HB 0457 2003
   
1 CHAMBER ACTION
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6          The Committee on Local Government & Veterans' Affairs recommends
7    the following:
8         
9          Committee Substitute
10          Remove the entire bill and insert:
11 A bill to be entitled
12          An act relating to the indigent care and trauma center
13    discretionary sales surtax; amending s. 212.055, F.S.;
14    reviving, reenacting, and amending the indigent care and
15    trauma center discretionary sales surtax; requiring a
16    biennial audit of a certain trust fund; requiring delivery
17    of the audit report to certain entities; deleting a future
18    expiration provision; providing an effective date.
19         
20          Be It Enacted by the Legislature of the State of Florida:
21         
22          Section 1. Notwithstanding the provisions of section 11 of
23    chapter 2000-312, Laws of Florida, subsection (4) of section
24    212.055, Florida Statutes, shall not stand repealed on October
25    1, 2005, as scheduled by such law, but that subsection, as
26    amended by section 13 of chapter 2000-312, Laws of Florida, is
27    revived and reenacted, and paragraph(g) of said subsection is
28    amended, to read:
29          212.055 Discretionary sales surtaxes; legislative intent;
30    authorization and use of proceeds.--It is the legislative intent
31    that any authorization for imposition of a discretionary sales
32    surtax shall be published in the Florida Statutes as a
33    subsection of this section, irrespective of the duration of the
34    levy. Each enactment shall specify the types of counties
35    authorized to levy; the rate or rates which may be imposed; the
36    maximum length of time the surtax may be imposed, if any; the
37    procedure which must be followed to secure voter approval, if
38    required; the purpose for which the proceeds may be expended;
39    and such other requirements as the Legislature may provide.
40    Taxable transactions and administrative procedures shall be as
41    provided in s. 212.054.
42          (4) INDIGENT CARE AND TRAUMA CENTER SURTAX.--
43          (a) The governing body in each county the government of
44    which is not consolidated with that of one or more
45    municipalities, which has a population of at least 800,000
46    residents and is not authorized to levy a surtax under
47    subsection (5), may levy, pursuant to an ordinance either
48    approved by an extraordinary vote of the governing body or
49    conditioned to take effect only upon approval by a majority vote
50    of the electors of the county voting in a referendum, a
51    discretionary sales surtax at a rate that may not exceed 0.5
52    percent.
53          (b) If the ordinance is conditioned on a referendum, a
54    statement that includes a brief and general description of the
55    purposes to be funded by the surtax and that conforms to the
56    requirements of s. 101.161 shall be placed on the ballot by the
57    governing body of the county. The following questions shall be
58    placed on the ballot:
59         
60          FOR THE. . . .CENTS TAX
61          AGAINST THE. . . .CENTS TAX
62         
63          (c) The ordinance adopted by the governing body providing
64    for the imposition of the surtax shall set forth a plan for
65    providing health care services to qualified residents, as
66    defined in paragraph (d). Such plan and subsequent amendments to
67    it shall fund a broad range of health care services for both
68    indigent persons and the medically poor, including, but not
69    limited to, primary care and preventive care as well as hospital
70    care. The plan must also address the services to be provided by
71    the Level I trauma center. It shall emphasize a continuity of
72    care in the most cost-effective setting, taking into
73    consideration both a high quality of care and geographic access.
74    Where consistent with these objectives, it shall include,
75    without limitation, services rendered by physicians, clinics,
76    community hospitals, mental health centers, and alternative
77    delivery sites, as well as at least one regional referral
78    hospital where appropriate. It shall provide that agreements
79    negotiated between the county and providers, including hospitals
80    with a Level I trauma center, will include reimbursement
81    methodologies that take into account the cost of services
82    rendered to eligible patients, recognize hospitals that render a
83    disproportionate share of indigent care, provide other
84    incentives to promote the delivery of charity care, promote the
85    advancement of technology in medical services, recognize the
86    level of responsiveness to medical needs in trauma cases, and
87    require cost containment including, but not limited to, case
88    management. It must also provide that any hospitals that are
89    owned and operated by government entities on May 21, 1991, must,
90    as a condition of receiving funds under this subsection, afford
91    public access equal to that provided under s. 286.011 as to
92    meetings of the governing board, the subject of which is
93    budgeting resources for the rendition of charity care as that
94    term is defined in the Florida Hospital Uniform Reporting System
95    (FHURS) manual referenced in s. 408.07. The plan shall also
96    include innovative health care programs that provide cost-
97    effective alternatives to traditional methods of service
98    delivery and funding.
99          (d) For the purpose of this subsection, the term
100    "qualified resident" means residents of the authorizing county
101    who are:
102          1. Qualified as indigent persons as certified by the
103    authorizing county;
104          2. Certified by the authorizing county as meeting the
105    definition of the medically poor, defined as persons having
106    insufficient income, resources, and assets to provide the needed
107    medical care without using resources required to meet basic
108    needs for shelter, food, clothing, and personal expenses; or not
109    being eligible for any other state or federal program, or having
110    medical needs that are not covered by any such program; or
111    having insufficient third-party insurance coverage. In all
112    cases, the authorizing county is intended to serve as the payor
113    of last resort; or
114          3. Participating in innovative, cost-effective programs
115    approved by the authorizing county.
116          (e) Moneys collected pursuant to this subsection remain
117    the property of the state and shall be distributed by the
118    Department of Revenue on a regular and periodic basis to the
119    clerk of the circuit court as ex officio custodian of the funds
120    of the authorizing county. The clerk of the circuit court shall:
121          1. Maintain the moneys in an indigent health care trust
122    fund;
123          2. Invest any funds held on deposit in the trust fund
124    pursuant to general law; and
125          3. Disburse the funds, including any interest earned, to
126    any provider of health care services, as provided in paragraphs
127    (c) and (d), upon directive from the authorizing county.
128    However, if a county has a population of at least 800,000
129    residents and has levied the surtax authorized in this
130    subsection, notwithstanding any directive from the authorizing
131    county, on October 1 of each calendar year, the clerk of the
132    court shall issue a check in the amount of $6.5 million to a
133    hospital in its jurisdiction that has a Level I trauma center or
134    shall issue a check in the amount of $3.5 million to a hospital
135    in its jurisdiction that has a Level I trauma center if that
136    county enacts and implements a hospital lien law in accordance
137    with chapter 98-499, Laws of Florida. The issuance of the checks
138    on October 1 of each year is provided in recognition of the
139    Level I trauma center status and shall be in addition to the
140    base contract amount received during fiscal year 1999-2000 and
141    any additional amount negotiated to the base contract. If the
142    hospital receiving funds for its Level I trauma center status
143    requests such funds to be used to generate federal matching
144    funds under Medicaid, the clerk of the court shall instead issue
145    a check to the Agency for Health Care Administration to
146    accomplish that purpose to the extent that it is allowed through
147    the General Appropriations Act; and
148          4. Prepare on a biennial basis an audit of the trust fund
149    specified in subparagraph 1. Commencing February 1, 2004, such
150    audit shall be delivered to the governing body and to the chair
151    of the legislative delegation of each authorizing county.
152          (f) Notwithstanding any other provision of this section, a
153    county shall not levy local option sales surtaxes authorized in
154    this subsection and subsections(2) and (3) in excess of a
155    combined rate of 1 percent.
156          (g) This subsection expires October 1, 2005.
157          Section 2. This act shall take effect upon becoming a law.