CODING: Words stricken are deletions; words underlined are additions.
HOUSE AMENDMENT
hbd-05 Bill No. HB 959, 1st Eng.
Amendment No. (for drafter's use only)
CHAMBER ACTION
Senate House
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5 ORIGINAL STAMP BELOW
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11 Representative(s) Lawson offered the following:
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13 Amendment (with title amendment)
14 On page 2, line 3,
15 remove from the bill: all of said line
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17 and insert in lieu thereof:
18 Section 2. Effective upon this act becoming a law,
19 subsection (4) of section 212.055, Florida Statutes, is
20 amended and subsection (7) is added to that section to read:
21 212.055 Discretionary sales surtaxes; legislative
22 intent; authorization and use of proceeds.--It is the
23 legislative intent that any authorization for imposition of a
24 discretionary sales surtax shall be published in the Florida
25 Statutes as a subsection of this section, irrespective of the
26 duration of the levy. Each enactment shall specify the types
27 of counties authorized to levy; the rate or rates which may be
28 imposed; the maximum length of time the surtax may be imposed,
29 if any; the procedure which must be followed to secure voter
30 approval, if required; the purpose for which the proceeds may
31 be expended; and such other requirements as the Legislature
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HOUSE AMENDMENT
hbd-05 Bill No. HB 959, 1st Eng.
Amendment No. (for drafter's use only)
1 may provide. Taxable transactions and administrative
2 procedures shall be as provided in s. 212.054.
3 (4) INDIGENT CARE AND TRAUMA CENTER SURTAX.--
4 (a) The governing body in each county the government
5 of which is not consolidated with that of one or more
6 municipalities, which has a population of at least 800,000
7 residents and is not authorized to levy a surtax under
8 subsection (5) or subsection (6), may levy, pursuant to an
9 ordinance either approved by an extraordinary vote of the
10 governing body or conditioned to take effect only upon
11 approval by a majority vote of the electors of the county
12 voting in a referendum, a discretionary sales surtax at a rate
13 that may not exceed 0.5 percent.
14 (b) If the ordinance is conditioned on a referendum, a
15 statement that includes a brief and general description of the
16 purposes to be funded by the surtax and that conforms to the
17 requirements of s. 101.161 shall be placed on the ballot by
18 the governing body of the county. The following questions
19 shall be placed on the ballot:
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21 FOR THE. . . .CENTS TAX
22 AGAINST THE. . . .CENTS TAX
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24 (c) The ordinance adopted by the governing body
25 providing for the imposition of the surtax shall set forth a
26 plan for providing health care services to qualified
27 residents, as defined in paragraph (d). Such plan and
28 subsequent amendments to it shall fund a broad range of health
29 care services for both indigent persons and the medically
30 poor, including, but not limited to, primary care and
31 preventive care as well as hospital care. The plan must also
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HOUSE AMENDMENT
hbd-05 Bill No. HB 959, 1st Eng.
Amendment No. (for drafter's use only)
1 address the services to be provided by the Level I trauma
2 center. It shall emphasize a continuity of care in the most
3 cost-effective setting, taking into consideration both a high
4 quality of care and geographic access. Where consistent with
5 these objectives, it shall include, without limitation,
6 services rendered by physicians, clinics, community hospitals,
7 mental health centers, and alternative delivery sites, as well
8 as at least one regional referral hospital where appropriate.
9 It shall provide that agreements negotiated between the county
10 and providers, including hospitals with a Level I trauma
11 center, will include reimbursement methodologies that take
12 into account the cost of services rendered to eligible
13 patients, recognize hospitals that render a disproportionate
14 share of indigent care, provide other incentives to promote
15 the delivery of charity care, promote the advancement of
16 technology in medical services, recognize the level of
17 responsiveness to medical needs in trauma cases, and require
18 cost containment including, but not limited to, case
19 management. It must also provide that any hospitals that are
20 owned and operated by government entities on May 21, 1991,
21 must, as a condition of receiving funds under this subsection,
22 afford public access equal to that provided under s. 286.011
23 as to meetings of the governing board, the subject of which is
24 budgeting resources for the rendition of charity care as that
25 term is defined in the Florida Hospital Uniform Reporting
26 System (FHURS) manual referenced in s. 408.07. The plan shall
27 also include innovative health care programs that provide
28 cost-effective alternatives to traditional methods of service
29 delivery and funding.
