HB 0457 2003
1	A bill to be entitled
2	An act relating to the indigent care and trauma center
3	discretionary sales surtax; amending s. 212.055, F.S.;
4	reviving, reenacting, and amending the indigent care and
5	trauma center discretionary sales surtax; deleting a
6	future expiration provision; providing an effective date.
7
8	Be It Enacted by the Legislature of the State of Florida:
9
10	Section 1. Notwithstanding the provisions of section 11 of
11	chapter 2000-312, Laws of Florida, subsection (4) of section
12	212.055, Florida Statutes, shall not stand repealed on October
13	1, 2005, as scheduled by such law, but that subsection, as
14	amended by section 13 of chapter 2000-312, Laws of Florida, is
15	revived and reenacted, and paragraph (g) of said subsection is
16	amended, to read:
17	212.055 Discretionary sales surtaxes; legislative intent;
18	authorization and use of proceeds.--It is the legislative intent
19	that any authorization for imposition of a discretionary sales
20	surtax shall be published in the Florida Statutes as a
21	subsection of this section, irrespective of the duration of the
22	levy. Each enactment shall specify the types of counties
23	authorized to levy; the rate or rates which may be imposed; the
24	maximum length of time the surtax may be imposed, if any; the
25	procedure which must be followed to secure voter approval, if
26	required; the purpose for which the proceeds may be expended;
27	and such other requirements as the Legislature may provide.
28	Taxable transactions and administrative procedures shall be as
29	provided in s. 212.054.
30	(4) INDIGENT CARE AND TRAUMA CENTER SURTAX.--
31	(a) The governing body in each county the government of
32	which is not consolidated with that of one or more
33	municipalities, which has a population of at least 800,000
34	residents and is not authorized to levy a surtax under
35	subsection (5), may levy, pursuant to an ordinance either
36	approved by an extraordinary vote of the governing body or
37	conditioned to take effect only upon approval by a majority vote
38	of the electors of the county voting in a referendum, a
39	discretionary sales surtax at a rate that may not exceed 0.5
40	percent.
41	(b) If the ordinance is conditioned on a referendum, a
42	statement that includes a brief and general description of the
43	purposes to be funded by the surtax and that conforms to the
44	requirements of s. 101.161 shall be placed on the ballot by the
45	governing body of the county. The following questions shall be
46	placed on the ballot:
47
48	FOR THE. . . .CENTS TAX
49	AGAINST THE. . . .CENTS TAX
50
51	(c) The ordinance adopted by the governing body providing
52	for the imposition of the surtax shall set forth a plan for
53	providing health care services to qualified residents, as
54	defined in paragraph (d). Such plan and subsequent amendments to
55	it shall fund a broad range of health care services for both
56	indigent persons and the medically poor, including, but not
57	limited to, primary care and preventive care as well as hospital
58	care. The plan must also address the services to be provided by
59	the Level I trauma center. It shall emphasize a continuity of
60	care in the most cost-effective setting, taking into
61	consideration both a high quality of care and geographic access.
62	Where consistent with these objectives, it shall include,
63	without limitation, services rendered by physicians, clinics,
64	community hospitals, mental health centers, and alternative
65	delivery sites, as well as at least one regional referral
66	hospital where appropriate. It shall provide that agreements
67	negotiated between the county and providers, including hospitals
68	with a Level I trauma center, will include reimbursement
69	methodologies that take into account the cost of services
70	rendered to eligible patients, recognize hospitals that render a
71	disproportionate share of indigent care, provide other
72	incentives to promote the delivery of charity care, promote the
73	advancement of technology in medical services, recognize the
74	level of responsiveness to medical needs in trauma cases, and
75	require cost containment including, but not limited to, case
76	management. It must also provide that any hospitals that are
77	owned and operated by government entities on May 21, 1991, must,
78	as a condition of receiving funds under this subsection, afford
79	public access equal to that provided under s. 286.011 as to
80	meetings of the governing board, the subject of which is
81	budgeting resources for the rendition of charity care as that
82	term is defined in the Florida Hospital Uniform Reporting System
83	(FHURS) manual referenced in s. 408.07. The plan shall also
84	include innovative health care programs that provide cost-
85	effective alternatives to traditional methods of service
86	delivery and funding.
87	(d) For the purpose of this subsection, the term
88	"qualified resident" means residents of the authorizing county
89	who are:
90	1. Qualified as indigent persons as certified by the
91	authorizing county;
92	2. Certified by the authorizing county as meeting the
93	definition of the medically poor, defined as persons having
94	insufficient income, resources, and assets to provide the needed
95	medical care without using resources required to meet basic
96	needs for shelter, food, clothing, and personal expenses; or not
97	being eligible for any other state or federal program, or having
98	medical needs that are not covered by any such program; or
99	having insufficient third-party insurance coverage. In all
100	cases, the authorizing county is intended to serve as the payor
101	of last resort; or
102	3. Participating in innovative, cost-effective programs
103	approved by the authorizing county.
104	(e) Moneys collected pursuant to this subsection remain
105	the property of the state and shall be distributed by the
106	Department of Revenue on a regular and periodic basis to the
107	clerk of the circuit court as ex officio custodian of the funds
108	of the authorizing county. The clerk of the circuit court shall:
109	1. Maintain the moneys in an indigent health care trust
110	fund;
111	2. Invest any funds held on deposit in the trust fund
112	pursuant to general law; and
113	3. Disburse the funds, including any interest earned, to
114	any provider of health care services, as provided in paragraphs
115	(c) and (d), upon directive from the authorizing county.
116	However, if a county has a population of at least 800,000
117	residents and has levied the surtax authorized in this
118	subsection, notwithstanding any directive from the authorizing
119	county, on October 1 of each calendar year, the clerk of the
120	court shall issue a check in the amount of $6.5 million to a
121	hospital in its jurisdiction that has a Level I trauma center or
122	shall issue a check in the amount of $3.5 million to a hospital
123	in its jurisdiction that has a Level I trauma center if that
124	county enacts and implements a hospital lien law in accordance
125	with chapter 98-499, Laws of Florida. The issuance of the checks
126	on October 1 of each year is provided in recognition of the
127	Level I trauma center status and shall be in addition to the
128	base contract amount received during fiscal year 1999-2000 and
129	any additional amount negotiated to the base contract. If the
130	hospital receiving funds for its Level I trauma center status
131	requests such funds to be used to generate federal matching
132	funds under Medicaid, the clerk of the court shall instead issue
133	a check to the Agency for Health Care Administration to
134	accomplish that purpose to the extent that it is allowed through
135	the General Appropriations Act.
136	(f) Notwithstanding any other provision of this section, a
137	county shall not levy local option sales surtaxes authorized in
138	this subsection and subsections (2) and (3) in excess of a
139	combined rate of 1 percent.
140	(g) This subsection expires October 1, 2005.
141	Section 2. This act shall take effect upon becoming a law.