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CHAMBER ACTION |
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The Committee on Local Government & Veterans' Affairs recommends |
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the following: |
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Committee Substitute |
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Remove the entire bill and insert: |
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A bill to be entitled |
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An act relating to the indigent care and trauma center |
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discretionary sales surtax; amending s. 212.055, F.S.; |
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reviving, reenacting, and amending the indigent care and |
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trauma center discretionary sales surtax; requiring a |
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biennial audit of a certain trust fund; requiring delivery |
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of the audit report to certain entities; deleting a future |
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expiration provision; providing an effective date. |
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Be It Enacted by the Legislature of the State of Florida: |
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Section 1. Notwithstanding the provisions of section 11 of |
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chapter 2000-312, Laws of Florida, subsection (4) of section |
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212.055, Florida Statutes, shall not stand repealed on October |
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1, 2005, as scheduled by such law, but that subsection, as |
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amended by section 13 of chapter 2000-312, Laws of Florida, is |
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revived and reenacted, and paragraph(g) of said subsection is |
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amended, to read: |
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212.055 Discretionary sales surtaxes; legislative intent; |
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authorization and use of proceeds.--It is the legislative intent |
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that any authorization for imposition of a discretionary sales |
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surtax shall be published in the Florida Statutes as a |
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subsection of this section, irrespective of the duration of the |
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levy. Each enactment shall specify the types of counties |
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authorized to levy; the rate or rates which may be imposed; the |
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maximum length of time the surtax may be imposed, if any; the |
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procedure which must be followed to secure voter approval, if |
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required; the purpose for which the proceeds may be expended; |
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and such other requirements as the Legislature may provide. |
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Taxable transactions and administrative procedures shall be as |
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provided in s. 212.054. |
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(4) INDIGENT CARE AND TRAUMA CENTER SURTAX.-- |
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(a) The governing body in each county the government of |
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which is not consolidated with that of one or more |
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municipalities, which has a population of at least 800,000 |
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residents and is not authorized to levy a surtax under |
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subsection (5), may levy, pursuant to an ordinance either |
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approved by an extraordinary vote of the governing body or |
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conditioned to take effect only upon approval by a majority vote |
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of the electors of the county voting in a referendum, a |
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discretionary sales surtax at a rate that may not exceed 0.5 |
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percent. |
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(b) If the ordinance is conditioned on a referendum, a |
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statement that includes a brief and general description of the |
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purposes to be funded by the surtax and that conforms to the |
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requirements of s. 101.161 shall be placed on the ballot by the |
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governing body of the county. The following questions shall be |
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placed on the ballot: |
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FOR THE. . . .CENTS TAX |
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AGAINST THE. . . .CENTS TAX |
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(c) The ordinance adopted by the governing body providing |
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for the imposition of the surtax shall set forth a plan for |
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providing health care services to qualified residents, as |
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defined in paragraph (d). Such plan and subsequent amendments to |
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it shall fund a broad range of health care services for both |
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indigent persons and the medically poor, including, but not |
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limited to, primary care and preventive care as well as hospital |
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care. The plan must also address the services to be provided by |
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the Level I trauma center. It shall emphasize a continuity of |
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care in the most cost-effective setting, taking into |
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consideration both a high quality of care and geographic access. |
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Where consistent with these objectives, it shall include, |
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without limitation, services rendered by physicians, clinics, |
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community hospitals, mental health centers, and alternative |
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delivery sites, as well as at least one regional referral |
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hospital where appropriate. It shall provide that agreements |
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negotiated between the county and providers, including hospitals |
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with a Level I trauma center, will include reimbursement |
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methodologies that take into account the cost of services |
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rendered to eligible patients, recognize hospitals that render a |
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disproportionate share of indigent care, provide other |
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incentives to promote the delivery of charity care, promote the |
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advancement of technology in medical services, recognize the |
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level of responsiveness to medical needs in trauma cases, and |
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require cost containment including, but not limited to, case |
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management. It must also provide that any hospitals that are |
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owned and operated by government entities on May 21, 1991, must, |
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as a condition of receiving funds under this subsection, afford |
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public access equal to that provided under s. 286.011 as to |
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meetings of the governing board, the subject of which is |
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budgeting resources for the rendition of charity care as that |
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term is defined in the Florida Hospital Uniform Reporting System |
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(FHURS) manual referenced in s. 408.07. The plan shall also |
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include innovative health care programs that provide cost- |
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effective alternatives to traditional methods of service |
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delivery and funding. |
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(d) For the purpose of this subsection, the term |
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"qualified resident" means residents of the authorizing county |
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who are: |
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1. Qualified as indigent persons as certified by the |
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authorizing county; |
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2. Certified by the authorizing county as meeting the |
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definition of the medically poor, defined as persons having |
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insufficient income, resources, and assets to provide the needed |
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medical care without using resources required to meet basic |
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needs for shelter, food, clothing, and personal expenses; or not |
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being eligible for any other state or federal program, or having |
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medical needs that are not covered by any such program; or |
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having insufficient third-party insurance coverage. In all |
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cases, the authorizing county is intended to serve as the payor |
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of last resort; or |
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3. Participating in innovative, cost-effective programs |
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approved by the authorizing county. |
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(e) Moneys collected pursuant to this subsection remain |
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the property of the state and shall be distributed by the |
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Department of Revenue on a regular and periodic basis to the |
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clerk of the circuit court as ex officio custodian of the funds |
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of the authorizing county. The clerk of the circuit court shall: |
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1. Maintain the moneys in an indigent health care trust |
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fund; |
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2. Invest any funds held on deposit in the trust fund |
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pursuant to general law; and |
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3. Disburse the funds, including any interest earned, to |
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any provider of health care services, as provided in paragraphs |
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(c) and (d), upon directive from the authorizing county. |
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However, if a county has a population of at least 800,000 |
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residents and has levied the surtax authorized in this |
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subsection, notwithstanding any directive from the authorizing |
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county, on October 1 of each calendar year, the clerk of the |
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court shall issue a check in the amount of $6.5 million to a |
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hospital in its jurisdiction that has a Level I trauma center or |
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shall issue a check in the amount of $3.5 million to a hospital |
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in its jurisdiction that has a Level I trauma center if that |
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county enacts and implements a hospital lien law in accordance |
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with chapter 98-499, Laws of Florida. The issuance of the checks |
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on October 1 of each year is provided in recognition of the |
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Level I trauma center status and shall be in addition to the |
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base contract amount received during fiscal year 1999-2000 and |
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any additional amount negotiated to the base contract. If the |
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hospital receiving funds for its Level I trauma center status |
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requests such funds to be used to generate federal matching |
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funds under Medicaid, the clerk of the court shall instead issue |
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a check to the Agency for Health Care Administration to |
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accomplish that purpose to the extent that it is allowed through |
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the General Appropriations Act; and |
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4. Prepare on a biennial basis an audit of the trust fund |
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specified in subparagraph 1. Commencing February 1, 2004, such |
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audit shall be delivered to the governing body and to the chair |
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of the legislative delegation of each authorizing county. |
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(f) Notwithstanding any other provision of this section, a |
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county shall not levy local option sales surtaxes authorized in |
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this subsection and subsections(2) and (3) in excess of a |
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combined rate of 1 percent. |
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(g) This subsection expires October 1, 2005.
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Section 2. This act shall take effect upon becoming a law. |