SENATE AMENDMENT
    Bill No. CS for CS for SB 546, 1st Eng.
    Amendment No. ___   Barcode 612010
                            CHAMBER ACTION
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11  Senator Bennett moved the following amendment:
12  
13         Senate Amendment (with title amendment) 
14         On page 7, between lines 4 and 5,
15  
16  insert:  
17         Section 3.  Section 212.055, Florida Statutes, as
18  amended by section 91 of chapter 2003-402, Laws of Florida, is
19  amended to read:
20         212.055  Discretionary sales surtaxes; legislative
21  intent; authorization and use of proceeds.--It is the
22  legislative intent that any authorization for imposition of a
23  discretionary sales surtax shall be published in the Florida
24  Statutes as a subsection of this section, irrespective of the
25  duration of the levy. Each enactment shall specify the types
26  of counties authorized to levy; the rate or rates which may be
27  imposed; the maximum length of time the surtax may be imposed,
28  if any; the procedure which must be followed to secure voter
29  approval, if required; the purpose for which the proceeds may
30  be expended; and such other requirements as the Legislature
31  may provide. Taxable transactions and administrative
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SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 procedures shall be as provided in s. 212.054. 2 (1) CHARTER COUNTY TRANSIT SYSTEM SURTAX.-- 3 (a) Each charter county which adopted a charter prior 4 to January 1, 1984, and each county the government of which is 5 consolidated with that of one or more municipalities, may levy 6 a discretionary sales surtax, subject to approval by a 7 majority vote of the electorate of the county or by a charter 8 amendment approved by a majority vote of the electorate of the 9 county. 10 (b) The rate shall be up to 1 percent. 11 (c) The proposal to adopt a discretionary sales surtax 12 as provided in this subsection and to create a trust fund 13 within the county accounts shall be placed on the ballot in 14 accordance with law at a time to be set at the discretion of 15 the governing body. 16 (d) Proceeds from the surtax shall be applied to as 17 many or as few of the uses enumerated below in whatever 18 combination the county commission deems appropriate: 19 1. Deposited by the county in the trust fund and shall 20 be used for the purposes of development, construction, 21 equipment, maintenance, operation, supportive services, 22 including a countywide bus system, and related costs of a 23 fixed guideway rapid transit system; 24 2. Remitted by the governing body of the county to an 25 expressway or transportation authority created by law to be 26 used, at the discretion of such authority, for the 27 development, construction, operation, or maintenance of roads 28 or bridges in the county, for the operation and maintenance of 29 a bus system, for the payment of principal and interest on 30 existing bonds issued for the construction of such roads or 31 bridges, and, upon approval by the county commission, such 2 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 proceeds may be pledged for bonds issued to refinance existing 2 bonds or new bonds issued for the construction of such roads 3 or bridges; 4 3. For each county, as defined in s. 125.011(1), used 5 for the development, construction, operation, and maintenance 6 of roads and bridges in the county; for the expansion, 7 operation, and maintenance of bus and fixed guideway systems; 8 and for the payment of principal and interest on bonds issued 9 for the construction of fixed guideway rapid transit systems, 10 bus systems, roads, or bridges; and such proceeds may be 11 pledged by the governing body of the county for bonds issued 12 to refinance existing bonds or new bonds issued for the 13 construction of such fixed guideway rapid transit systems, bus 14 systems, roads, or bridges and no more than 25 percent used 15 for nontransit uses; and 16 4. Used by the charter county for the planning, 17 development, construction, operation, and maintenance of roads 18 and bridges in the county; for the planning, development, 19 expansion, operation, and maintenance of bus and fixed 20 guideway systems; and for the payment of principal and 21 interest on bonds issued for the construction of fixed 22 guideway rapid transit systems, bus systems, roads, or 23 bridges; and such proceeds may be pledged by the governing 24 body of the county for bonds issued to refinance existing 25 bonds or new bonds issued for the construction of such fixed 26 guideway rapid transit systems, bus systems, roads, or 27 bridges. Pursuant to an interlocal agreement entered into 28 pursuant to chapter 163, the governing body of the charter 29 county may distribute proceeds from the tax to a municipality, 30 or an expressway or transportation authority created by law to 31 be expended for the purpose authorized by this paragraph. 3 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 (2) LOCAL GOVERNMENT INFRASTRUCTURE SURTAX.