Senate Bill sb2186c1

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    Florida Senate - 2003                           CS for SB 2186

    By the Committee on Health, Aging, and Long-Term Care; and
    Senators Argenziano and Lawson




    317-2261-03

  1                      A bill to be entitled

  2         An act relating to the indigent care surtax;

  3         amending s. 212.055, F.S.; allowing small

  4         counties having a specified population to levy

  5         an indigent care surtax; providing procedures;

  6         providing uses of the surtax; providing a

  7         maximum tax rate; providing an effective date.

  8  

  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)1.  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 - 2003                           CS for SB 2186
    317-2261-03




 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         2.  Notwithstanding subparagraph 1., the governing body

 5  of any county that has a population of fewer than 30,000

 6  residents may levy an indigent care surtax pursuant to an

 7  ordinance conditioned to take effect only upon approval by a

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

 9  referendum. The surtax may be levied at a rate not to exceed 1

10  percent.

11         (b)  If the surtax is conditioned to take effect upon

12  approval in a referendum, a statement that includes a brief

13  and general description of the purposes to be funded by the

14  surtax and that conforms to the requirements of s. 101.161

15  shall be placed on the ballot by the governing body of the

16  county. The following questions shall be placed on the ballot:

17  

18                     FOR THE. . . .CENTS TAX

19                   AGAINST THE. . . .CENTS TAX

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21         (c)1.  The ordinance adopted by the governing body

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

23  plan for providing health care services to qualified

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

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

26  care services for indigent persons and the medically poor,

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

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

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

30  into consideration a high quality of care and geographic

31  access. Where consistent with these objectives, it shall

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    Florida Senate - 2003                           CS for SB 2186
    317-2261-03




 1  include, without limitation, services rendered by physicians,

 2  clinics, community hospitals, mental health centers, and

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

 4  referral hospital where appropriate. It shall provide that

 5  agreements negotiated between the county and providers shall

 6  include reimbursement methodologies that take into account the

 7  cost of services rendered to eligible patients, recognize

 8  hospitals that render a disproportionate share of indigent

 9  care, provide other incentives to promote the delivery of

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

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

12  innovative health care programs that provide cost-effective

13  alternatives to traditional methods of service delivery and

14  funding.

15         2.  In addition to the uses specified or services

16  required to be provided under this subsection, the ordinance

17  adopted by a county that has a population of fewer than 30,000

18  residents may pledge surtax proceeds to service new or

19  existing bond indebtedness incurred to finance, plan,

20  construct, or reconstruct a public or not-for-profit hospital

21  in such county and any land acquisition, land improvement,

22  design, or engineering costs related to such hospital, if the

23  governing body of the county determines that a public or

24  not-for-profit hospital existing at the time of issuance of

25  the bonds authorized under this subparagraph would, more

26  likely than not, otherwise cease to operate. The plan required

27  under this paragraph may, by an extraordinary vote of the

28  governing body of such county, provide that some or all of the

29  surtax revenues and any interest earned must be expended for

30  the purpose of servicing such bond indebtedness. Such county

31  may also use the services of the Division of Bond Finance of

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    Florida Senate - 2003                           CS for SB 2186
    317-2261-03




 1  the State Board of Administration pursuant to the State Bond

 2  Act to issue bonds under this subparagraph. A jurisdiction may

 3  not issue bonds under this subparagraph more frequently than

 4  once per year. Any county that has a population of fewer than

 5  30,000 residents at the time any bonds authorized in this

 6  subparagraph are issued retains the authority granted under

 7  this subparagraph throughout the terms of such bonds,

 8  including the term of any refinancing bonds, regardless of any

 9  subsequent increase in population which would result in such

10  county having 30,000 or more residents.

11         (d)  For the purpose of this subsection, "qualified

12  residents" means residents of the authorizing county who are:

13         1.  Qualified as indigent persons as certified by the

14  authorizing county;

15         2.  Certified by the authorizing county as meeting the

16  definition of the medically poor, defined as persons having

17  insufficient income, resources, and assets to provide the

18  needed medical care without using resources required to meet

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

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

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

22  such program; or having insufficient third-party insurance

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

24  the payor of last resort; or

25         3.  Participating in innovative, cost-effective

26  programs approved by the authorizing county.

27         (e)  Moneys collected pursuant to this subsection

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

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

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

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    Florida Senate - 2003                           CS for SB 2186
    317-2261-03




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

 2  court shall:

 3         1.  Maintain the moneys in an indigent health care

 4  trust fund.

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

 6  pursuant to general law.

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

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

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

10  county.

11         4.  Disburse the funds, including any interest earned,

12  to service any bond indebtedness authorized in this subsection

13  upon directive from the authorizing county, which directive

14  may be irrevocably given at the time the bond indebtedness is

15  incurred.

16         (f)  Notwithstanding any other provision of this

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

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

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

20  supported medical school is located in the county or the

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

22  excess of a combined rate of 1.5 percent.

23         Section 2.  This act shall take effect upon becoming a

24  law.

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    Florida Senate - 2003                           CS for SB 2186
    317-2261-03




 1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 2                         Senate Bill 2186

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 4  The Committee Substitute deletes the option of the ordinance
    levying an indigent care surtax in a county with fewer than
 5  30,000 residents being approved by a unanimous vote of the
    governing body of the county and deletes language that granted
 6  the county authorizing a bond under the new provision in the
    bill to retain the authority granted in the bill regardless of
 7  amendments to or repeal of the new provision.

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