30 (d) For the purpose of this subsection, the term
31 "qualified resident" means residents of the authorizing county
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HOUSE AMENDMENT
hbd-05 Bill No. HB 959, 1st Eng.
Amendment No. (for drafter's use only)
1 who are:
2 1. Qualified as indigent persons as certified by the
3 authorizing county;
4 2. Certified by the authorizing county as meeting the
5 definition of the medically poor, defined as persons having
6 insufficient income, resources, and assets to provide the
7 needed medical care without using resources required to meet
8 basic needs for shelter, food, clothing, and personal
9 expenses; or not being eligible for any other state or federal
10 program, or having medical needs that are not covered by any
11 such program; or having insufficient third-party insurance
12 coverage. In all cases, the authorizing county is intended to
13 serve as the payor of last resort; or
14 3. Participating in innovative, cost-effective
15 programs approved by the authorizing county.
16 (e) Moneys collected pursuant to this subsection
17 remain the property of the state and shall be distributed by
18 the Department of Revenue on a regular and periodic basis to
19 the clerk of the circuit court as ex officio custodian of the
20 funds of the authorizing county. The clerk of the circuit
21 court shall:
22 1. Maintain the moneys in an indigent health care
23 trust fund;
24 2. Invest any funds held on deposit in the trust fund
25 pursuant to general law; and
26 3. Disburse the funds, including any interest earned,
27 to any provider of health care services, as provided in
28 paragraphs (c) and (d), upon directive from the authorizing
29 county. However, if a county has a population of at least
30 800,000 residents and has levied the surtax authorized in this
31 subsection, notwithstanding any directive from the authorizing
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HOUSE AMENDMENT
hbd-05 Bill No. HB 959, 1st Eng.
Amendment No. (for drafter's use only)
1 county, on October 1 of each calendar year, the clerk of the
2 circuit court shall issue a check in the amount of $6 million
3 to a hospital in its jurisdiction that has a Level I trauma
4 center. The issuance of the checks on October 1 of each year
5 is provided in recognition of the Level I trauma center status
6 and shall be in addition to the base contract amount received
7 during fiscal year 1999-2000 and any additional amount
8 negotiated to the base contract.
9 (f) Notwithstanding any other provision of this
10 section, a county shall not levy local option sales surtaxes
11 authorized in this subsection and subsections (2) and (3) in
12 excess of a combined rate of 1 percent.
13 (g) This subsection expires October 1, 2005.
14 (7) VOTER-APPROVED INDIGENT CARE SURTAX.--
15 (a) The governing body in each county that has a
16 population of less than 800,000 residents may levy an indigent
17 care surtax pursuant to an ordinance conditioned to take
18 effect only upon approval by a majority vote of the electors
19 of the county voting in a referendum. The surtax may be levied
20 at a rate not to exceed 0.5 percent, except that if a publicly
21 supported medical school is located in the county, the rate
22 shall not exceed 1 percent.
23 (b) A statement that includes a brief and general
24 description of the purposes to be funded by the surtax and
25 that conforms to the requirements of s. 101.161 shall be
26 placed on the ballot by the governing body of the county. The
27 following questions shall be placed on the ballot:
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29 FOR THE. . . .CENTS TAX
30 AGAINST THE. . . .CENTS TAX
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5
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hbd0016 12:51 pm 00959-0008-913687
HOUSE AMENDMENT
hbd-05 Bill No. HB 959, 1st Eng.
Amendment No. (for drafter's use only)
1 (c) The ordinance adopted by the governing body
2 providing for the imposition of the surtax must set forth a
3 plan for providing health care services to qualified
4 residents, as defined in paragraph (d). The plan and
5 subsequent amendments to it shall fund a broad range of health
6 care services for indigent persons and the medically poor,
7 including, but not limited to, primary care and preventive
8 care, as well as hospital care. It shall emphasize a
9 continuity of care in the most cost-effective setting, taking
10 into consideration a high quality of care and geographic
11 access. Where consistent with these objectives, it shall
12 include, without limitation, services rendered by physicians,
13 clinics, community hospitals, mental health centers, and
14 alternative delivery sites, as well as at least one regional
15 referral hospital where appropriate. It shall provide that
16 agreements negotiated between the county and providers shall
17 include reimbursement methodologies that take into account the
18 cost of services rendered to eligible patients, recognize
19 hospitals that render a disproportionate share of indigent
20 care, provide other incentives to promote the delivery of
21 charity care, and require cost containment, including, but not
22 limited to, case management. The plan must also include
23 innovative health care programs that provide cost-effective
24 alternatives to traditional methods of service delivery and
25 funding.