-- 2 (a)1. The governing authority in each county may levy 3 a discretionary sales surtax of 0.5 percent or 1 percent. The 4 levy of the surtax shall be pursuant to ordinance enacted by a 5 majority of the members of the county governing authority and 6 approved by a majority of the electors of the county voting in 7 a referendum on the surtax. If the governing bodies of the 8 municipalities representing a majority of the county's 9 population adopt uniform resolutions establishing the rate of 10 the surtax and calling for a referendum on the surtax, the 11 levy of the surtax shall be placed on the ballot and shall 12 take effect if approved by a majority of the electors of the 13 county voting in the referendum on the surtax. 14 2. If the surtax was levied pursuant to a referendum 15 held before July 1, 1993, the surtax may not be levied beyond 16 the time established in the ordinance, or, if the ordinance 17 did not limit the period of the levy, the surtax may not be 18 levied for more than 15 years. The levy of such surtax may be 19 extended only by approval of a majority of the electors of the 20 county voting in a referendum on the surtax. 21 (b) A statement which includes a brief general 22 description of the projects to be funded by the surtax and 23 which conforms to the requirements of s. 101.161 shall be 24 placed on the ballot by the governing authority of any county 25 which enacts an ordinance calling for a referendum on the levy 26 of the surtax or in which the governing bodies of the 27 municipalities representing a majority of the county's 28 population adopt uniform resolutions calling for a referendum 29 on the surtax. The following question shall be placed on the 30 ballot: 31 4 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 ....FOR the ....-cent sales tax 2 ....AGAINST the ....-cent sales tax 3 4 (c) Pursuant to s. 212.054(4), the proceeds of the 5 surtax levied under this subsection shall be distributed to 6 the county and the municipalities within such county in which 7 the surtax was collected, according to: 8 1. An interlocal agreement between the county 9 governing authority and the governing bodies of the 10 municipalities representing a majority of the county's 11 municipal population, which agreement may include a school 12 district with the consent of the county governing authority 13 and the governing bodies of the municipalities representing a 14 majority of the county's municipal population; or 15 2. If there is no interlocal agreement, according to 16 the formula provided in s. 218.62. 17 18 Any change in the distribution formula must take effect on the 19 first day of any month that begins at least 60 days after 20 written notification of that change has been made to the 21 department. 22 (d)1. The proceeds of the surtax authorized by this 23 subsection and any interest accrued thereto shall be expended 24 by the school district or within the county and municipalities 25 within the county, or, in the case of a negotiated joint 26 county agreement, within another county, to finance, plan, and 27 construct infrastructure and to acquire land for public 28 recreation or conservation or protection of natural resources 29 and to finance the closure of county-owned or municipally 30 owned solid waste landfills that are already closed or are 31 required to close by order of the Department of Environmental 5 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 Protection. Any use of such proceeds or interest for purposes 2 of landfill closure prior to July 1, 1993, is ratified. 3 Neither the proceeds nor any interest accrued thereto shall be 4 used for operational expenses of any infrastructure, except 5 that any county with a population of less than 75,000 that is 6 required to close a landfill by order of the Department of 7 Environmental Protection may use the proceeds or any interest 8 accrued thereto for long-term maintenance costs associated 9 with landfill closure. Counties, as defined in s. 125.011(1), 10 and charter counties may, in addition, use the proceeds and 11 any interest accrued thereto to retire or service indebtedness 12 incurred for bonds issued prior to July 1, 1987, for 13 infrastructure purposes, and for bonds subsequently issued to 14 refund such bonds. Any use of such proceeds or interest for 15 purposes of retiring or servicing indebtedness incurred for 16 such refunding bonds prior to July 1, 1999, is ratified. 17 2. For the purposes of this paragraph, 18 "infrastructure" means: 19 a. Any fixed capital expenditure or fixed capital 20 outlay associated with the construction, reconstruction, or 21 improvement of public facilities which have a life expectancy 22 of 5 or more years and any land acquisition, land improvement, 23 design, and engineering costs related thereto. 24 b. A fire department vehicle, an emergency medical 25 service vehicle, a sheriff's office vehicle, a police 26 department vehicle, or any other vehicle, and such equipment 27 necessary to outfit the vehicle for its official use or 28 equipment that has a life expectancy of at least 5 years. 29 c. Any expenditure for the construction, lease, or 30 maintenance of, or provision of utilities or security for, 31 facilities as defined in s. 29.008. 6 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 3. Notwithstanding any other provision of this 2 subsection, a discretionary sales surtax imposed or extended 3 after the effective date of this act may provide for an amount 4 not to exceed 15 percent of the local option sales surtax 5 proceeds to be allocated for deposit to a trust fund within 6 the county's accounts created for the purpose of funding 7 economic development projects of a general public purpose 8 targeted to improve local economies, including the funding of 9 operational costs and incentives related to such economic 10 development. The ballot statement must indicate the intention 11 to make an allocation under the authority of this 12 subparagraph. 