CUYAHOGA COUNTY HEALTH CARE FACILITY REVENUE BOND APPLICATION

Transcription

1 CUYAHOGA COUNTY HEALTH CARE FACILITY REVENUE BOND APPLICATION WHAT CAN BE FINANCED Bond proceeds can be used for purchase, construction or rehabilitation of a project (including

2 land and buildings), and to fund most related fees and expenses which may include construction financing, legal, audit, bond underwriting and issuance costs. Health Care Facility Bonds are issued for the public purpose of better providing for the health and welfare of the people by enhancing the availability, efficiency, and economy of hospital facilities and the services rendered. The project should be consistent with all local zoning, building, and development plans. Qualified Private Activity Bonds are tax-exempt bonds issued by public entities to provide lowcost financing for private projects that serve a public purpose. Federal tax law imposes a number of restrictions and requirements on the issuance of tax-exempt Private Activity Bonds. Federal tax law requires that these bond issues conform to certain procedural requirements in order to be issued on a tax-exempt basis. Ohio law permits cities, counties, and townships to issue bonds. Bonds are issued in the name of the County but are not obligations of the County and are not backed or secured by its full faith and credit, taxing power or any other public revenue sources. The project developer/entity is solely responsible for repayment, subject to any insurance or guarantee by a third party. ORC (E) Hospital facilities means buildings, structures and other improvements, additions thereto and extensions thereof, furnishings, equipment, and real estate and interests in real estate, used or to be used for or in connection with one or more hospitals, emergency, intensive, intermediate, extended, long-term, or self-care facilities, diagnostic and treatment and outpatient facilities, facilities related to programs for home health services, clinics, laboratories, public health centers, research facilities, and rehabilitation facilities, for or pertaining to diagnosis, treatment, care, or rehabilitation of sick, ill, injured, infirm, impaired, disabled, or handicapped persons, or the prevention, detection, and control of disease, and also includes education, training, and food service facilities for health professions personnel, housing facilities for such personnel and their families, and parking and service facilities in connection with any of the foregoing; and includes any one, part of, or any combination of the foregoing; and further includes site improvements, utilities, machinery, facilities, furnishings, and any separate or connected buildings, structures, improvements, sites, utilities, facilities, or equipment to be used in, or in connection with the operation or maintenance of, or supplementing or otherwise related to the services or facilities to be provided by, any one or more of such hospital facilities. HOW TO APPLY

3 1. Review your proposed project with bond counsel to ensure that the project complies with all state and federal tax laws. 2. Secure the commitment of a lender to credit enhance the bond issue, and a commitment of an underwriter to sell the bonds or an institutional investor to purchase the bonds. (Often these are handled by the same financial institution) 3. Obtain a Health Care Facility Revenue Bond (HCFRB) application by calling Sabrina Roberts in the Office of Health and Humans Services at (216) or visit the Cuyahoga County Department of Development s website for all Bond Program applications and documents. 4. Complete and file the HCFRB application with the Office of Health and Human Services, Sabrina Roberts, sroberts@cuyahogacounty.us or call (216) APPLICATION PROCEDURE One original, signed application must be submitted. Applications may be obtained from Cuyahoga County s Office of Health and Human Services (216) , Cuyahoga County Department of Development s website or Bond Counsel and submitted to Cuyahoga County, Office of Health & Human Services, Attention: Sabrina Roberts, 310 West Lakeside Avenue, Suite 500, Cleveland, Ohio FEES A non-refundable application fee of One Thousand Dollars ($1,000.00) must be submitted with the signed application. Make all checks payable to: CUYAHOGA COUNTY The application must be submitted at least thirty (30) business days in advance of the requested Board of County Commissioners meeting. The applicant is required to provide the Cuyahoga County Prosecutor s Office, Civil Division, draft copies of all agreements. The Cuyahoga County Board of County Commissioners meeting schedule can be obtained from After January 1, 2011, consult the County website for information concerning the schedule of County Council. Any requests for Refunding are considered new applications. Issuance Fees: Health Care Facility Revenue/Refunding Bonds (HCFRB) One-fourth of one percent (1/4 th of 1%) of the Issuance amount is due and payable to Cuyahoga County for amounts up to fifteen million dollars ($15,000,000) Issuance amounts over fifteen million dollars are payable at a rate of one-tenth of one percent (1/10 th of 1%) of the remaining balance. Issuance fees are due and payable no later than the bond issue closing date. All checks are payable to the Cuyahoga County and mailed to the Office of Health & Human Services, 310 West Lakeside Avenue, Suite 500, Cleveland, Ohio 44113, Attention: Sabrina Roberts. Change Fee: Fees are required on each occurrence of bond activity which requires Office of Health and Human

