CODING: Words stricken are deletions; words underlined are additions.
HOUSE AMENDMENT
Bill No. HB 531
Amendment No. 1 (for drafter's use only)
CHAMBER ACTION
Senate House
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5 ORIGINAL STAMP BELOW
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11 The Committee on Health Care Services offered the following:
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13 Amendment (with title amendment)
14 Remove from the bill: Everything after the enacting clause
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16 and insert in lieu thereof:
17 Section 1. Subsection (4) of section 212.055, Florida
18 Statutes, is amended, and subsection (7) is added to that
19 section, 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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HOUSE AMENDMENT
Bill No. HB 531
Amendment No. 1 (for drafter's use only)
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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HOUSE AMENDMENT
Bill No. HB 531
Amendment No. 1 (for drafter's use only)
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:
3
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HOUSE AMENDMENT
Bill No. HB 531
Amendment No. 1 (for drafter's use only)
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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HOUSE AMENDMENT
Bill No. HB 531
Amendment No. 1 (for drafter's use only)
1 circuit court shall issue a check in the amount of $6 million
2 to a hospital in its jurisdiction that has a Level I trauma
3 center. The issuance of the checks on October 1 of each year
4 is provided in recognition of the Level I trauma center status
5 and shall be in addition to the base contract amount received
6 during fiscal year 1999-2000 and any additional amount
7 negotiated to the base contract.
8 (f) Notwithstanding any other provision of this
9 section, a county shall not levy local option sales surtaxes
10 authorized in this subsection and subsections (2) and (3) in
11 excess of a combined rate of 1 percent.
12 (g) This subsection expires October 1, 2005.
13 (7) VOTER-APPROVED INDIGENT CARE SURTAX.--
14 (a) The governing body in each county that has a
15 population of less than 800,000 residents may levy an indigent
16 care surtax pursuant to an ordinance conditioned to take
17 effect only upon approval by a majority vote of the electors
18 of the county voting in a referendum. The surtax may be levied
19 at a rate not to exceed 0.5 percent.
20 (b) A statement that includes a brief and general
21 description of the purposes to be funded by the surtax and
22 that conforms to the requirements of s. 101.161 shall be
23 placed on the ballot by the governing body of the county. The
24 following questions shall be placed on the ballot:
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26 FOR THE. . . .CENTS TAX
27 AGAINST THE. . . .CENTS TAX
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29 (c) The ordinance adopted by the governing body
30 providing for the imposition of the surtax must set forth a
31 plan for providing health care services to qualified
5
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HOUSE AMENDMENT
Bill No. HB 531
Amendment No. 1 (for drafter's use only)
1 residents, as defined in paragraph (d). The plan and
2 subsequent amendments to it shall fund a broad range of health
3 care services for indigent persons and the medically poor,
4 including, but not limited to, primary care and preventive
5 care, as well as hospital care. It shall emphasize a
6 continuity of care in the most cost-effective setting, taking
7 into consideration a high quality of care and geographic
8 access. Where consistent with these objectives, it shall
9 include, without limitation, services rendered by physicians,
10 clinics, community hospitals, mental health centers, and
11 alternative delivery sites, as well as at least one regional
12 referral hospital where appropriate. It shall provide that
13 agreements negotiated between the county and providers shall
14 include reimbursement methodologies that take into account the
15 cost of services rendered to eligible patients, recognize
16 hospitals that render a disproportionate share of indigent
17 care, provide other incentives to promote the delivery of
18 charity care, and require cost containment including, but not
19 limited to, case management. The plan must also include
20 innovative health care programs that provide cost-effective
21 alternatives to traditional methods of service delivery and
22 funding.
23 (d) For the purpose of this subsection, "qualified
24 residents" means residents of the authorizing county who are:
25 1. Qualified as indigent persons as certified by the
26 authorizing county;
27 2. Certified by the authorizing county as meeting the
28 definition of the medically poor, defined as persons having
29 insufficient income, resources, and assets to provide the
30 needed medical care without using resources required to meet
31 basic needs for shelter, food, clothing, and personal
6
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HOUSE AMENDMENT
Bill No. HB 531
Amendment No. 1 (for drafter's use only)
1 expenses; not being eligible for any other state or federal
2 program or having medical needs that are not covered by any
3 such program; or having insufficient third-party insurance
4 coverage. In all cases, the authorizing county shall serve as
5 the payor of last resort; or
6 3. Participating in innovative, cost-effective
7 programs approved by the authorizing county.
8 (e) Moneys collected pursuant to this subsection
9 remain the property of the state and shall be distributed by
10 the Department of Revenue on a regular and periodic basis to
11 the clerk of the circuit court as ex officio custodian of the
12 funds of the authorizing county. The clerk of the circuit
13 court shall:
14 1. Maintain the moneys in an indigent health care
15 trust fund.
16 2. Invest any funds held on deposit in the trust fund
17 pursuant to general law.
18 3. Disburse the funds, including any interest earned,
19 to any provider of health care services, as provided in
20 paragraphs (c) and (d), upon directive from the authorizing
21 county.
22 (f) Notwithstanding any other provision of this
23 section, a county may not levy local option sales surtaxes
24 authorized in this subsection and subsections (2) and (3) in
25 excess of a combined rate of 1 percent.
26 Section 2. This act shall take effect upon becoming a
27 law.
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30 ================ T I T L E A M E N D M E N T ===============
31 And the title is amended as follows:
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HOUSE AMENDMENT
Bill No. HB 531
Amendment No. 1 (for drafter's use only)
1 Remove from the title of the bill: the entire title
2
3 and insert in lieu thereof:
4 A bill to be entitled
5 An act relating to discretionary sales
6 surtaxes; amending s. 212.055, F.S.; expanding
7 the authorized use of the indigent care surtax
8 to include trauma centers; renaming the surtax;
9 requiring the plan set out in the ordinance to
10 include additional provisions concerning Level
11 I trauma centers; providing requirements for
12 annual disbursements to hospitals on October 1
13 to be in recognition of the Level I trauma
14 status and to be in addition to a base contract
15 amount plus any negotiated additions to
16 indigent care funding; authorizing certain
17 counties to levy a voter-approved indigent care
18 surtax; providing for the surtax to be
19 conditioned upon approval by a majority vote of
20 the electors; limiting the rate of the surtax;
21 providing requirements for the ordinance
22 adopted by the governing body of the county
23 which imposes the surtax; providing for
24 proceeds of the surtax to be used to provide
25 health care services to qualified residents;
26 defining "qualified residents"; providing for
27 the administration of proceeds collected
28 pursuant to the surtax; limiting the total
29 amount of certain local option sales surtaxes
30 that may be imposed by a county; providing an
31 effective date.
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