13 (e) School districts, counties, and municipalities 14 receiving proceeds under the provisions of this subsection may 15 pledge such proceeds for the purpose of servicing new bond 16 indebtedness incurred pursuant to law. Local governments may 17 use the services of the Division of Bond Finance of the State 18 Board of Administration pursuant to the State Bond Act to 19 issue any bonds through the provisions of this subsection. In 20 no case may a jurisdiction issue bonds pursuant to this 21 subsection more frequently than once per year. Counties and 22 municipalities may join together for the issuance of bonds 23 authorized by this subsection. 24 (f)1. Notwithstanding paragraph (d), a county that has 25 a population of 50,000 or less on April 1, 1992, or any county 26 designated as an area of critical state concern on the 27 effective date of this act, and that imposed the surtax before 28 July 1, 1992, may use the proceeds and interest of the surtax 29 for any public purpose if: 30 a. The debt service obligations for any year are met; 31 b. The county's comprehensive plan has been determined 7 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 to be in compliance with part II of chapter 163; and 2 c. The county has adopted an amendment to the surtax 3 ordinance pursuant to the procedure provided in s. 125.66 4 authorizing additional uses of the surtax proceeds and 5 interest. 6 2. A municipality located within a county that has a 7 population of 50,000 or less on April 1, 1992, or within a 8 county designated as an area of critical state concern on the 9 effective date of this act, and that imposed the surtax before 10 July 1, 1992, may not use the proceeds and interest of the 11 surtax for any purpose other than an infrastructure purpose 12 authorized in paragraph (d) unless the municipality's 13 comprehensive plan has been determined to be in compliance 14 with part II of chapter 163 and the municipality has adopted 15 an amendment to its surtax ordinance or resolution pursuant to 16 the procedure provided in s. 166.041 authorizing additional 17 uses of the surtax proceeds and interest. Such municipality 18 may expend the surtax proceeds and interest for any public 19 purpose authorized in the amendment. 20 3. Those counties designated as an area of critical 21 state concern which qualify to use the surtax for any public 22 purpose may use only up to 10 percent of the surtax proceeds 23 for any public purpose other than for infrastructure purposes 24 authorized by this section. 25 (g) Notwithstanding paragraph (d), a county in which 26 40 percent or more of the just value of real property is 27 exempt or immune from ad valorem taxation, and the 28 municipalities within such a county, may use the proceeds and 29 interest of the surtax for operation and maintenance of parks 30 and recreation programs and facilities established with the 31 proceeds of the surtax. 8 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 (h) Notwithstanding any other provision of this 2 section, a county shall not levy local option sales surtaxes 3 authorized in this subsection and subsections (3), (4), and 4 (5) in excess of a combined rate of 1 percent. 5 (3) SMALL COUNTY SURTAX.-- 6 (a) The governing authority in each county that has a 7 population of 50,000 or less on April 1, 1992, may levy a 8 discretionary sales surtax of 0.5 percent or 1 percent. The 9 levy of the surtax shall be pursuant to ordinance enacted by 10 an extraordinary vote of the members of the county governing 11 authority if the surtax revenues are expended for operating 12 purposes. If the surtax revenues are expended for the purpose 13 of servicing bond indebtedness, the surtax shall be approved 14 by a majority of the electors of the county voting in a 15 referendum on the surtax. 16 (b) A statement that includes a brief general 17 description of the projects to be funded by the surtax and 18 conforms to the requirements of s. 101.161 shall be placed on 19 the ballot by the governing authority of any county that 20 enacts an ordinance calling for a referendum on the levy of 21 the surtax for the purpose of servicing bond indebtedness. 22 The following question shall be placed on the ballot: 23 24 ....FOR the ....-cent sales tax 25 ....AGAINST the ....-cent sales tax 26 27 (c) Pursuant to s. 212.054(4), the proceeds of the 28 surtax levied under this subsection shall be distributed to 29 the county and the municipalities within the county in which 30 the surtax was collected, according to: 31 1. An interlocal agreement between the county 9 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 governing authority and the governing bodies of the 2 municipalities representing a majority of the county's 3 municipal population, which agreement may include a school 4 district with the consent of the county governing authority 5 and the governing bodies of the municipalities representing a 6 majority of the county's municipal population; or 7 2. If there is no interlocal agreement, according to 8 the formula provided in s. 218.62. 