4 Services staff review, County Prosecutor s office review and/or recommendation to the BOCC or County Council. Changes requiring action by the Board of County Commissioners or County Council will be reviewed upon submission of the request along with a five hundred dollar fee ($500.00). Please forward all checks and information to: Sabrina Roberts Administrator of Health Policy and Programs Office of Health and Human Services 310 W. Lakeside Avenue, Suite 500 Cleveland, Ohio Phone: Fax: sroberts@cuyahogacounty.us BOND COUNSEL/BORROWER COUNSEL When bond counsel or bond counsel s firm also represents the borrower and/or the underwriter in a proposed conduit bond issue, bond counsel must provide written communication to the County Prosecutor s Office identifying legal counsel for all parties. This should be done at the time of application to the Office of Health and Human Services. The County will, in such situations, be entitled to hire a separate Issuer Counsel at Borrower s expense to represent the County. Selection of Issuer s Counsel will be made by County Prosecutor s Office. The fee will be determined by the County Prosecutor s Office. The bond issuance resolution will include a provision appointing Issuer s Counsel and specifying that the fee is to be paid by the Borrower. Scheduling Approval of Issuance Resolutions and TEFRA Hearings The Cuyahoga County Office of Health and Humans Services (HHS) is responsible for securing the appropriate Board of County Commissioner s or County Council meeting date from the Clerk s office. HHS staff will coordinate with Bond Counsel to determine the appropriate date for the project to be heard. Bond counsel of the applicant must contact the Cuyahoga County Office of Health and Human Services at least thirty (30) business days in advance of the requested Board of County Commissioners or County Council meeting. The applicant is required to provide the Cuyahoga County Prosecutor s Office, Civil Division, and the Office of Health and Human Services draft copies of the resolution and all agreements at that time. A letter addressed to the Cuyahoga County Board of Commissioners or County Council, 1219 Ontario Street, Cleveland, Ohio 44113, Attention: Board President or Council President, cc: Sabrina Roberts, must be sent prior to the scheduled board meeting, requesting to be heard before the BOCC or County Council and providing a brief description of the project. Notice of Public Hearing

5 The bond counsel for the applicant is responsible for preparing the Notice of Public Hearing (Tax Equity and Fiscal Responsibility Act (TEFRA) Hearing), which must be approved by the Cuyahoga County Prosecutor s Office. It must not be published prior to the applicant receiving approval from the Prosecutor s Office. The public hearing may be held at the time of issuance. The Cuyahoga County Office of Health and Human Services staff and the Clerk s Office must receive a copy of the public hearing notification, as published, at least one week prior to the requested hearing date. Required Documents for Approval of Issuance 1. Legal drafts of required documents must be received by the Assistant County Prosecutor and the Office of Health and Human Services (Sabrina Roberts), thirty (30) days prior, to the time bond counsel requests a date to be heard before the Board of County Commissioners or County Council. 2. Bond counsel is expected to prepare the issuance resolutions for the Commissioners' or County Council s Journal. The Clerk's Office will return certified copies of each completed resolution to bond counsel. 3. At the time of application, the following item must be received by the Office of Health and Human Services: Support for the project by the local jurisdiction, evidenced by a letter from its chief elected official, or other means satisfactory to the Board of County Commissioners or County Council. Representatives of the applicant who can answer questions about the project must attend the Commissioners' meeting that approval is scheduled. This may include bond counsel and company representatives. Documents will be returned to the Prosecutor s Office by the Clerk s Office when they have been signed, witnessed and notarized, for release to bond counsel when it is appropriate to do so. A final transcript of all signed legal documents must be submitted, on disk, to the Cuyahoga County Office of Health and Human Services, The Clerk of the Board, and the County Prosecutor s Office for filing. Please include on the cover of each disk, or accompanying cover letter, the date of maturity of the bonds.

