Senate Bill 0802c1

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    Florida Senate - 2000                            CS for SB 802

    By the Committee on Comprehensive Planning, Local and Military
    Affairs; and Senators Saunders and Silver




    316-1785-00

  1                      A bill to be entitled

  2         An act relating to the county public hospital

  3         surtax; amending s. 212.055, F.S.; revising

  4         provisions that require the counties authorized

  5         to levy the surtax to annually appropriate a

  6         specified minimum amount for operation,

  7         administration, and maintenance of the county

  8         public general hospital; providing procedure

  9         for disbursement of funds by certain counties;

10         requiring a public health authority or agency

11         in such counties to adopt and implement a

12         health care plan for indigent health care

13         services; specifying provisions of the plan;

14         providing an effective date.

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16  Be It Enacted by the Legislature of the State of Florida:

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18         Section 1.  Paragraph (d) of subsection (5) of section

19  212.055, Florida Statutes, is amended, present paragraph (e)

20  of that subsection is redesignated as paragraph (f), and a new

21  paragraph (e) is added to that subsection, to read:

22         212.055  Discretionary sales surtaxes; legislative

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

24  legislative intent that any authorization for imposition of a

25  discretionary sales surtax shall be published in the Florida

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

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

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

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

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

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

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    Florida Senate - 2000                            CS for SB 802
    316-1785-00




  1  be expended; and such other requirements as the Legislature

  2  may provide.  Taxable transactions and administrative

  3  procedures shall be as provided in s. 212.054.

  4         (5)  COUNTY PUBLIC HOSPITAL SURTAX.--Any county as

  5  defined in s. 125.011(1) may levy the surtax authorized in

  6  this subsection pursuant to an ordinance either approved by

  7  extraordinary vote of the county commission or conditioned to

  8  take effect only upon approval by a majority vote of the

  9  electors of the county voting in a referendum.  In a county as

10  defined in s. 125.011(1), for the purposes of this subsection,

11  "county public general hospital" means a general hospital as

12  defined in s. 395.002 which is owned, operated, maintained, or

13  governed by the county or its agency, authority, or public

14  health trust.

15         (d)  As provided in subparagraphs 1. and 2., the county

16  must shall continue to contribute each year an amount equal to

17  at least 80 percent of that percentage of the total county

18  budget appropriated for the operation, administration, and

19  maintenance of the county public general hospital from the

20  county's general revenues in the fiscal year of the county

21  ending September 30, 1991, as follows:.

22         1.  Sixty-five percent of such amount must be promptly

23  and irrevocably remitted to the public health trust, agency,

24  or authority responsible for the county public general

25  hospital, to be used solely for the purpose of operating and

26  maintaining such hospital.

27         2.  Thirty-five percent of such amount must be promptly

28  and irrevocably remitted to a public health authority or

29  agency that is wholly independent from the public health

30  trust, agency, or authority responsible for the county public

31  general hospital, to be used solely for the purpose of funding

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    Florida Senate - 2000                            CS for SB 802
    316-1785-00




  1  the plan for indigent health care services provided for in

  2  paragraph (e).

  3         (e)  A health authority shall be chartered by the

  4  county commission upon this act becoming law. The authority

  5  shall adopt and implement a health care plan for indigent

  6  health care services. Until such time as the authority is

  7  created, the funds provided for in subparagraph 2. of

  8  paragraph (d) shall be placed in a restricted account set

  9  aside from other county funds and not disbursed by the county

10  for any other purpose.

11         1.  The plan shall divide the county into a minimum of

12  four and maximum of six service areas, with no more than one

13  participant hospital per service area. The county general

14  hospital shall be designated as the provider for one of the

15  service areas.  Services shall be provided through

16  participants' primary acute care facility.

17         2.  The plan and subsequent amendments to it shall fund

18  a broad range of health care services for both indigent

19  persons and the medically poor, including, but not limited to,

20  primary care, preventive care, hospital emergency room care,

21  and hospital care. Where consistent with these objectives, the

22  plan shall include, without limitation, services rendered by

23  physicians, clinics, community hospitals, mental health

24  centers, and alternative delivery sites, as well as at least

25  one regional referral hospital per service zone. The plan

26  shall provide that agreements negotiated between the authority

27  and providers will include reimbursement methodologies that

28  take into account the cost of services rendered to eligible

29  patients, recognize hospitals that render a disproportionate

30  share of indigent care, provide other incentives to promote

31  the delivery of charity care to draw down federal funds where

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    Florida Senate - 2000                            CS for SB 802
    316-1785-00




  1  appropriate, and require cost containment, including, but not

  2  limited to, case management. In no event shall such

  3  reimbursement rates exceed the Medicaid rate. The plan must

  4  also provide that any hospitals owned and operated by

  5  government entities on or after the effective date of this act

  6  must, as a condition of receiving funds under this subsection,

  7  afford public access equal to that provided under s. 286.011

  8  as to any meeting of the governing board the subject of which

  9  is budgeting resources for the retention of charity care, as

10  that term is defined in the rules of the Agency for Health

11  Care Administration. The plan shall also include innovative

12  health care programs that provide cost-effective alternatives

13  to traditional methods of service and delivery funding.

14         3.  The plan's benefits shall be made available to all

15  county residents currently eligible to receive health care

16  services as indigents or medically poor as defined in

17  paragraph (4)(d).

18         4.  Eligible residents who participate in the health

19  care plan shall receive coverage for a period of 12 months or

20  the period extending from the time of enrollment to the end of

21  the current fiscal year, per enrollment period, whichever is

22  less.

23         Section 2.  This act shall take effect July 1, 2000.

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    Florida Senate - 2000                            CS for SB 802
    316-1785-00




  1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  2                              SB 802

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  4  Requires Miami-Dade County to establish a health authority to
    provide indigent health care services upon the CS becoming
  5  law.

  6  Provides that the funds allocated for the authority must be
    placed in a restricted account until the authority is created.
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    Requires the plan for indigent health care services must
  8  divide the county into 4-6 service areas and that the county
    general hospital is designated as the provider for one of the
  9  service areas. In addition, requires that one regional
    referral hospital be located per service zone.
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