9 10 Any change in the distribution formula shall take effect on 11 the first day of any month that begins at least 60 days after 12 written notification of that change has been made to the 13 department. 14 (d)1. If the surtax is levied pursuant to a 15 referendum, the proceeds of the surtax and any interest 16 accrued thereto may be expended by the school district or 17 within the county and municipalities within the county, or, in 18 the case of a negotiated joint county agreement, within 19 another county, for the purpose of servicing bond indebtedness 20 to finance, plan, and construct infrastructure and to acquire 21 land for public recreation or conservation or protection of 22 natural resources. However, if the surtax is levied pursuant 23 to an ordinance approved by an extraordinary vote of the 24 members of the county governing authority, the proceeds and 25 any interest accrued thereto may be used for operational 26 expenses of any infrastructure or for any public purpose 27 authorized in the ordinance under which the surtax is levied. 28 2. For the purposes of this paragraph, 29 "infrastructure" means any fixed capital expenditure or fixed 30 capital costs associated with the construction, 31 reconstruction, or improvement of public facilities that have 10 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 a life expectancy of 5 or more years and any land acquisition, 2 land improvement, design, and engineering costs related 3 thereto. 4 (e) A school district, county, or municipality that 5 receives proceeds under this subsection following a referendum 6 may pledge the proceeds for the purpose of servicing new bond 7 indebtedness incurred pursuant to law. Local governments may 8 use the services of the Division of Bond Finance pursuant to 9 the State Bond Act to issue any bonds through the provisions 10 of this subsection. A jurisdiction may not issue bonds 11 pursuant to this subsection more frequently than once per 12 year. A county and municipality may join together to issue 13 bonds authorized by this subsection. 14 (f) Notwithstanding any other provision of this 15 section, a county shall not levy local option sales surtaxes 16 authorized in this subsection and subsections (2), (4), and 17 (5) in excess of a combined rate of 1 percent. 18 (4) INDIGENT CARE AND TRAUMA CENTER SURTAX.-- 19 (a) The governing body in each county the government 20 of which is not consolidated with that of one or more 21 municipalities, which has a population of at least 800,000 22 residents and is not authorized to levy a surtax under 23 subsection (5), may levy, pursuant to an ordinance either 24 approved by an extraordinary vote of the governing body or 25 conditioned to take effect only upon approval by a majority 26 vote of the electors of the county voting in a referendum, a 27 discretionary sales surtax at a rate that may not exceed 0.5 28 percent. 29 (b) If the ordinance is conditioned on a referendum, a 30 statement that includes a brief and general description of the 31 purposes to be funded by the surtax and that conforms to the 11 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 requirements of s. 101.161 shall be placed on the ballot by 2 the governing body of the county. The following questions 3 shall be placed on the ballot: 4 5 FOR THE. . . .CENTS TAX 6 AGAINST THE. . . .CENTS TAX 7 8 (c) The ordinance adopted by the governing body 9 providing for the imposition of the surtax shall set forth a 10 plan for providing health care services to qualified 11 residents, as defined in paragraph (d). Such plan and 12 subsequent amendments to it shall fund a broad range of health 13 care services for both indigent persons and the medically 14 poor, including, but not limited to, primary care and 15 preventive care as well as hospital care. The plan must also 16 address the services to be provided by the Level I trauma 17 center. It shall emphasize a continuity of care in the most 18 cost-effective setting, taking into consideration both a high 19 quality of care and geographic access. Where consistent with 20 these objectives, it shall include, without limitation, 21 services rendered by physicians, clinics, community hospitals, 22 mental health centers, and alternative delivery sites, as well 23 as at least one regional referral hospital where appropriate. 24 It shall provide that agreements negotiated between the county 25 and providers, including hospitals with a Level I trauma 26 center, will include reimbursement methodologies that take 27 into account the cost of services rendered to eligible 28 patients, recognize hospitals that render a disproportionate 29 share of indigent care, provide other incentives to promote 30 the delivery of charity care, promote the advancement of 31 technology in medical services, recognize the level of 12 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 responsiveness to medical needs in trauma cases, and require 2 cost containment including, but not limited to, case 3 management. It must also provide that any hospitals that are 4 owned and operated by government entities on May 21, 1991, 5 must, as a condition of receiving funds under this subsection, 6 afford public access equal to that provided under s. 286.011 7 as to meetings of the governing board, the subject of which is 8 budgeting resources for the rendition of charity care as that 9 term is defined in the Florida Hospital Uniform Reporting 10 System (FHURS) manual referenced in s. 408.07. The plan shall 11 also include innovative health care programs that provide 12 cost-effective alternatives to traditional methods of service 13 delivery and funding. 