6 APPLICANT INFORMATION Project Name: Total Issuance Amount: $ 1. Applicant Name, Address, and Phone Number: Please list all above information for Contact Person: Business Organization Designation: Corporation, Limited Partnership, Sole Proprietorship, Non-Profit, Limited Liability Co.,General Partnership Date and State of Organization 2. Legal Name of Borrower, Address, and Phone Number: (If different from Applicant) Please list all above information for Contact Person: Business Organization Designation: Corporation, Limited Partnership, Sole Proprietorship, Non-Profit, Limited Liability Co., or General Partnership Date and State of Organization 3. Name and Phone Number of the following: -Person in Charge of Project -Investment Banker/Placement Agent -Bond Counsel -Underwriter -Underwriter s Counsel

7 4. Has the applicant or management of applicant been informed of any current or ongoing investigation of the applicant or borrower with respect to possible violations of state or federal laws, including but not limited to, securities or anti-trust laws? Yes No If yes, please furnish details in a separate attachment. 5. Has the applicant or any of the persons associated with the project or applicant ever been charged with, or convicted of, any criminal offenses other than a minor misdemeanor? Yes No If yes, please furnish details in a separate attachment. 6. Has the applicant or any of the persons associated with the project or the applicant been subject to any disciplinary action, past or pending, by any administrative, governmental or regulatory body? Yes No If yes, please furnish details in a separate attachment. 7. Has the applicant or any person associated with the project or the applicant, or any concern with which any person (s) associated with the project has been associated with by ownership, been a party to bankruptcy, in receivership or adjudicated as bankrupt? Yes No If yes, please furnish details in a separate attachment. 8. Has the applicant or any person associated with the project or the applicant been denied a business-related license, or had such a license revoked by any administrative, governmental or regulatory agency? Yes No If yes, please furnish details in a separate attachment. 9. Is the applicant or any person associated with the project or applicant currently debarred, suspended, or disqualified from contracting with any federal, state or municipal agency? Yes No If yes, please furnish details in a separate attachment. 10. If Applicable, has construction begun on the project? Yes No If no, anticipated start date: 11. Will any of the funds to be borrowed through the issuing political subdivision or agency be used to repay or refinance an existing mortgage or outstanding loan? Yes No If yes, please furnish details in a separate attachment.

8 PROJECT COSTS 14. State costs reasonably necessary for the completion of the proposed project including any utilities, access roads, or appurtenant facilities, using the following categories: Description of Cost Land acquisition Building acquisition Building construction/ Renovations Total Project Amount $ $ $ Equipment, machinery $ Engineering & architectural fees $ Legal fees $ Financing charges $ Other (specify) $ Fee to issuing political subdivision or agency $ Total project cost Equity contribution, if any Subsidized financing, if any (city/state/federal) Bond financing requested: Construction financing Permanent financing $ $ $ $ $ Maturity Years Anticipated Bond Rate Term Tax credit project Yes No If yes, name of tax credit purchaser:

9 THE PROJECT 1. Description of proposed facility: a. List location and description of proposed facility (street address, municipality size, number of stories and building materials). Provide descriptive material and site location information as an attachment. b. Anticipated starting date of construction/acquisition: 2. What is the nature of the business to be conducted at this location? 3. Will the project change the usage of other locations operated by the company?

10 APPLICANT CERTIFICATION I HEREBY CERTIFY that I have the authority to apply for financial assistance on behalf of the entity described herein, and that the information contained herein and attached hereto is true, complete and correct to the best of my knowledge. I understand that this information may be made available for public review as well as the County s notice of approval or denial of financing related to this application, including an explanation of its reasons. I understand that any willful misrepresentation on this application or any of the attachments thereto could result in a fine and/or imprisonment under provisions of the United States Criminal Code. IN WITNESS WHEREOF, the undersigned, being duly authorized so to do, have signed this application. CORPORATION/PARTNERSHIP: Name (Please type or print) Date By: President/CEO/ General Partner Date Attest: Secretary Date INDIVIDUAL: Business Name Witness Date

11 Please attach the following information or address the following questions: A. What is the facility's current policy on providing services to the Medicaid, Medicare, and indigent populations? Please provide copies of these policies and include any sliding fee scale in use. B. For the two year period preceding this request, please provide the following information for each facility to benefit from the bonds. 1. Identify costs (not charges) incurred and payments received for the categories listed below: a. Medicaid b. Medicare c. indigent or charitable care. Please distinguish indigent care costs from bad debt. d. HUD /Section 8 2. List facility operating costs for each facility included in the proposed issuance. 3. Identify amounts paid to and received from the Hospital Care Assurance Program or other funding source(s), such as United Way Services, which are used to support charitable care. C. State the public purpose that will be served through the issuance of these bonds. D. For the two years preceding this request, note any violations of Internal Revenue Service Audit Guidelines for Hospitals, Manual Transmittal 7(10)69-38, Section Information must be provided for each facility to benefit from the bonds. Note: Other health care facilities should identify violations of IRS audit guidelines specific to their organizations. E. Please note whether any of the items to be financed are reviewable through the Certificate of Need process. F. Please attach a listing of the projects to be financed through bond proceeds (project description) If applicable, describe whether the project consists of new construction or acquisition/additions and/or renovations to existing building(s) or describe any expansion and/or renovation work, include the number of beds available after construction/renovation. G. Describe how the transaction will be structured (what denominations the bonds will be issued in) and state the preferred date you would like to have the public hearing. Please note that final approval of dates to appear on the Commissioners' agenda rests with the Clerk of the Board's office.

