the public work is 50% completed, and nothing further after that; or
2. Withhold no more than 5% of the dollar value of all work satisfactorily completed until the public work is substantially completed.

If upon substantial completion of the public work minor items remain uncompleted, an amount equal to 200% of the value of each item as determined by the architect-engineer shall be withheld until the item is completed. [IC 36-1-12-14(c)]

The escrow agreement must contain the following provisions:

1. The escrow agent shall invest all escrowed principal in obligations selected by the escrow agent.
2. The escrow agent shall hold the escrowed principal and income until receipt of notice from the board and the contractor, or the contractor and the subcontractor, specifying the part of the escrowed principal to be released from the escrow and the person to whom that portion is to be released. After receipt of the notice, the escrow agent shall remit the designated part of escrowed principal and the same proportion of then escrowed income to the person specified in the notice.
3. The escrow agent shall be compensated for his services, to be paid from the escrowed income.
4. The contractor shall furnish the board with a performance bond equal to the contract price. If acceptable to the board, the bond may provide for incremental bonding in the form of multiple or chronological bonds that, when taken as a whole, equal the contract price. The surety on the performance bond may not be released until one year after the date of the board's final settlement with the contractor. [IC 36-1-12-14(e)]

Final Payment

The contractor shall be paid in full, including all escrowed principal and escrowed income, by the board and escrow agent, within sixty-one (61) days after the date of substantial completion. If within sixty-one (61) days after the date of substantial completion there remains uncompleted minor items, an amount equal to 200% of the value of each item as determined by the architect-engineer shall be withheld until the item is completed. [IC 36-1-12-14(f)]

If the board wishes to award a contract for a public work costing less than $25,000, the procedures outlined for public works costing $25,000 or more may be followed, or the following procedures may be used:

Plans and Specifications

All plans and specifications for public buildings must be approved by the State Board of Health, State Fire Marshal, State Building Commissioner, and other state agencies designated by statute. [IC 36-1-12-10]

Inviting Quotes

The board shall invite quotes from at least three persons known to deal in the class of work proposed to be done by mailing them a notice stating that plans and specifications are on file in a specified office. The notice must be mailed not less than seven days before the time fixed for receiving quotes. [IC 36-1-12-5]

Public Meeting

The board may not require a person to submit a quote before the meeting at which quotes are to be received. The meeting for receiving quotes must be open to the public. All quotes received shall be opened publicly and read aloud at the time and place designated. [IC 36-1-12-5]

Award of Contract

The board shall award the contract for the public work to the lowest responsible and responsive quoter. [IC 36-1-12-5]

Rejection of All Quotes

The board may reject all quotes submitted. If the board rejects all quotes, the board may negotiate and enter into agreements for the work in the open market without inviting or receiving quotes if the board establishes in writing the reasons for rejecting the quotes. [IC 36-1-12-5]

The political subdivision may purchase or lease materials in the manner provided in IC 36-1-9 and perform any public work by means of its own work force, without awarding a contract whenever the cost of that public work project is estimated to be less than $100,000. Before the political subdivision may perform any work under this section by means of its own work force, the political subdivision must have a group of employees on its staff who are capable of performing the construction, maintenance, and repair applicable to that work. For purposes of this subsection, the cost of a public work project includes the actual cost of materials, labor, equipment, rental, a reasonable rate for use of trucks and heavy equipment owned, and all other expenses incidental to the performance of the project. [IC 36-1-12-3]

The cost of a single public work project may not be divided into two or more projects for the purpose of avoiding the requirement to solicit bids. The cost is defined by IC 36-1-12-19(a) to include cost of materials, labor, equipment rental, and all other expenses incidental to the performance of the project.

Any board member or officer of the political subdivision, bidder, quoter, or other person who is party to a public work contract who knowingly violates IC 36-1-12-19 commits a Class A infraction.