14 (d) For the purpose of this subsection, the term 15 "qualified resident" means residents of the authorizing county 16 who are: 17 1. Qualified as indigent persons as certified by the 18 authorizing county; 19 2. Certified by the authorizing county as meeting the 20 definition of the medically poor, defined as persons having 21 insufficient income, resources, and assets to provide the 22 needed medical care without using resources required to meet 23 basic needs for shelter, food, clothing, and personal 24 expenses; or not being eligible for any other state or federal 25 program, or having medical needs that are not covered by any 26 such program; or having insufficient third-party insurance 27 coverage. In all cases, the authorizing county is intended to 28 serve as the payor of last resort; or 29 3. Participating in innovative, cost-effective 30 programs approved by the authorizing county. 31 (e) Moneys collected pursuant to this subsection 13 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 remain the property of the state and shall be distributed by 2 the Department of Revenue on a regular and periodic basis to 3 the clerk of the circuit court as ex officio custodian of the 4 funds of the authorizing county. The clerk of the circuit 5 court shall: 6 1. Maintain the moneys in an indigent health care 7 trust fund; 8 2. Invest any funds held on deposit in the trust fund 9 pursuant to general law; 10 3. Disburse the funds, including any interest earned, 11 to any provider of health care services, as provided in 12 paragraphs (c) and (d), upon directive from the authorizing 13 county. However, if a county has a population of at least 14 800,000 residents and has levied the surtax authorized in this 15 subsection, notwithstanding any directive from the authorizing 16 county, on October 1 of each calendar year, the clerk of the 17 court shall issue a check in the amount of $6.5 million to a 18 hospital in its jurisdiction that has a Level I trauma center 19 or shall issue a check in the amount of $3.5 million to a 20 hospital in its jurisdiction that has a Level I trauma center 21 if that county enacts and implements a hospital lien law in 22 accordance with chapter 98-499, Laws of Florida. The issuance 23 of the checks on October 1 of each year is provided in 24 recognition of the Level I trauma center status and shall be 25 in addition to the base contract amount received during fiscal 26 year 1999-2000 and any additional amount negotiated to the 27 base contract. If the hospital receiving funds for its Level I 28 trauma center status requests such funds to be used to 29 generate federal matching funds under Medicaid, the clerk of 30 the court shall instead issue a check to the Agency for Health 31 Care Administration to accomplish that purpose to the extent 14 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 that it is allowed through the General Appropriations Act; and 2 4. Prepare on a biennial basis an audit of the trust 3 fund specified in subparagraph 1. Commencing February 1, 2004, 4 such audit shall be delivered to the governing body and to the 5 chair of the legislative delegation of each authorizing 6 county. 7 (f) Notwithstanding any other provision of this 8 section, a county shall not levy local option sales surtaxes 9 authorized in this subsection and subsections (2) and (3) in 10 excess of a combined rate of 1 percent. 11 (5) COUNTY PUBLIC HOSPITAL SURTAX.--Any county as 12 defined in s. 125.011(1) may levy the surtax authorized in 13 this subsection pursuant to an ordinance either approved by 14 extraordinary vote of the county commission or conditioned to 15 take effect only upon approval by a majority vote of the 16 electors of the county voting in a referendum. In a county as 17 defined in s. 125.011(1), for the purposes of this subsection, 18 "county public general hospital" means a general hospital as 19 defined in s. 395.002 which is owned, operated, maintained, or 20 governed by the county or its agency, authority, or public 21 health trust. 22 (a) The rate shall be 0.5 percent. 23 (b) If the ordinance is conditioned on a referendum, 24 the proposal to adopt the county public hospital surtax shall 25 be placed on the ballot in accordance with law at a time to be 26 set at the discretion of the governing body. The referendum 27 question on the ballot shall include a brief general 28 description of the health care services to be funded by the 29 surtax. 30 (c) Proceeds from the surtax shall be: 31 1. Deposited by the county in a special fund, set 15 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 aside from other county funds, to be used only for the 2 operation, maintenance, and administration of the county 3 public general hospital; and 4 2. Remitted promptly by the county to the agency, 5 authority, or public health trust created by law which 6 administers or operates the county public general hospital. 