CODING: Words stricken are deletions; words underlined are additions.
SENATE AMENDMENT
Bill No. CS/HB 2339
Amendment No.
CHAMBER ACTION
Senate House
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11 Senators Lee, Hargrett, Grant and Sebesta moved the following
12 amendment:
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14 Senate Amendment (with title amendment)
15 On page 105, between lines 12 and 13,
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17 insert:
18 Section 64. Subsection (4) of section 212.055, Florida
19 Statutes, is 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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Amendment No.
1 procedures shall be as provided in s. 212.054.
2 (4) INDIGENT CARE AND TRAUMA CENTER SURTAX.--
3 (a) The governing body in each county the government
4 of which is not consolidated with that of one or more
5 municipalities, which has a population of at least 800,000
6 residents and is not authorized to levy a surtax under
7 subsection (5) or subsection (6), may levy, pursuant to an
8 ordinance either approved by an extraordinary vote of the
9 governing body or conditioned to take effect only upon
10 approval by a majority vote of the electors of the county
11 voting in a referendum, a discretionary sales surtax at a rate
12 that may not exceed 0.5 percent.
13 (b) If the ordinance is conditioned on a referendum, a
14 statement that includes a brief and general description of the
15 purposes to be funded by the surtax and that conforms to the
16 requirements of s. 101.161 shall be placed on the ballot by
17 the governing body of the county. The following questions
18 shall be placed on the ballot:
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20 FOR THE. . . .CENTS TAX
21 AGAINST THE. . . .CENTS TAX
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23 (c) The ordinance adopted by the governing body
24 providing for the imposition of the surtax shall set forth a
25 plan for providing health care services to qualified
26 residents, as defined in paragraph (d). Such plan and
27 subsequent amendments to it shall fund a broad range of health
28 care services for both indigent persons and the medically
29 poor, including, but not limited to, primary care and
30 preventive care as well as hospital care. The plan must also
31 address the services to be provided by the Level I trauma
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SENATE AMENDMENT
Bill No. CS/HB 2339
Amendment No.
1 center. It shall emphasize a continuity of care in the most
2 cost-effective setting, taking into consideration both a high
3 quality of care and geographic access. Where consistent with
4 these objectives, it shall include, without limitation,
5 services rendered by physicians, clinics, community hospitals,
6 mental health centers, and alternative delivery sites, as well
7 as at least one regional referral hospital where appropriate.
8 It shall provide that agreements negotiated between the county
9 and providers, including hospitals with a Level I trauma
10 center, will include reimbursement methodologies that take
11 into account the cost of services rendered to eligible
12 patients, recognize hospitals that render a disproportionate
13 share of indigent care, provide other incentives to promote
14 the delivery of charity care, promote the advancement of
15 technology in medical services, recognize the level of
16 responsiveness to medical needs in trauma cases, and require
17 cost containment including, but not limited to, case
18 management. It must also provide that any hospitals that are
19 owned and operated by government entities on May 21, 1991,
20 must, as a condition of receiving funds under this subsection,
21 afford public access equal to that provided under s. 286.011
22 as to meetings of the governing board, the subject of which is
23 budgeting resources for the rendition of charity care as that
24 term is defined in the Florida Hospital Uniform Reporting
25 System (FHURS) manual referenced in s. 408.07. The plan shall
26 also include innovative health care programs that provide
27 cost-effective alternatives to traditional methods of service
28 delivery and funding.
29 (d) For the purpose of this subsection, the term
30 "qualified resident" means residents of the authorizing county
31 who are:
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1 1. Qualified as indigent persons as certified by the
2 authorizing county;
3 2. Certified by the authorizing county as meeting the
4 definition of the medically poor, defined as persons having
5 insufficient income, resources, and assets to provide the
6 needed medical care without using resources required to meet
7 basic needs for shelter, food, clothing, and personal
8 expenses; or not being eligible for any other state or federal
9 program, or having medical needs that are not covered by any
10 such program; or having insufficient third-party insurance
11 coverage. In all cases, the authorizing county is intended to
12 serve as the payor of last resort; or
13 3. Participating in innovative, cost-effective
14 programs approved by the authorizing county.
15 (e) Moneys collected pursuant to this subsection
16 remain the property of the state and shall be distributed by
17 the Department of Revenue on a regular and periodic basis to
18 the clerk of the circuit court as ex officio custodian of the
19 funds of the authorizing county. The clerk of the circuit
20 court shall:
21 1. Maintain the moneys in an indigent health care
22 trust fund;
23 2. Invest any funds held on deposit in the trust fund
24 pursuant to general law; and
25 3. Disburse the funds, including any interest earned,
26 to any provider of health care services, as provided in
27 paragraphs (c) and (d), upon directive from the authorizing
28 county. However, if a county has a population of at least
29 800,000 residents and has levied the surtax authorized in this
30 subsection, notwithstanding any directive from the authorizing
31 county, on October 1 of each calendar year, the clerk of the
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1 court shall issue a check in the amount of $6.5 million to a
2 hospital in its jurisdiction that has a Level I trauma center
3 or shall issue a check in the amount of $3.5 million to a
4 hospital in its jurisdiction that has a Level I trauma center
5 if that county enacts and implements a hospital lien law in
6 accordance with chapter 98-499, Laws of Florida. The issuance
7 of the checks on October 1 of each year is provided in
8 recognition of the Level I trauma center status and shall be
9 in addition to the base contract amount received during fiscal
10 year 1999-2000 and any additional amount negotiated to the
11 base contract. If the hospital receiving funds for its Level I
12 trauma center status requests such funds to be used to
13 generate federal matching funds under Medicaid, the clerk of
14 the court shall instead issue a check to the Agency for Health
15 Care Administration to accomplish that purpose to the extent
16 that it is allowed through the General Appropriations Act.
17 (f) Notwithstanding any other provision of this
18 section, a county shall not levy local option sales surtaxes
19 authorized in this subsection and subsections (2) and (3) in
20 excess of a combined rate of 1 percent.
21 (g) This subsection expires October 1, 2005.
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23 (Redesignate subsequent sections.)
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26 ================ T I T L E A M E N D M E N T ===============
27 And the title is amended as follows:
28 On page 9, line 16, after the semicolon,
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30 insert:
31 amending s. 212.055, F.S.; expanding the
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Amendment No.
1 authorized use of the indigent care surtax to
2 include trauma centers; renaming the surtax;
3 requiring the plan set out in the ordinance to
4 include additional provisions concerning Level
5 I trauma centers; providing requirements for
6 annual disbursements to hospitals on October 1
7 to be in recognition of the Level I trauma
8 center status and to be in addition to a base
9 contract amount, plus any negotiated additions
10 to indigent care funding; authorizing funds
11 received to be used to generate federal
12 matching funds under certain conditions and
13 authorizing payment by the clerk of the court;
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