In case of an emergency the board may contract for a public work project without advertising for bids if bids or quotes are invited from at least two persons known to deal in the public work required to be done. The minutes of the board must show the declaration of emergency and the names of the persons invited to bid or provide quotes. The notice requirements for hiring of an architect or engineer may also be waived. [IC 36-1-12-9]

IC 5-11-1-26 requires the State Board of Accounts to include in its examination report a political subdivision's compliance with IC 5-16-8, which requires use of steel products made in the United States for construction and alterations of public buildings except under certain circumstances.

Whenever the political subdivision decides to hire an architect, engineer, or land surveyor, the political subdivision may:

1. Publish a notice in accordance with the requirements of publishing legal notices as found in IC 5-3-1;
2. Provide for notice (other than notice in accordance with IC 5-3-1) as it determines is reasonably calculated to inform those performing professional services of the proposed project;
3. Provide for notice in accordance with both subdivision (1) and (2); or
4. Determine not to provide any notice.

If the political subdivision provides for notice in accordance with the above, each notice must include:

1. The location of the project;
2. A general description of the project;
3. The general criteria to be used in selecting professional services firms for the project.
4. The place where any additional project description or specifications are on file;
5. The hours of business of the public agency; and
6. The last date for accepting statements of qualifications from interested parties.

A contract by the board for a public work project must conform to the wage scale provisions of IC 5-16-7. [IC 36-1-12-15]

A contract by the board for public work must conform with the antidiscrimination provisions of IC 5-16-6. The board may consider a violation of IC 5-16-6 a material breach of contract, as provided in IC 22-9-1-10. [IC 36-1-12-15]

Every contract for the construction, alteration, or repair of any public building or public work in the State of Indiana shall contain provisions by which the contractor agrees:

1. That in the hiring of employees for the performance of work under this contract or any subcontract hereunder, no contractor, or subcontractor, nor any person acting on behalf of such contractor or subcontractor, shall, by reason of race, religion, color, sex, national origin, or ancestry, discriminate against any citizen of the State of Indiana who is qualified and available to perform the work to which the employment relates;
2. That no contractor, subcontractor, nor any person on his behalf shall, in any manner, discriminate against or intimidate any employee hired for the performance of work under this contract on account of race, religion, color, sex, national origin or ancestry.
3. That there may be deducted from the amount payable to the contractor by the State of Indiana or any municipal corporation thereof, under this contract, a penalty of five dollars for each person for each calendar day during which such person was discriminated against or intimidated in violation of the provisions of the contract; and
4. That this contract may be cancelled or terminated by the State of Indiana or by any municipal corporation thereof, and all money due or to become due hereunder may be forfeited, for a

Governmental units should collect any overpayments made.

Compensation and any other payments for goods and services should not be paid in advance of receipt of the goods or services unless specifically authorized by statute. Payments made for goods or services which are not received may be the personal obligation of the responsible official or employee.

Any compensation, premium, bonus, or product earned as a result of the purchase of goods or services by the governmental unit becomes the property of the governmental unit.

The executive director and all persons whose duty it is to handle funds of the hospital must execute a corporate surety bond in the amount and with conditions required by the board. If a treasurer is elected by the board, the treasurer shall be separately bonded in an amount fixed by the board but not less than $25,000. The board may elect an assistant treasurer who may not be a member of the board and who must be separately bonded in an amount fixed by the board greater than $25,000. The bond on all persons except the treasurer and assistant treasurer may be a blanket corporate surety bond conditioned for the faithful performance of duties. All bonds required by this subsection must be approved by the board and filed with the county recorder. [IC 16-22-2-9(c)]

The governing board is the supreme authority in a hospital and is responsible for the management, control, and operation of the hospital. The board has the powers and duties set forth in this chapter. The governing board has the powers granted to boards of nonprofit corporations under IC 23-17. [IC 16-22-3-1]

The governing board may do the following: [IC 16-22-3-11]