7 (d) Except as provided in subparagraphs 1. and 2., the 8 county must continue to contribute each year an amount equal 9 to at least 80 percent of that percentage of the total county 10 budget appropriated for the operation, administration, and 11 maintenance of the county public general hospital from the 12 county's general revenues in the fiscal year of the county 13 ending September 30, 1991: 14 1. Twenty-five percent of such amount must be remitted 15 to a governing board, agency, or authority that is wholly 16 independent from the public health trust, agency, or authority 17 responsible for the county public general hospital, to be used 18 solely for the purpose of funding the plan for indigent health 19 care services provided for in paragraph (e); 20 2. However, in the first year of the plan, a total of 21 $10 million shall be remitted to such governing board, agency, 22 or authority, to be used solely for the purpose of funding the 23 plan for indigent health care services provided for in 24 paragraph (e), and in the second year of the plan, a total of 25 $15 million shall be so remitted and used. 26 (e) A governing board, agency, or authority shall be 27 chartered by the county commission upon this act becoming law. 28 The governing board, agency, or authority shall adopt and 29 implement a health care plan for indigent health care 30 services. The governing board, agency, or authority shall 31 consist of no more than seven and no fewer than five members 16 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 appointed by the county commission. The members of the 2 governing board, agency, or authority shall be at least 18 3 years of age and residents of the county. No member may be 4 employed by or affiliated with a health care provider or the 5 public health trust, agency, or authority responsible for the 6 county public general hospital. The following community 7 organizations shall each appoint a representative to a 8 nominating committee: the South Florida Hospital and 9 Healthcare Association, the Miami-Dade County Public Health 10 Trust, the Dade County Medical Association, the Miami-Dade 11 County Homeless Trust, and the Mayor of Miami-Dade County. 12 This committee shall nominate between 10 and 14 county 13 citizens for the governing board, agency, or authority. The 14 slate shall be presented to the county commission and the 15 county commission shall confirm the top five to seven 16 nominees, depending on the size of the governing board. Until 17 such time as the governing board, agency, or authority is 18 created, the funds provided for in subparagraph (d)2. shall be 19 placed in a restricted account set aside from other county 20 funds and not disbursed by the county for any other purpose. 21 1. The plan shall divide the county into a minimum of 22 four and maximum of six service areas, with no more than one 23 participant hospital per service area. The county public 24 general hospital shall be designated as the provider for one 25 of the service areas. Services shall be provided through 26 participants' primary acute care facilities. 27 2. The plan and subsequent amendments to it shall fund 28 a defined range of health care services for both indigent 29 persons and the medically poor, including primary care, 30 preventive care, hospital emergency room care, and hospital 31 care necessary to stabilize the patient. For the purposes of 17 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 this section, "stabilization" means stabilization as defined 2 in s. 397.311(29). Where consistent with these objectives, the 3 plan may include services rendered by physicians, clinics, 4 community hospitals, and alternative delivery sites, as well 5 as at least one regional referral hospital per service area. 6 The plan shall provide that agreements negotiated between the 7 governing board, agency, or authority and providers shall 8 recognize hospitals that render a disproportionate share of 9 indigent care, provide other incentives to promote the 10 delivery of charity care to draw down federal funds where 11 appropriate, and require cost containment, including, but not 12 limited to, case management. From the funds specified in 13 subparagraphs (d)1. and 2. for indigent health care services, 14 service providers shall receive reimbursement at a Medicaid 15 rate to be determined by the governing board, agency, or 16 authority created pursuant to this paragraph for the initial 17 emergency room visit, and a per-member per-month fee or 18 capitation for those members enrolled in their service area, 19 as compensation for the services rendered following the 20 initial emergency visit. Except for provisions of emergency 21 services, upon determination of eligibility, enrollment shall 22 be deemed to have occurred at the time services were rendered. 23 The provisions for specific reimbursement of emergency 24 services shall be repealed on July 1, 2001, unless otherwise 25 reenacted by the Legislature. The capitation amount or rate 26 shall be determined prior to program implementation by an 27 independent actuarial consultant. In no event shall such 28 reimbursement rates exceed the Medicaid rate. The plan must 29 also provide that any hospitals owned and operated by 30 government entities on or after the effective date of this act 31 must, as a condition of receiving funds under this subsection, 18 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 afford public access equal to that provided under s. 286.011 2 as to any meeting of the governing board, agency, or authority 3 the subject of which is budgeting resources for the retention 4 of charity care, as that term is defined in the rules of the 5 Agency for Health Care Administration. The plan shall also 6 include innovative health care programs that provide 7 cost-effective alternatives to traditional methods of service 8 and delivery funding. 