12 H. Please attach a listing of sites within the community at which health care services are provided. Service sites should be listed in connection with the administering health facility and should briefly detail the type of services provided at each site. Special care should be taken to identify places that offer primary care/preventive/well adult or well child care. I. Provide a listing of the Officers and Board members for each facility that will benefit from the issuance. 1. Provide the name of any related organization(s) (more than 20% common ownership or control) and describe the relationship with the proposed project owner and/or applicant whether it is as a subsidiary, or direct or indirect affiliation(s). 2. List all owners, managing members, and partners of applicant. 3. List all stockholders/members having 20% or more interest in applicant. If the applicant is a publicly held corporation, please provide the latest proxy statement indicating stock ownership. J. State the estimated amount of the proposed issuance distinguishing new issuance from refunding. K. What impact will the proposed issuance have on the community? (i.e., downsizing, new jobs) If any existing jobs will be lost, please explain. L. Provide the names, telephone numbers, and addresses of bond counsel and a contact for each of the facilities that would benefit from the proposed issuance. M. Identify the location in the lease in which the community benefits statement will be placed. If a new application, a template will be furnished. N. A copy of the letter of support from the highest ranking elected official in the project s jurisdiction. O. A copy of the letter (M) sent to the Cuyahoga County Board of Commissioners or County Council, 1219 Ontario Street, Cleveland, Ohio 44113, Attention: Board President or Council President, cc: Sabrina Roberts, requesting to be heard before the BOCC or County Council and providing a brief description of the project.

13 P. If 501(c)(3) application, please submit the following additional item: -Copy of Non-profit organization s IRS tax exempt determination letter. Q. Detailed project operating cost items, depreciation and projected debt service. R. Submit a signed Workforce Cooperation Agreement For assistance in completing the required Workforce Cooperation Agreement, please contact: Anthony M. Schweppe Business Services Manager Employment Connection 1020 Bolivar Road Cleveland, OH (216) (216) FAX aschweppe@cuyahogacounty.us S. Submit a signed copy of the Cuyahoga Access to a Medical Home Initiative Memorandum of Understanding (MOU). T. Describe the environmental impact that is anticipated as a result of the proposed project? (air, water, noise, etc.) Please forward all checks and information to: Sabrina Roberts Administrator of Health Policy and Programs Office of Health and Human Services 310 W. Lakeside Avenue, Suite 500 Cleveland, Ohio Phone: Fax: sroberts@cuyahogacounty.us

14 The Cuyahoga Access to a Medical Home Initiative PARTNERS' MEMORANDUM OF UNDERSTANDING WHEREAS, the Cuyahoga Access to a Medical Home (CAMH) Initiative advances the vision of a health system which promotes 100% access and 0% health disparities; and WHEREAS, recognizes the significant health resources available in Cuyahoga County committed to providing care to all persons despite ability to pay; and WHEREAS, desires to coordinate these resources to better serve all persons despite ability to pay, and WHEREAS, the Cuyahoga Access to a Medical Home Initiative provides the vehicle through which public and private resources can be coordinated to ensure maximum efficiency of community resources, NOW, THEREFORE, agrees to fully participate in the development of the Cuyahoga Access to a Medical Home Initiative, a community-wide strategy that: 1. Provides a medical home to participants 2. Encourages and promotes timely and appropriate use of medical homes for primary and wellness care 3. Honors primary care providers referrals for diagnostic and specialty care and prescriptions 4. Designs and implements a primary care registry and information system that: Links participants with available services Registers participants and tracks them from point of entry through the system Records how and where care is delivered Produces health outcome measures IN WITNESS WHEREOF, has entered the Agreement as of the date set forth. (YOUR ORGANIZATION S NAME) By: Title: Date: