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14	212.055, Florida Statutes, shall not stand repealed on October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