9 3. The plan's benefits shall be made available to all 10 county residents currently eligible to receive health care 11 services as indigents or medically poor as defined in 12 paragraph (4)(d). 13 4. Eligible residents who participate in the health 14 care plan shall receive coverage for a period of 12 months or 15 the period extending from the time of enrollment to the end of 16 the current fiscal year, per enrollment period, whichever is 17 less. 18 5. At the end of each fiscal year, the governing 19 board, agency, or authority shall prepare an audit that 20 reviews the budget of the plan, delivery of services, and 21 quality of services, and makes recommendations to increase the 22 plan's efficiency. The audit shall take into account 23 participant hospital satisfaction with the plan and assess the 24 amount of poststabilization patient transfers requested, and 25 accepted or denied, by the county public general hospital. 26 (f) Notwithstanding any other provision of this 27 section, a county may not levy local option sales surtaxes 28 authorized in this subsection and subsections (2) and (3) in 29 excess of a combined rate of 1 percent. 30 (6) SCHOOL CAPITAL OUTLAY SURTAX.-- 31 (a)1. The school board in each county may levy, 19 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 pursuant to resolution conditioned to take effect only upon 2 approval by a majority vote of the electors of the county 3 voting in a referendum, a discretionary sales surtax at a rate 4 that may not exceed 0.5 percent. 5 2.(b) The resolution shall include a statement that 6 provides a brief and general description of the school capital 7 outlay projects to be funded by the surtax. If applicable, the 8 resolution must state that the district school board has been 9 recognized by the State Board of Education as having a Florida 10 Frugal Schools Program. The statement shall conform to the 11 requirements of s. 101.161 and shall be placed on the ballot 12 by the governing body of the county. The following question 13 shall be placed on the ballot: 14 15 ....FOR THE ....CENTS TAX 16 ....AGAINST THE ....CENTS TAX 17 18 3.(c) The resolution providing for the imposition of 19 the surtax shall set forth a plan for use of the surtax 20 proceeds for fixed capital expenditures or fixed capital costs 21 associated with the construction, reconstruction, or 22 improvement of school facilities and campuses which have a 23 useful life expectancy of 5 or more years, and any land 24 acquisition, land improvement, design, and engineering costs 25 related thereto. Additionally, the plan shall include the 26 costs of retrofitting and providing for technology 27 implementation, including hardware and software, for the 28 various sites within the school district. Surtax revenues may 29 be used for the purpose of servicing bond indebtedness to 30 finance projects authorized by this subsection, and any 31 interest accrued thereto may be held in trust to finance such 20 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 projects. Neither the proceeds of the surtax nor any interest 2 accrued thereto shall be used for operational expenses. If the 3 district school board has been recognized by the State Board 4 of Education as having a Florida Frugal Schools Program, the 5 district's plan for use of the surtax proceeds must be 6 consistent with this subsection and with uses assured under 7 the Florida Frugal Schools Program. 8 4.(d) Any school board imposing the surtax shall 9 implement a freeze on noncapital local school property taxes, 10 at the millage rate imposed in the year prior to the 11 implementation of the surtax, for a period of at least 3 years 12 from the date of imposition of the surtax. This provision 13 shall not apply to existing debt service or required state 14 taxes. 15 5.(e) Surtax revenues collected by the Department of 16 Revenue pursuant to this subsection shall be distributed to 17 the school board imposing the surtax in accordance with law. 18 (b)1. Notwithstanding the provisions of paragraph (a), 19 the school board in any county may use up to 50 percent of the 20 revenues generated by the surtax for operational purposes 21 solely for salaries and benefits for teachers. However, in 22 addition to the requirements of paragraph (a), the resolution 23 providing for the imposition of the surtax shall specify the 24 percentage of surtax revenues to be used solely for salaries 25 and benefits for teachers as authorized by this paragraph. The 26 plan setting forth the use of surtax proceeds shall include 27 uses solely for salaries and benefits for teachers. The plan 28 shall provide criteria to account for use of proceeds solely 29 for salaries and benefits for teachers and shall provide for 30 an annual report by the school board documenting such use. 31 2. The school board of any county which has levied the 21 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 surtax authorized in this subsection before July 1, 2004, and 2 wishes to use a percentage of surtax revenues solely for 3 salaries and benefits for teachers as provided in this 4 paragraph may do so only pursuant to a new resolution 5 conditioned to take effect only upon approval by a majority 6 vote of the electors of the county voting in a referendum as 7 provided in subparagraph (a)2. However, the amount of surtax 8 revenues authorized for use solely for salaries and benefits 9 for teachers under this subparagraph shall be available only 10 to the extent such revenues are not otherwise dedicated to 11 service bond indebtedness in such counties as provided in 12 paragraph (a), if applicable. 