1. Adopt an employee benefit program that may include a vacation policy and employee discounts.
2. Authorize expenditure of hospital funds for payment of advertising and placement fees for personnel and physicians.
3. Expend hospital funds in an amount not to exceed 0.5% of hospital revenues for the preceding calendar year for a program that directly contributes to the productivity or morale of personnel, volunteers, or physicians. However, this subdivision does not apply to an employee benefit program under subdivision (1), or an employee compensation arrangement, including a productivity bonus.
4. Adopt a plan that provides for hospital employee sickness or accident disability and contract for and purchase insurance plans from an insurance company licensed to transact business in Indiana.
5. Contract for and purchase adequate pension and retirement plans for hospital personnel from the public employee's retirement fund of Indiana or from any company authorized to do such business in Indiana.
6. Enter into deferred compensation agreements with employees and other contractual personnel and fund deferred obligations by contracting with insurance companies licensed to transact business in Indiana.
7. Expend hospital funds to pay dues of the executive director and department heads for memberships in local, state, or national hospital or professional associations or organizations that the board determines are of direct benefit to the hospital.
8. Establish and operate employee registries for part-time or temporary hospital employees.
9. Pay a part or all of the costs of these plans out of hospital funds.
10. Expend hospital funds for reasonable expenses incurred by persons and their spouses who are interviewed for employment or for medical staff appointment and for reasonable moving expenses for the persons and their spouses if employed or appointed to the hospital medical staff.
11. Expend hospital funds, advance tuition payments, or establish a tuition refund program for the education or professional improvement of nurses and other professional or technical employees of the hospital for inservice training and attending seminars or other special courses of instruction when the board determines that the expenditures directly benefit the hospital.
12. Conduct business in a state adjacent to Indiana. (IC 16-22-3-11)

"The board is a body corporate and politic with the style of "The Board of Trustees of __________ Hospital," to include the full name of the hospital. In that name and capacity, the board may do the following:

1. Sue and be sued . . .
2. Possess the real and personal property of the hospital and the hospital funds in the hospital's corporate name for the hospital's benefit.
3. Exercise the other powers, duties and responsibilities set forth in this article." [IC 16-22-3-24]

"Upon the recommendation of the executive director, a governing board shall do the following:

1. Fix the compensation, including incentives for productivity, of all hospital employees.
2. Adopt personnel and management policies consistent with the governing boards of other hospitals in Indiana." [IC 16-22-3-10]

"The governing board shall appoint an executive director as the administrative head of the hospital. The executive director:

1. Is the executive agent of the board in the administration of the board's policies;
2. Is the liaison officer between the board and the medical staff;
3. Shall employ hospital personnel; and
4. Has the other powers and duties delegated to the executive director by the board or specifically assigned to the executive director in this article." [IC 16-22-3-8]

IC 16-22-3-12(a) states: “The state board of accounts shall approve or prescribe the manner in which the hospital records are kept, shall audit the records of the hospital, and may approve forms for use by all hospitals or groups of hospitals.”

IC 16-22-3-12(c) states: “A hospital may elect to have an audit required under subsection (a) performed by an independent certified public accounting firm that is experienced in hospital matters. The audit report must be kept on file at the hospital and a copy must be provided to the state board of accounts. The audit engagement by a certified public accounting firm must be performed pursuant to guidelines established by the state board of accounts.”

A governing board that receives a financial subsidy from the county for hospital operations, excluding mental health or ambulance services, during the preceding calendar or fiscal year must file with the county executive and the county fiscal body an annual report showing the income and expenses of the operating fund for the preceding calendar or fiscal year by major classification according to the chart of accounts approved by the state board of accounts. The annual report shall be published one time. Hospital records may be kept in hard copy, on microfilm, or via another data system acceptable to the state board of accounts. [IC 16-22-3-12(b)]

"The governing board shall establish reasonable charges for patient care and other hospital services for the residents of the county and may provide patient care and other hospital services to nonresidents of the county upon terms and conditions the board establishes by rule." [IC 16-22-3-13(a)]

"Money in the hospital funds shall be deposited in the manner determined by the governing board." [IC 16-22-3-16]. To provide for adequate safeguarding of cash, receipts should be deposited in the depository or depositories designated by the governing board in a timely manner.

