House Bill hb1549

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    Florida House of Representatives - 2002                HB 1549

        By Representative Stansel






  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.

  8  

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

10  

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 House of Representatives - 2002                HB 1549

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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:

  9  

10                     FOR THE. . . .CENTS TAX

11                   AGAINST THE. . . .CENTS TAX

12  

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 pursuant to an

16  ordinance approved by an extraordinary vote of the county

17  commission or conditioned to take effect only upon approval by

18  a majority vote of the electors of the county voting in a

19  referendum. In addition to the uses otherwise set out in this

20  subsection, a county that has a population of fewer than

21  30,000 residents may use the services of the Division of Bond

22  Finance of the State Board of Administration pursuant to the

23  State Bond Act to issue bonds under this subsection. A

24  jurisdiction may not issue bonds under this subsection more

25  frequently than once per year. Any county that has a

26  population of fewer than 30,000 residents at the time the

27  bonds authorized in this subsection are issued retains the

28  authority granted under this subsection throughout the term of

29  the bonds, including the term of any refinancing bonds,

30  regardless of any subsequent increase in population which

31  results in the county's having 30,000 or more residents. The

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    Florida House of Representatives - 2002                HB 1549

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  1  rate of the surtax levied under this paragraph may not exceed

  2  1 percent.

  3         (d)(c)  The ordinance adopted by the governing body

  4  providing for the imposition of the surtax must set forth a

  5  plan for providing health care services to qualified

  6  residents, as defined in paragraph (e)(d). The plan and

  7  subsequent amendments to it shall fund a broad range of health

  8  care services for indigent persons and the medically poor,

  9  including, but not limited to, primary care and preventive

10  care, as well as hospital care. It shall emphasize a

11  continuity of care in the most cost-effective setting, taking

12  into consideration a high quality of care and geographic

13  access. Where consistent with these objectives, it shall

14  include, without limitation, services rendered by physicians,

15  clinics, community hospitals, mental health centers, and

16  alternative delivery sites, as well as at least one regional

17  referral hospital where appropriate. It shall provide that

18  agreements negotiated between the county and providers shall

19  include reimbursement methodologies that take into account the

20  cost of services rendered to eligible patients, recognize

21  hospitals that render a disproportionate share of indigent

22  care, provide other incentives to promote the delivery of

23  charity care, and require cost containment, including, but not

24  limited to, case management. The plan must also include

25  innovative health care programs that provide cost-effective

26  alternatives to traditional methods of service delivery and

27  funding. In addition to the services otherwise authorized

28  under this subsection, in counties having a population of

29  fewer than 30,000 residents the plan for providing health care

30  services to qualified residents may, by an extraordinary vote

31  of the county commission, provide that some or all of the

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    Florida House of Representatives - 2002                HB 1549

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  1  surtax revenues and any interest accrued thereon must be

  2  expended for the purpose of servicing bond indebtedness

  3  incurred to finance, plan, construct, or reconstruct a public

  4  hospital in the county and for any land acquisition, land

  5  improvement, design, or engineering costs related thereto, if

  6  the county commission has determined that a currently existing

  7  public hospital would, more likely than not, otherwise cease

  8  to operate.

  9         (e)(d)  As used in For the purpose of this subsection,

10  the term "qualified residents" means residents of the

11  authorizing county who are:

12         1.  Qualified as indigent persons as certified by the

13  authorizing county;

14         2.  Certified by the authorizing county as meeting the

15  definition of the medically poor, defined as persons having

16  insufficient income, resources, and assets to provide the

17  needed medical care without using resources required to meet

18  basic needs for shelter, food, clothing, and personal

19  expenses; not being eligible for any other state or federal

20  program or having medical needs that are not covered by any

21  such program; or having insufficient third-party insurance

22  coverage. In all cases, the authorizing county shall serve as

23  the payor of last resort; or

24         3.  Participating in innovative, cost-effective

25  programs approved by the authorizing county.

26         (f)(e)  Moneys collected pursuant to this subsection

27  remain the property of the state and shall be distributed by

28  the Department of Revenue on a regular and periodic basis to

29  the clerk of the circuit court as ex officio custodian of the

30  funds of the authorizing county. The clerk of the circuit

31  court shall:

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    Florida House of Representatives - 2002                HB 1549

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  1         1.  Maintain the moneys in an indigent health care

  2  trust fund.

  3         2.  Invest any funds held on deposit in the trust fund

  4  pursuant to general law.

  5         3.  Disburse the funds, including any interest earned,

  6  to any provider of health care services, as provided in

  7  paragraphs (c) and (d), upon directive from the authorizing

  8  county.

  9         4.  Disburse the funds, including any interest accrued

10  thereon, to service any bond indebtedness otherwise authorized

11  in this section, upon a directive from the authorizing county,

12  which directive may be irrevocably given at the time the bond

13  indebtedness is incurred.

14         (g)(f)  Notwithstanding any other provision of this

15  section, a county may not levy local option sales surtaxes

16  authorized in this subsection and subsections (2) and (3) in

17  excess of a combined rate of 1 percent or, if a publicly

18  supported medical school is located in the county or the

19  county has a population of fewer than 30,000 residents, in

20  excess of a combined rate of 1.5 percent.

21         Section 2.  This act shall take effect October 1, 2002.

22  

23            *****************************************

24                          SENATE SUMMARY

25    Allows counties having a population of fewer than 30,000
      residents to levy an indigent care surtax at a rate of no
26    more than 1 percent. Provides procedures and uses,
      including expending tax proceeds on a public hospital.
27  

28  

29  

30  

31  

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