13 3. This paragraph is repealed July 1, 2008. 14 (7) VOTER-APPROVED INDIGENT CARE SURTAX.-- 15 (a) The governing body in each county that has a 16 population of less than 800,000 residents may levy an indigent 17 care surtax pursuant to an ordinance conditioned to take 18 effect only upon approval by a majority vote of the electors 19 of the county voting in a referendum. The surtax may be levied 20 at a rate not to exceed 0.5 percent, except that if a publicly 21 supported medical school is located in the county, the rate 22 shall not exceed 1 percent. 23 (b) A statement that includes a brief and general 24 description of the purposes to be funded by the surtax and 25 that conforms to the requirements of s. 101.161 shall be 26 placed on the ballot by the governing body of the county. The 27 following questions shall be placed on the ballot: 28 29 FOR THE. . . .CENTS TAX 30 AGAINST THE. . . .CENTS TAX 31 22 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 (c) The ordinance adopted by the governing body 2 providing for the imposition of the surtax must set forth a 3 plan for providing health care services to qualified 4 residents, as defined in paragraph (d). The plan and 5 subsequent amendments to it shall fund a broad range of health 6 care services for indigent persons and the medically poor, 7 including, but not limited to, primary care and preventive 8 care, as well as hospital care. It shall emphasize a 9 continuity of care in the most cost-effective setting, taking 10 into consideration a high quality of care and geographic 11 access. Where consistent with these objectives, it shall 12 include, without limitation, services rendered by physicians, 13 clinics, community hospitals, mental health centers, and 14 alternative delivery sites, as well as at least one regional 15 referral hospital where appropriate. It shall provide that 16 agreements negotiated between the county and providers shall 17 include reimbursement methodologies that take into account the 18 cost of services rendered to eligible patients, recognize 19 hospitals that render a disproportionate share of indigent 20 care, provide other incentives to promote the delivery of 21 charity care, and require cost containment, including, but not 22 limited to, case management. The plan must also include 23 innovative health care programs that provide cost-effective 24 alternatives to traditional methods of service delivery and 25 funding. 26 (d) For the purpose of this subsection, "qualified 27 residents" means residents of the authorizing county who are: 28 1. Qualified as indigent persons as certified by the 29 authorizing county; 30 2. Certified by the authorizing county as meeting the 31 definition of the medically poor, defined as persons having 23 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 insufficient income, resources, and assets to provide the 2 needed medical care without using resources required to meet 3 basic needs for shelter, food, clothing, and personal 4 expenses; not being eligible for any other state or federal 5 program or having medical needs that are not covered by any 6 such program; or having insufficient third-party insurance 7 coverage. In all cases, the authorizing county shall serve as 8 the payor of last resort; or 9 3. Participating in innovative, cost-effective 10 programs approved by the authorizing county. 11 (e) Moneys collected pursuant to this subsection 12 remain the property of the state and shall be distributed by 13 the Department of Revenue on a regular and periodic basis to 14 the clerk of the circuit court as ex officio custodian of the 15 funds of the authorizing county. The clerk of the circuit 16 court shall: 17 1. Maintain the moneys in an indigent health care 18 trust fund. 19 2. Invest any funds held on deposit in the trust fund 20 pursuant to general law. 21 3. Disburse the funds, including any interest earned, 22 to any provider of health care services, as provided in 23 paragraphs (c) and (d), upon directive from the authorizing 24 county. 25 (f) Notwithstanding any other provision of this 26 section, a county may not levy local option sales surtaxes 27 authorized in this subsection and subsections (2) and (3) in 28 excess of a combined rate of 1 percent or, if a publicly 29 supported medical school is located in the county, in excess 30 of a combined rate of 1.5 percent. 31 24 10:51 AM 04/28/04 s0546c2c-21e0b
SENATE AMENDMENT Bill No. CS for CS for SB 546, 1st Eng. Amendment No. ___ Barcode 612010 1 (Redesignate subsequent sections.) 2 3 4 ================ T I T L E A M E N D M E N T =============== 5 And the title is amended as follows: 6 On page 1, line 8, after the semicolon, 7 8 insert: 9 amending s. 212.055, F.S.; authorizing counties 10 to use a portion of surtax revenues for certain 11 operational purposes under certain 12 circumstances; providing requirements and 13 limitations; providing for future repeal; 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 25 10:51 AM 04/28/04 s0546c2c-21e0b