IC 16-22-3-20 states:

1. As used in this section, "financial institution" has the meaning set forth in IC 5-13-4-10.
2. The board may invest money in the hospital funds within the county or the state as the board determines. The money may be invested in the following:
   1. Any account paying interest and subject to withdrawal by negotiable orders of withdrawal, unlimited as to amount or number (NOW accounts).
   2. Passbook savings accounts.
   3. Certificates of deposit.
   4. Money market deposit accounts.
   5. Any interest bearing account that is authorized to be set up and offered by a financial institution or brokerage firm registered and authorized to do business in Indiana.
   6. Repurchase or resale agreements involving the purchase and guaranteed resale of any interest bearing obligations issued or fully insured or guaranteed by the United States or any United States government agency in which type of agreement the amount of money must be fully collateralized by interest bearing obligations as determined by the current market value computed on the day the agreement is effective.
   7. Mutual funds offered by a financial institution or brokerage firm registered and authorized to do business in Indiana.
   8. Securities backed by the full faith and credit of the United States Treasury or fully insured or guaranteed by the United States or any United States government agency.
   9. Pooled fund investments for participating hospitals offered, managed, and administered by a financial institution or brokerage firm registered or authorized to do business in Indiana.

This subsection does not prevent the board from using money in the hospital funds to capitalize projects undertaken under section 1(b) and 1(c) [IC 16-22-3-1(b) and IC 16-22-3-1(c)] of this chapter.

3. Any interest derived from an investment under subsection (b) becomes a part of the hospital funds invested. Interest derived from the investment of money raised by bonded or other indebtedness in excess of funds needed for hospital buildings may be applied by the governing board to the appropriate bond redemption, interest, or sinking fund.

IC 16-22-3-2(a) states: "The governing board may purchase, construct, remodel, repair, enlarge, or acquire buildings and real or personal property for hospital purposes, upon terms and conditions acceptable to the board."

IC 16-22-3-3 states: “The governing board may lease real or personal property on reasonable terms and conditions.”

IC 16-22-3-4 states: "The governing board may purchase or acquire materials, services, equipment, and supplies required to operate and maintain the hospital at prices the board considers reasonable."

IC 16-22-3-7 states: "Claims against the hospital must be allowed and approved by the governing board before payment by the disbursing officer. However, the board may, subject to review and approval at the board's next regular meeting, authorize the following:

1. Compensation of hospital employees upon certification of payrolls by the executive director.
2. Payment of invoices for materials, services, equipment, and supplies required for the operation and maintenance of the hospital upon certification by the executive director of the following:
   1. The invoices are true and correct.
   2. The items were ordered and received by the hospital."

IC 16-22-3-14(c) states: “The board may transfer a part of the hospital funds to a nonprofit corporation organized under IC 23-7-1.1 (before its repeal on August 1, 1991) or IC 23-17 that is:

1. A hospital foundation organized and operated for the exclusive benefit of the hospital; or
2. A related or controlled entity; if adequate provision is made for working capital and other known and anticipated hospital needs.”

IC 16-22-3-14(d) states: “If a transfer includes public funds of the hospital, the public funds transferred to the foundation or related or controlled entity may be audited by the state board of accounts unless:

1. The hospital foundation or related or controlled entity files annually with the treasurer of the hospital a copy of an audit report prepared by an independent certified public accountant; and
2. The audit report is on file at the hospital and is made available to the state board of accounts.”

IC 16-22-3-27 states, in part: “(a) The governing board may request support from the county, either by appropriation from the county general fund or by a separate tax levy . . . (b) If the county provides a direct financial subsidy to a hospital from a tax levy, the hospital board may not provide those funds from to an entity created under IC 16-22-3-1(b) for three years. After three years, all funds, with interest, must be repaid within ten years.” Those entities include organizations and associations that benefit the hospital, partnerships and joint ventures, and other corporations.