26 (d) For the purpose of this subsection, "qualified
27 residents" means residents of the authorizing county who are:
28 1. Qualified as indigent persons as certified by the
29 authorizing county;
30 2. Certified by the authorizing county as meeting the
31 definition of the medically poor, defined as persons having
6
File original & 9 copies 04/28/00
hbd0016 12:51 pm 00959-0008-913687
HOUSE AMENDMENT
hbd-05 Bill No. HB 959, 1st Eng.
Amendment No. (for drafter's use only)
1 insufficient income, resources, and assets to provide the
2 needed medical care without using resources required to meet
3 basic needs for shelter, food, clothing, and personal
4 expenses; not being eligible for any other state or federal
5 program or having medical needs that are not covered by any
6 such program; or having insufficient third-party insurance
7 coverage. In all cases, the authorizing county shall serve as
8 the payor of last resort; or
9 3. Participating in innovative, cost-effective
10 programs approved by the authorizing county.
11 (e) Moneys collected pursuant to this subsection
12 remain the property of the state and shall be distributed by
13 the Department of Revenue on a regular and periodic basis to
14 the clerk of the circuit court as ex officio custodian of the
15 funds of the authorizing county. The clerk of the circuit
16 court shall:
17 1. Maintain the moneys in an indigent health care
18 trust fund.
19 2. Invest any funds held on deposit in the trust fund
20 pursuant to general law.
21 3. Disburse the funds, including any interest earned,
22 to any provider of health care services, as provided in
23 paragraphs (c) and (d), upon directive from the authorizing
24 county.
25 (f) Notwithstanding any other provision of this
26 section, a county may not levy local option sales surtaxes
27 authorized in this subsection and subsections (2) and (3) in
28 excess of a combined rate of 1 percent or, if a publicly
29 supported medical school is located in the county, in excess
30 of a combined rate of 1.5 percent.
31 Section 3. Except as otherwise provided herein, this
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HOUSE AMENDMENT
hbd-05 Bill No. HB 959, 1st Eng.
Amendment No. (for drafter's use only)
1 act shall take effect July 1, 2000.
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4 ================ T I T L E A M E N D M E N T ===============
5 And the title is amended as follows:
6 remove from the title of the bill: the entire title
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8 and insert in lieu thereof:
9 An act relating to indigent health care;
10 amending s. 154.306, F.S.; providing for
11 excluding active-duty military personnel and
12 certain institutionalized county residents from
13 state population estimates when calculating a
14 county's financial responsibility for
15 hospitals' treatment of specific counties'
16 indigent residents; amending s. 212.055, F.S.;
17 expanding the authorized use of the indigent
18 care discretionary sales surtax to include
19 trauma centers; renaming the surtax; requiring
20 the plan set out in the ordinance to include
21 additional provisions concerning Level I trauma
22 centers; providing requirements for annual
23 disbursements to hospitals on October 1 to be
24 in recognition of the Level I trauma status and
25 to be in addition to a base contract amount
26 plus any negotiated additions to indigent care
27 funding; authorizing certain counties to levy a
28 voter-approved indigent care discretionary
29 sales surtax; providing for the surtax to be
30 conditioned upon approval by a majority vote of
31 the electors; limiting the rate of the surtax;
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hbd0016 12:51 pm 00959-0008-913687
HOUSE AMENDMENT
hbd-05 Bill No. HB 959, 1st Eng.
Amendment No. (for drafter's use only)
1 providing requirements for the ordinance
2 adopted by the governing body of the county
3 which imposes the surtax; providing for
4 proceeds of the surtax to be used to provide
5 health care services to qualified residents;
6 defining "qualified residents"; providing for
7 the administration of proceeds collected
8 pursuant to the surtax; limiting the total
9 amount of certain local option sales surtaxes
10 that may be imposed by a county; providing
11 effective dates.
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File original & 9 copies 04/28/00
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