Senate Bill sb1374c1
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Florida Senate - 2002 CS for SB 1374
By the Committee on Comprehensive Planning, Local and Military
Affairs; and Senator Mitchell
316-1911-02
1 A bill to be entitled
2 An act relating to health care; amending s.
3 212.055, F.S.; allowing small counties having a
4 specified population to levy an indigent care
5 surtax; providing procedures; providing uses of
6 the surtax; providing a maximum tax rate;
7 providing an effective date.
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9 Be It Enacted by the Legislature of the State of Florida:
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11 Section 1. Subsection (7) of section 212.055, Florida
12 Statutes, is amended to read:
13 212.055 Discretionary sales surtaxes; legislative
14 intent; authorization and use of proceeds.--It is the
15 legislative intent that any authorization for imposition of a
16 discretionary sales surtax shall be published in the Florida
17 Statutes as a subsection of this section, irrespective of the
18 duration of the levy. Each enactment shall specify the types
19 of counties authorized to levy; the rate or rates which may be
20 imposed; the maximum length of time the surtax may be imposed,
21 if any; the procedure which must be followed to secure voter
22 approval, if required; the purpose for which the proceeds may
23 be expended; and such other requirements as the Legislature
24 may provide. Taxable transactions and administrative
25 procedures shall be as provided in s. 212.054.
26 (7) VOTER-APPROVED INDIGENT CARE SURTAX.--
27 (a) The governing body in each county that has a
28 population of less than 800,000 residents may levy an indigent
29 care surtax pursuant to an ordinance conditioned to take
30 effect only upon approval by a majority vote of the electors
31 of the county voting in a referendum. The surtax may be levied
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Florida Senate - 2002 CS for SB 1374
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1 at a rate not to exceed 0.5 percent, except that if a publicly
2 supported medical school is located in the county, the rate
3 shall not exceed 1 percent.
4 (b) A statement that includes a brief and general
5 description of the purposes to be funded by the surtax and
6 that conforms to the requirements of s. 101.161 shall be
7 placed on the ballot by the governing body of the county. The
8 following questions shall be placed on the ballot:
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10 FOR THE. . . .CENTS TAX
11 AGAINST THE. . . .CENTS TAX
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13 (c) Notwithstanding paragraph (a), the governing body
14 in each county that has a population of fewer than 30,000
15 residents may levy an indigent care surtax conditioned to take
16 effect only upon approval by a majority vote of the electors
17 of the county voting in a referendum. In addition to the uses
18 otherwise set out in this subsection, a county that has a
19 population of fewer than 30,000 residents may use the services
20 of the Division of Bond Finance of the State Board of
21 Administration pursuant to the State Bond Act to issue bonds
22 under this subsection. A jurisdiction may not issue bonds
23 under this subsection more frequently than once per year. Any
24 county that has a population of fewer than 30,000 residents at
25 the time the bonds authorized in this subsection are issued
26 retains the authority granted under this subsection throughout
27 the term of the bonds, including the term of any refinancing
28 bonds, regardless of any subsequent increase in population
29 which results in the county's having 30,000 or more residents.
30 The rate of the surtax levied under this paragraph may not
31 exceed 1 percent.
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Florida Senate - 2002 CS for SB 1374
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1 (d)(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 (e)(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. In addition to the services otherwise authorized
26 under this subsection, in counties having a population of
27 fewer than 30,000 residents the plan for providing health care
28 services to qualified residents may, by an extraordinary vote
29 of the county commission, provide that some or all of the
30 surtax revenues and any interest accrued thereon must be
31 expended for the purpose of servicing bond indebtedness
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Florida Senate - 2002 CS for SB 1374
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1 incurred to finance, plan, construct, or reconstruct a public
2 hospital in the county and for any land acquisition, land
3 improvement, design, or engineering costs related thereto, if
4 the county commission has determined that a currently existing
5 public hospital would, more likely than not, otherwise cease
6 to operate.
7 (e)(d) As used in For the purpose of this subsection,
8 the term "qualified residents" means residents of the
9 authorizing county who are:
10 1. Qualified as indigent persons as certified by the
11 authorizing county;
12 2. Certified by the authorizing county as meeting the
13 definition of the medically poor, defined as persons having
14 insufficient income, resources, and assets to provide the
15 needed medical care without using resources required to meet
16 basic needs for shelter, food, clothing, and personal
17 expenses; not being eligible for any other state or federal
18 program or having medical needs that are not covered by any
19 such program; or having insufficient third-party insurance
20 coverage. In all cases, the authorizing county shall serve as
21 the payor of last resort; or
22 3. Participating in innovative, cost-effective
23 programs approved by the authorizing county.
24 (f)(e) Moneys collected pursuant to this subsection
25 remain the property of the state and shall be distributed by
26 the Department of Revenue on a regular and periodic basis to
27 the clerk of the circuit court as ex officio custodian of the
28 funds of the authorizing county. The clerk of the circuit
29 court shall:
30 1. Maintain the moneys in an indigent health care
31 trust fund.
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Florida Senate - 2002 CS for SB 1374
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1 2. Invest any funds held on deposit in the trust fund
2 pursuant to general law.
3 3. Disburse the funds, including any interest earned,
4 to any provider of health care services, as provided in
5 paragraphs (c) and (d), upon directive from the authorizing
6 county.
7 4. Disburse the funds, including any interest accrued
8 thereon, to service any bond indebtedness otherwise authorized
9 in this section, upon a directive from the authorizing county,
10 which directive may be irrevocably given at the time the bond
11 indebtedness is incurred.
12 (g)(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 or the
17 county has a population of fewer than 30,000 residents, in
18 excess of a combined rate of 1.5 percent.
19 Section 2. This act shall take effect October 1, 2002.
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21 STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
COMMITTEE SUBSTITUTE FOR
22 SB 1374
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24 This CS differs from the bill as filed in that it removes the
option to levy the indigent care surtax by extraordinary vote
25 of the county commission.
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