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





                                                  SENATE AMENDMENT

    Bill No. HB 509, 1st Eng.

    Amendment No.    

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11  Senator Mitchell moved the following amendment:

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13         Senate Amendment (with title amendment) 

14         On page 9, between lines 13 and 14,

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16  insert:

17         Section 6.  Subsection (7) is added to section 212.055,

18  Florida Statutes, to read:

19         212.055  Discretionary sales surtaxes; legislative

20  intent; authorization and use of proceeds.--It is the

21  legislative intent that any authorization for imposition of a

22  discretionary sales surtax shall be published in the Florida

23  Statutes as a subsection of this section, irrespective of the

24  duration of the levy.  Each enactment shall specify the types

25  of counties authorized to levy; the rate or rates which may be

26  imposed; the maximum length of time the surtax may be imposed,

27  if any; the procedure which must be followed to secure voter

28  approval, if required; the purpose for which the proceeds may

29  be expended; and such other requirements as the Legislature

30  may provide.  Taxable transactions and administrative

31  procedures shall be as provided in s. 212.054.

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                                                  SENATE AMENDMENT

    Bill No. HB 509, 1st Eng.

    Amendment No.    





 1         (7)  VOTER-APPROVED INDIGENT CARE SURTAX.--

 2         (a)  The governing body in each county that has a

 3  population of less than 800,000 residents may levy an indigent

 4  care surtax pursuant to an ordinance conditioned to take

 5  effect only upon approval by a majority vote of the electors

 6  of the county voting in a referendum. The surtax may be levied

 7  at a rate not to exceed 0.5 percent, except that if a publicly

 8  supported medical school is located in the county, the rate

 9  shall not exceed 1 percent.

10         (b)  A statement that includes a brief and general

11  description of the purposes to be funded by the surtax and

12  that conforms to the requirements of s. 101.161 shall be

13  placed on the ballot by the governing body of the county. The

14  following questions shall be placed on the ballot:

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16                     FOR THE. . . .CENTS TAX

17                   AGAINST THE. . . .CENTS TAX

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19         (c)  The ordinance adopted by the governing body

20  providing for the imposition of the surtax must set forth a

21  plan for providing health care services to qualified

22  residents, as defined in paragraph (d). The plan and

23  subsequent amendments to it shall fund a broad range of health

24  care services for indigent persons and the medically poor,

25  including, but not limited to, primary care and preventive

26  care, as well as hospital care. It shall emphasize a

27  continuity of care in the most cost-effective setting, taking

28  into consideration a high quality of care and geographic

29  access. Where consistent with these objectives, it shall

30  include, without limitation, services rendered by physicians,

31  clinics, community hospitals, mental health centers, and

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                                                  SENATE AMENDMENT

    Bill No. HB 509, 1st Eng.

    Amendment No.    





 1  alternative delivery sites, as well as at least one regional

 2  referral hospital where appropriate. It shall provide that

 3  agreements negotiated between the county and providers shall

 4  include reimbursement methodologies that take into account the

 5  cost of services rendered to eligible patients, recognize

 6  hospitals that render a disproportionate share of indigent

 7  care, provide other incentives to promote the delivery of

 8  charity care, and require cost containment, including, but not

 9  limited to, case management. The plan must also include

10  innovative health care programs that provide cost-effective

11  alternatives to traditional methods of service delivery and

12  funding.

13         (d)  For the purpose of this subsection, "qualified

14  residents" means residents of the authorizing county who are:

15         1.  Qualified as indigent persons as certified by the

16  authorizing county;

17         2.  Certified by the authorizing county as meeting the

18  definition of the medically poor, defined as persons having

19  insufficient income, resources, and assets to provide the

20  needed medical care without using resources required to meet

21  basic needs for shelter, food, clothing, and personal

22  expenses; not being eligible for any other state or federal

23  program or having medical needs that are not covered by any

24  such program; or having insufficient third-party insurance

25  coverage. In all cases, the authorizing county shall serve as

26  the payor of last resort; or

27         3.  Participating in innovative, cost-effective

28  programs approved by the authorizing county.

29         (e)  Moneys collected pursuant to this subsection

30  remain the property of the state and shall be distributed by

31  the Department of Revenue on a regular and periodic basis to

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                                                  SENATE AMENDMENT

    Bill No. HB 509, 1st Eng.

    Amendment No.    





 1  the clerk of the circuit court as ex officio custodian of the

 2  funds of the authorizing county. The clerk of the circuit

 3  court shall:

 4         1.  Maintain the moneys in an indigent health care

 5  trust fund.

 6         2.  Invest any funds held on deposit in the trust fund

 7  pursuant to general law.

 8         3.  Disburse the funds, including any interest earned,

 9  to any provider of health care services, as provided in

10  paragraphs (c) and (d), upon directive from the authorizing

11  county.

12         (f)  Notwithstanding any other provision of this

13  section, a county may not levy local option sales surtaxes

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

15  excess of a combined rate of 1 percent or, if a publicly

16  supported medical school is located in the county, in excess

17  of a combined rate of 1.5 percent.

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19  (Redesignate subsequent sections.)

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

23  And the title is amended as follows:

24         On page 1, line 21, after the semicolon,

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26  insert:

27         amending s. 212.055, F.S.; authorizing certain

28         counties to levy a voter-approved indigent care

29         discretionary sales surtax; providing for the

30         surtax to be conditioned upon approval by a

31         majority vote of the electors; limiting the

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                                                  SENATE AMENDMENT

    Bill No. HB 509, 1st Eng.

    Amendment No.    





 1         rate of the surtax; providing requirements for

 2         the ordinance adopted by the governing body of

 3         the county which imposes the surtax; providing

 4         for proceeds of the surtax to be used to

 5         provide health care services to qualified

 6         residents; defining "qualified residents";

 7         providing for the administration of proceeds

 8         collected pursuant to the surtax; limiting the

 9         total amount of certain local option sales

10         surtaxes that may be imposed by a county;

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