IC 16-22-3-27(c) states: “If the board enters into a lease or sublease contract or a loan agreement with the state authority, the board may request the county to adopt a separate tax levy to support the board's obligation to make payments under that contract or agreement.” IC 16-22-3-27.5 states, in part: “ (a) If (1) the board has authorized the hospital to enter into a lease or sublease contract or a loan agreement with the state authority under this chapter; and (2) the lease or sublease contract or the loan agreement provides that a portion of the lease or loan payment is to be paid from taxes. (b) the county council, or city-county council in the case of a county with a consolidated city, shall annually levy a tax that is sufficient to produce each year along with other available funds an amount that is sufficient to pay the portion of the lease or loan payment that is required to be paid from taxes.”

IC 16-22-3-30 states: “The powers of the board described in this chapter (IC 16-22-3) shall be liberally construed to effect the purposes of this article (IC 16-22) and to enable the hospital to be maintained and operated as a first class hospital.”

IC 16-22-4-1 states: “The county officers may establish a cumulative building or sinking fund for the erection of new hospital buildings, the repairing, remodeling, and enlarging of old hospital buildings, and the equipment of new, enlarged, and old hospitals owned and operated by the county, a voluntary nonprofit association, or a nonprofit corporation.” IC 16-22-4-4 states: “The county officers may, in compliance with IC 6-1-1-41, levy a tax on all taxable property within the county to provide money for a fund established under this chapter.”

A hospital may establish a cumulative building or sinking fund as described in IC 16-22-4, or may continue cumulative building funds established under IC 16-12-16 (before its repeal on September 2, 1971), IC 16-12-15 (before its repeal on July 1, 1993), or IC 16-12-1.4 (before its repeal on July 1, 1993). The county executive may issue and sell general obligation bonds of the county to finance the costs of, or the enlargement or remodeling of, hospital buildings. [IC 16-22-5]

The county executive of a county owning and operating only one county hospital may, upon the written request of by the governing board of the hospital, adopt a resolution for the creation of an authority, otherwise referred to as a Hospital Association. The authority is created for the purpose of financing, acquiring, constructing, renovating, equipping, and leasing to the county land and a building, including an existing building, for hospital purposes. [IC 16-22-6]

A hospital corporation or authority is defined as being a political subdivision. [IC 36-1-2-10 and IC 36-1-2-13]

The Indiana Medical Malpractice Act (the Act) identifies the amounts recoverable for acts of malpractice and the hospital’s financial responsibility for such acts. IC 34-18-14-3 identifies the total amount recoverable for an injury or death of a patient. IC 34-18-4 describes the establishment of financial responsibility of a hospital and certain other health care providers, including, among other things, the minimum annual aggregate amount of malpractice liability insurance. IC 34-18-5 requires hospitals and certain other health care providers to contribute annually to the Indiana Patient’s Compensation Fund, as described in IC 34-18-6. This fund may be used to pay medical malpractice claims in excess of certain amounts, under certain terms and conditions.

All personal property held for the owner by the State of Indiana, or any political subdivision thereof, that has remained unclaimed by the owner for more than three years is presumed abandoned. Every person holding funds or other property, tangible, or intangible, presumed abandoned under this chapter shall report to the attorney general of the state of Indiana with respect to the property as provided in IC 32-34-1-26. Unclaimed property may include such things as property left for safekeeping which was not claimed and overpayments on patient accounts not refunded to the patient or his or her representative. [IC 32-34-1]

The hospital is responsible for complying with the decisions of the governing board as evidenced in the board minutes and other written memoranda.

The hospital is responsible for completing an accurate inventory of materials and supplies on a regular basis.

The hospital is responsible for completing an accurate inventory of pharmacy goods on a regular basis. The inventory should be performed as near as possible to the end of the hospital's fiscal year.