SENATE AMENDMENT
    Bill No. CS for CS for SB 1312
    Amendment No. ___   Barcode 411108
                            CHAMBER ACTION
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11  Senator Silver moved the following substitute for amendment
12  (874776):
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14         Senate Amendment (with title amendment) 
15         On page 35, between lines 22 and 23,
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17  insert:
18         Section 26.  Paragraph (e) of subsection (5) of section
19  212.055, Florida 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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    9:31 AM   05/02/01                              s1312c2c-3828n

SENATE AMENDMENT Bill No. CS for CS for SB 1312 Amendment No. ___ Barcode 411108 1 procedures shall be as provided in s. 212.054. 2 (5) COUNTY PUBLIC HOSPITAL SURTAX.--Any county as 3 defined in s. 125.011(1) may levy the surtax authorized in 4 this subsection pursuant to an ordinance either approved by 5 extraordinary vote of the county commission or conditioned to 6 take effect only upon approval by a majority vote of the 7 electors of the county voting in a referendum. In a county as 8 defined in s. 125.011(1), for the purposes of this subsection, 9 "county public general hospital" means a general hospital as 10 defined in s. 395.002 which is owned, operated, maintained, or 11 governed by the county or its agency, authority, or public 12 health trust. 13 (e) The Public Health Trust, created by the county 14 commission, shall adopt and implement a health care plan for 15 indigent health care services for a period of one year 16 beginning July 1, 2001. A governing board, agency, or 17 authority shall be chartered by the county commission upon 18 this act becoming law. The governing board, agency, or 19 authority shall adopt and implement a health care plan for 20 indigent health care services. The governing board, agency, 21 or authority shall consist of no more than seven and no fewer 22 than five members appointed by the county commission. The 23 members of the governing board, agency, or authority shall be 24 at least 18 years of age and residents of the county. No 25 member may be employed by or affiliated with a health care 26 provider or the public health trust, agency, or authority 27 responsible for the county public general hospital. The 28 following community organizations shall each appoint a 29 representative to a nominating committee: the South Florida 30 Hospital and Healthcare Association, the Miami-Dade County 31 Public Health Trust, the Dade County Medical Association, the 2 9:31 AM 05/02/01 s1312c2c-3828n
SENATE AMENDMENT Bill No. CS for CS for SB 1312 Amendment No. ___ Barcode 411108 1 Miami-Dade County Homeless Trust, and the Mayor of Miami-Dade 2 County. This committee shall nominate between 10 and 14 3 county citizens for the governing board, agency, or authority. 4 The slate shall be presented to the county commission and the 5 county commission shall confirm the top five to seven 6 nominees, depending on the size of the governing board. Until 7 such time as the governing board, agency, or authority is 8 created, the funds provided for in subparagraph (d)2. shall be 9 placed in a restricted account set aside from other county 10 funds and not disbursed by the county 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 public 14 general hospital shall be designated as the provider for one 15 of the service areas. Services shall be provided through 16 participants' primary acute care facilities. 17 2. The plan and subsequent amendments to it shall fund 18 a defined range of health care services for both indigent 19 persons and the medically poor, including primary care, 20 preventive care, hospital emergency room care, and hospital 21 care necessary to stabilize the patient. For the purposes of 22 this section, "stabilization" means stabilization as defined 23 in s. 397.311(30). Where consistent with these objectives, the 24 plan may include services rendered by physicians, clinics, 25 community hospitals, and alternative delivery sites, as well 26 as at least one regional referral hospital per service area. 27 The plan shall provide that agreements negotiated between the 28 Public Health Trust governing board, agency, or authority and 29 providers shall recognize hospitals that render a 30 disproportionate share of indigent care, provide other 31 incentives to promote the delivery of charity care to draw 3 9:31 AM 05/02/01 s1312c2c-3828n
SENATE AMENDMENT Bill No. CS for CS for SB 1312 Amendment No. ___ Barcode 411108 1 down federal funds where appropriate, and require cost 2 containment, including, but not limited to, case management. 3 From the funds specified in subparagraphs (d)1. and 2. for 4 indigent health care services, service providers shall receive 5 reimbursement at a Medicaid rate to be determined by The 6 Public Health Trust the governing board, agency or authority 7 created pursuant to this paragraph for the initial emergency 8 room visit, and a per-member per-month fee or capitation for 9 those members enrolled in their service area, as compensation 10 for the services rendered following the initial emergency 11 visit. Except for provisions of emergency services, upon 12 determination of eligibility, enrollment shall be deemed to 13 have occurred at the time services were rendered. The 14 provisions for specific reimbursement of emergency services 15 shall be repealed on July 1, 2001, unless otherwise reenacted 16 by the Legislature. The capitation amount or rate shall be 17 determined prior to program implementation by an independent 18 actuarial consultant. In no event shall such reimbursement 19 rates exceed the Medicaid rate. The plan must also provide 20 that any hospitals owned and operated by government entities 21 on or after the effective date of this act must, as a 22 condition of receiving funds under this subsection, afford 23 public access equal to that provided under s. 286.011 as to 24 any meeting of the governing board, agency, or authority the 25 subject of which is budgeting resources for the retention of 26 charity care, as that term is defined in the rules of the 27 Agency for Health Care Administration. The plan shall also 28 include innovative health care programs that provide 29 cost-effective alternatives to traditional methods of service 30 and delivery funding. 31 3. The plan's benefits shall be made available to all 4 9:31 AM 05/02/01 s1312c2c-3828n
SENATE AMENDMENT Bill No. CS for CS for SB 1312 Amendment No. ___ Barcode 411108 1 county residents currently eligible to receive health care 2 services as indigents or medically poor as defined in 3 paragraph (4)(d). 4 4. Eligible residents who participate in the health 5 care plan shall receive coverage for a period of 12 months or 6 the period extending from the time of enrollment to the end of 7 the current fiscal year, per enrollment period, whichever is 8 less. 9 5. At the end of each fiscal year, the Public Health 10 Trust governing board, agency, or Authority shall prepare an 11 audit that reviews the budget of the plan, delivery of 12 services, and quality of services, and makes recommendations 13 to increase the plan's efficiency. The audit shall take into 14 account participant hospital satisfaction with the plan and 15 assess the amount of poststabilization patient transfers 16 requested, and accepted or denied, by the county public 17 general hospital. 18 Section 27. Section 11 of chapter 2000-312, Laws of 19 Florida, is amended to read: 20 Section 11. The provisions of this act shall be 21 reviewed by the Legislature prior to October 1, 2006 2005, and 22 shall be repealed on that date unless otherwise reenacted by 23 the Legislature. 24 25 (Redesignate subsequent sections.) 26 27 28 ================ T I T L E A M E N D M E N T =============== 29 And the title is amended as follows: 30 On page 3, line 5 31 5 9:31 AM 05/02/01 s1312c2c-3828n
SENATE AMENDMENT Bill No. CS for CS for SB 1312 Amendment No. ___ Barcode 411108 1 after the second semicolon, insert: 2 amending s. 212.055, F.S.; revising provisions 3 relating to the county public hospital surtax; 4 revising procedures and requirements for 5 adoption and implementation of the health care 6 plan for indigent health care services; 7 amending s. 11 of ch. 2000-312, Laws of 8 Florida; postponing future review and repeal of 9 said provisions; 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 6 9:31 AM 05/02/01 s1312c2c-3828n