CODING: Words stricken are deletions; words underlined are additions.





                                                  SENATE AMENDMENT

    Bill No. CS for SB 1078

    Amendment No.    

                            CHAMBER ACTION
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11  Senators Lee, Grant, Hargrett and Sebesta moved the following

12  amendment:

13

14         Senate Amendment (with title amendment) 

15         On page 9, between lines 13 and 14,

16

17  insert:

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) or subsection (6), may levy, pursuant to an

24  ordinance either approved by an extraordinary vote of the

25  governing body or conditioned to take effect only upon

26  approval by a majority vote of the electors of the county

27  voting in a referendum, a discretionary sales surtax at a rate

28  that may not exceed 0.5 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

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 1078

    Amendment No.    





 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:

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 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

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 1078

    Amendment No.    





 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

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 1078

    Amendment No.    





 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; and

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

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 1078

    Amendment No.    





 1  that it is allowed through the General Appropriations Act.

 2         (f)  Notwithstanding any other provision of this

 3  section, a county shall not levy local option sales surtaxes

 4  authorized in this subsection and subsections (2) and (3) in

 5  excess of a combined rate of 1 percent.

 6         (g)  This subsection expires October 1, 2005.

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 8

 9  ================ T I T L E   A M E N D M E N T ===============

10  And the title is amended as follows:

11         On page 1, lines 2-21, delete those lines

12

13  and insert:

14         An act relating to local option taxes; amending

15         s. 125.901, F.S.; authorizing the appointment

16         of an alternate delegate member for a county

17         governing body to a council on children's

18         services; amending ss. 125.0104, 212.0305,

19         F.S.; providing that a county that elects to

20         assume responsibility for audit and enforcement

21         with respect to the local option tourist

22         development tax, area of critical state concern

23         tourist impact tax, or convention development

24         taxes may use certified public accountants in

25         administering its duties; providing for

26         application of confidentiality and penalty

27         provisions to such agents; amending s. 213.053,

28         F.S.; providing for information sharing;

29         amending s. 212.055, F.S.; providing a

30         distribution of proceeds from the Local

31         Government Infrastructure Surtax to be used

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 1078

    Amendment No.    





 1         solely for county detention facilities under

 2         certain circumstances; providing definitions;

 3         expanding the authorized use of the indigent

 4         care surtax to include trauma centers; renaming

 5         the surtax; requiring the plan set out in the

 6         ordinance to include additional provisions

 7         concerning Level I trauma centers; providing

 8         requirements for annual disbursements to

 9         hospitals on October 1 to be in recognition of

10         the Level I trauma center status and to be in

11         addition to a base contract amount, plus any

12         negotiated additions to indigent care funding;

13         authorizing funds received to be used to

14         generate federal matching funds under certain

15         conditions and authorizing payment by the clerk

16         of the court;

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